04/04/2026
Recently I had the pleasure of presenting at the Asia Pacific Osteopathic Summit, surrounded by practitioners ranging from those with under five years’ experience to over 40 years in practice—a truly inspiring mix of perspectives.
One aspect was running a workshop exploring the management of complex cases in paediatrics. The aim was to encourage deeper thinking around clinical reasoning—particularly in the context of multifactorial presentations including late pregnancy complications, birth challenges, early hypoxia, seizures, and ongoing feeding, digestive, respiratory and neurological difficulties.
What stood out most was the richness of discussion. In small groups, practitioners shared thoughtful, principle-based approaches, highlighting the depth of osteopathic reasoning across all levels of experience. It reinforced the importance of truly listening and taking a comprehensive history.
Since then, I’ve been reflecting on how impactful it is to create space for parents to share their full experience of pregnancy, birth, and the postnatal period. So often, mothers express—sometimes weeks or months later—that they haven’t yet had the opportunity to process or voice their experience.
As osteopaths, we are in a unique position to offer that space. Beyond structural, neurological and visceral care, the psychosocial dimension is equally vital. Listening, validating, educating, and guiding families toward appropriate ongoing support—whether that be medical, psychological, or osteopathic—can make a profound difference.
To achieve this in practice, I allow a double appointment for a new patient. If I have seen the mum through pregnancy, I will use this to look after them both.
If I have not seen the mother before, I use this first appointment for the infant and may follow up with another double appointment to be able to look after the mum and the baby.
I personally do not use forms as I don’t find this is the way my brain takes in information. I find talking to the parents directly allows me to glean the information I need in a more organic fashion. And offers them the opportunity to express their concerns as we go along.
Following the history, I perform a thorough overall examination without honing in on one particular presentation as experience tells me, even though these babies have been examined in hospital by midwives and pediatricians, things can be overlooked and it is important for us to take the time to perform a complete toe to top examination.
Starting globally then becoming more specific and incorporating all systems in examination, including osteopathic evaluation.
I wanted to share this here because it is my observation that often with very complex cases we can feel overwhelmed and want to dive in hands-on. I’d just like to reassure you that stepping back, taking your time and looking overall allows us to evaluate the needs of the child and the family. There may be priorities in treatment, but in many complex situations, the care needs to be multi pronged, both with other disciplines and for ourselves, as the osteopathic care is likely to be long-term. My experience with complex presentations is not only addressing the immediate issues such as feeding difficulties, but persisting over months to years to help with overall development and potential.
I’m interested to know what others might think around this.
