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From:
"Jennifer Tow, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 10 Jan 2014 22:09:39 -0500
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I have been referring babies for bodywork for 20 years. Where there is any impairment to function due to birth trauma, intra-uterine positioning or post-partum trauma, bodywork is my first recommendation (in concert with STS, co-bathing, babywearing--of course and often Bach Flowers). I have often noted that many of my clients could never have bf successfully if I did not have a network of bodyworkers to refer to. IATP accepts that bodywork is an integral part of the team approach to addressing oral dysfunction where TT is involved and most of our member docs are referring routinely for bodywork. While working with Betty Coryllos and Cliff O'Callahan I found that referring prior to revision enhanced outcomes and that often additional tissue would become more accessible for revision with bodywork. For that reason, I routinely ask my clients to take babies for bodywork prior to revision as well as after. Bodywork can also remove any restrictions that are caused by trauma and can sometimes leave the TT more easy to assess.  

Personally, CST is not usually my first choice, but the provider I recommend depends on the skills of the provider, the insurance issues, the parents' comfort with one type of provider over another and the state or country in which my client (or I) reside at the time. I prefer a chiropractor who incorporates CST, and often this means that insurance will cover in the States but not elsewhere. Sometimes a PT or OT who uses CST is a good choice for coverage. A DO who actually practices osteopathy can be another option and in EU, often osteos are the best choice. I spent a lot of years getting to know the providers in my area--going to appts with my clients and learning about what they do. For my clients via Skype (90% of my clients), I help them find a bodyworker who understands breastfeeding mechanics if at all possible and I usually discus the baby and my observations, what I think is going on structurally with respect to breastfeeding. 

Virtually 100% of my clients take their babies for bodywork when I recommend it. I think this comes from the fact that my own understanding of structure and function is so sound that I am confident in making referrals. I often do not refer CSTs (unless they are IBCLCs or work with IBCLCs frequently) is bc they often believe that CST can fix everything including a TT and many do not have any specific training with infants. But, again, all those variables I noted above come into play. 

I co-published a paper with Dr Vallone in 2009 that might be helpful to some folks on this topic. 
http://www.icapediatrics.com/files/articlelc&dc.pdf


Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC




Date:    Thu, 9 Jan 2014 21:40:39 -0800
From:    Melinda Harris-Moulton <[log in to unmask]>
Subject: Re: CST continued

CST Discussion
Since I don't foresee funding for evaluation of CST to improve
breastfeeding in infants anytime soon, Who in this group are recommending
it?
 And perhaps more importantly, when a parent wants to utilize this care,
does insurance ever pay?
I'm going to ask the woman who does CST In my community: I'm wondering if
she will get paid by insurance since she's also an Occupational Therapist.
And I wonder what ICD-9 codes will be covered by insurance for this
care. Anyone with experience in getting CST covered by insurance?
Melinda Harris-Moulton, ARNP IBCLC
Olympia, WA


On Tue, Jan 7, 2014 at 3:14 AM, heather <[log in to unmask]> wrote:

> " I think the evidence is that conventional medicine can learn a lot from
>> the way confident, caring practitioners outside the mainstream relate to
>> their clients, how these clients are empowered and how they gain in
>> confidence. We have *tons* of good, biologically-plausible, testable
>>  evidence of the immense value of touch and human connection, emotional and
>> physical. I think it is vastly more likely that this is what is 'working' -
>> when it 'works' . Heather Welford Neil NCT bfc, tutor, UK" Okay.  Is this
>> statement testable?
>>
>
> Yes - you give dummy/sham treatment to babies in one group, and actual
> treatment to the babies in the other group, with no difference between the
> mode of interaction except this.
>
>
>   Can psychological impact be subjected to double blind studies?  If so,
>> how would you design a CST study that differentiates between any physical
>> benefit and any psychological benefit?
>>
>
>
> This would be difficult, especially with crying/fussy/sleepless babies and
> stressed parents. But yes, psychological impact is testable, with objective
> measures which relate to parents' self-reported effects (stress index,
> parent daily hassles index....there are a few of these about).
>
> One interesting study http://adc.bmj.com/content/
> early/2011/02/23/adc.2010.199877.abstract into the effects of cranial
> osteopathy on children with cerebral palsy found no objective improvement
> in the group who had had the treatment, compared to the group who had not
> (they did  not have sham treatment either - no treatment at all)....not one
> improvement in motor skils, quality of life, and no improvement in carers'
> quality of life, either etc.
>
> But the parents of the treated children thought there *were* differences -
> vague, unspecified and 'global'.  One might say 'oh well, if the parents
> believed the kids showed some improvement, even if they couldn't say what
> it was, then obviously something has worked and even if it hasn't worked,
> then it's ok for people to delude themselves'.  Or one might say 'this is a
> fairly strong indication that just being treated makes people believe that
> something improves, and it may well not be an improvement, and actually
> it's not ok for people to delude themselves.'
>
>
>  For example, acupuncture has been tested by having some patients
>> receiving real acupuncture and some receiving real acupuncture needles at
>> fake points, and the real acupuncture has won.
>>
>
>  Indeed - some studies do show this, but others do not. Not all are
> well-designed, but it is difficult to do a well-designed fully blinded
> study. A major study http://archinte.jamanetwork.
> com/article.aspx?articleid=413107 found real and sham to give the same
> (positive) results in relieving pain, which indicates a role of placebo.
> Another study http://archinte.jamanetwork.com/article.aspx?articleid=
> 414934  showed similar positive results for both.
>
>
>
>
>
> Heather Welford Neil
> NCT bfc, tutor,UK
> --
>

 

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