The area of the baby’s head that leads the way out of the
birth canal is the occipital area, the back of the head. It
is the area that will take the brunt of obstruction if there
is a delay in delivery.
When there has been a long delivery, perhaps sixteen,
twenty or twenty-four hours for a first baby, or even after
twelve hours for a later baby – and sometimes we find
mothers who have been in labor for several days, or perhaps
even more important, there has been a period of false labor
before the real thing began. False labor can be particularly
damaging because the contraction is occurring and the baby’s
head has nowhere to go because the birth canal is not
opening. So the baby is being compressed from above and
below. It is the occipital area that takes that impact. That
is where the hypoglossal nerve to the tongue and the vagus
nerve to the digestive tract pass out through the skull.
These are the areas that are the first to show the stress of
One of the most important questions we can ask is, “Did
your baby have any trouble vomiting, spitting up?” If the
answer is “yes” then we know that there was some degree of a
problem in this area at birth.
Within the occiput also is that large opening through
which the whole brain stem becomes the spinal cord. All of
the nerve pathways that go to every structure in your body
below the base of the skull must pass out through that hole
in the occiput. Therefore, if the occiput is deformed by
such pressures as we have described, the injury to the
nervous system may vary all the way from the child who has
mild spitting up to the child who is hyperactive, the child
who is uncontrollable, who is aggressive, who eventually
goes on to have learning problems, behavior problems and the
whole gamut. So this is a most critical area, the area that
we always look at when we look at newborn babies.
Then we consider the skull as a whole. The skull is made
up of some twenty-six bones. At this age some of those bones
are in several parts. Therefore, the potential for
compression in one or more areas is quite great if there was
compression in the pelvis on the head during birth.
An osteopathic physician’s hands are feeling hands,
they are monitoring hands. They are not pushing things
around. They are monitoring how that mechanism inside is
working and how we can go with it to permit it to release
areas of restriction.
The temporal bone, that bone which I mentioned as
carrying the ear, may also be compressed because it is very
close to the occipital area. It is not unknown to find that
the baby has its first ear infection at a few weeks of age.
When that is so it suggests that the problem may have arisen
from the trauma of birth. When that mechanism begins to move
freely then the child recovers from the recurrent
When the head is compressed from the front backwards, a
compressive force, which we will find particularly if the
baby who was reversed in the birth canal. It was a posterior
occiput rather than an anterior one. This sort of
compression jams the skull at the center of its base.
At birth the occiput is not just one bone, as it is in
the adult. In the infant the occiput is four bones because
it is not yet fully developed. That large hole of the
foremen magnum, through which the brain stem passes, is
circled by developing parts of the occiput.
The area of the base of the skull that becomes compressed
is the area we are primarily concerned with in our small
babies. The problems we find there may continue and cause
difficulties later in life.
The sooner you treat the baby the easier it is, but you
never say “there is nothing that can be done.” No matter how
much or how little progress is made, progress is
Life is always in motion. Life is always getting better
or it is getting worse. We may not work as frequently; we
may work for an intensive period to get over the major
problem, then watch that the progress we have made is
maintained, but let’s go back again. What we do in the
process of a treatment is just like unlocking the door so
now those who are inside can move around. We have permitted
progress to occur.