omt for common infant and children complaints › uploads › 3 › 9 › 8 › 0 › 39809635 ›...
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OMT for Common
Infant and Children
Complaints ARLENE O’DONNELL, DO
FEB 6, 2020
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Disclosures
Nothing to disclose
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Objectives
Infants Latch
Reflux
Nasolacrimal duct obstruction
Overriding sutures
Plagiocephaly
Jaundice
Torticollis
Colic
Children
URI
Otitis media
Asthma
Pneumonia/RSV
Constipation
Behavioral disorders
Scoliosis
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OMT screening
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Latch issues
Infant
Noisy eating
Won’t stay latched
Poor milk transfer/weight gain
Fatigue
Fussy
Mom
Painful
Cracked/bleeding nipples
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Poor latch
Evaluate for
Tongue tie
Lip Tie
If Mom’s the problem:
Engorged: Reverse pressure softening
Flattened/inverted nipple: pump prior to latch, nipple
shield
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Latch Issues
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Latch OMT
Also evaluate hyoid, diaphragm, sacrum, SBS, clavicles
Condyles
Base of tongue
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Vomer
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Reflux
Prevalence
Overfeeding
Age (months) % prevalence
0-3 50%
4 67%
7 14%
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Reflux
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OMT
Also evaluate: SBS, OA, OM sutures, sacrum, clavicles
Diaphragm/ Thorax/ Ribs
Stomach
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Nasolacrimal duct obstruction
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Nasolacrimal duct obstruction
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OMT
Also evaluate: Cranial strains, SBS, sacrum, diaphragm
Frontonasal
decompression
Maxilla
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Overriding sutures
Frontal bone flattens
Occipital bone moves backward
Parietal bones override
Resolves in 1st few days
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Plagiocephaly
Don’t miss craniosynostosis
Consider torticollis
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Plagiocephaly
Significant decrease in 8 weeks
Cranial vault asymmetry P=0.02
Skull base asymmetry P=0.01
Transcranial vault asymmetry P<0.003
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OMT
Also evaluate: dura, clavicle, neck-anterior/posterior, diaphragm, pelvis, sacrum
V-spread
Cranial molding
Sacrum/lumbar
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Torticollis
Congenital muscular torticollis most
common
Check for
SCM mass
developmental dysplasia of hip
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Torticollis
3/2016
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Torticollis OMT
Also evaluate diaphragm, sacrum, SBS
Dura tent and falx Clavicles
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Constipation
No pediatric studies
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Colic
Normal crying
Age Time (minutes)
>6 wks 117-133
10-12 wks 68
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Constipation/Colic/Jaundice
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OMT
Colon Sacrum/Pelvis
Colon-peristalsis
Also evaluate: diaphragm, OA, Cranial base, thoracic, ribs
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Peds
Children
URI
Otitis media
Asthma
Pneumonia/RSV
Constipation
Behavioral disorders
Scoliosis
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Otitis Media/URI
Most common cause- viral
OMT
Lymphatic drainage into lymphatic/thoracic duct
Anterior cervical musculature/trachea/hyoid
Zygomatic motion
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Otitis Media/URI
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OMT
Also evaluate: thoracic inlet, T1-4, Ribs, diaphragm
Eustachian tube
Hyoid
Temporal bones
Zygoma
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Lung issues
Asthma
Reactive airway disease
Pneumonia
Bronchiolitis
Cystic Fibrosis
Poor cough reflex
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Lung issues
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OMT
Also evaluate: Clavicles, Hyoid, trachea, cranium, pelvis, lymphatics
Diaphragm
Sternum/Thorax
Ribs
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Behavior
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OMT
Also evaluate: Cranial strains, sutures, Sternum, pericardium, pelvis, sacrum
Parietal lift Nape of neck
Sacral CV4
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Scoliosis
Check
Leg length discrepancy
Cranial base
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OMT
Also evaluate: Pelvis, Lower extremity, diaphragms of body, clavicles, spine
Condyles
Sacrum Fascial body
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OMT outcomes
Vision
Sleep
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OMT in practice
Somatic dysfunction causes more than just pain
Consider OMT for a variety of pediatric complaints
Screen, screen, screen
Treat what you find
Be active: move around the exam room/treat where they want
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References
Osteopathic Manipulation in Breastfed Newborns. (ClinicalTrials.gov). ClinicalTrials.gov identifier: NCT03945474. Updated May 10, 2019.
Nelson SP, Chen EH, Syniar GM, Christoffel KK. Prevalence of symptoms of gastroesophageal reflux during infancy. A pediatric practice-based survey. Pediatric Practice Research Group. Arch Pediatr Adolesc Med. 1997 Jun;151(6):569-72
Pacchiarotti C, Maioli F, Campisano, M, et al. Gastroesophageal Reflux in Infants and Osteophatic Manipolative Treatment: An Alternative Therapy? Arch Dis Child [307384.797]. 2014;99(Suppl 2):A291.
Burina L, Curtis S, Mancini J, Yao S. Use of Osteopathic Manipulative Treatment (OMT) to Treat Congenital Torticollis and Positional Plagiocephaly in an Infant: A Case Report. Poster presented AAO Convocation 3/2016; Orlando, FL.
Wolke D, Bilgin A, Samara M. Systematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants. J Pediatr. 2017 Jun;185:55-61.e4. doi: 10.1016/j.jpeds.2017.02.020. Epub 2017 Apr 3.
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References
Carnes D, Plunkett A, Ellwood J, Miles C, Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analysis. BMJ Open. 2018;8;e010410. doi:10.1136/bmjopen-2017-019040
Blood S, Hurwitz B. Brain Wave Pattern Changes in Children with ADD/ADHD following Osteopathic Manipulation: A Pilot Study. AAO Journal. 2000; Spring: 19-20.
OMT technique resources:
Carreiro J. Pediatric Manual Medicine: An Osteopathic Approach. Churchill Livingstone, Elsevier 2009.
VanBuskirk R. The Still technique Manual. 2nd ed. Indianapolis. AAO; 2006
Seffinger M. Foundations of Osteopathic Medicine. 4th ed. Wolters Kluwer. 2018.
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Questions?