NEW YORK CITY — Markus Lienert had a traumatic journey into this world about six months ago.
Before he was born via emergency cesarean section, he spent hours in labor with his neck bent. The process left Markus with torticollis (the medical term for a twisted neck) and digestive issues, as well as slightly lopsided eyes, ears and jaw, according to his mother Amy Lienert, who adopted him.
To straighten out the baby's body, Lienert takes her son for weekly visits to Dr. Laurie Mullen, a chiropractor who specializes in a little-known treatment called Sacro Occipital Technique (SOT). Following the treatments, which involve gentle prodding of out-of-place cranial bones, Markus' eyes and ears are notably more aligned and his neck is almost completely corrected, according to Lienert.
"To have [Mullen] remedy that alignment so quickly and early on, I think it changed his life," said Lienert, a personal project manager who at the time of treatment lived in Washington Heights, where Mullen runs her practice.
Mullen is one of a handful of New York City chiropractors who offer SOT treatments, a controversial form of chiropractic adjustments, to babies and children. The service, which can cost as much as $325 for an hourlong initial visit and $110 for 15-minute followup visits, promises to help with everything from aligning crooked facial features to fixing internal issues like colic and troubled digestion. SOT can also benefit adults, according to chiropractors.
But critics warn that the techniques are unproven to work on children, and could pose a range of risks, from serious danger to being just a waste of money.
INTERACTIVE PHOTO: Amy Lienert said Markus' neck became so twisted with torticollis during labor that his head dipped nearly to his right shoulder. The child's right eye, once lower than the left eye, is more aligned after the treatment, the chiropractor said.
Because most chiropractic training does not include work on children, some medical professionals fear that any use of SOT or other chiropractic work could put children in danger.
"You can become a board-certified chiropractor without ever touching a child," said Dr. Dyan Hes, a pediatrician in Gramercy and assistant professor of pediatrics at Weill Medical College of Cornell University. She said conventional treatments for birth trauma like torticollis normally involves a referral to a physiotherapist or an occupational therapist, who stretches and strengthens a baby's neck.
The pediatrician added that chiropractors don't have enough training to work with children and infants and should not apply the techniques to their growing bodies.
Hes said often there's no need for parents to be concerned about the long-term effects of flat head syndrome, adding that parents are encouraged to vary their baby's sleeping positions over time, and that in combination with growth of the brain, the head will naturally round out. In conventional medicine, a small number of infants with flat head syndrome are prescribed to wear a helmet, Hes said.
Asymmetries in a baby's face can also align naturally with age, according to Hes.
Still, advocates say the proof of SOT's effectiveness is in the results.
Mom Sarah Felsenthal, whose 3-year-old daughter, Arielle, had a series of SOT treatments when she was a year old, said she couldn't be happier that her family used the treatments.
Felsenthal said she first went to Mullen for aesthetic reasons: to round out a flat spot on Arielle's head. Like many parents concerned about Sudden Infant Death Syndrome (SIDS), Felsenthal followed medical recommendations to have Arielle sleep on her back. The constant pressure caused the soft cranial bones to flatten at the back of the baby's head.
But after several SOT sessions with Mullen, the shape of Arielle's head had visibly improved, according to Felsenthal.
"I'm a big believer that if you can fix something aesthetically you should," said the New Jersey mom who commuted in for the treatments. "Obviously, I am reasonable about this and I don't mean surgery."
SOT practitioners who work with kids say their techniques are more gentle than typical chiropractic work, and harmonize the spine, the organs, the extremities and especially the 26 bones of the skull in a bid to help the body work as intended. They say that's perfect for the types of trauma that children can experience in the birth process.
Many parents who access SOT treatments, which only chiropractors can be trained to perform, do so for its promise of aligning their child's physical features, such as one eye appearing bigger than the other or rounding out a misshapen head, according to the SOT-certified chiropractors interviewed by DNAinfo New York.
These aesthetic issues can be an indicator that something internal — in Markus' case it was digestive issues — is also out of whack, according to Mullen.
"It is really something where you can make so much profound change in a person's life that later becomes much more difficult [to fix] later," said Mullen, who has been a chiropractor since 2001.
SoHo-based chiropractor Dr. Beth Forgosh said when a baby arrives at her practice, she does a physical examination and then gets a history of the child's time in the womb and during labor from the parents.
Forgosh then feels through each bone in the skull to see what is out of place and what movements are irregular. Then she uses gentle nudges and prods to guide the bones back into position.
"It's not a crack and not a massage," Forgosh said. "It's more a very subtle hand movement."
Some baby patients can be fixed in one session, said Forgosh, but others require dozens of treatments. Forgosh charges $325 for an initial visit and $110 for followup appointments.
Dr. Michael Cindrich, a chiropractor based in Greenwich Village, used SOT adjustments to ease bouts of depression and anger in his son, who, after enduring a 40-hour labor, came out with a cone-shaped head.
About five parents each month bring their young children to Cindrich for chiropractic sessions that include SOT, according to the chiropractor. Few people are aware of the technique's benefits for children, so 100 percent of his SOT patients come through word of mouth, the chiropractor said.
To incorporate SOT into his practice, Cindrich completed a basic SOT course in 1995 and advanced training in 1996, clocking up more than 200 hours of total training in SOT.
Cindrich took issue with suggestions that chiropractors are not sufficiently trained to work with children, saying he did supervised work on children during his training, albeit not on infants.
However, he said he understands chiropractors cannot replace a medical doctor for infants.
"What we do does not replace what a pediatrician does," Cindrich said.