"How wonderful it is that nobody need wait a single moment
before starting to improve the world.
Anne Frank

CST for Pediatrics


Dr. Green has been working with babies and children since 1989 at the Upledger Foundation’s Brain and Spinal Cord Dysfunction center.  He worked with children suffering from delivery trauma, vaccination complications, positional cranial distortions, cerebral palsy - spastic and flaccid, strokes due to neonatal heart surgery complications, seizure disorders, learning disabilities, behavioral problems and dietary complications. In 1993, Jim was asked by Dr. Upledger to teach and oversee the Cranial Sacral Therapy 2 (CST-2) courses in North America, which for years, was the only course that taught baby and children CST protocols. In 1996, he was asked to assist in the creation of the Pediatric CST course, going on to then become its director.

Children offer a unique and different set of challenges for the therapist using CST. A primary tenet in the treatment of children is that they are not small adults but rather, their bodily systems are smaller, therefore, the cues and signs they give to us as therapists are more refined and delicate. It demands greater skill and clarity on the part of the therapist to be more actively involved and participatory in the work. The CST work is great in heading off any problems that may occur down the road, counteracting the wait and see attitude of many conventional therapies today.

babyCommonly in sessions with babies and children, their emotions can range from cooing to crying, and from agitation to deep sleep, many times all in the same session.

What causes this? Babies often cry because they are sensitive and tuned in to the changes taking place inside of them. CST is designed to allow the baby’s or child’s body to recreate the position of injury, strain, or trauma, from womb positioning to labor and delivery, so that they can be released out of the tissues. This is often undetectable to the naked eye or conventional medicine. When the baby or child is receiving CST, the therapist’s hands are quite relaxed and the overall demeanor is quiet and calm as they allow the baby/child to rid itself of the birth event that allowed the baby to transition from water to air.

The birthing process alone can be quite intense for babies. Physiologists have suggested it is one of the toughest workouts on the baby’s lungs and kidneys. Maybe this is Mother Nature’s design to encourage survival, considering forces of over 50 to 60 lbs may be placed upon the baby as they are delivered from the birth canal. This can result in skull and facial distortions, strained necks, torticollis, strained shoulders, sleep interruptions, language problems, digestive disorders, and a host of other maladies.

Once the baby has been born, about 4-6 craniosacral therapy sessions are recommended to start the baby off on the road to a happy and healthy life. It is also recommended that parents receive CST, especially for the mother who has gone through a quite trying and sometimes traumatic time of her own. Because parents are so connected to their own children, even therapist's seek outside assistance for their own child's needs.

Typically, after a session is over, the baby or child will respond with smiles, eye contact, laughter, and sometimes deep sleep. A round of applause is usually given to the child for a job well done!

Here are some typical questions I am commonly asked regarding craniosacral therapy with babies and children:

1) How do I know if the person working on my child is experienced in Pediatric Craniosacral Therapy?

First, how long has the therapist been doing CST? Since the pediatric material is not usually presented in depth until the fourth level class and some students don't get into it until the advanced, or sixth level class, it does beg the question of how long the therapist has been practicing CST. Secondly, what is their professional background? Needless to say, doctors, nurses, physiotherapists, and occupational therapists usually have very strong pediatric backgrounds. Thirdly, if the therapist is a massage therapist or some other kind of body worker, they should be able to share confidently with the parents where they got their training and expertise, how many children they see regularly in their practices, and if they have referrals from other parents. Finally, the bottom line: are they getting results with your child? We usually ask parents to get four to six sessions before making a decision about the efficacy of the craniosacral therapist. You should start seeing changes within a few sessions- some of the changes will look like symptoms are increasing or progress is regressing. These are common but you need to start seeing something change in a timely manner- if not, look for another therapist. I spent many years at the Upledger Institute and working with Dr. Upledger, he would always work with the entire body, not just the baby's head. The name craniosacral therapy can be a very misleading name. We work with the entire body not just the head and pelvis.

Recently, I have run into two families with children who have been receiving CST for over a year and a half and in both instances, the families had not seen any appreciable results. Parents, this is unsatisfactory to say the least. Many people now claim they are doing craniosacral therapy because it's popular and can be lucrative for a mediocre therapist but their background in the work is weak. I feel for the frustration of all the parents out there who so much want to help their babies with complimentary therapies. The biggest upset I hear from all my parents is not the money, not the energy to get to the sessions, but it is the loss of time because parents know that the earlier the intervention, the better the outcome for their children.

2) Why is it so difficult to be present in the sessions when the baby is so upset?

Nature hard wires our nervous system to be sympathetic (feel what they feel) to our children and even more so for the mother. Historically, that's where our food and safety comes from. When the baby cries it usually means he or she is hungry, upset, needs to be changed, is gassy, wants mom, etc. It is very natural for the parent to want to pick up the child and comfort them. This all gets altered or strained when the baby is having difficulties and now needs medical attention. Now the parent has to inhibit their natural urge to comfort and protect the baby and allow medical staff to intervene and do what's best for the baby. One thing you will become aware of if you spend enough time around babies, whether they are in the hospitals, airplanes, restaurants, or parks, is that you won't hear too many of them crying for too long( even though it is a natural and healthy response for babies to do). Why? Because it is a natural response for the parent to comfort, making adults feel purposeful as opposed to uncomfortable or helpless, and because it often reminds us adults that we too would like to cry about many things in our life as well. We applaud all of our parents for their trust and courage in themselves, their children, the therapists, and the CST process.

Once again, one has to keep in mind the journey of the baby. The opportunity for the baby to become restricted in the womb, complications from cord wrap, the intensity of the labor and delivery process, the dramatic shift from water breathing to air breathing, can be quite intense for the baby and the mother as well. Did you ever notice how intense the feeling can be in a delivery room, even for very experienced doctors and nurses? Physiologists often say being born is one of the toughest workouts we will ever experience- perhaps it's mother nature's way of preparing us for the challenges that lay ahead in our lives. Our job in CST is to give the baby the opportunity to let go of what it no longer wants or needs in their system while it is fresh and easy to do so. 

3) The baby slept through the session this time. Did he still get as much from it as when he cries during a session?

This might seem like a strange question, but it's not uncommon for a parent who is familiar with manual therapies and how kids respond during sessions to ask such a question. The key piece to keep in mind when doing CST is that we move in layers at the child's pace. Some layers the child will have to actively express through and other's they will be content to sleep through. It makes no difference to the quality of the work they are receiving or doing. Another point worth mentioning is that in some sessions you can carry on conversations with the parents during the session without losing any quality of the work, while other sessions demand the full attention of the therapist and any discussion outside of the work is a distraction. At all times, however, the therapist should be aware of keeping contact with their hands on the child during the session whether they are in conversation or not.

4) What is the importance of mouthwork in CST with babies and children?

Starting from CST-1 and onward, there is an emphasis in freeing up the soft tissue/fascial strains around and within the mouth due to restrictions in late pregnancy and the birth process with labor and delivery. These tissues have direct connections with the head and neck, the throat, chest, and back, which in turn, benefits the visual and auditory systems, helps with swallowing, speech, tongue motor activity and torticollis, which in turn helps with breathing, digestion, elimination and finally, the child's ability to calm and relax themselves. In my experience, there seems to be a general lack of interest in performing mouthwork on the part of many CST practitioners in the field who work regularly on babies and children. Many of the issues described previously will not clear unless the hard palate and/or floor of the tongue are released. In working with children who have teeth, we usually wear a little plastic ring guard under our gloves to accomplish the work. For the child who is labeled autistic or PDD, hyperactive, or orally defensive, the constant moving requires high skill on the part of the therapist to be effective in achieving results in the mouth. Parents will want to be aware that occasionally, these more-involved children will often bite their lips which may cause some bleeding in sessions which can look dramatic but creates no lasting consequences. Also, some baby teeth can become loose and in extenuating circumstances, even come out. Mouthwork can take an entire session, and the skilled therapist will often wind up working in a child's mouth either the first session or within the first few sessions. Not doing mouthwork in a timely fashion will limit beneficial effects for the child's continued progress.

5) In CST sessions with my child, I have often noticed that the therapist uses very full contact with their arms, chest and even their head to stabilize and work with them. What is the purpose of this?

This is a great question and one we get asked a lot about. Because we are working with fascia and fascia connects throughout the entire body, the impact of the womb experience and the delivery process is very global and therefore requires a more complete contact with the whole child at one time. Therefore, when you are performing whole body/global unwinding techniques, you must address all the fascial restrictions simultaneously in order to get the most effective and efficient results. Even if you are working multi-hands, the skilled therapist will often benefit the client more by having softer contact over a broader surface, simulating what a baby goes through during the womb and delivery experience. When the child is more involved, that is, has more serious complications in their developmental and cognitive abilities, they will often discolor in sessions which means they may turn very red, or even blue. This is a common temporary feature seen when doing the whole body CST work in the Pediatric population. Again, this is due to the opening and releasing of layers of insult or trauma of what the baby has already experienced. 

6) Why has the CST progress stopped or slowed for my child?

On occasion, the parent will notice that the CST work has either come to a plateau, a stop, or even led to regression in their child. Some of the most common factors that contribute to this are: growth spurts, vaccinations, emotional stress in the household including a new sibling, a change in a parent's job status or career, a change in schools, chronic illness for a family member, death of a family member, financial crises, orthodontia, surgery, and accidents. It is strongly advised that parents continue the CST sessions to help the child during these short-term challenges and that these plateaus or regressions are more related to natural and external causes rather than the efficacy of craniosacral therapy.

7) How does craniosacral therapy help with my child's seizure disorder/epilepsy?

babyAs you know, CST is wonderful for addressing soft tissue and fascial strains. In years of working with children with seizure disorders, from absent to grand mal, we find areas of soft tissue restriction most commonly in the upper torso including elbows, shoulders and the neck. However, tissue restrictions could come from anywhere in the body and create enough of an electrical impulse through irritation to also bring about epileptic attacks. In our experience, these restrictions are usually the result of problematic womb positioning and/or a birth/delivery trauma. It is very important for the family, especially the mother to know that these problems often have nothing to do with diet, work schedule, exercise program, stresses at home, etc. On the other side of it, you could also have a very experienced senior obstetrician who loves what they do, is in no rush for the delivery and doesn't use forceps, suction or even do an episiotomy and still wind up with severe soft tissue restrictions due to the birth position of the fetus and presentation. The delivery can be so severe that the baby is so tired out that they are seen as a "good baby" who never fusses or makes too much noise but by 7 or 10 or 12 months of age starts to present with seizures. Once the baby has had more than two seizure episodes they are usually dealt with in the standard medical way.

In conventional medicine, they commonly look at seizures and their origins as having to do with a problem with the central nervous system, that there is a burst of electrical impulses in the brain that escape their normal limits creating seizures.  They then spread to neighboring areas and create uncontrolled electrical activity resulting in muscle twitches or convulsions. The standard treatment approach is to address the problem with chemicals such as Tegretol, Zarontin,  Neurontin, and Dilantin to name a few. These epileptic drugs control seizures, however, they will never cure them which is why when people go the conventional medical route, they usually need to continue the medications for the rest of their life. The problem is that long term medication use has serious adverse affects on the developing brain and central nervous system which can cause life time deficits for the child and effect the quality of their life. If the medications are not effective enough, the doctor is usually placed in the position of having to increase the dosage higher and higher and if that eventually fails, then the next step is a very invasive surgery that separates the bridge between the hemispheres of the brain known as the corpus collosum. The impact of the neurosurgeon having to go into the brain can have devastating effects on the child and like with all surgeries, there is no guarantee of success. Parents always have to trust that the decisions they make for their child and family are the best decisions available at that time, knowing what they know.

Much of the success we have with seizure disorders is a combination of the myofascial and unwinding components of craniosacral therapy. Often the children will replicate positions of how they were stuck prior to delivery or in the womb and by patiently holding the child in these positions, releases occur which allow the musculature to relax thus relieving the build-up of electrical excitement from the nervous system into the brain. The CST work can be quite involved and take some time.

Parents, it is of utmost importance that you understand that as the child is receiving the CST work, they will often experience more frequent and severe seizures, albeit, for short periods of time after their sessions. It is very common that children will often appear to go backward in their developmental processes to get hold of a new piece, bringing it forward so they can then integrate it into where they are now. Also, parents who bring their children in already on seizure medications will see the results take a little longer and be a bit slower as we never interfere with the doctor's/parents medical intervention, however, be aware that medication is designed to suppress seizures whereas the CST is designed to elicit seizures so that they may come up and discharge from the nervous system. Our goal is to rid the body of seizures.

8) A note to dads, fathers, and men in general- read this!

I want to start off by saying that I appreciate all the caring and concern I have seen over these long years from all the fathers who sometimes accompany their children to the therapy sessions. The reason you bring your babies to the craniosacral therapist is because you are not completely satisfied with what conventional medical care is offering for your family. And I agree. When it comes to medically addressing the needs of the family in a healthier and more preventative way, our healthcare system seems unable to offer complimentary or alternative approaches other than dealing with sickness and disease, which seems to be at its best in the emergency room and trauma center. This is the reason that modalities such as massage, acupuncture, chiropractic, and soft tissue manual therapies such as CST have attracted such a huge interest in the last few decades. Having said this, my observation has been that when it comes to being in CST sessions as we work on your babies, that when the sessions get tough and they do- babies cry, fuss, kick and scream and just generally get very upset,  you guys as a group, don't do a very good job with your emotions and your boundaries. Your emotions and feelings become so strong that your ability to be constructive and helpful in the CST session is no longer possible. That is why we will sometimes ask you to step out of the room or seriously consider not accompanying your child to the sessions. Having worked with children since 1989, I have tried to put on the website as much clear and honest information as I can to help my parents, especially my dads, be fully informed and aware of the nature of the work so that when the sessions get intense- and they do- everyone is prepared ahead of time. We can all work together to get your child healthy and back on track for a full and meaningful life.

Finally, parents will want to be aware that in the last twenty years or so, popularity of many of the osteopathic manual therapies like CST, myofascial release, lymphatic drainage, visceral manipulation, etc., have spawned a host of copycat therapies that promise amazing results in a short period of time. However, they are vague as to what the therapy entails or where the developer got his inspiration or source materials. Also, be mindful of any therapies that claim that they can evaluate you today and set up a treatment plan that suggests they know how your body or your baby's will respond in four, eight, or twelve sessions from that point. Anyone who purports to have this kind of premonition about your health and wellness for the future deserves investigation.

It is always best to do some of your own research and find out as much as you can about the therapies and practitioners you are interested in and for this, the internet has proven to be of great value for the general lay population. Having said that, also remember that sometimes the best therapist is not on the first few pages of your Google search or even on the internet itself. When I worked at the Upledger Institute, we had terrific practitioners from Miami to Bangor and from Seattle to San Diego and all points in between. A number of these teachers are no longer associated with UI, and are not in their directories but are phenomenal therapists and still have regular clientele.

9) What else can I do for my child besides the CST work?

A great suggestion we have for parents is to also get some CST sessions for themselves. This helps parents to be more relaxed and present when the CST sessions with their children become more intense, which it often does. It can give valuable insights into the nature of the work and what their child is experiencing first hand. The parents are on the same side of the equation, and it creates a balancing of dynamics in the family with the CST work. Many parents have also found Chiropractic medicine, Traditional Chinese Medicine, massage/bodywork, homeopathy and naturopathic medicine to be of tremendous value. Again, it is the challenge of finding a skillful therapist who is efficient with their work and communicates clearly with the family that makes all the difference between successful or mediocre outcomes. Brain Gym, Sensory Integration, Neuro-Developmental technique, the Doman/Delacato Cross-Patterning program are all wonderful therapies that can lead to a healthier lifestyle for baby and parents.

Please familiarize yourself with our consent forms as you will be asked to sign them before the start of your session.

Consent form for Pediatric Craniosacral Therapy treatment