MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Osteopathic manipulative treatment (OMT) is frequently recommended by osteopaths for improving breastfeeding. But does it work?

This double-blind randomised clinical trial tested whether OMT was effective for facilitating breastfeeding. Breastfed term infants were eligible if one of the following criteria was met:

  • suboptimal breastfeeding behaviour,
  • maternal cracked nipples,
  • maternal pain.

The infants were randomly assigned to the intervention or the control group. The intervention consisted of two sessions of early OMT, while in the control group, the manipulations were performed on a doll behind a screen. The primary outcome was the exclusive breastfeeding rate at 1 month, which was assessed in an intention-to-treat analysis. Randomisation was computer generated and only accessible to the osteopath practitioner. The parents, research assistants and paediatricians were masked to group assignment.

One hundred twenty-eight mother-infant dyads were randomised, with 64 assigned to each group. In each group, five infants were lost to follow-up. In the intervention group, 31 of 59 (53%) of infants were still exclusively breastfed at 1 month vs 39 of 59 (66%) in the control group. After adjustment for suboptimal breastfeeding behaviour, caesarean section, use of supplements and breast shields, the adjusted OR was 0.44. No adverse effects were reported in either group.

The authors concluded dryly that OMT did not improve exclusive breastfeeding at 1 month.

This is a rigorous trial with clear and expected results. It was conducted in cooperation with a group of 7 French osteopaths, and the study was sponsored by the ‘Société Européenne de Recherche en Osthéopathie Périnatale et Pédiatrique’, the ‘Fonds pour la Recherche en Ostéopathie’ and ‘Formation et Recherche Ostéopathie et Prévention’. The researchers need to be congratulated on publishing this trial and expressing the results so clearly despite the fact that the findings were not what the osteopaths had hoped for.

Three questions come to my mind:

  1. Is any of the many therapeutic recommendations of osteopaths valid?
  2. Why was it ever assumed that OMT would be effective?
  3. Do we really have to test every weird assumption before we can dismiss it?

2 Responses to Osteopathic manipulative treatment for improving breastfeeding?

  • The effects of osteopathy beyond mere manual therapy for MSK symptomatology (and even for that are highly dubious beyond mere time and placebo) are totally implausible, pseudoscientific and mere fantasy.

    So why anyone with a grasp on reality and half a brain would think it necessary to conduct a trial to establish what ought to have been a foregone conclusion is beyond me. There is no plausible mechanism for an effect here beyond wishful thinking and magic.

    IMNSVHO no, we don’t need to test every half-witted suggestion before tossing it upon the garbage pile along with homeopathy and reiki where they belong. Some things are just really really stupid, implausible and have no rational basis behind them and can be designated as ‘trash from the get-go.

    The earth is a sphere (more or less). Evolution is true. The earth is 4.5 billion years old (sorry NOT 6000.)
    Osteopaths do NOT have magical powers – get over it.

    • I can conceive a situation where it is necessary to trial implausible treatments: if many people believe it works, we need science to show that it doesn’t. how else would we have got rid of bloodletting and so much other stuff?

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