Benjamin Shield, Ph.D.
Effects of Obstetrical Interventions on the
Craniosacral System that Influence Breastfeeding
The Craniosacral System involves the structures from the head to the pelvis. This includes bones, sutures, fluids, membranes and other soft tissue components. At birth, these structures have a unique vulnerability.
When we think of an adult’s head, we imagine a relatively firm structure. At the time of birth, a baby’s head is primarily fluid and membrane. A baby’s head can be imagined as a sea of membrane with bones floating in that sea. Many of the bones that are individual bones as adults exist in babies as bones within bones. The sutures resulting from the bones coming in contact with one another do not form until the ages of two through four.
This presentation of the baby’s head is to allow for the systematic reduction in the overall size of the head during the birth process. It also allows for the rapid expansion of the brain during the early years. And where this presentation allows for the safety and growth of the child, it allow makes the baby more vulnerable to obstetrical interventions.
One obstetrical intervention that can result in various possible injuries is vacuum extraction (ventouse). As the cup is applied to the vertex of the baby’s head, contents of the baby’s head are sucked into the cup. This includes bones, membranes, fluids and delicate tissues. Pressure is then applies to pull the baby out by tractioning this tissue. This force is not a linear traction, but also involves a degree of torsion as well.
As the tissue is suctioned into the cup, the Aqueduct of Sylvius, which is the channel that connects the third and fourth ventricles, can become kinked. These ventricles are fluid filled chambers and are involved in the circulation of the cerebral spinal fluid. Any restriction of this flow can result in a backpressure that can create increased intracranial pressure. This can result in hydrocephaly as well as multiple other pathologies.
The pulling and torsioning can also result in the displacement of cranial bones, membranes and cranial nerves that can last a lifetime. It can also create a type of shock to the baby that interferes with the bonding process and the baby’s ability to breastfeed.
Any injury or impingement to cranial nerves V, VII, IX, X, XI and XII can be detrimental to the baby’s ability to breastfeed. Cranial nerve V is involved with muscles of mastication (chewing) and is closely associated with suckling. Cranial nerve VII is involved with muscles of facial expression, which are also actively used in the suckling process. Cranial nerve IX innervated the muscles of the throat and is involved with the baby’s ability to swallow. Cranial nerve X is involved with the baby’s ability to swallow, as well as the entire gastrointestinal system. Cranial nerve XI is involved with the baby’s ability to orient its head. So, injury to this nerve can restrict the baby’s ability to orient to the breast. Cranial nerve XII is involved with the baby’s ability to utilize its tongue while suckling.
Forceps can also injure these same cranial nerves. The medial, longitudinal and torsional forces can compress the pathways of these nerves. Forceps can also have potential injury to the brain stem where basic metabolic processes are monitored and controlled. Injury to the brain stem can have a significant effect on breastfeeding.
Both ventouse and forceps can result in creating forces that overwhelm the baby and interfere with its ability to engage with the mother and with its environment. Often the baby is left in a sympathetic state of fight or flight. More likely, the baby may be left in a state of parasympathetic shock and withdrawal. All which would affect the baby’s ability to breastfeed.
Craniosacral therapy can assist in normalizing the injuries of the obstetrical interventions. Through gentle, purposeful and respectful touch, Craniosacral therapy helps to normalize the baby’s structure, remove impingements, and balance effects on the autonomic nervous system. I feel that not every baby needs to be treated, but every baby should have the advantage of being evaluated.
William Sutherland, the founder of Cranial Osteopathy, had a favorite expression. He said, “As the twig is bent, so grows the tree.” If we can help to correct the injuries created by obstetrical interventions, we can not only assist the baby in optimal breastfeeding, but also help prevent learning, structural, sensory, developmental and behavioral problems later in life.