Complementary Therapies in Clinical Practice 43 (2021) 101357

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Complementary Therapies in Clinical Practice

journal homepage: http://www.elsevier.com/locate/ctcp

The use of osteopathic manipulative treatment in the newborn nursery and

its effect on health in the first six months of life: A retrospective
observational case-control study
Miriam V. Mills 1
Department of Osteopathic Manual Medicine, Oklahoma State University Center for Health Sciences, 1111 West 17th Street, Tulsa, OK, 74107, USA

A R T I C L E I N F O A B S T R A C T

Keywords: Background: Limitations of traditional medicine and rising interest in complementary medicine call for a closer
Osteopathic manipulation look at the potential relevance of manual medicine, specifically osteopathic manipulative treatment (OMT) in
Manual medicine children.
OMT
Objective: To conduct a retrospective observational pilot study of babies who received OMT in the newborn
Newborn
Colic
nursery compared to those who did not, by quantifying their outpatient health issues in the first 6 months of life,
Plagiocephaly and to determine the feasibility of further definitive randomized controlled trials of a similar nature.
Scoliosis Design: Retrospective chart review of the first 6 months of life from pediatric clinic records of 58 case-matched
Cranial manipulation pairs of children, half of whom received OMT as part of their routine newborn care by virtue of their physician
Cranio-sacral therapy “call” assignment to the author. The sample from which the case-matched control group was chosen were babies
who had received routine allopathic newborn care without OMT. Both groups received their pediatric care in the
same academic ambulatory clinic and received no further OMT.
Methods: Outpatient paper chart review consisted of tabulation by points of the following variables: mention of
spitting/vomiting, gassiness, food intolerance, irritability/sleeplessness, colic suggested or diagnosed, episodes of
otitis media, frequency of antibiotics given, frequency of upper respiratory infections, frequency of lower res­
piratory problems, diarrhea, and rashes, separated by month of visit in which the variable was reported.
Results: Exploratory analysis by Pearson Chi-square yielded a few statistically significant differences between the
2 groups, in favor of the OMT-treated group, including Month 2 food intolerance (Х21 = 4.14, P = .04), Month 3
colic suggested (Х21 = 4.14, P = .04), Month 5 spitting/vomiting (Х21 = 8.59, P = .003), and Month 5 antibiotic
usage (Х21 = 6.33, P = .012).
Conclusions: Findings point to the need for further research in this area based on the suggestion that OMT given to
a newborn can positively affect that baby’s short-term and quite possibly long-term health, specifically related to
GI complaints and irritability. Other studies would benefit from a variety of methodologic changes, including
correlation of timing of administration of OMT with possible symptoms and changes in those symptoms over
longer periods of observation, as well as correlation of anatomic osteopathic findings with specific symptoms.

1. Introduction interventions [1,2]. Despite numerous advances in medical science in

1.1. Historical background
A.T. Still introduced Osteopathic Manipulative Treatment (OMT) at a
time when arsenic and leeches were the standard of medical care. Now
fully licensed physicians, able to practice medicine across the USA,
Doctors of Osteopathy (DOs) have training beyond that of MDs that al­
lows them to affect physiological pathology through structural
the past century, new challenges underscore the limitations of the
traditional medical repertoire [3], spurring a rise in the use of comple­
mentary and alternative medicine [4] and rekindling interest in the
benefits of manual medicine. Nonetheless, Wikipedia still describes
osteopathy as “pseudo-science.” [5].
So what do DOs “do” [6–8] and is it safe? Osteopathic physicians
utilize a number of physical approaches to the bones, fascia, and fluids in
the body, sometimes with direct, sometimes indirect, and sometimes a

E-mail address: miriam.mills@okstate.edu.

1
Alternate address: Mills Manual Medicine, 3401 E 21st St., Tulsa, OK, 74114.

https://doi.org/10.1016/j.ctcp.2021.101357
Received 21 September 2020; Received in revised form 27 February 2021; Accepted 2 March 2021
Available online 6 March 2021
1744-3881/© 2021 The Author. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
M.V. Mills
mix or balance of the 2 forces, with specific attention to relieving the
strain on the anatomic (somatic) correlates of physiologic dysfunction.
They are guided by findings related to asymmetry, abnormalities in
range or motion of body parts, and tissue texture changes in the area.
The somatic dysfunction may actually be distant from the area of the
symptom, but knowledge of the anatomy of nerves, arteries, veins,
lymph, and cerebrospinal fluid drainage informs the treatment and
serves to explain the beneficial changes from the intervention. Occa­
sionally the treatment involves such subtle movement that it is hardly
perceptible. This is particularly true of osteopathy in the cranial field,
which addresses more than the cranium, and is especially useful in
children. Most treatments used in children are gentle and well-tolerated
[9–11], and do not involve high velocity techniques that have been the
most likely to be associated with treatment reactions. [12,13], There are
advantages to having experienced physicians treat patients with OMT in
the hospital or the outpatient pediatric setting, as they understand the
implications of the differential diagnoses of an infant’s clinical course,
and are able to administer this, or another, treatment in a timely fashion.
Since a report in 1920 about the 1918 influenza pandemic that
showed a strikingly lower death rate in patients treated by osteopaths
[14], research has explored the use of OMT in a variety of clinical sit­
uations. The principles of osteopathy emphasize that the body has
self-healing, self-regulating mechanisms by which structure influences
function, and function can influence structure [15,16]. This is nowhere
more profound than is manifest in the growing child.[17,18]
Consider the compressive forces to babies’ heads, pre-, peri-, or
postnatally, which can be further affected by positional and gravita­
tional influences such as the “back to sleep” initiative to prevent Sudden
Infant Death Syndrome [19]. Growth, which is proportionately greatest
in infancy, often exacerbates asymmetries, so it is appropriate to
consider addressing these problems sooner rather than later. Frymann
reported findings of compression in various areas of the skull that were
associated with specific symptoms on examination of 1250 newborns
[20]. She also described that children with learning problems are
significantly more likely than those without such problems to have had a
difficult delivery resulting in deformity of the infant’s head by mother’s
recollection [21]. More recently, several studies on use of OMT on
premature babies indicate potential benefits [22–24]. These studies
demonstrate the ability to construct well-designed research in a setting
where allopathic and osteopathic medicine can be used side by side,
safely and effectively.
The potential applications of OMT to pediatrics are many, and extend
to areas other than musculoskeletal problems [25–27]. Despite a num­
ber of studies suggesting a benefit of OMT in conditions such as sucking
difficulties [28], colic [29], dacryostenosis [30], plagiocephaly [31–33],
torticollis [34], otitis media [35,36], voiding difficulties [37], scoliosis
[38,39], headaches [40–42], concussions [43,44], and more chronic
conditions [45] such as cerebral palsy [46] and attention deficit disorder
(ADD) [47], studies are often challenged because of their methodology.
1.2. Colic and structure/function correlates
The author started her pediatric practice as a traditional MD but
introduced OMT into her treatment after 8 years in practice, first
employing it on babies with colic., Colic, though often considered to be a
self-limited malady, may actually have far-reaching implications. Along
with gastro-esophageal reflux, a common comorbidity, colic may be
related to autonomic dysregulation [48,49]. Children with colic or
feeding problems often have a history of difficult delivery, unplanned
c-section, low APGAR, augmented labor, abnormal presentation, or the
use of forceps or suction extraction.[50,51] This observation, and the
fact that colic is more common in firstborn children [52], who may have
more difficulty traversing the birth canal, may support this structur­
e/function relationship, opening the possibility of intervention with
manual modalities.
If colic has a structural correlate, one could suggest that children
2
Complementary Therapies in Clinical Practice 43 (2021) 101357
with colic as babies might continue to have problems later in life
[53–55], as was the observation of the author in her practice [56]. “Just
as the twig is bent, the tree’s inclined.” [57] Consider the anatomy: any
deformation from the most volume-optimized spherical shape of the
head can potentially compress a vital structure, given the rich network
of nerves, arteries, veins, and drainage conduits that traverse the cranial
base. [58,59], If structural asymmetries of the head can have clinical
consequences beyond cosmetic, then such asymmetries might be related
to other asymmetries in the body [60–63], not grossly obvious to the
parent, but which may become clinically significant as the child grows
[64–67]. Unfortunately, research reports on the use of OMT in plagio­
cephaly, torticollis, and scoliosis are short-term observations, and the
manipulative treatment of these patterns of early onset may take longer
than most studies have observed, as growth can affect the benefit of
treatment. In the author’s experience treating early onset scoliosis,
which seemed to be associated with prior torticollis and/or plagioce­
phaly, the need for treatment increased during growth spurts and
markedly decreased after puberty.
1.3. Challenges of doing research on OMT
A few systematic reviews of pediatric osteopathic research [68–70],
while acknowledging a number of high-quality studies, generally weigh
in on the evidence as “insufficient” or “inconclusive” for most condi­
tions, with sharp criticism of methodology. However, such sweeping
dismissal should not negate the findings reported, but might instead
suggest further investigation into potentially promising treatment mo­
dalities. Historically, osteopathic researchers have fewer avenues to
fund their research than allopathic (MD) investigators [71,72], and are
under-represented as first or senior authors in original publications in
the 3 high-impact pediatric journals [73,74]. Very few osteopathic
physicians serve as the editor-in-chief or on the editorial boards of major
academic journals, or have served on a National Advisory Committee for
the National Institutes of Health [75,76]. Following the recent transition
of post-graduate medical education combining osteopathic and allo­
pathic residency accreditation, it is hoped these disparities will be
addressed [77].
The challenges of doing prospective, placebo-controlled [78], unbi­
ased, blinded studies using OMT are many, considering the sheer diffi­
culty of documenting all the facets of this sometimes seemingly
mysterious process, which is both art and science. The treatment ad­
dresses somatic dysfunction, and not the specific symptom, which may
manifest as distant from the dysfunction. There is no “recipe” for
treatment of each disease, though there may be anatomic clues and
protocols for how to begin. Standardization of treatment protocol is
antithetical to the osteopathic principle of pragmatically treating the
dysfunction with the most effective modality, which may vary according
to each patient. Experienced practitioners utilize even further variations
on treatments than are taught in medical school and beyond. Further­
more, it is difficult to demonstrate effectiveness or cost benefit that may
require more prolonged observation than most published studies. Inter-
and intra-examiner reliability in diagnosing somatic dysfunction must
be verified, but may be difficult to quantify given that the process of
observation may itself provide unintended treatment. For this reason,
placebo controls may prove challenging. Since most placebo controls
involve light touch, it is difficult to separate that from the known benefit
of “meaningful touch,” which is also part of the nuanced osteopathic
approach. Perhaps light touch on placebo controls can be administered
by practitioners entirely unfamiliar with manual interventions.
1.4. Research question
At the time this pilot study was conceived, the author had been of­
fering OMT as part of routine newborn care for at least 4 years, at no
extra charge, to all parents of newborns. Neither parents nor nurses
made any report of adverse outcomes related to the OMT. Conversely,
M.V. Mills
there were a number of reports of improvement in suck difficulties,
spitting up, and irritability, often immediately after the treatment. The
author sought to document these observations using chart reviews of
newborns she had treated compared with matched controls. The
research questions addressed by the chart review were:
1. Are the 2 sample groups chosen for the study (one which received
OMT as newborns and one which did not) comparable?
2. Does retrospective pediatric chart review of the first 6 months of life
yield any difference between these 2 groups in a variety of health
issues (including spitting/vomiting, gassiness, food intolerance, ir­
ritability/sleeplessness, colic, otitis media, antibiotic given, upper
respiratory infection, lower respiratory problems, diarrhea, or
rashes?)
2. Research design
2.1. Background and setting
Coincident with normal newborn care in the hospital, the author
routinely obtained verbal informed consent for OMT from the parents
after a brief explanation of the procedure. The newborn exam and OMT
were performed in the presence of the mother. By rough estimate, less
than 2% of parents declined OMT. The treatment generally lasted 5–10
min, and was provided once or twice, depending on the length of the
baby’s hospital stay. It consisted of articulation, direct and indirect
myofascial release, balanced membranous tension, and balanced liga­
mentous tension. [79] Specific findings of the osteopathic examination
were not detailed in the hospital chart, only that the treatment was
given. Although the author had been granted privileges to perform such
treatment, the institution was primarily allopathic, the author was the
only pediatrician at the institution performing OMT, and the
newly-utilized electronic medical records did not accommodate
recording osteopathic findings.
Institutional Review Board approval was obtained for the study and
chart review instruments from both the osteopathic institution (Okla­
homa State University Center for Health Sciences: 2001008) where the
author served as clinical faculty, and the host clinic institution (Uni­
versity of Oklahoma Health Science Center, Tulsa: 09749), an allopathic
medical school, where the author was on adjunct faculty. Charts for
patients seen for their newborn care by the author between July 1999
and June 2001 were included, and others born during the same time
period were randomly chosen from patients never seen by the author.
The study was not registered as a clinical trial, as it was a retro­
spective observational study, and because assignment of the patients to
the treatment group was not under the control of the investigator. The
author did not record the number of patients who declined OMT, and
hospital charts were not reviewed as part of the study. It is therefore
possible that there are some, albeit very few, included in the treatment
group that did not actually receive OMT. Patients included in the study
were only those who were followed in the host allopathic academic
clinic subsequent to their newborn care, in order to assure similar pe­
diatric care among them. The study patients did not receive OMT
beyond the newborn period, because the clinic involved did not offer
OMT to their patients during the data collection time period.
Of 389 patients presumed to have been treated by the PI during the
target 2-year birth period, determined from billing records for newborn
care, 120 were found to be patients at the host clinic and not in the
author’s practice. This constituted the treatment sample. Charts of 1010
other children from that clinic, born during the same time period, and
who received comparable obstetric and pediatric care but not OMT,
were then pulled, and a convenience sample of the first 125–130 charts
found for each of the 8 seasons (3-month periods) of patients born in the
same 2 year period as the treated infants, were selected for review. This
constituted the control sample. Because this was a retrospective pilot
study, with a pre-determined limited number of cases in the treatment
3
Complementary Therapies in Clinical Practice 43 (2021) 101357
sample, power analysis was not done. An excess number of control pa­
tient charts were pulled in order to provide sufficient patients to case-
match with the treatment patients by a number of potentially con­
founding demographic variables.
Charts reviewed were limited to children born at 2 hospitals in close
proximity to each other, drawing from a similar demographic popula­
tion. Only patients on Medicaid (federally funded medical care) were
included in the study, in order to make the groups more equal
economically. None of the patients in the control sample received their
newborn care from the author.
2.2. Eligibility criteria and data collection
Pediatric charts of all 1130 children (120 treated and 1010 un­
treated) were reviewed by trained medical students, blinded to the
intervention variable and the purpose of the study, at the host clinic,
which serves a large Medicaid population. Outpatient charts were
reviewed for the patients’ first 6 months of life. Continuity of care was
established if the child was seen at least 4 times during the 6 month
period, with the first visit no later than 2 ½ months of age, and the last no
sooner than 5 ½ months of age. The chart was excluded for lack of
continuity of care, wrong or unknown hospital of birth, insurance other
than Medicaid, if the infant was less than 35 weeks gestation or had
spent more than 48 h in a transitional or intensive care nursery, had a
chromosomal, gastrointestinal, or cardiac anomaly, had an immune
deficiency, or had come to the clinic for subspecialty care only rather
than primary care.
Demographic data (including sex, birth order, exposure to smokers,
day care attendance, breast feeding, birth complications, and significant
family history of GI problems) were recorded, in order to be used as
criteria for case-matching the treatment sample patients with controls,
born in the same 3 month period (“season”) of the 2 years included in the
study.
An independent pediatric nurse practitioner from the host clinic,
blind to the intervention variable, hand matched the treated patients
who met criteria with untreated patients by as many of the following
variables as possible: sex, firstborn status, daycare exposure, exposure to
smoker in the home, family history of GI problems, and history of any
birth complications, in that order. If there was a better match on more of
the “later” criteria that one of the earlier (e.g, sex), the “better” match
was made.
The data from the chart were separated by month of the child’s life
and recorded on study forms, which provided for recording of frequency
by tally of mentions during each month of spitting/vomiting, gassiness,
food intolerance, irritability/sleeplessness, colic suggested, otitis media,
antibiotics given, upper respiratory infection, lower respiratory prob­
lems, diarrhea, or rashes, as either a subjective symptom or objective
observation. For each month, the tallies were totaled. No prior validated
instrument to record these variables was available.
2.3. Data analysis
Data were entered into SPSS version 10.0 (SPSS Inc, Chicago, Ill.) by
an individual who was blinded to the intervention variable and the
purpose of the study. The data were separated by month of life and were
analyzed using the Pearson Chi-square test. This analysis did not account
for the matching between the cases and controls. Analysis of the dei­
dentified data was performed initially by the author, with consultation
from 2 statisticians, one from each institution (FKW and LLB listed
below) and analysis was corroborated later by a third statistician (GJC
also listed below).
3. Results
Of the 120 treated babies found to be patients at the host clinic, 58
met the criteria described above. Of the 1010 charts pulled from the
M.V. Mills Complementary Therapies in Clinical Practice 43 (2021) 101357

untreated sample born during matched 3-month periods, 228 met Table 2
criteria, and from those, 58 were chosen for the control sample, matched Study outcomes measures – 116 matched paired patients.
as described above for as many demographic variables as possible. Of Variable Intervention Control Pearson Х2a Significance
those who did not meet criteria, incomplete data for the 6 month period
Spitting/Vomiting
was found in 669 cases, a different hospital of birth was found in 52 Month 1 3 5 .537 .46
cases, hospital not noted in 7 patients, wrong insurance (not Medicaid Month 2 1 4 1.881 .17
population) in 6 cases, too long in the NICU in 6, referral to a faculty Month 3 3 3 0 n/a
subspecialist as primary reason for attending the clinic - to a gastroen­ Month 4 2 2 0 n/a
Month 5 0 8 8.593 .003
terologist in 36 patients and a cardiologist in 2 cases. Month 6 2 3 .209 .65
There were 30 males and 28 females in the treatment group, and 31 Described as gassy
males and 27 females in the controls. None of the differences between Month 1 1 1 0 n/a
the demographic variables were statistically significant, indicating that Month 2 1 4 1.881 .17
Month 3 0 1 1.009 .32
the 2 groups were indeed matched along these variables (See Table 1).
Month 4 0 1 1.009 .32
The data analysis of the chart review was performed on the matched 116 Month 5 0 0 n/a n/a
patients (See Table 2). Month 6 0 0 n/a n/a
Comparisons of the clinical variables yielded a few statistically sig­ Food intolerance
nificant (p < .05) differences between the groups for individual months, Month 1 1 3 1.036 .31
Month 2 0 4 4.143 .04
in the direction of fewer symptoms in the treatment sample, including Month 3 0 2 2.035 .15
food intolerance, colic suggested, spitting/vomiting, and antibiotic Month 4 0 0 n/a n/a
usage. Month 5 0 1 1.009 .32
Month 6 0 1 1.009 .32
Irritability/Sleeplessness
Mo 2 Food intolerance, Х21 = 4.14, p = .04
Month 1 5 2 1.368 .24
Mo 3 Colic suggested, Х21 = 4.14, p = .04 Month 2 2 6 2.148 .14
Mo 5 Spitting/vomiting, Х21 = 8.59, p = .003 Month 3 5 6 1.0 .75
Mo 5 Antibiotic usage, Х21 = 6.33, p = .01 Month 4 2 7 3.011 .08
Month 5 4 5 .120 .73
Month 6 11 7 1.052 .31
No statistically significance differences were found favoring the
Colic Suggested
control sample for any of the variables for any month period. Month 1 2 1 .342 .56
Month 2 1 1 0 n/a
Month 3 0 4 4.143 .04
3.1. Discussion of study Month 4 0 1 1.009 .32
Month 5 0 0 n/a n/a
Given the large number of variables explored, true power was not Month 6 0 0 n/a n/a
Otitis Media
expected, but it is of interest that even without statistical significance,
Month 1 1 1 0 n/a
many of the study variables expected to be involved in the structure/ Month 2 2 2 0 n/a
function relationship showed a trend benefiting the treatment group Month 3 0 2 3.080 .08
(such as irritability/sleeplessness and otitis media, consistent with the Month 4 1 2 .342 .56
author’s experience in her practice) and those variables such as rash, Month 5 1 3 1.306 .31
Month 6 8 3 2.511 .11
URI, and diarrhea showed no clear trend. The retrospective chart review
Antibiotics Given
probably missed some babies with colic, allowing the first visit to be as Month 1 2 1 .342 .56
late as 2 ½ months old, when colic often gets better. The increase in Month 2 0 2 2.035 .15
symptoms in the both groups in month 5 is of interest, and might be Month 3 6 2 2.148 .14
related to challenges to the morphology brought on by eruption of teeth Month 4 2 5 1.368 .24
Month 5 0 6 6.327 .01
(as described above.) Month 6 8 11 .566 .45
Future studies elucidating and clarifying these results would benefit Upper Resp Infect
from a number of modifications of study design such as. Month 1 1 2 .342 .56
Month 2 3 4 .152 .70
Month 3 10 6 1.160 .28
Table 1 Month 4 2 5 1.368 .24
Demographic variables in the 116 matched patientsa. Month 5 3 6 1.084 .30
Variable† Intervention Control Pearson Significance Month 6 13 7 2.175 .14
Group Group Х2 Lower Resp Probb
Month 1 0 2 2.035 .15
Firstborn 23 (47) 26 (53) .318 .57 Month 2 1 1 0 n/a
Female 28 (51) 27 (49) .035 .85 Month 3 0 2 2.035 .15
Breast fed 26 (49) 27 (51) .035 .85 Month 4 0 0 n/a n/a
Day care attendance 9 (45) 11 (55) .242 .62 Month 5 2 2 0 n/a
Exposure to smokerb 31 (54) 26 (46) .862 .35 Month 6 1 3 1.306 .31
Family history of GI 23 (56) 18 (44) .943 .33 Diarrhea
problems Month 1 1 1 0 n/a
Recorded 31 (46) 37 (54) 1.279 .26 Month 2 2 2 0 n/a
difficulties with Month 3 0 3 3.080 .08
birthc Month 4 1 2 .342 .56
Month 5 1 3 1.036 .31
†
Х2 analysis of all variables showed no statistically significant differences be­
Month 6 8 3 2.511 .11
tween groups. Rashes Mentioned
a
Values are given as either number (percentage); Data obtained from clinic Month 1 6 2 2.148 .14
chart analysis. Noted as “yes” if recorded. Month 2 7 5 .372 .54
b
At home or day care. Month 3 8 7 .077 .78
c
Use of forceps or suction, unplanned c-section, 1 min APGAR <5, low scalp (continued on next page)
pH, stay in transitional care >24 h.

4
M.V. Mills Complementary Therapies in Clinical Practice 43 (2021) 101357

Table 2 (continued ) Wood, DO, Jessica Statz, DO, Jillian Riley, DO (all of OSU-CHS).
Variable Intervention Control Pearson Х2a Significance
Author statement
Month 4 4 1 1.881 .17
Month 5 3 2 .209 .64
Month 6 4 3 .152 .70 Miriam V. Mills, M.D. began her training in osteopathic manipula­
a tion in 1991, after practicing general allopathic pediatric medicine for 8
Computed for 2 × 2 table.
b
Including pneumonia, bronchiolitis, wheezing.
years, and continues until today. In the ensuing years, her experience
using it liberally for a wide variety of conditions has convinced her that
early use of OMT in children can reverse or prevent many common
- require written informed consent
pediatric maladies, in a non-invasive and cost-effective manner. In
- document and correlate events of delivery and clinical variables in
addition to her private practice in pediatrics and OMT, she has served on
the nursery
the faculty of three medical schools, allopathic and osteopathic, has
- document specific types of treatment given and any immediate re­
taught OMT nationally and internationally, and is one of 3 US MD’s
actions to it
honored as a Fellow of the Osteopathic Cranial Academy. Further
- include specific descriptions of somatic dysfunction
description of her experience using OMT in a general pediatric setting is
- involve larger patient numbers and monitor health for longer periods
available in the February 2021 issue of this journal.2
- utilize a placebo control group
- assess inter-rater reliability of somatic dysfunction findings
Statistical consultation
- document head (a)symmetry by standardized instruments at the
onset and periodically during the study period
Frances K. Wen, PhD. (University of Oklahoma Health Sciences
- include clinic follow-up shortly after discharge
Center), Laura L. B. Barnes, PhD, and Gary J. Conti, EdD (both of
- allow for OMT for osteopathic intervention in the treatment group
Oklahoma State University at the time of the study).
periodically through the study period
- utilize analysis of electronic medical records
Manuscript Review
… among other possibilities. Given the author’s experience utilizing
OMT with long-term observation of its effect on children in her practice, Jane C. Johnson, MA (AT Still Research Institute).
it would also be of interest to monitor those changes over a prolonged
observation compared with usual patient care in an otherwise similar Acknowledgments
practice during the same period of time.
I certify that the funding support for this project, my affiliation as
faculty of an osteopathic institution, or my private practice of pediatrics,
4. Conclusion
which includes OMT, has in no way influenced the outcomes reported in
this study. I had full access to all of the data in the study and take re­
There is sufficient evidence from this pilot study to justify further
sponsibility for the integrity of the data and the accuracy of the data
research exploring the effect of OMT on babies’ short and long-term
analysis.
health, and by what mechanism. The unique combination of skills
gained by physicians from osteopathic training allows them access to
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