Category Archives: Cranial Adjusting

How Chiropractic Care Helps Improve Breastfeeding

You have probably heard that Chiropractic care can help with breastfeeding issues. However, you probably have not been told how specifically this can help. There are a wide variety of things that can impact how well a baby is able to breastfeed. Cranial alignment, spinal alignment, TMJ (temporomandibular joint) alignment, fascial restriction, dural restriction, tongue tie, lip tie, cranial nerve function, etc. There are clearly more things that can impact breastfeeding, but these are the major ones in which chiropractors can help. This article will go over each of these aspects and explain how and why they can affect nursing.

Spinal Alignment

Let’s start with spinal alignment. It was found in a study many years ago that up to 95 percent of babies born had some degree of upper cervical misalignment. The Upper cervical consists of the C1 or atlas and the C2 or axis vertebrae. The occiput sits right on the Atlas and closely affects upper cervical alignment as well. Babies go through a traumatic experience being born and most develop some type of misalignment. This upper cervical alignment is very important for several reasons. One is that this is the area of the brain stem. The brain stem is home to many of the vital centers of breathing heart rate blood pressure as well as the origin of many of the cranial nerves that innervate the head, neck, tongue and throat. If there is a misalignment in the upper cervical spine around these areas, then it can lead to inflammation that affects the brain stem function and the cranial nerve function. Altered cranial nerve function can cause an abnormal suck/swallow/breath pattern or affect how the tongue and jaw move to latch and suckle. Upper cervical misalignment can also lead to tight musculature and fascia in the upper neck. This can cause the baby not to be able to open their mouth as wide or hold a latch through the whole suck swallow breath rhythm.

Cranial Alignment

Cranial alignment and movement is very important as well. Proper occipital movement on the atlas allows for the baby to be able to tip and rotate his head optimally to find the nipple and latch. Proper temporal bone motion affects the range of motion of the jaw. The Jaw attaches into the temporal bone so if the temporal bone is not moving the way it is supposed to or it is stuck in an abnormal position it affects how the mandible is able to move in the TMJ and it may get stuck or tight while trying to open in order to latch. Altered temporal motion or positioning can lead to tight fascia or muscles that cross the TMJ. This again can pull the mandible to one side or pull the mandible into the joint too much so it can’t rotate and pivot the way it needs to in order to open fully. Altered maxillary shape and movement can affect how well the baby is able to latch or maintain a latch. The bottom of the maxilla forms the hard palate. If the palate is too high or too flat, it can make it harder for the baby to maintain a proper seal when trying to latch and suckle. The Maxilla should be a smooth semicircle from one side of the gum line to the other. Often times one side will be flat or there will be a ridge or a peak in the center of the palate which will all indicate that the maxilla is not shaped properly or moving properly.

Connective Tissue

One aspect that will affect all the cranial bones as well as whole body movement and flexibility is the dural tightness. The dura is the connective tissue that attaches from the surface of the nervous system to the surface of the skull, sacrum, and vertebrae. Most times tightness in this system is associated with the findings of a tongue and lip tie. This tightness will present as a very stiff baby. He won’t want to flex forward or droop his head toward his chest. He often is stiff and straight through the mid and upper back and down through the sacrum. He often times has shrugged shoulders and can have a tendency to arch his back often. If a child is stiff and inflexible, this is going to make it more difficult for them to relax their jaw and open wide enough for a proper deep latch. If a baby is tight and stiff and anxious trying to nurse, then typically it makes the experience quite a bit harder. Babies who are stiff like this also usually have fascial restrictions through their neck, upper back, shoulders, often down through their sacrum and hips. Again, a baby who is tight and ridged is not going to move comfortably to get in an optimal position to open their mouth wide and achieve a proper latch and suck swallow pattern.

Lip and Tongue Tie

One of the biggest issues that is more and more prevalent today is newborns with a lip and tongue tie. I have done a whole blog post on just this topic if you want more information (here). But here is some basics. With a tongue tie there is extra tissue or tighter tissue underneath the tongue that is restricting the upward motion of the tongue. It affects other movements as well but mainly the upward motion of the back of the tongue. This means that they can’t bring the back of the tongue up to form a seal on the breast. This leads to the baby needing to alter his tongue movement to try to transfer milk. This altered movement is linked with altered throat movement during swallowing, so the suck swallow breath pattern is altered. This can lead to babies clicking while nursing, scraping the nipple with their tongue, swallowing air leading to reflux and colic. Tongue ties also cause restriction in the connective tissue throughout the jaw, throat and neck which affects how they open, latch, suck, swallow, etc.

Lip ties are additional tight tissue that connects the lip to the upper gum line. This will affect maxillary movement and shape as well as affecting how wide the baby can open his mouth to latch. Often you will notice you have to flip his upper lip up or there will be a blister that starts to form at the middle of his lip.

Chiropractic Care

All of these issues can be helped by a chiropractor. Chiropractors can help align the upper cervical spine and cranial bones. A chiropractor proficient in craniosacral therapy can help stretch the dural tissue and establish proper cranial movement. Chiropractors that utilize CST usually know how to do myofascial release or bodywork to help loosen the tissue restrictions throughout the head, neck, jaw, throat, shoulders, upper back, rib cage, sacrum, and hips. They can also release and loosen the tight tissue of a tongue and lip tie to help improve tongue movement. Chiropractors can also align the TMJ itself and make sure that the surrounding soft tissue and muscles are released and relaxed so that the baby can open his mouth wide and have a better latch. Chiropractic care is essential to help babies have optimal spinal, cranial, TMJ and whole-body motion. Chiropractic care allows the baby to be as relaxed and loose as possible to be able to move his head neck and tongue as freely as possible to achieve a proper latch and breastfeed affectively.

Anatomy of an Ear Infection

An ear infection is one of the most common childhood conditions. Many of those children who develop an ear infection typically end up developing many more subsequent infections. The mainstream medical treatment for an ear infection is a round of antibiotics. Unfortunately, when a child continues to develop ear infections, the treatment does not change. The only change comes in the strength of the antibiotic. It can be frustrating to put your child through one round of antibiotics after another in hopes that they will somehow stop developing ear infections. The good news is that there is another approach that can have amazing results without the use of medications. This article will explore the anatomy of an ear infection and how chiropractic can help end the cycle of infections and antibiotics.

Anatomy

Here is a picture that shows the outer ear, middle ear, and inner ear. The external auditory meatus, or ear canal is part of your outer ear. This is the canal where you develop ear wax. Ear wax is part of the immune system. It is a good thing. You will find more when your immune system is active and trying to protect the body. When the immune system fights off the threat and is less active then the wax is resorbed without any problems.  Next, there is the tympanic membrane, or the eardrum. This is a thin membrane that vibrates when sound enters the ear. The vibration then causes three little bones in your middle ear to vibrate and transmit this vibration to the cochlear nerve so you hear sound. The middle ear also has the semicircular canals that are part of your vestibular system. These canals are filled with fluid and the shifting of this fluid helps you to sense where you are in space. Proper stimulation of these canals allows you to have good balance. While abnormal stimulation of the canals can lead to vertigo. The middle ear then drops into the eustachian tube. This cartilaginous tube opens to your pharynx, right behind your soft palate. The eustachian tubes help you equalize pressure within your ear so you can hear properly and the fluid in your semicircular canals can move and function properly. The outer ear and middle ear are mostly surrounded by bone and fascia. As you move further inward towards the inner ear and the eustachian tube there is more soft tissue and fascia as well as several muscles that attach to and surround the eustachian tube. There are four muscles that attach to the eustachian tube, but two are mostly responsible for opening the eustachian tube during swallowing. These muscles of the soft palate are the tensor veli palatini and the levator veli palatini. The former is innervated by cranial nerve 5 and the later cranial nerve 10, the vagus nerve.

Infection

Most ear infections that you are going to have are in the middle ear, behind the eardrum. You can see in the first picture that there is a little pocket behind the eardrum where fluid can build up and provide an environment for bacteria, virus or fungus to grow. (It is important to note that most ear infections have a viral and bacterial component.) Typically the middle ear does not have fluid in it. Any fluid would drain down the eustachian tube into the throat so there would not be any environment for an infection to occur. However sometimes the eustachian tube can not equalize pressure effectively and fluid builds up. This occurs more often in the early years of childhood because the eustachian tubes start out more horizontal as infants and become more vertical as you grow.

There are several things that can lead to this build up of fluid. One is a misalignment in the upper cervical spine. Misalignment causes inflammation in the joints of the spine as well as in the muscles and soft tissue that attach to the bones that are misaligned and not moving properly. This inflammation can press in on the eustachian tubes making it harder for them to drain fluid from the middle ear. Another cause can be a lack of proper motion in the cranial bones. Cranial bones surround the ear canal and eustachian tube. The cranial bones move in a rhythmic motion along with the soft tissue that attaches to them. If the cranial bones are not moving, the soft tissue and fascia attached to them lack motion. Therefore fluid is allowed to build up and not drain with the movement of the soft tissue. A more and more prevalent cause for the eustachian tube not being able to drain properly is a tongue tie. Tongue ties affect the soft tissue within the mouth and throat. Tongue ties affect the natural resting position of the tongue as well as the fascial tension within the mouth and throat. This altered tongue position and the increased tension in the soft tissue of the throat make it harder for the eustachian tubes to equalize pressure in the middle ear and drain any fluid that may develop there. Cranial nerve dysfunction that typically accompanies a tongue tie also causes soft palate dysfunction as well as dysfunction within the muscular function of the muscles of the pharynx and larynx which includes the muscles that attach to the eustachian tube.

Chiropractic Care

Chiropractic adjustments can help with all of these things. A spinal adjustment helps align the upper cervical spine and balance the musculature. Cranial work and myofascial release helps improve cranial motion and reduces soft tissue tension allowing for better drainage of the middle ear. Upper cervical adjustments and cranial adjustments also help to stimulate the vagus nerve and improve cranial nerve function so that the musculature of the pharynx, including those that attach to the eustachian tubes, as well as the soft palate can function properly and therefore help the eustachian tube to open, equalize pressure, and drain any fluid from the middle ear. Regular chiropractic adjustments allow the body to function optimally and prevent the development of fluid in the middle ear. Therefore preventing the environment for bacterial, viral, or fungal growth and infection.

Ruptured Eardrum and Tubes

Sometimes when the pressure produced by an infection in the middle ear is too much, the eardrum ruptures. This is ok. There is no cause for alarm. Typically your child will be crying and screaming about how much pain they are in, then all of a sudden they feel fine. This is usually an indication that the eardrum has ruptured. You can look and see if there is fluid or pus coming out of the ear. This is normal. Don’t put anything into the ear, you want to avoid anything that may lead to further infection. Usually I recommend essential oils around the ear or a cotton ball with essential oils placed or taped right on the outside of the ear canal. Usually if the eardrum has ruptured the fluid is not draining down the eustachian tube properly so avoid liquids or oils in the ear. It usually takes a few weeks to fully heal, but when it does you will not even notice that it happened. There is usually not even a scar on the eardrum.

Ear tubes are typically the last resort of typical medical treatment for recurrent ear infections. A small slit is put in the eardrum where a plastic tube is placed. The eardrum then heals around the tube. This allows for air to flow from the outer ear to the middle ear. This allows for better equalization of pressure as well as a possible route for fluid to flow out if it begins to build up. However, unlike the eustachian tube which slants downward to allow gravity to pull fluid down from the middle ear, the outer ear is higher than the middle ear and fluid would have to flow upward to drain out of the middle ear. Therefore, if the eustachian tubes are still blocked or not draining, fluid can still pool in the middle ear and provide the environment for infection. Tubes are also foreign plastic to the body. This means that eventually the body will reject the tubes and they will fall out. Typically tubes last only a few years at best before the body pushes them back out. Therefore, even with tubes, chiropractic care is still necessary to allow for proper function of the eustachian tube, pharynx and all the surrounding soft tissue, connective tissue and bone.

Torticollis

Torticollis is a fairly common condition that babies, toddlers, even adults can get. This condition is characterized by tightening of the musculature of the neck to cause the head to rotate one direction and tilt slightly to the opposite direction. All children that present with this condition do not all present identical.  In some children the head is very restricted in rotation and will only look one direction. In other children the head prefers one rotation but can more easily be rotated the other way. These variations have to do with the degree of spinal misalignment, cranial misalignment and muscular and fascial tension.

Standard medical treatment usually consists of simply stretching the muscles and forcing the head the opposite direction. While this can help to loosen some of the muscles in the neck, it is not an optimal treatment and can lead to a lot of distress for you and your child. Torticollis is not just tight muscles on one side of the neck.  There are always spinal misalignments in the upper cervical spine along with altered cranial bone movement and fascial tightness. These things cannot be stretched away. A chiropractor needs to perform an adjustment to mobilize the upper cervical spine and do cranial adjusting and myofascial release to loosen the connective tissue and muscles while establishing proper cranial movement and position. Bodywork and fascial release is an important part of therapy that is not the same as stretching. The connective tissue in the body is not released by stretching. It is released by a light touch that helps to unwind the connective tissue to loosen it. Adults need the same care as well, if they develop torticollis. Stretching may help it feel better or a little looser for a little while, but the root of the problem is not being addressed.

Some children have this issue resolve in one or two visits to the chiropractor, some need more regular treatment to resolve all of the underlying issues. Often times there are complicating issues such as a tongue and lip tie or plagiocephaly that will require a longer duration of care. Torticollis can lead to altered head shape or plagiocephaly, difficulty nursing, digestive issues, reflux, irritability, colic, etc. It is important to correct torticollis as soon as you realize that your baby is looking toward one side more often. The longer it goes on, the longer it may take to correct all of the additional issues that arise.

Torticollis is a serious condition that needs to be addressed. However, it is a condition that can easily be corrected if you visit a good pediatric chiropractor. Certified pediatric chirorpactors look at the whole picture and address all the issues associated with the torticollis; the spinal misalignments, cranial misalignments, and muscular and fascial restrictions.

The Importance of Cranial Rhythm and 7 Ways to Help Maintain Proper Motion

Many of us know that babies are born with soft spots where their skull is not fully bone yet. We also know that the skull becomes all bone, therefore the soft spots or fontanelles, close at a certain point in childhood (the last one closes usually around 2 years old). Most of us, however, do not realize that the bones in our head move in a rhythmic motion from before we are born throughout our entire lives, regardless of whether our cranial sutures and fontanelles close. This motion is vital to not only brain and nervous system function, but it is vital for whole body function.

Origins of Cranial Adjusting/Craniosacral Therapy

In the late 1800s and early 1900s, Dr. William Sutherland, an osteopathic doctor, was the first to recognize that the movement of the cranial bones and eventually uncovered a rhythmic fluid motion that encompassed the entire body.  He called this rhythm the “primary respiratory mechanism”. This mechanism includes the rhythmic motion of the cranial bones, nervous system, and spine along with fluctuations in cerebral spinal fluid flow and shifting tension among dural membranes (connective tissue surrounding the brain and nervous system). These movements are all involuntary and completely separate from cardiac pulse and breathing. Dr. Sutherland believed that a skilled practitioner connecting with this primary respiratory mechanism could bring about a therapeutic effect and therefore enhance health.

Many other Doctors and Chiropractors came to understand the importance of cranial motion and developed their own techniques to ensure proper movement. Major Bertrand Dejarnette developed Sacro Occipital Technique. Dr George Goodheart developed Applied Kinesiology. One of the most well-known and heard of techniques is Craniosacral Technique developed by Dr. John Upledger. Over 50 years after Dr. Sutherland, Dr. Upledger discovered this same rhythmic motion in the dural connective tissue while he was preforming surgery. He notice there was movement of the nervous system and dura that was at a different rate than the respiration and cardiac pulse of the patient. He later performed many years of research that became the basis of Craniosacral Technique. This technique allows a practitioner to contact the sacrum as well as the cranial bones, and due to the dural attachement from the cranial bones through the spinal column to the sacrum, correct the primary respiratory mechanism. Both Dr. Sutherland and Dr. Upledger believed that this mechanism was a mechanism that could be used for self-healing, and that at the hands of a skilled practitioner one could see improvements in health.

More recent histological and anatomical examination of the cranial sutures have validated that they are not completely fused and in fact have intricate articulations that allow specific movements. The 106 articulations between the 22 cranial bones all are shaped and connected to allow for the rhythmic motion of the primary respiratory mechanism. This motion occurs 6-12 times per minute. Disruptions in this motion can affect the entire body and cause physical or emotional symptoms. Dural or fascial restrictions can affect cranial nerve function and stimulation. It can also affect cerebral spinal fluid flow and therefore impact the nutrient and water distribution to different areas of the brain, spinal cord and peripheral nerves. For example, dural tissue attached at the temporal bones is contiguous with fascia of the carotid sheath (this contains part of the vagus nerve), the fibrous pericardium (around the heart), and the respiratory diaphragm. Therefore, a restriction in the dural tissue at the temporal bone can affect vagal stimulation as well as cardiac and respiratory function.

A well-functioning primary respiratory mechanism allows for full cranial and dural movement, as well as proper cerebral spinal fluid fluctuation. With this mechanism working properly, there is no interference occurring in the nervous system and no areas of restriction that would hinder function in the body. However, many things can disrupt this primary respiratory mechanism and cause alterations in cranial motion and positioning. Adhesions and areas of restriction and congestion develop which can have a negative effect on the way the body functions. There are, however, things that you can do to allow for proper cranial motion in your own child.

7 Ways to Help Maintain Proper Motion

1)     Cranial Adjustments

Baby’s cranial bones are very moldable and easily shaped. Often times, babies will be born with cranial bones that have molded quite a bit. This could be from the way they were resting in the uterus or because of the pressures placed upon the cranium during labor and delivery. Nursing can play a huge role in helping initially increasing cranial motion to help return the cranium to a symmetrical and round shape. However, most of the time a trained therapist is needed to ensure that all of the cranial bones are moving properly and there are no overlaps in the sutures or dural tightness and adhesions preventing motion. Chiropractors who are certified by the ICPA are proficient in cranial adjusting as well as therapists trained in Craniosacral Technique. There are many other techniques that can be affective in cranial manipulation such as Sacro Occipital Technique and Applied Kinesiology. Making sure that you find someone who has been trained in cranial adjusting and someone who is comfortable and confident in adjusting cranial bones is important.

Cranial adjusting, as mentioned above not only can bring proper symmetry, shape, and motion to the bones of the skull, but can affect whole body function and can have a positive effect on issues such as colic, digestive issues, reflux, sinus issues, ear infections, sleep issues, etc. Cranial manipulation can impact vagal stimulation and increase parasympathetic activity. This can decrease inflammation in the gut and improve digestive, respiratory, and cardiac function.

2)     Breastfeeding

Breastfeeding is extremely good for many reasons. One of those reasons is that it can help proper development of the cranial bones and mandible.  The sucking motion required for breastfeeding flattens the breast tissue up against the palate which helps shape and mold the roof of the mouth which is also the bottom of the sinus cavity. Breastfeeding allows for optimal shaping of the palate so it is smooth and rounded and not too high and narrow. High and narrow palates will cause the sinus cavity to become smaller and narrower.  This can lead to future sinus issues.  The sucking motion that presses the breast tissue into the palate helps to move the cranial bones and stimulate growth centers in the facial bones. Typically with breastfeeding the baby is held in different positions and he or she nurses on both breasts so the growth centers on each side of the cranial and facial bones are stimulated evenly. This sucking motion also aids in cerebral spinal fluid flow and helps to stimulate pituitary hormone release particularly growth factors.

3)     Lip and Tongue Tie Release

It is seemingly becoming more and more prevalent these days to see a baby with a lip and/or tongue tie. A lip tie is present when the frenulum or connective tissue between the upper lip and gum is overdeveloped and restrictive to the movement of the upper lip.  A tongue tie is present when the lingual frenulum or connective tissue between the bottom of the tongue and the lower jaw is overdeveloped and restrictive to the movement of the tongue.  Lip and tongue ties are thought to be genetic and are midline defects that are associated with genetic abnormalities that impact the body’s ability to methylate, such as MTHFR. Lip and tongue ties can vary greatly in degree and effect on function.  Lip and tongue ties restrict the function of the oral cavity. They affect the amount the jaw can open, the strength, movement and function of the tongue, and the movement, development and growth of the cranial bones. The restriction in the connective tissue extends deeper into the connective fascia that surrounds the cranium, jaw and can affect the tissue extending into the neck, shoulders, and even into the diaphragm, abdomen, hips and legs. Releasing the tongue and lip tie can have greatly relieving effect for a newborn. It is wise to have cranial adjustments, craniosacral therapy, or other fascial release technique performed after the tongue and lip tie release to ensure that all the connective tissue restrictions are released and full function is restored. The tongue tie and lip tie can be release through the use of scissors or through a cutting laser. It is recommended that each parent do their research in determining which method of treatment is available and most beneficial for their child. Release of these ties will help to encourage proper cranial and mandible development and growth. It will allow for proper growth center stimulation in the facial and cranial bones. It will also encourage full cranial rhythm and movement allowing for proper cranial and facial symmetry.

4)     Babywearing

Wearing your baby in a carrier, sling or wrap is beneficial in numerous ways including supporting cranial shape and motion. Babywearing allows the child to be upright off the floor or out of a seat so there is no risk of developing a “flat spot” from lying in one position for prolonged periods of time. The upright posture also encourages suboccipital muscle development to aid in proper occipital alignment upon the atlas (first vertebrae in the neck). Babywearing also has been connected to extended breastfeeding.  The suckling required for breastfeeding increases cranial movement and also stimulates growth centers among the facial bones allowing for full functional growth of the facial bones and mandible.

5)     No Contraptions

Coinciding with babywearing, keeping babies out of contraptions like car seats, bouncy seats and swings will benefit the cranial bones and the primary respiratory mechanism. Contraptions like car seats limit the baby’s range of motion and confine the baby to typically lay in the same position with the same consistent pressure on the same area of the skull. It only takes less than 5grams of pressure to move and influence cranial motion. So if a baby is laying in the same position with the same pressure for extended periods the cranial bones will mold to fit that pressure. This is typically how flat spots develop, and the skull should not have flat spots. Flat spots indicate that there is altered shape and motion to the different cranial bones. This affects the cerebral spinal fluid movement and can lead to adhesions in the dural tissue causing other symptoms. If flat spots do develop despite your best effort to not have them in a car seat or other contraption for long periods, then finding a practitioner who can perform craniosacral technique or other means of cranial adjusting is recommended.

6)     No Headbands or Bows

Having two little girls myself, I know that a headband with a big bow or flower on it can look very cute. However, like I mentioned above, it takes less than 5grams of pressure to influence the cranial bones shape and motion. So placing a tight headband that constricts the cranium will not only change the shape of the head but will decrease the movement of the cranial bones and negatively impact the primary respiratory mechanism. Many parents who have little girls who are bald for a long time will want to always have a headband on their baby since they can not clip on bows to her hair. This will always constrict motion of the cranial bones and work towards altering the shape of the cranium. Typically a headband will wrap around the occiput, temporal, sphenoid and frontal bones. Even slight alterations in the shape or motion of the occiput can cause misalignments in any other cranial bone. This again will cause adhesions in the dura and affect the nutrient saturation of the nervous system. One lesser evil that I encourage moms to do is to keep the headband or bow in your bag and only slip it on for pictures and then take it right back off. Look for red marks and signs of the bow on the head after you take it off. The more marks and redness you see left behind after the bow is off tells you there is more pressure being applied by the headband. Bows and headbands look cute, but have a huge impact on the shape and motion of the cranium.

7)     Vary Sleeping Positions

Many times parents will place their baby in a crib, basinet, or co-sleeper for naps and bedtime. These devices then stay in the same place and the baby is placed in the same position in them. This can cause the baby to develop a flat spot from continual pressure in one area. The baby will often develop a more comfortable sleeping position they prefer to obtain while in the crib or sleeper. Moving the crib around the room or placing the baby in the crib facing the opposite direction will help to vary the position the baby maintains during sleep. It will also give variability to what side the baby is approached from when he or she wakes up. Therefore the baby will not grow accustom to turning one way to wait for mom or dad when he or she wakes up. Altering sleeping positions for the baby will give him or her varied stimulation and change the way pressure is placed on the head due to the direction he or she will look depending on the position of the crib or sleeper. Back sleeping has been supported by the American Pediatric Association to help prevent SIDS but this campaign has also contributed to flat spots due to back sleeping. Ensuring that there are varied sleeping positions and plenty of tummy time is vital to maintaining cranial symmetry and function if the parent chooses to encourage back sleeping.

 

Many things can contribute to proper cranial motion and function. These suggestions can help parents to take actionable steps towards improving their child’s health through properly functioning cranial movement and rhythm.