Mother & Baby
Osteopathy may be helpful in treating a variety of complaints in pregnancy and is also suitable for treating children. Dimi Argyros has undertaken post graduate training in paediatrics and sees children of all ages from newborns up. Dimi also has a particular interest in treating pregnant women although all the osteopaths in the practice treat them.
Below is some information regarding pain and pregnancy and helpful hints as well as Tummy Time information and advice.
Pregnancy
Common complaints of Pregnancy
- Lower back pain
- Sacroiliac joint pain
- Coccyx pain
- Neck and upper back pain
- Indigestion
Changes in Pregnancy
Increased progesterone levels which increases production of relaxin which
cause increased laxity of ligaments and joints.
Increased curvature of the lower back , mid back and lower neck.
Centre of gravity is shifted forward.
Enlargement of breasts put increased strain on the thoracic spine and neck
Flexibility of lumbar spine, sacroiliac joints, pubic-symphysis joints and hips
is required to adapt to changes of pregnancy.
Restrictions of any of the above may result in pain or discomfort.
Symphysis Pubis Dysfunction
Usually starts in the second trimester but may start in the first.
Pain over pubic symphysis and into lower abdo or under the pelvic floor.
Reccomendations:
Put a pillow between your knees in bed at night.
Floating in a pool help to take the weight off your back for a while.
Deep water aerobics or deep water running may be helpful as well.
Keep your legs and hips as parallel/symmetrical as possible when moving or
turning in bed.
Some women also find it helpful to have their partners stabilize their hips and
hold them ‘together’ when rolling over in bed or otherwise adjusting position.
When standing, stand symmetrically, with your weight evenly distributed
through both legs
Sit down to get dressed, especially when putting on underwear or pants
Avoid ‘straddle’ movements
Swing your legs together as a unit when getting in and out of cars; use plastics
or something smooth and slippery (like a garbage bag) on the car seat to help
you enter car backwards and then turn your legs as a unit.
An ice pack may feel soothing and help reduce inflammation in the pubic area.
Move slowly and without sudden movements.
Avoid breaststroke which may strain the symphysis pubis, and take care
getting in and out of the bath or pool.
Antenatal yoga classes may help as they stretch the lower back and hip
muscles reducing the strain on the symphysis pubis. Deep breathing exercises
help increase relaxation and circulation.
An Osteopath may help restore normal movement to the lower back and
balance up the pelvic joints during a preganancy. which can help take the
pressure of the pubic symphysis.
Avoid sitting in low chairs – getting out of them will strain your symphysis
pubis.
Avoid heavy lifting and pushing supermarket trolleys.
Be careful when pushing pushchairs, sudden jolts or going round corners can
strain your symphysis pubis.
Do less heavy work and avoid long walks.
Sitting or lying down too much can become painful so keep gently active with
frequent short rests sitting in an upright chair, perhaps with a cushion under
you.
Research in the UK shows that 1 in 36 pregnant women suffer from some sort
of pelvic pain so although it is quite common you can do things to help.
Tummy Time
What is Tummy Time?
Placing your baby on their front to play when they are AWAKE and SUPERVISED!
Babies should still be placed on their backs to sleep!
Importance of Tummy time
Provides new sensory experiences, increases physical challenges, and provides much needed relief from constant pressure to the back of the head. It also helps strengthen neck, shoulder and arm muscles and thus helps develop head control.
Strengthening these muscles is essential later to help with rolling, crawling,sitting, pulling to stand and fine motor development including balance, co-ordination of hand-eye movements and sensory processing. (Jennings et al 2005)
Helps minimise the risks of developing Flat Head Syndrome (FHS).
What is Flat Head Syndrome (FHS)
Flattening of the back part of the babies skull usually due to constant pressure on very soft and mouldable heads.
Plagiocephaly is flattening on one side of the head.
Brachiocephaly is flattening across the back of the head.
Risk factors for developing FHS
Sleeping in the same position on their backs-particularly in the first six weeks. (Hutchinson et al, 2003)
Torticollis- muscle imbalance-preference to turning head in one direction.
Restriction of cervical and thoracic spine motion.
Having less than 15 minutes a day of tummy time.
Bottle feeding always on the same side.
Always carrying child on the same side.
Indicators of neck muscle dysfunction
Preference to cervical rotation in one direction
Preference to breast feeding on one side may also indicate neck mobility
problems. (Littlefield et al, 2001)
How to prevent flat head syndrome
With treatment of identified neck muscle dysfunction–ie:with manual therapy such as osteopathy and including exercises to stretch torticollis and other muscles dysfunctions.
Tummy time >15 minutes/ day.
Repositioning including:
Alternating end of cot and arm carrying positioning from day 1 and/or
Alternating supine head position during sleep by turning the head.
Alternating the side the baby feeds on if bottle fed.
Place stimulating toys to encourage rotation to the restricted side or alternating sides once restriction decreased.
Minimising time spent in car seats and bouncy chairs.
Change the position of light in the room so it is on the babies restricted side.
Even young babies will turn towards the light source.
If the baby sucks its thumb then try covering its preferred hand (if its on the same side as the restriction)- this will encourage them to suck the other side and thus encourage turning to the other side.
Tummy Time
Can be started from day 1 for a minute or 2 a few times a day.
Initially can be on your chest or knees but progress to a firmer surface.
A pillow or towel under their chest often help tolerance initially.
Progress to 20-30 minutes 2-3 times a day by 3-4 months.
Get down to their level and play with them.
Use mirrors, toys and lights to get their attention
BACK TO SLEEP- TUMMY TO PLAY!!!
References:
Hutchison L, DipHSc, PG DipSc,. Thompson J M. D, PhD and Ed Mitchell A, MB, DCH, DSc (Med). (2003). Determinants of Nonsynostotic Plagiocephaly: A Case-Control Study. Pediatrics. Vol. 112 No. 4 October . pp. e316-e316.
Jennings JT, Sarbaugh BG and Payne NS. (2005). Conveying the message about optimal Infant Positions. Physical & Occupational Therapy in Paediatrics, Vol. 25(3).
Littlefield TR, Reiff JL, Rekate HL. Diagnosis and management of deformational plagiocephaly. Barrow Neurological Institute Quarterly. 2001;17(4):18–25
