Case Study – 8-month-old boy that was born prematurely at 33 weeks

Manuel is an 8-month-old boy that was born prematurely at 33 weeks. He was in the NICU for 1 month but was released home with no additional services and no medical diagnosis. His mother was referred to Early Intervention (birth to 3) services when he was having difficulties feeding, he was not rolling, he was not bearing weight in the feet and he was significantly falling behind with all developmental milestones.

Manuel’s only service provider was Emily. He presented with plagiocephaly (mis-shaped head), and significant muscle tightness along the length of the spine. He was not rolling over or tolerating tummy time. He had very little active neck or spine rotation. He was not able to sit up on his own. He was spilling formula from his mouth when he took a bottle. He was unable to tolerate food with textures and he was not able to use his hands to pick up objects.  He couldn’t hold his bottle. 

The first treatment his mother was trained to do the “basic four” massages: 1. Pinching and pulling the skin next to the spine 2. Acupressure to ST36 3. Circle rubbing on the Abdomen 4. Supplementing the SP on the thumb. Following the first treatment, Manuel had more active movement at his neck and his sitting balance started to improve.

In the following 10 treatments, the focus was on the Integrative Manual Therapy protocol for Speech and Swallowing Disorders and addressing muscle imbalance in his pelvis, neck, and face. These are techniques that involve gently holding the child’s body for 3min at a time. For an active child, it can be done in the child’s sleep.

His mother was trained to do acupressure on his face in order to address the Plagiocephaly. These points were extremely tender as first and very gentle pressure was needed to release them.

She was also given massage and acupressure strategies to support Manuel’s overall health during the week per Emily’s assessment and suggestions


The outcome was very good. In the 11 sessions Manuel became an independent eater. He quickly stopped dribbling when taking a bottle. He started to actively use his hands for play and holding his bottle. He started tolerating texture in his food, including finger foods. He began tolerating tummy time and eventually rolling on his tummy. His head shape significantly improved and rounded out (see before and after pictures above). He became much more aware of his environment and much more social with his family. Manuel went on to eat, walk and talk like his brothers and sisters.

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