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Pre-Natal changes require the body to adapt quickly to considerable extra demands. Where there has been any previous stress or pre-existing injury to the mother's body, adaptation may not take place smoothly. This can lead to back pain, groin pain, rib pain or pelvic pain as well as many other conditions. It is generally not difficult to keep patients comfortably on track throughout their pregnancy with a minimum of intervention. Some conditions may be more stubborn, however, but there is almost always some degree of relief available. Different osteopathic or acupuncture techniques become appropriate at various points during the pregnancy so patients should not be afraid to seek help even in the very early or very late stages. Morning sickness, for example can frequently respond to basic treatment and advice.

Before delivery, at about 37 to 38 weeks, we suggest a special appointment to check the final mobility of the pelvis and especially the sacrum, which has to move considerably during delivery. In this session we will revise positions for labour appropriate to your particular back and posture. You will also be offered guidance on latching and feeding techniques, from an osteopathic perspective, which is the commonest cause of post-natal trouble.

Difficult labour can give rise to long-term problems. Trouble may follow if the labour has been either very long or very rapid, or if the baby has been delivered using ventouse, forceps or caesarean section. Epidural pain relief is not without its complications, especially if there has been difficulty establishing the correct positioning of the needle. With the lower body anesthetised, it has also been known for the legs or hips to be left in positions that might otherwise be guarded against, with obvious potential consequences. If this has been the case, a check-up is best done within 2 to 3 weeks after delivery.

Feeding Routines and the 24-hour demands of the newborn rapidly replace personal concerns after delivery. Carrying and cradling the baby tend to bring unused muscles out of hibernation. As well as causing stiffness in the upper back, shoulder and arm, the supply of milk can also become compromised. This can all be quickly addressed. Young mothers are regularly bombarded by well-intentioned often very forceful advice and opinions at a highly emotional and impressionable period in their lives. It can be very beneficial to rationalise this a little and help mothers and their babies make their own progress comfortably together, free of inappropriate expectation or worry.

Post-Natal problems may show up as back pain, incontinence or pain during sexual intercourse. After the birth, it is important to check whether the mother's pelvis has repositioned itself and to give specific exercises to strengthen the pelvic floor, if necessary. Both mothers and fathers often experience back pain or neck pain at this time, due to the long hours of carrying or feeding their baby. Most mothers will have treatment approximately once a month to keep symptoms at bay while they are feeding.

Children

Birth and delivery is a very stressful experience for the baby as well as the parents. Babies heads are made up of 22 bones, which are compressed and overlap before re-expand during passage through the birth canal. Problems seen early after birth may include sticky eyes, poor latching to the breast, irritability or babies that are just very clingy and want to be held all the time. Cranial osteopathy may be able to exert a positive influence at this level. It is best to bring a baby for treatment sooner rather than later as they are much easier to treat when they are weeks rather than months old.

Caesarean Section presents the baby with a different situation. Caesarian deliveries can either be planned or emergency. In the latter event, they might have been selected as the birth was not progressing as hoped. In this instance, it is possible for the baby to be left slightly in shock and they can be very irritable. Caesarian babies can be more congested early on than babies who were born by vaginal delivery because they missed out on being compressed through the chest during birth. This can potentially lead to ongoing multiple infections of the ear, nose, throat or chest.

Colic, reflux, glue ear, wind and constipation are frequently encountered neonatal problems. These are areas that still require much more clinical research and reliable studies into non-orthodox treatment showing cause and effect are scant; due to ethical considerations as much as anything else. Many health professionals, as well as other "therapists", make various claims regarding the treatment of children which are difficult to substantiate. They will often talk about non-musculoskeletal conditions for which there is no firm evidence for the efficacy of their treatment. As well as those conditions above, references have been made to colic, Down's syndrome, autism, learning difficulties, cerebral palsy and the list goes on. Generally, as mentioned above, exhausted young mothers can be a very impressionable target audience. I believe that it would be very wrong, a huge lapse of integrity, and probably a breach of the law to offer something to them that could not be justified.

Having said that, in preliminary research studies of cranial osteopathic treatment on babies, some parents did perceive positive changes in their children. These include reduced colicky crying, better feeding, improved sleep, less unsettled irritable behaviour and increased quiet happy spells. This is certainly something that I find to be true on the whole, anecdotally. It must be stressed that the reasons for and certainty of any improvement are still a matter of debate, despite the vast amount of support and interest that has been attracted over the last hundred years, or so. Very young babies can be quite tense and when they start crying find it difficult to stop, due to their immature nervous and emotional systems. Perhaps gentle treatment such as cranial osteopathy may help them to relax just enough to overcome this. Whatever the link between cause and effect, progress and treatment depends very much on the baby and the parents. The earlier a child can be seen, the less treatment they are likely to require, so there is no need to wait before being seen.

Older children with back pain, neck pain growing pains and other musculoskeletal symptoms are often seen too. In particular, it is important to ensure that there is not likely to be any long-term difficulty if they have an accident or break a bone. Adolescence is another time when children are commonly seen. Growth spurts and hormonal changes may well lead to aches and pains that are amenable to treatment. Childhood is also a good time to establish appropriate posture and exercise habits.

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