A Little Story about Ear Infections

Ear-Infection-610x406One of the most common complaints that plague early childhood are recurrent ear infections, particularly between the ages of 3 months to 3 years old.1 As well as being extremely painful, they are often accompanied by fever, nausea, vomiting, diarrhea and hearing loss.2 Up to 20% of children will suffer from recurrent infections and the younger the child is when they have their first infection, the more likely it is to reoccur.3

Recurrent ear infections occur when the first infection in the middle ear, either viral or bacterial, isn’t completely resolved, or, put another way, hasn’t drained properly through the ear. This is more common in children for three main reasons:

  1. The angle of the tube that drains the middle ear, the Eustachian tube, is more horizontal due to the size of the child’s face, as opposed to an adult where the tube is more vertical4
  2. The child spends more time lying flat, especially in babies, so gravity can’t assist as much in draining the ear as it would in an adult
  3. Children aren’t generally as good as ‘popping’ their ears as an adult is.

The medical management of recurrent ear infections is, generally, to treat with a course of antibiotics.1 If the infections are recurrent enough to have an impact on the child’s speech and language due to sustained hearing loss, surgical interventions may be considered, commonly known as grommets.

Osteopathic management offers another avenue of treatment, which can be used independently or in conjunction with medication. As the frequent infection suggests poor ability to drain through the middle ear the osteopath with look at the child’s posture, neck movement, surrounding muscle tone and tissue restriction. By gently treating surrounding areas of restriction, the eustachian tube is free to drain the middle ear more efficiently. Treatment is comfortable for the child and, as osteopaths treat the whole body, treatment can also improve the function of the rib cage, neck and shoulders which supports the child’s growth and assists teething problems.

Studies have shown osteopathic management of recurrent ear infections result in a significant decrease in reoccurrence of infection, and subsequently less need for frequent antibiotic use and/or surgery.5,6

References:

  1. Beers, M., Porter, R., Jones, T., et. al., eds., 2006. The merck manual of diagnosis and therapy. Whitehouse Station: Merck Research Laboratories.
  2. Kliegman, R., Stanton, B., Schor, N., St Geme III, J. and Behrman, R., 2011. Nelson textbook of pediatrics. 19th Edition. Philadelphia: Saunders.
  3. Lissauer, R. and Clayden, G., 2012. Illustrated textbook of paediatrics. Fourth Edition. Edinburgh: Mosby Elsevier.
  4. Moore, K.L., Dalley, A.F. and Agur, A.M.R., 2010. Clinically Oriented Anatomy, Sixth Edition.  Baltimore: Lippincott Williams & Wilkins.
  5. Degenhardt BF & Kuchera ML. Osteopathic Evaluation and Manipulative Treatment in Reducing Morbidity of Otitis Media: A Pilot Study. JAOA. 2006 June 106; 6: 327-334.
  6. Mills MV et al. The Use of Osteopathic Manipulative Treatment as Adjuvant Therapy in Children With Recurrent Acute Otitis Media. ARCH PEDIATR ADOLESC MED. 2003 September; 157: 861-866.

More information can be found about how we can help you at http://www.kaneandross.co.uk

Breathing; a short introduction.

Breathing of moving air into and out of the lungs and is divided into two phases; inspiration and expiration.

During inspiration, the diaphragm and muscles between the ribs contract, causing the rib cage to expand and the pressure within the thorax to decrease. This causes air to rush in and fill the lungs.

During expiration, the diaphragm and rib muscles relax, causing the pressure in the thorax to increase and forcing air out.

Breathing is under both conscious and unconscious control. Area’s in the brain stem monitor blood oxygen levels, carbon dioxide levels and the pH of the blood and adjusts your rate of breathing accordingly. Our mood can have an involuntary effect on our breathing rate too: quick, shallow breathing if we are angry or stressed and slow, deep breathing if we are relaxed.

However, we are also able to change our breathing rates consciously depending on our activity, for example when meditating or singing.

An osteopath can assess your breathing pattern by…

  • The number of breaths per minute.
  • The balance between inspiration and expiration
  • The location of your breathing – upper rib or lower rib breathing.

An osteopath will commonly look at your breathing as part of your treatment plan, especially when presenting with neck and back problems.

More information can be found about how we can help you at http://www.kaneandross.co.uk

Nervous baby and problems sleeping.

img-thingSome babies may sleep for only short periods and may sleep very little during the day or the night whilst others may wake at the slightest noise or want to be held all the time.

These babies may have tension on the bony membranous tissue surrounding their skull, keeping their nervous system in an alert state and making it difficult for them to relax and go into a deep sleep.

An osteopath can help to release the tensions in you baby’s body, helping it to relax.

What can you do?

  • Swaddling your baby can help to settle them.
  • Place a firm hand on your babies tummy to help them relax.
  • Alternatively, let them hold your finger.

More information can be found about how we can help you at http://www.kaneandross.co.uk

Noisy Sleeper

Baby’s nasal areas are very small and narrow. If any mucous is present in the area it is difficult to drain away.

Lack of drainage can disturb or prevent your baby from sleeping as well as causing them to breathe noisily when they are asleep.

A congested nose can reduce their ability to suck, which can result in wind in their tummies.

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Babies born via C-sections tend typically have a lot of mucous build up, as their chests have not been compressed through the vaginal canal, and it is good to seek treatment to prevent mucous retention.

Saline drops or suction from the baby’s nose may help.

Osteopathy can release tension in the mid face and chest to allow mucous drainage to occur.

Check our colic section for information and advice regarding wind in your baby’s tummy.

More information can be found about how we can help you at http://www.kaneandross.co.uk

Colic and Reflux

Colic is a broad term used for abdominal pain and effects up to 40% of babies. The main symptom is excessive crying in a baby who is healthy and well fed.

The five main reasons for colic are…

  • excessive wind due to a poor suckling technique.
  • difficulty digesting food due to an immature gut.
  • reflux – acid and milk from a baby’s stomach going into the oesophagus or mouth.
  • constipation.
  • lactose intolerance – this is much less common.

In a recent study, babies with colic who were treated by an osteopath cried two hours less and needed less carrying than babies with colic that went untreated*

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Osteopathic treatment can help your baby pass wind more easily, release tension around the diaphragm to reduce the symptoms of reflux and specialised techniques to the bowels may help with constipation.

If your baby cannot open its mouth well to feed, has a poor latch or is gulping an osteopath can release any compression at the base of the skull and jaw to improve latching. This has added benefit for you as it will help to reduce cracked nipples and improve the baby’s food intake.

What can you do to help your baby?

  • Feed your baby at a more upright angle.
  • Hold your baby upright after feeding.
  • Massage your baby’s tummy in a clockwise direction 3-4 times per day when they are not in pain.
  • Don’t feed your baby more than every two hours in order to give them more time to digest.
  • Give your baby baths.
  • Various medications can help – ask your GP or pharmacist.

*Hayden C. & Mullinger B. (2006) A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complementary therapies in clinic practice. May 12(2), pp83-90.

 

More information can be found about how we can help you at http://www.kaneandross.co.uk

Flat head syndrome

A flat head, also known as plagiocephaly can be caused by restrictions of movement in the neck, tightness of the neck muscles or compression at the base of the skull.

All of these mean that when your baby lies on its back to sleep, it will lie mostly on the same side or the same position. As the head is reasonably soft it may become flat.

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What you may notice:

  • Your baby’s head looks asymmetrical
  • Either directly after delivery or a couple of weeks after birth you may notice a flat area developing.
  • Your baby feeds much better on one side
  • Your baby prefers to look one way and may not be able to turn its head fully to the opposite side.
  • Your baby sleeps to only one side.

Plagiocephaly is distortion of the head and cranial asymmetry and is often completely an avoidable problem if diagnosed and treated early. Look out for the above signs.

What can you do to help prevent plagiocephaly?

  • Stimulate or attract your baby’s attention to the side your baby avoids
  • When you are with your baby, lay it on its stomach to help lengthen and strengthen the neck.
  • When your baby is asleep, turn your baby’s head away from its preferable side.
  • Remember to always ensure your baby sleeps on its back.

Babies who are developing flat heads should be seen as quickly as possible – the sooner the problem is identified, the sooner the cause can be identified and treated.

What will an osteopath do?

The osteopath’s main aim will be to get full range of movement in the neck using muscle and fascia stretches, articulating the neck joints and using cranial techniques.

Treatment is gentle and babies are usually quite settled during treatment. With full range of neck movement, the head stops becoming flatter.

The osteopath will also give you exercise and postural advice to prevent the stiffness re-occurring.

More information can be found about how we can help you at http://www.kaneandross.co.uk

Sticky eyed baby.

Babies are often born with sticky eyes, either due to a blocked tear duct or compression around this area during delivery.

Directly after the birth you may notice the eyes and the area around the bridge of the nose looking puffy.

What can you do?

sleeping-baby

  • Keep your baby’s eyes clean to avoid infection.
  • Gently cleanse your baby’s eyes with cooled boiled water or breast milk wiping from inner to outer eye using clean cotton wool for each eye.
  • Do not try to prise your baby’s eyelids open if they are stuck together.
  • Take your baby to see a GP if light seems to hurt their eyes, the eye is inflamed, angry or red or if the structure of the eye or eyelid doesn’t seem right.

What can an osteopath do?

  • Osteopathic treatment can be helpful for blocked tear ducts.
  • The osteopath can gently manipulate the upper and mid part of the face to enable the tear ducts to unblock.
  • Massage the tear duct and teach you how to do the same at home.

More information can be found about how we can help you at http://www.kaneandross.co.uk

Baby requiring constant feeding.

Having a baby that takes a long time to feed and leaves little time between feeds can leave you feeling tired and isolated.

Your baby may be a ‘windy’ feeder, tongue-tied or unable to suck efficiently. Feeding is a complex task and can be difficult and tiring due to mechanical stresses through the head, face, jaw and throat. Also, the nerves to the tongue and face muscles may have been irritated either inter-uterine or during birth, making sucking difficult.

What can you do?

  • sleeping baby (1)Ask a professional if your baby is tongue-tied.
  • Ensure that your baby is gaining weight.
  • Space your babies feeds evenly even if you need to use a dummy or finger.
  • Remember, it is normal to feed your baby as often as every 2-4 hours.
  • Ask an osteopath to check your baby’s neck and it’s sucking mechanism.
  • An osteopath can also check your babies diaphragm and abdomen for signs of reflux and wind.
  • Also check our feeding posture post to ensure you are relaxed and avoid neck or back pain.

Difficulty with latching or sucking

One of the most important parts of breastfeeding is having your baby latched on correctly. Babies are born knowing how to latch on and suckle correctly, but with more than 40 muscles to control the lips, tongue, jaw, cheeks and soft palate; anything affecting these will have an impact on how well your baby will feed.

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Compression of the back of the head or jaw during birth or from the use of forceps may affect the nerves or muscles to the tongue and mouth causing difficulty with latching or sucking.

What to look out for during feeding:

  • Your baby may not open its mouth wide enough.
  • Your baby may not turn to one breast.
  • You may experience sore or cracked nipples.

To prevent feeding difficulties and to avoid frustration, these problems should be addressed as soon as possible; it is ideal to see an osteopath before your baby is a week old.

Osteopathic treatment will usually focus on the back of the head, neck, jaw and hyoid bone.

You can also get the advice of a lactation consultant at this time and take a look at our feeding posture post to make sure you are relaxed whilst your baby is feeding.

Posture whilst feeding

You are likely to be sitting up for 6-8 hours each day when feeding, so it is important to get this right!

A comfortable chair and good feeding posture is essential in order to prevent neck or back pain.

Pain whilst feeding may shorten your feeding time. It is better to correct bad posture before pain develops than treating pain once developed.

Have a good chair. A chair with arms to rest your elbows and ensuring feet are flat on the floor with your bottom at the back of the seat is preferable.

Prevent leaning forward. A footstool to lift the foot on the side the baby is feeding will prevent forward leaning. At night, sit in a chair rather than sitting in bed.

Protect your neck. When feeding at night, use a travel pillow to support the neck and prevent your head dropping forward if you fall asleep. A book or TV can stop you looking down at your baby and prevent neck pain.

Have everything you need at your feeding station. Ensure you have drinks, food and anything else you may need at hand.

Feed where you feel comfortable. This may not necessarily be your baby’s room as you may feel isolated here. If possible have more than one place in your home to feed.

When breastfeeding, ensure the baby’s nose is at nipple height. Keep your elbow supported by cushions – try two normal and one V Pillow. When you take your breast out of the bra it should sit on the top pillow.

When bottle-feeding, changing position is important.  Change arms frequently keeping elbows supported. Try to get somebody else to wind or feed your baby if your neck or upper back is sore.

Always seek treatment to avoid any current pain from increasing.

More information can be found about how we can help you at http://www.kaneandross.co.uk