Medicine out of the mainstream
Monday, December 01, 2003
Osteopaths offer help for breastfeeding moms A surprising solution for nursing problems By Marie TessierCindy Richards / Chicago Parent Laura Labott feeds her son Jonah, 3 weeks. If breastfeeding doesn't go smoothly, perhaps an osteopath may help.
Kurt Heinking was as anxious as any first-time father when his wife, Laura, gave birth to their son, Kyle. In the hours, then days, after Kyle was born, fatherly anxiety mounted as it became clear that breastfeeding was not going to come easily. During his career as an osteopathic physician, Kurt Heinking had witnessed other infants and mothers struggle to get started breastfeeding. But it was excruciating to watch it in his own family as time dragged on.
"It was incredibly difficult to watch," says Heinking, of Darien. "We felt guilty, frustrated and scared, because we were really pro-breastfeeding."
Worried the baby might become dehydrated, Dad made a phone call to a colleague trained in pediatric osteopathic manipulative medicine to treat the baby for his suckling difficulty.
When Kyle was 2 or 3 days old, Heinking's then-partner in medical practice, Ken Ramey, came in to assess whether the base of the baby's skull might be out of alignment and impinging on a nerve crucial to the suckling reflex. He put his hands on the baby's head, and with a gentle technique virtually imperceptible to an untrained observer, helped ease tension at the base of the baby's skull so that the infant's body could heal itself. Within hours, Kyle was latched on, eating hungrily, Heinking says.
"It was a huge relief," Heinking says. "It gives you a real feeling of success, knowing that the baby is eating and things are going to be all right."
Though the American Osteopathic Association is based in Chicago and osteopaths work in family practices throughout the metropolitan area, osteopathic manipulative medicine is not a well-known tool on labor and delivery floors in most hospitals.
"Whether an infant gets the proper treatment depends a lot on where you are in the nation-and it depends on who's treating the mother and who's treating the infant," says Anne Habenicht, a professor of osteopathic manipulative medicine at the Chicago College of Osteopathic Medicine at Midwestern University in Downers Grove. "Mothers and fathers need to find out from their obstetricians and caregivers what kinds of treatments are available to newborns and whether osteopaths are part of the team."
Osteopaths are on staff at most hospitals, and three hospitals in Illinois are accredited by the American Osteopathic Association-Thorek Hospital and Medical Center in Chicago; St. James Hospital and Health Center in Chicago Heights and St. James Hospital and Health Center in Olympia Fields.
The Chicago area is a center for osteopathic training at the Chicago College of Osteopathic Medicine. The campus at Downers Grove graduates about 150 new physicians each year, according to college statistics.
Parents and prospective parents who want to include osteopathic physicians in their babies' care can identify a physician's training by the initials following the name. If the initials say "D.O.," the physician has osteopathic training, which emphasizes primary and preventive care. If the initials say "M.D.," the physician has medical training (though some osteopathic physicians take the test to become a board-certified M.D.).
The suckling difficulty that Kyle Heinking experienced is common after a difficult vaginal delivery, Kurt Heinking and Anne Habenicht say. Some infants are born with what many people describe as a "clenched jaw" condition that prevents them from latching on to the breast and suckling properly. However, Habenicht says such suckling difficulties are often misdiagnosed.
"It's not really a clenched jaw," Habenicht says. "It's just that these little guys don't have real good control of their tongues."
Suckling difficulties can arise for a variety of reasons, but are routine in babies who have difficulty traversing a mother's pelvis.
"Every baby gets his head slammed against his mother's cervix for several hours, then their head is supposed to get slowly squeezed through the birth canal," Habenicht says. "When mom's pelvis is a little funky, that baby won't have as much room to come out."
Vacuum extractions can pose special difficulties on a baby's head, too, Habenicht and Heinking say. That's because the baby's pliable head bones and soft tissue don't have the proper time to gently mold into place.
The result can often be that the infant's cranial bones get stuck out of their proper place and impinge on the connective tissue that covers the brain, called the dura.
"The stress and strain of birth can really mess up a kid's dura," Habenicht says. "It can lock into place. Basically, if that happens, the bones need to be nudged back into the proper place."
For osteopathic physicians, diagnosing and treating an infant with suckling difficulties can be remarkably simple, Habenicht and Heinking say.
"If an osteopath puts her hands on a baby's head with this condition, one side will feel nice and free," Habenicht says. "The other side feels like you're walking into a wall."
The major trick for osteopaths treating an infant for sucking dysfunction is simply being in place to make the diagnosis and treat the condition. Habenicht says she routinely assesses a newborn's cranium in the hospital if she is to be the primary care physician. For the most part, it's only osteopaths who are familiar enough to make the referral to another osteopath, as Kurt Heinking did after Kyle was born. After that, he says, giving an infant's body the chance to heal itself is as easy as a subtle, skillful, healing set of hands.
"The nice thing about treating infants and newborns is that they respond so quickly," she says.
Organizations • American Osteopathic Association directory; (800) 621-1772; www.aoa-net.org.
• The LaLeche Leauge; The Art of Breastfeeding; (847) 519-7730; www.lalecheleague.com.
Marie Tessier is a writer and editor who lives in Bangor, Maine, with her husband and 7-year-old son.