Children's Health

Cranial Surgery for Infants

Recently, a parent of one of my pediatric cranial patients shared with me an article published in the February, 1996 issue of The Wall Street Journal (WSJ). I found the information so outrageous and alarming that I needed to share it with everyone. The headline reads "Some Physicians Do Unnecessary Surgery On Heads of Infants." It seems that neurosurgeons are removing infants' skulls, "remodeling" the bone, and reattaching the skull to correct what is a simple, functional problem - positional molding.

In 1992, the United States and a number of other countries adopted the recommendation that babies sleep on their backs to reduce the occurrence of Sudden Infant Death Syndrome (SIDS). In every country where this recommendation has been publicized, doctors are now seeing an epidemic of misshapen infant heads, specifically, flattening in the back. The director of pediatric surgery at St. Louis Children's Hospital reports a 400% increase in these cases since 1992. The result has been an "epidemic", (per WSJ) of misdiagnosis of craniosynostosis - a condition where the sutures fuse prematurely, resulting in deformity and increased intracranial pressure. Craniosynostosis is a serious condition, but it is extremely rare. Perhaps only 1 in 3,000 babies have some form of it; the type which results in posterior flattening is even rarer, perhaps 1 in 100,000. There is some ambiguity in the statistics, since specialists now believe that the statistics, too, are based in inaccurate diagnosis.

Literally hundreds of babies are having their skulls sawed off, reshaped and reattached. The best result: a scar from ear to ear. A few babies have died during surgery and others have been left permanently disabled. However, even with a "good" result, the emotional cost of this procedure is high. Now that I have seen several of these children in my practice, I have seen other, undocumented side effects. After surgery, adhesions form in the dura which affect the pelvic biomechanics. As a result, these children have an awkward, stiff gait and a lack of coordination. Correcting the biomechanical defect is almost impossible due to the continuing effect of the scar tissue.

An alternative medical procedure involves the children wearing helmets for 23 hours a day. The problem with this approach is the immobilization of the cranial structures. The intent is purely cosmetic - to force the head to round.

A far simpler and better solution is available. It is a relatively simple matter to restore the alignment and, more importantly, the functional integrity, of the cranium in infants. The cranial vault functions as a hydrostatic pump, moving in a rhythmic manner to pump cerebrospinal fluid through the ventricular system of the brain. An infant's brain more than doubles in size during the first 18 months of life. During this developmental period, important neurological interconnections are being made as the brain matures. You can observe the changes in a baby's increasing motor skills. Adequate cerebrospinal fluid circulation provides important communication between brain cells as they migrate, myelinate and interconnect. Immobilizing or surgically impairing this system can adversely affect cognitive and neurologic function. Dr. John Upledger, a world-famous cranial osteopath traces autism to immobilization of the cranial vault. (Craniosacral Therapy), Upledger & Vredevoogd, Eastland Press 1983).

Most cases of skull modeling respond well to precise cranial adjustment. Adjusting the skull is a simple matter of fingertip pressure, usually inside the mouth, freeing the sutural lock. Many serious conditions respond to cranial adjusting, including strabismus, autism and traumatic deformation of the cranium. Even genetically impaired children function more fully with cranial adjusting, although the genetic defect can never be erased. Premature infants who have been on a respirator for weeks to months also have cranial distortions which impair eyesight and balance. However, those distortions occur inside the mouth and are therefore harder to visualize. I have corrected many such cases in my practice.

If cranial surgery is recommended for your child (or any child you know), I strongly urge a consultation first with a pediatric cranial chiropractor, such as myself, to determine if there isn't a less invasive, more humane method to achieve a better result.

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