Everything you need to know about Pilates and Osteopathy for the Pre and Postnatal Period

Why should I participate in specific pre and postnatal pilates?

Prenatal Pilates at Eastern Osteopathy

Your body is doing amazing things to prepare for birth. As you progress through pregnancy, your body undergoes many changes. As osteopaths, we understands the physiological changes your body is going through throughout this period. Mia’s additional pilates training has deepened her understanding of what exercises are safe and relevant during the different trimesters of pregnancy. Exercises can be tailored to you and your individual needs throughout your pregnancy, with the focus of helping to prepare you for your birth and the postnatal period.

Postnatal Pilates at Eastern Osteopathy

Congratulations, you have had your baby and now you are ready to get back to your everyday activities and exercise!

Your body is recovering from the changes it has undergone throughout your pregnancy. Once you have your baby, the goal is to assist in restoring your body’s structure and function. At Eastern Osteo we work with a postpartum exercise guideline, which we tailored to you and your goals. Pilates is great for the postnatal period as we can begin to ease your body back into exercise with low impact activity. Regardless of your goal, if you want to exercise or not, there are many benefits to some postnatal pilates inspired workouts. You are now caring for someone else, this requires strength and function as your baby gets bigger and bigger! 

Mia is currently doing 1:1 consultations, focused on getting back into movement in the postpartum period. This entails a 45 minute consultation where a combination of manual therapy, assessment and implementation of exercises are utilised. This allows for individual time, advice and technique review so that you have the tools to correctly implement these practices at home. 

How does Eastern Osteopathy use Pilates inspired exercises in conjunction with manual therapy?

The beauty of having the combination of osteopathy and pilates is that Mia is able to assist and treat your pain with manual therapy and then prescribe pilates inspired exercises to maintain and improve function. 

Mia and Kathryn work together to formulate the most suitable program for your individual needs. Kathryn treats pelvic floor dysfunction with manual therapy; as we utilise a holistic approach, we know that other structures in the body can contribute to your pelvic floor dysfunction, and Mia works on these through manual therapy. In addition to manual therapy, Mia and Kathryn work together to design movement programs specific to you and your presenting complaint.

Tips for Prolapse During Pregnancy

Have you been diagnosed with a prolapse and are wishing to conceive or are already pregnant?

This can be a scary time. Worried that pregnancy and birth might make your prolapse worse? Trust me this is common concern and a conversation we have with patients regularly. And it is scary and frightening, but it’s important to know that having a prolapse while pregnant is manageable and safe with some guidance, exercises and lifestyle modification. Our tips for managing this time are below.

Connect with your breath and pelvic floor

Spend time observing your breath, feel the subtle lengthening and decent as you breath in & as you breath out notice the pelvic floor engage and lift. Once you have connected with your breath you can add a gentle lift and engagement of your pelvic floor as you breath out. You can do this while in a semi-reclined position, seated, childs pose and standing.

SEE a Pelvic Floor practitioner

If you have a prolapse please make an appointment to see a qualified pelvic floor practitioner (osteopath/physiotherapis) to have your pelvic floor assessed and an individualised pelvic floor rehabilitation program created. This may involve strengthening exercises, breathing strategies and or ways to improve neuromuscular timing and coordination

Manage your constipation

Constipation is commonly experienced during pregnancy and along with straining is a major risk factor for prolapse. Consuming adequate water & fibre along with creating a healthy bowel routine while adapting good pooping posture & not straining is essential for minimising impact of prolapse on the pelvic floor. Oh and don’t forget the squatty potty to help achieve optimal pooping posture and the use of ooo cha to help expel the unwanted waste.

Listen to your body

Take the time to listen to your body; understand that your body, posture and centre of gravity is constantly changing and with this your prolapse symptoms can also change. A easy activity last week can cause a pressure and dragging sensation today. Knowing your body will allow you to alter your movements strategies to minimise impact on prolapse.

Use the Recovery Position

When feeling tired and extra pressure, bulging and dragging sensation in your vagina, taking some time to rest in a recovery position is important. Lying on your back with your legs up the wall or resting on a chair. Placing a pillow under your pelvis encourages your organs to move away from the entrance of your vagina. Then observe the natural rhythm of your breath & gently engaging your pelvic floor with your exhale. If lying on your back is uncomfortable, makes you feel dizzy or nauseous; please stop this exercise.

Exhale with Exertion

As you roll over, sit to stand, lift and other activities that involve some exertion; perform the activity with an exhale. As you prepare to move, exhale and gently blow out. By gently blowing & feeling your core engage & then moving, minimises the force directed to your pelvic floor and pelvic organs.

Look at your Posture

We know postural changes can influence the force and pressure applied to the pelvic floor. We also know pregnancy is a time of ever changing posture. Rather then sinking into these poor postural changes try to stand, sit and lye in alignment with our natural curvature. A quick way to test if your posture is optimal, check in and see if breathing is effortless, then we know our posture and alignment is on point. Having trouble try untucking your butt!!

Stay Active and whole body strengthening

Staying active & strengthening your whole body is great for overall pelvic health. It is important to exercise symptom free and under the guidance of your health care provider and/or within the pregnancy guidelines.

As a bonus regular exercise can help stimulate a bowel movement.

Manage your stress

When looking at our pelvic health we know stress can impact your ability to have a bowel movement and constipation is a risk factor for prolapse. We also know when stressed you will clench your pelvic floor muscles which in turn impacts the ability to contract effectively. Studies tell us when stressed our prolapse symptoms will bother us more. This doesn’t mean the symptoms are worse just that they bother you more causing more stress. Developing good stress management strategies is essential.

Pregnancy and Exercise

Exercise during pregnancy should be done and is safe, in a healthy, uncomplicated pregnancy. In fact, performing the recommended type and amount of physical activity during pregnancy achieves health benefits for mother and baby including reducing risk of pre-eclampsia, pregnancy induced hypertension, a reduction in instrumental delivery and unplanned caesarean section birth, and may help to reduce the severity of lower back and pelvic girdle pain.

According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) evidence-based guidelines for physical activity in pregnant women, it is recommended that in a normal pregnancy woman participate in 150-300 minutes of moderate intensity or if previously exercising can continue 75-150 minutes of vigorous intensity exercise per week.
This can be completed over a minimum of three days per week, however, being active every day (ideally 30 minutes per day, less if previously inactive) is encouraged and doing some physical activity is better than none.

Training should be a combination of aerobic (brisk walking, cycling, swimming, dancing, exercise classes) and strength (body weight, light weight or resistance band) exercises and exercise intensity will vary depending how physically active you were or we not pre-pregnancy. Women who were active prior to conceiving can continue with their usual activities for as long as they feel comfortable but are advised to check with a health professional if they would like to continue with vigorous intensity or high impact sports and exercise.

Additionally, some exercises may need to be modified as your pregnancy progresses due to biomechanical changes and pain i.e. after 16 weeks it is best to avoid exercises lying on your back.

Exercise is not recommended in all circumstances. The following are cases in which exercise is not recommended;

• Incompetent cervix

• Ruptured membranes, preterm labour

• Premature labour

• Persistent second or third trimester bleeding

• Placenta previa

• Pre-eclampsia

• Evidence of intrauterine growth restriction

• Multiple gestation (triplets or higher number)

• Poorly controlled Type 1 diabetes, hypertension or thyroid disease

• Other serious cardiovascular, respiratory or systemic disorder
  

Stop and seek advice from a health professional if you experience any of the following while being physically active:

• Chest pain

• Persistent excessive shortness of breath – that does not resolve with rest

• Severe headache

• Persistent dizziness / feeling faint – that does not resolve with rest

• Regular painful uterine contractions

• Vaginal bleeding

• Amniotic fluid loss

• Calf pain, swelling or redness

• Sudden swelling of the ankles, hands or face

• Decreased foetal movement

Still unsure what physical activity you can or cannot be doing during pregnancy speak with your health care provider before starting an exercising program.

*Exercise intensity ratings are based on ratings of perceived exertion on a scale of 1-10 where 1 is not moving and 10 is maximal effort. Activities in the range 3-7 indicate moderate-vigorous intensity and are considered safe and are recommended for health benefits in pregnant women. This can also be judged by the ‘talk test’ in which a conversation can be held during moderate intensity activities but difficult during vigorous activities.

Brown, W.J., Hayman, M, Haakstad, L.A.H., Mielke, G.I. et al. (2020). Evidence-based physical activity guidelines for pregnant women. Report for the Australian Government Department of Health. Canberra: Australian Government Department of Health.

Kate's Tips for Pooping in the Postpartum Period

Now let me tell you something I found out the hard way… NO ONE tells you that having a vaginal birth can feel like the baby is coming out of your bum. Anyone with me??

Postnatally, there are lots of conversations about looking after your vagina; regarding tissue tearing, episiotomy and surgical repairs. Today however, we are doing a 180 and talking about the rectum, and, you guessed it... poop. It certainly makes sense that this area might be tender, and if you have had the privilege of seeing a vaginal birth in person or via photos or video, you can see how the rectum has been pulled and stretched away from its usual position. As unpleasant as this may sound, we do actually need for this to occur, as it helps make room for the little (or in my case - not so little) one, to exit. 

Personally, I had more pain rectally after giving birth than I did vaginally. I actually had no redness, swelling or stitches associated with my magic vagina, but did I have rectal pain? HELL YES! And let me tell you, I was more than a little scared to go poop. However, I knew that prolonging the act was definitely not going to help in the long term. 

So today I'm giving you my top tips for pooping directly after you give birth. 

• This is a biggy.. please don’t delay the poop! It might seem scary, but the longer you wait and the more you suppress the urge to eliminate waste, the more backed up you will get. As the stool backs up, it ends up being stored in the descending colon, and in doing so water is removed from your poop making it harder and harder. This will make it more painful and even harder to pass. If you feel the urge, please be brave and poop. 

• When it's time to go, remember to use the squatty potty. The posture the squatty potty encourages helps to relax the pelvic floor muscle (puborectalis), which straightens your back passage and allows poop to exit with ease. Adding a low tone sound like mooooo, zoooooo or rooooooo can aid in this process by encouraging your abdominal muscles and diaphragm to contract, increasing the pressure around the rectum and stimulating the parasympathetic nervous system.

• Still nervous about doing a poop? Take a small pillow with you, placing it on your lower belly (this is even more important if you’ve had a cesarean section) and adding some pressure. The act of pooping requires tension (intra abdominal pressure IAP) to be created by our diaphragm and abdominal muscles , the pressure from the pillow can help regulate the IAP normally created by our stomach muscles. Plus it takes pressure off your fresh scar. 

• A great way of stimulating the parasympathetic and dampening the sympathetic nervous system is with relaxed diaphragmatic breathing. If you are not sure how to do this, check out this video. When we stimulate our parasympathetic nervous system, it gets our digestive system moving and stimulates our rectum to contract while inhibiting our internal anal sphincter, i.e. the back passage opens. The parasympathetic nervous system is all about rest and digest. This type of breathing will also massage the bowel with the rhythmic motion of your breath. Plus, as a bonus, diaphragmatic breathing will also start building an awareness of your breath and pelvic floor muscles. Did you know that when contracting your pelvic floor muscles you increase blood flow to the area which also aids in healing and recovery?

• As I’m sure you know, things can be a little tender downstairs after a vaginal birth. If you can handle the pain after giving birth, try to avoid medication containing codeine, as it will clog you up even more. There are other alternatives such as panadol for pain relief, and the use of ice to numb the area. Using ice as a cold compress also aids in your recovery by adding compression to your first aid steps. 

• If you are having trouble with passing stool and need help with softening the waste, magnesium oxide can be a great way to achieve this. However, before taking magnesium please consult with your maternity health team. 

• Your first meal after giving birth should be nutrient rich and easy to digest. Why hello Bone broth, this yummy nourishing substance can be a great way to keep you hydrated during the labour, plus it will help to give you loads of energy (trust me when I say you will need it) during the birth, and again once you have your new bubba in your arms. This liquid gold is rich in collagen (did I mention collagen can help repair any tissue damage during the labour), gelatin and lots of minerals which are thought to have many medicinal properties, one of which is strengthening the gut lining and improving our immune system. YAY! This is exactly why people offer to cook chicken soup when we are sick. When I say cook I don't mean reheat from a can. I mean the type of soup our nannas cooked when we were young. Not sure on how to cook a bone broth? Check out Chloe’s blog. You can consume the bone broth on it’s own or use it as a base for your yummy soup.

• Look after your gut MICROBIOME - these are the bugs that live in our gut - with the greatest concentration being in our large bowel, they are very much involved with the health and function of the bowel, and the quality and ease of our poop! Pregnancy and birth interventions can cause lots of disruptions to our microbiome, so it’s important to support and rebalance the microbiome postnatally (in fact it’s super important to optimise it the whole way through pregnancy learn more about that here.

• We need both PRE & PRObiotics to restore & maintain our microbiome - this can get confusing - let me explain; PREbiotics feed the good bugs and PRObiotics are the good bugs. PREbiotics are found food in plant foods (a rich and diverse plant-based diet creates a rich and diverse gut microbiome) and PRObiotics are found in fermented foods and drinks (yoghurt, kefir, kombucha, sauerkraut etc) or supplements can be used. 

Supplemental PRObiotics are amazing to use postnatally for gut health. They help with motility, reducing inflammation, repairing tissue, regulating stool composition (keeping them soft!) etc. BUT (and this is a big but!) not all probiotics are created equal, you need to consider specific strains, mechanism of action (what they do in the body) and also quality of manufacture. We recommend Qiara - it has lots of great research, many of the beneficial mechanisms of action and it’s a quality Australian made product, it’s actually a breastmilk strain (meaning it was originally isolated from healthy human breast milk). As well as having many proven benefits for gut health and the gut microbiome - it also helps breast milk microbiome, breastfeeding outcomes and infant gut, microbiome & immune development. As far as PRObiotics go - it’s one of the best. I wish every mum and baby could have it. 

• When choosing food from a menu in a hospital, or if you have a friend or family member who has organised a food roster (these can be the best!), just remember to be fussy and ask for nutrient rich, organic whole foods that rot and make up the colours of the rainbow. Having a 1kg tray of lasagne delivered to your door, as yummy as it sounds, may not be the best for your digestive system. Chicken soup with a side order of sauerkraut can be an awesome request.

• Most importantly, when eating, take your time to chew, chew, chew your food. Chewing breaks our food down and promotes the production of gastric enzymes. Gastric enzymes are responsible for breaking our food down to an appropriate size for the small intestine to start removing nutrients. The act of chewing, filling our stomach and dumping into the small intestine stimulates a nerve pathway that causes our colon, and it’s natural peristaltic motion, to start. This peristalsis gently propels our stool through the large intestine. Way to go chewing, filling and dumping (pun intended)!

• Water, water, water! Always have a water bottle on hand and take it everywhere. Being hydrated is absolutely essential if you plan to breastfeed. It is vital to be hydrated for the production of your milk. Did you also know that dehydration can be a major cause of constipation? Since you are taking your bottle everywhere, when you have had a poop or a wee, rather than wiping the area with dry toilet paper, try using a soft damp cloth, especially if you have stitches, hemorrhoids or fissures.

• Whether you have, small graze or a minor perineal tear, an epsiotomy or a larger tear involving the external anal sphincter; it’s likely your perineal area ( the space between your vagina and anus) will be tender and need some ice and compression for 24-48hrs. Keep the area dry and clean. When drying after a shower, remember to dab the area dry. 

• Sleep. When you can, get some sleep. Hahaha… I know that this idea is good in theory but quite hard to achieve in practice. However, it is super important that you look after yourself and get sleep when you can. Try to limit screen time - especially at the 2 am feed... as tempting as it is to pick up your phone, DON’T! The blue light can affect your melatonin levels, therefore making it much harder to go back to sleep. 

• Move. This may seem like a hard task, but starting with small walks like checking the mail can be a great way to stimulate your GUT to get moving. 

At Eastern Osteopathy we believe that having good quality poop and optimising your gastrointestinal tract (GIT) health should be part of all new mamas postnatal health plans. Doing so will not just have a positive impact on your git, it will have a positive impact on your immune system, your mental health, the function of your pelvic floor and then there are the health benefits to your new baby. 

Pregnancy and Postpartum during COVID with Bernadette Lack, Midwife and Personal Trainer

As part of our expert zoom series, Liz was joined by Bernadette Lack, a midwife and personal trainer, to discuss all things pregnancy and the postpartum period, and how to navigate these times during COVID.

For more information about Bernadette Lack and pregnancy, visit Bernadette’s website for resources and Bernadette’s program. You can also find more resources on Bernadette’s Instagram page.

Leaky Gut, Leaky Vagina and the microbiome with functional nutritionist emma parks

Recently Kate got together with Emma Park a functional nutritionist to talk all things gut health, gut microbiome, leaky gut and leaky vagina; in particular for the pre and post natal period #first1000days. You can check out their video below #first1000days.

We have also linked Emma's guide to pre and probiotic foods to benefit your gut.

For more information on Emma Park and functional nutrition, visit Emma's website for more resources or to book an appointment to see Emma. If you are particularly interested in pre and post natal gut health and the importance of children's gut health, information on Emma's courses can be found on First 1000 days and you can join Emma's First 1000 days Facebook group for more resources.

4 reasons why all women should have a postnatal check up

Dr Kathryn Johns

Giving birth can involve lots of tears, love, fear, gratitude and a little bit of OMG! The transition to parenting is a time of discovery and working out your new life as a mother or father of one (two, three or more)! There is so much emphasis on #selfcare for mothers, but when the new addition arrives mama tends not to come first or second. Selfcare is forgotten or put to the bottom of the ‘things to do’ list.

At Eastern Osteopathy we believe there is no better time than postnatally to embrace the self care message, and look after you. For postnatal mothers, we offer postnatal appointments with our women’s health osteopaths. Aside from self care, here are the four main reasons why we believe you should put mama first, and make an appointment.

1. Change

In the hours to days after giving birth your entire body goes through rapid anatomical changes; in particular the anterior abdominal wall (the front of your stomach/belly region) and the pelvic floor. These two areas make up a major component of your core canister.

Your sleep (if any) will be interrupted. You will be tired (aka exhausted) and spending your time breastfeeding (or bottle feeding, or expressing, or both), carrying, cuddling, settling, all while your body is adjusting to its new posture without the support of a strong core. At Eastern osteopathy we encourage all new mamas to make an appointment in the weeks following the birth of their little one to make sure their bodies are in alignment, and moving correctly. When this is achieved we place less stress and strain on our muscles and joints, creating an environment optimum for healing.

2. Pelvic floor

Pregnancy, and giving birth vaginally places huge stress on your body; in particular your pelvic floor muscles (PFMs). It is estimated that during a vaginal birth the PFMs stretch up to 3.5 times their normal length, (WOW!) allowing your little one to pass through your vaginal canal. For some women, to aid in this process, tearing of the perineum or an episiotomy may be required. It’s no surprise it can take some time for these muscles to recover and heal.

Pelvic floor dysfunction can look different for everyone. We find many of our patients only associate accidental leakage with PFD. For many people, this is not the case. PFD can present with a variety of symptoms ranging from, but not limited to, incontinence of urine or faeces, urgency and frequency of urination to constipation or pelvic girdle pain. Not sure if you have an issue with your pelvic floor? Take our short questionnaire here.

At Eastern Osteopathy, we don’t believe you should wait for pelvic floor symptoms to present before seeking postnatal osteopathic care. Being proactive about your health with osteopathic treatment, and getting an appropriate rehabilitation program, involving movement practices, breathing exercises and pelvic floor strengthening, or relaxation techniques is essential after pregnancy.

Both myself (Dr. Kathryn Johns - osteopath) and Dr. Elizabeth Johns - osteopath have completed further training in the assessment, retraining and rehabilitation of the pelvic floor; using both internal and external techniques.

We have also been trained in the use of a Real Time Ultrasound to diagnose pelvic floor and deep abdominal dysfunction. The RTU machine allows Elizabeth and myself to assess your pelvic floor without the need for an internal assessment.

When assessing your pelvic floor, we don’t just assess its function (i.e. how strong it is, and how many kegals you should do), we also look at your body as a whole to see if there are any biomechanical issues that could be impacting on how well your pelvic floor functions.

For more information check out our blog on What to expect from a women’s pelvic health assessment.

3. Diastasis Recti Abdominal (DRA) abdominal separation

During pregnancy DRA is a normal, natural process which allows your body to stretch and change as your little one grows. Research has estimated that by 35 weeks gestation, 100% of soon to be mamas have DRA and by 12 weeks postpartum just under 40% of new mamas will have a DRA. (1) If at 8 weeks postpartum you have a DRA, studies have shown that without intervention, you will still have a separation 12 months after giving birth. (2)

Assessment of the DRA is not about the size of the gap, what we will be looking for is the ability to create tension across the gap (anatomically known as the linea alba). Creating tension in the Linea alba is achieved by correct contraction of the core muscles. If you are unable to create tension, we will endeavour to work out why. Is it due to whole body alignment impacting on the function of your deep core? Or do you need to learn to reconnect and strengthen your deep core?

During your appointment you will be taught how to assess and monitor your ability to generate tension within the linea alba, as to determine when an exercise is appropriate for you.

For more information see Diastasis Recti on our website

4. Pain 

For many mamas to be, pregnancy pelvic girdle pain (PPGP) is reality and for most of these ladies, giving birth resolves the symptoms of their PPGP! For some women, it’s not that simple. 1 in 10 women with PPGP are still suffering with chronic and severe PGP up to 11 years after giving birth (3).

Giving birth, feeding, carrying and settling your young babe can result in a variety of new complaints including, but not limited to, the following:

• Lower back and pelvis pain

• Pelvic girdle and pubic symphysis pain

• Mid back pain during and after breastfeeding

• Neck pain and headaches 

• Wrist pain

As osteopaths, the emphasis of our treatment is on the whole person and not solely on their symptoms. We use a variety of techniques to gently release any strains present; relieve pain, discomfort and improve mobility to support the body’s ability to heal.

A common question we regularly get asked by our pregnant patients is: How soon after giving birth can I have treatment? If you are in pain, you can receive treatment within hours.

Nine months ago I gave birth to my second daughter. Hours later I could barely sit due to coccyx pain, making breastfeeding near impossible. Lucky for me, I have a twin sister who is an osteopath (and my business partner, aka Liz) Less than 12 hours after giving birth I had an osteopathic treatment. The relief soon followed and shortly after, I was able to breastfeed and care for my daughter in comfort.

◦◦◦◦◦

At Eastern Osteopathy we see postnatal women at all stages, from those who have been mamas for only a couple of days to mamas who are now grandmothers, and have been putting up with their symptoms for a couple decades. We believe it’s never too late to start looking after yourself and putting mama first! 

Regardless of your concerns during your postnatal check up; as osteopaths, we look at your body as a whole and create an individualised treatment plan, addressing any areas in your body (joints, ligaments, fascia and muscles), movement patterns, dysfunctional postural or breathing patterns that may be impacting on your overall health. 

The treatment will include a physical treatment, lifestyle advice and a specific rehabilitation program to support your treatment outcomes. Generally these programs will include movement practices, breathing exercises and pelvic floor strengthening or relaxation techniques.

To book your postnatal appointment: book online here or call us on 9042 0407.

Want to know more? Call the clinic on 9042 0407 to speak with us today.

References

1. Moto P G, Pascoal A G, Carita A I, Bo K 2014 - prevalance and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther 2014

2. Coldron Y, Stokes M J, Newham D J, et al 2008 - postpartum characteristics of rectus abdominis on ultrasound imaging. Manual therapy 13: 112

3. Elden, H et al (2016). BMC Musculoskeletal Disorders, 17(1), 276.

Osteopathy assisting newborns with feeding

Dr Elizabeth Johns

Did you know? For an infant to successfully feed they need to be able to coordinate sucking, swallowing and breathing. Sounds simple, but this process relies on 6 cranial nerves and over 60 muscles acting on 22 bones all functioning appropriately to allow your new little bub to feed. Amazingly, for many newborns this is not an issue. I’m actually surprised that we don’t see more babies with feeding issues. 

Poor sucking and feeding can compromise the transfer of milk from mum to baby. This not only impacts the amount of milk your baby is getting at the time, remaining milk stasis can impact on your future milk production. This creates a cycle where less milk is produced, in turn adding to the difficulty of the baby's feeding, further impacting milk production and so on. (1)

It is within the first month of life that babies are most at risk of being weaned from breastfeeding. Of mothers who choose to stop breastfeeding during this time, fifty percent report biomechanical issues with their baby as problem. (2)

The first few weeks of navigating everything to do with becoming a mum or a mother of 2 or 3 can be very daunting. It is during this time where support for the mother and education around lactation and breastfeeding is most important. 

Research now suggests that poor sucking has a strong association with epidural, analgesics, forceps delivery, vacuum extraction, induction of labour, caesarean birth, and/or long or difficult labour.

Babies are subjected to enormous forces during birth. To help adapt to this force, a baby's head has 34 sutures / joints that allow 22 bones / boney segments to overlap and mold as they twist and turn to squeeze out through their mum’s pelvis. When extra force is added (i.e. forceps, vacuum suction, long labour), more force is transferred to the babies presenting body parts. 

As osteopaths, we commonly observe that mechanical forces during the birth process can disrupt the alignment of boney structures through the head, neck and body impacting on nerves, joints and muscle function.

Despite not experiencing the aforementioned force, babies born via cesarean births are not immune to having biomechanical issues with breastfeeding. Lactation consultants report more issues with breastfeeding in babies born via cesarean compared to vaginal births. (3)

How can an osteopath help if you baby is having mechanical issues with feeding? 

The process of breastfeeding is complex. For this reason, we don’t have a recipe. When assessing and treating a baby who is having biomechanical issues impacting their ability to feed effectively, we approach each infant as an individual; considering all the different muscles, joints and nerves that are involved in the coordination of sucking, swallowing and breathing. 

We use a very gentle technique called cranial osteopathy. This assists the body’s natural, self-healing mechanism to release any strains, improve the movement and function of neck, base of head and jaw while also re-establishing an overall state of health and balance. 

Promisingly, research into osteopathic treatment to help with mechanical sucking issues is starting to emerge. Recent research revealed that osteopathic treatment, alongside lactation consultants, in the treatment of infants with biomechanical sucking difficulties was more effective to improve latching and sucking when compared to lactation consultants alone. (4) A small pilot study has also shown that infants with sucking dysfunction who received osteopathic treatment, obtained a significant positive impact on the quality of their feeding. (5)

If you would like further information, please call (03) 9042 0407 to speak to one of our osteopaths.

References

1. Smith LJ., & Kroeger, M. Impact of Birthing Practices on Breastfeeding Second edition

2. Homdrum, A., & Miller, J. (2015). Maternal report of feeding practices: A cross-sectional survey of 1753 mothers presenting infants to a chiropractic teaching clinic. Journal of Clinical Chiropractic Pediatrics, 15(1), 1198–1202.

3. Kearney, MH., Cronenwett, LR., Reinhardt, R. (1990) Cesarean delivery and breastfeeding outcomes. Birth, 17(2):97-103.

4. Herzhaft-Le Roy, J., Xhignesse, M. & Gaboury I. (2016). Efficacy of an Osteopathic Treatment Coupled With Lactation Consultations for Infants’ Biomechanical sucking difficulties: A Randomized Controlled Trial. Journal of Human Lactation, Vol(1) 165-171.

5. Fraval, M. (1998). A pilot study: Osteopathic treatment of infant with a sucking dysfunction. Journal of the American Academy of Osteopathy, 8(2), 25–33.

Four Month Sleep Regression

Dr Kathryn Johns

The four month sleep regression... It’s a thing!! How did you all cope?

Let me share with you my experience when Harper, my second daughter started to go through sleep regression. By 6 weeks Harper, the golden child, was either sleeping through or waking once a night and sleeping until 7.30ish. Was I tired? Yes.. Exhausted? No. 

Then it happened. Harper turned four months and two days old and the sleep regression began. 

I’m lucky, my best friend, business partner and twin sister (aka Liz), has spent all of her working osteo career treating babies. So I asked Liz what exactly is happening to Harper? Why, around four months, do babies regress with sleep? Can osteopathy help? Here is what Liz had to say: 

Firstly, the 4 month sleep regression is absolutely normal (hard but normal, exhausting but normal). As hard as it might feel right now, congratulations, your little bubba has reached a developmental milestone!

To help understand what’s going on with your bubba it’s important to understand the 4 stages of sleep. 

The stages of sleep are categorised by light sleep, deep sleep and REM sleep. A normal sleep cycle consist of four stages of sleep that are repeated every 90-120 minutes. Newborns skip the first two stages of sleep and go straight to deep sleep (Stage 3 & Stage 4). 

Stage One - The earliest stage of sleep, referred to as drowsiness or pre-sleep. This is the lightest stage of sleep when we can easily be woken. Slow rolling eye movements that occur as our bodies relax and soften.

Stage Two - The predominant sleep stage during a normal night’s sleep. Stage comprises approximately 40-60% of our sleep time. Still classes as light sleep, the body reduces its activity to prepare for deep sleep. Body temperature increases and heart rate decreases.

Stage Three - Moderate to deep “slow wave” sleep. During this stage our bodies are busy repairing and rejuvenating, growing and developing. In stage 3, we are least likely to be interrupted or woken from external stimuli.

Stage Four - REM (rapid eye movement) sleep. It is during this stage we do most of our dreaming and our brain consolidates information and memories. During REM breathing is rapid, irregular and shallow. If woken during REM sleep, we can wake feeling tired or groggy.

Normally at the age of four months your baby starts going through all four stages of sleep . With these changes, more time is spent in lighter sleep, making it easier to wake. During this period your baby is also going through developmental changes and becoming more alert adding to the ease at which they wake up. 

The good news is, although this is a permanent change to your babies sleep cycle, they will adapt. They will sleep again, you will sleep again!

Can osteopathy help? There is limited research into the benefits of osteopathy in helping improve babes sleeping. However it is very common for parents to bring their kids in for treatment to help with sleep. From my clinical experience, osteopathic treatment is really helpful in removing tension and we all know when we remove tension in our bodies we feel more relaxed. As a result we often see babies sleep patterns improve with treatment.