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Blake Myers, ND
This case involves a 10-day-old newborn delivered via cesarean section at 37 weeks, who experienced a period of asphyxia of unknown duration in the first hour after delivery. She was resuscitated, intubated, and flown to the nearest major hospital, where she remained in the Neonatal Intensive Care Unit (NICU). Her mother described her as “floppy”, non-responsive to stimuli, without a gag reflex, and “barely opens her eyes”. She had thick mucus secretions requiring hourly suctioning, and esophageal dysmotility raised concern for recurrent aspiration.
The Neurology team expressed concern for periventricular leukomalacia (PVL) or other hypoxic brain injury. She was on parenteral nutrition and 4L/min of high-flow oxygen. Based on clinical presentation and case history, a single dose of a homeopathic medicine was given. After 5 days post-remedy administration, the mother reported that the next day the child’s “eyes were more open, muscle tone had improved, and gag reflex had returned. Neurology remarked on her rapid neurologic recovery. Her MRI was normal. Although oxygen and mucus management remained ongoing, the child discontinued parenteral nutrition and demonstrated neurologic improvement.
Asphyxia is a state of hypoxia caused by any means that disrupts proper oxygenation, although a common cause is choking. Perinatal asphyxia, AKA birth asphyxia, is when oxygenation and blood gas concentrations are altered directly before, during, or after delivery.1 This has multiple potential causes and is considered separately from asphyxia in a neonate away from the delivery process, such as with choking.
Neurologic impacts of neonatal asphyxia include encephalopathy, which can result in hypotonia, apnea, issues with sucking ability, seizures, and abnormal oculomotor and pupillary movements.1 MRI can be abnormal, and in some instances, neonatal asphyxia can result in Periventricular leukomalacia (PVL).
PVL is a condition in infants caused by a lack of oxygen supply to the periventricular area of the brain that results in death of white matter tissue. It is most common in premature infants.2 This periventricular area of the brain is found around the ventricles – the fluid-filled spaces in the brain – which house the neurons that innervate the corresponding muscles of the body.3
Through their development, children suffering from PVL may experience2,3:
PVL is also the leading cause of cerebral palsy.2
There is no treatment for PVL, but severity may be minimized early by carefully monitoring arterial blood gases.2
Given the limited medical interventions available in a case of prolonged brain hypoxia, employing a safe modality such as classical homeopathy should be a consideration among all other options available.
Phone visit (without video) of a 10-day-old female with a history of asphyxia of unknown duration in the first hour after her cesarean (C-section) delivery.
Subjective: Mother reports a healthy pregnancy with delivery at 37 weeks. She labored for 13 hours at home, and the child’s heart rate dropped. They were then transferred to the hospital. The infant was delivered via C-section.
Within the first hour postpartum, the mother began breastfeeding the infant (Sky). After 15 minutes, Sky made a gurgling sound and fell asleep on her mother’s breast. Dad noticed that Sky “looked a little blue”. Mom pulled her away, and there was blood coming out of her nose and mouth, and she wasn’t breathing. It is unclear how long she might not have been breathing.
The medical staff performed CPR, and the child was intubated and flown to the nearest major hospital center, where she has been in the NICU ever since (10 days ago).
She was on a CPAP initially for the first 3 days. Had been on her side all day at first. A nurse rolled her on her back, and she stopped breathing again and was intubated again for 4 hours. Not on CPAP currently but on high-flow oxygen, at 4L/min.. They went to 2L/min. The oxygen saturation went to 70-80% a couple of days ago. Lying on her back, her O2 saturation gets worse. Sometimes her breathing is too fast, and she uses accessory muscles.
Description of the child as given by the mother:
She has a secretion in her throat, and they don’t know where it’s coming from.
It causes a snoring sound pretty regularly. The secretion gets in the way of breathing and eating, and is suctioned out by the medical staff every hour. She is getting IV nutrition and a feeding tube with some breast milk. The doctor says she has no gag reflex. The secretions are a clearish, whitish phlegm. They look pretty thick. She lost a lot of weight. She was 5 lbs 6 oz. At birth, it went down to 4 lbs 8 oz, and is now back up to 5 lbs—3 oz.
Neurologists were worried about her brain and thought she probably had PVL on the first MRI. They said she could have cerebral palsy or a delay in learning. They returned later and said the head neurologist didn’t think it showed this, so it’s unclear.
She is non-responsive. “Like a ragdoll. Floppy.”
She is moving her arms and legs a bit more than initially.
Responds to mom’s voice sometimes.
Didn’t cry for many days. She did cry the other day when she got a heel prick.
Overall, though, she is unresponsive to stimuli.
“She barely opens her eyes. Maybe half of one eye here and there.” Sleeps most of the time (more than a typical infant).
She “does little quivers.” When she was born, her jaw would move weirdly side to side, and doctors were worried about seizures. Now, this is not happening with her jaw. She gets short spurts of full-body shaking or quivering, and her back muscles have also done that.
ENT scope demonstrated dysmotility in her esophagus.
No vomiting of milk.
Skin color is pink.
All other body systems were reported as normal.
Objective: No observations due to it being a phone call.
In homeopathy, the differential diagnosis involves identifying a list of remedies that may represent the simillimum- those most closely matching the totality of the case. I chose to share this case primarily to illustrate that even if you don’t regularly practice homeopathy—even if you only half-paid attention to homeopathy in school, or aren’t familiar with the repertory—there’s still a strong chance you could arrive at the correct remedy by stepping back and focusing on the core themes of the case. At Bastyr University, I was taught that Dr. Bastyr used to say you need “three legs to sit on a stool” – meaning three clear, confirmatory symptoms of the remedy to justify prescribing it. That concept applies well here.
In a case like this, it is important not to become overwhelmed by the situation’s seriousness, whether it involves an infant or any other fear or discomfort that may arise. Instead, reflect on what remedies come to mind based on what is known.
This infant experienced oxygen deprivation. Her key presenting features are:
1. “Floppy”, “Like a ragdoll”
2. Relatively unresponsive to stimuli (even her gag reflex doesn’t respond)
3. Excessive sleepiness.
Do any remedies come to mind? These three legs of your stool are strong in this case – symptoms you know without a doubt. You can lean hard on them to get to a few possible remedies.
If no remedies come to mind, you could always present these themes to a homeopath friend, and they could quickly guide you to a remedy to help this child. Getting the main ideas/themes is your primary job.
Here is the way I repertorized this case using the Cycles and Segments method. The repertoire used is Synthesis Treasure Edition 2009.
Segments (themes) in this case:
1. Hypotonic/“Floppy”
2. Sleepy
3. Asphyxia
4. Unresponsive to stimuli
5. Snoring
6. Tremors/Quivering
All of these represent different clear themes in the case.
As you consider the key points of each remedy (E.g., Ars = anxious and restless; Bell = Hot, red, quick-acting), the list of 12 remedies quickly gets whittled down. Three remedies stand out to me as considerations for the major issues this child is presenting: Carbo vegetabilis, Laurocerasus, and Opium.
If we ask which remedy from these is sleepy, unresponsive, and atonic, we have a clear basic picture of opium. Another way to think of it is that opium can go as far as to cause a comatose state, which isn’t a big leap in imagination from what is described here.
Opium 200C, once
Expectations: I expect, at minimum, to see her tone improve, not sleep excessively, and her reaction to external stimuli improve. Other improvements are welcome, but within a short follow-up time, the first three symptoms, which clue me into her neurologic function, are what I want to see to know if her response to the remedy was favorable.
The day after the remedy was administered, Sky’s mother reports that her eyes were opened and she was “awake a lot more.” She is awake a lot more now.
The neurology team commented on how much her muscle tone had improved the next day. She now has a gag reflex. Her tone is still not typical of a healthy newborn but continues to improve. Whereas her arms used to fall when lifted and released, she now holds them up. She is no longer trembling or quivering.
Her response to exams, blood draw, parents, and general stimuli is now typical. She is trying to pull out the nasal cannula regularly. Mucus and oxygenation are still a problem. Oxygen is at 2L/min.
Brain MRI is normal. She is still on a feeding tube due to the continued fear of aspiration during breastfeeding.
This case demonstrates that while the effective clinical use of classical homeopathy can sometimes feel like a daunting and time-consuming undertaking, there are also instances where it can be just as straightforward. When we have patients who are faced with potentially life-altering or life-threatening scenarios, in particular when there is little that conventional medicine has to offer to address the issues at hand meaningfully, homeopathy should be a welcome treatment modality alongside all other potential interventions. Those of us exposed to the fundamentals of this centuries-old system of medicine have the opportunity, and the obligation, to implement it to the best of our ability. It may shift the trajectory of health positively, even in our youngest patients and most concerning cases.
The purpose here is not to demonstrate or attempt to convince of the efficacy of homeopathy. Instead, I hope to inspire my colleagues who perhaps don’t utilize homeopathy regularly to trust their potential to have a meaningful impact in cases where they may not have the tools to help otherwise.
A 10-day-old with asphyxia shortly after birth experienced a rapid and clear improvement of symptoms following administration of the homeopathic remedy Opium 200C. This case demonstrates that in certain instances, anyone with fundamental homeopathic training can take the primary symptoms and themes from a case to find the simillimum and have a meaningful impact.
Dr. Blake Myers is a Naturopathic Physician and Assistant Professor in graduate studies in Integrative and Functional Nutrition at Saybrook University They graduated from Bastyr University in 2014 and from Iowa State University of Science and Technology with a B.S. in Biology in 20210. Dr. Blake’s clinical experience ranges from primary care to complex chronic illness. From 2016 until 2020, they worked with an addiction medicine specialist doing integrative addiction medicine, accelerated opiate detoxification, and served as an attending physician at The Clearing residential treatment center on San Juan Island, WA. They currently live in Spearfish, SD.
Blake Myers, ND
This case involves a 10-day-old newborn delivered via cesarean section at 37 weeks, who experienced a period of asphyxia of unknown duration in the first hour after delivery. She was resuscitated, intubated, and flown to the nearest major hospital, where she remained in the Neonatal Intensive Care Unit (NICU). Her mother described her as “floppy”, non-responsive to stimuli, without a gag reflex, and “barely opens her eyes”. She had thick mucus secretions requiring hourly suctioning, and esophageal dysmotility raised concern for recurrent aspiration.
The Neurology team expressed concern for periventricular leukomalacia (PVL) or other hypoxic brain injury. She was on parenteral nutrition and 4L/min of high-flow oxygen. Based on clinical presentation and case history, a single dose of a homeopathic medicine was given. After 5 days post-remedy administration, the mother reported that the next day the child’s “eyes were more open, muscle tone had improved, and gag reflex had returned. Neurology remarked on her rapid neurologic recovery. Her MRI was normal. Although oxygen and mucus management remained ongoing, the child discontinued parenteral nutrition and demonstrated neurologic improvement.
Asphyxia is a state of hypoxia caused by any means that disrupts proper oxygenation, although a common cause is choking. Perinatal asphyxia, AKA birth asphyxia, is when oxygenation and blood gas concentrations are altered directly before, during, or after delivery.1 This has multiple potential causes and is considered separately from asphyxia in a neonate away from the delivery process, such as with choking.
Neurologic impacts of neonatal asphyxia include encephalopathy, which can result in hypotonia, apnea, issues with sucking ability, seizures, and abnormal oculomotor and pupillary movements.1 MRI can be abnormal, and in some instances, neonatal asphyxia can result in Periventricular leukomalacia (PVL).
PVL is a condition in infants caused by a lack of oxygen supply to the periventricular area of the brain that results in death of white matter tissue. It is most common in premature infants.2 This periventricular area of the brain is found around the ventricles – the fluid-filled spaces in the brain – which house the neurons that innervate the corresponding muscles of the body.3
Through their development, children suffering from PVL may experience2,3:
PVL is also the leading cause of cerebral palsy.2
There is no treatment for PVL, but severity may be minimized early by carefully monitoring arterial blood gases.2
Given the limited medical interventions available in a case of prolonged brain hypoxia, employing a safe modality such as classical homeopathy should be a consideration among all other options available.
Phone visit (without video) of a 10-day-old female with a history of asphyxia of unknown duration in the first hour after her cesarean (C-section) delivery.
Subjective: Mother reports a healthy pregnancy with delivery at 37 weeks. She labored for 13 hours at home, and the child’s heart rate dropped. They were then transferred to the hospital. The infant was delivered via C-section.
Within the first hour postpartum, the mother began breastfeeding the infant (Sky). After 15 minutes, Sky made a gurgling sound and fell asleep on her mother’s breast. Dad noticed that Sky “looked a little blue”. Mom pulled her away, and there was blood coming out of her nose and mouth, and she wasn’t breathing. It is unclear how long she might not have been breathing.
The medical staff performed CPR, and the child was intubated and flown to the nearest major hospital center, where she has been in the NICU ever since (10 days ago).
She was on a CPAP initially for the first 3 days. Had been on her side all day at first. A nurse rolled her on her back, and she stopped breathing again and was intubated again for 4 hours. Not on CPAP currently but on high-flow oxygen, at 4L/min.. They went to 2L/min. The oxygen saturation went to 70-80% a couple of days ago. Lying on her back, her O2 saturation gets worse. Sometimes her breathing is too fast, and she uses accessory muscles.
Description of the child as given by the mother:
She has a secretion in her throat, and they don’t know where it’s coming from.
It causes a snoring sound pretty regularly. The secretion gets in the way of breathing and eating, and is suctioned out by the medical staff every hour. She is getting IV nutrition and a feeding tube with some breast milk. The doctor says she has no gag reflex. The secretions are a clearish, whitish phlegm. They look pretty thick. She lost a lot of weight. She was 5 lbs 6 oz. At birth, it went down to 4 lbs 8 oz, and is now back up to 5 lbs—3 oz.
Neurologists were worried about her brain and thought she probably had PVL on the first MRI. They said she could have cerebral palsy or a delay in learning. They returned later and said the head neurologist didn’t think it showed this, so it’s unclear.
She is non-responsive. “Like a ragdoll. Floppy.”
She is moving her arms and legs a bit more than initially.
Responds to mom’s voice sometimes.
Didn’t cry for many days. She did cry the other day when she got a heel prick.
Overall, though, she is unresponsive to stimuli.
“She barely opens her eyes. Maybe half of one eye here and there.” Sleeps most of the time (more than a typical infant).
She “does little quivers.” When she was born, her jaw would move weirdly side to side, and doctors were worried about seizures. Now, this is not happening with her jaw. She gets short spurts of full-body shaking or quivering, and her back muscles have also done that.
ENT scope demonstrated dysmotility in her esophagus.
No vomiting of milk.
Skin color is pink.
All other body systems were reported as normal.
Objective: No observations due to it being a phone call.
In homeopathy, the differential diagnosis involves identifying a list of remedies that may represent the simillimum- those most closely matching the totality of the case. I chose to share this case primarily to illustrate that even if you don’t regularly practice homeopathy—even if you only half-paid attention to homeopathy in school, or aren’t familiar with the repertory—there’s still a strong chance you could arrive at the correct remedy by stepping back and focusing on the core themes of the case. At Bastyr University, I was taught that Dr. Bastyr used to say you need “three legs to sit on a stool” – meaning three clear, confirmatory symptoms of the remedy to justify prescribing it. That concept applies well here.
In a case like this, it is important not to become overwhelmed by the situation’s seriousness, whether it involves an infant or any other fear or discomfort that may arise. Instead, reflect on what remedies come to mind based on what is known.
This infant experienced oxygen deprivation. Her key presenting features are:
1. “Floppy”, “Like a ragdoll”
2. Relatively unresponsive to stimuli (even her gag reflex doesn’t respond)
3. Excessive sleepiness.
Do any remedies come to mind? These three legs of your stool are strong in this case – symptoms you know without a doubt. You can lean hard on them to get to a few possible remedies.
If no remedies come to mind, you could always present these themes to a homeopath friend, and they could quickly guide you to a remedy to help this child. Getting the main ideas/themes is your primary job.
Here is the way I repertorized this case using the Cycles and Segments method. The repertoire used is Synthesis Treasure Edition 2009.
Segments (themes) in this case:
1. Hypotonic/“Floppy”
2. Sleepy
3. Asphyxia
4. Unresponsive to stimuli
5. Snoring
6. Tremors/Quivering
All of these represent different clear themes in the case.
As you consider the key points of each remedy (E.g., Ars = anxious and restless; Bell = Hot, red, quick-acting), the list of 12 remedies quickly gets whittled down. Three remedies stand out to me as considerations for the major issues this child is presenting: Carbo vegetabilis, Laurocerasus, and Opium.
If we ask which remedy from these is sleepy, unresponsive, and atonic, we have a clear basic picture of opium. Another way to think of it is that opium can go as far as to cause a comatose state, which isn’t a big leap in imagination from what is described here.
Opium 200C, once
Expectations: I expect, at minimum, to see her tone improve, not sleep excessively, and her reaction to external stimuli improve. Other improvements are welcome, but within a short follow-up time, the first three symptoms, which clue me into her neurologic function, are what I want to see to know if her response to the remedy was favorable.
The day after the remedy was administered, Sky’s mother reports that her eyes were opened and she was “awake a lot more.” She is awake a lot more now.
The neurology team commented on how much her muscle tone had improved the next day. She now has a gag reflex. Her tone is still not typical of a healthy newborn but continues to improve. Whereas her arms used to fall when lifted and released, she now holds them up. She is no longer trembling or quivering.
Her response to exams, blood draw, parents, and general stimuli is now typical. She is trying to pull out the nasal cannula regularly. Mucus and oxygenation are still a problem. Oxygen is at 2L/min.
Brain MRI is normal. She is still on a feeding tube due to the continued fear of aspiration during breastfeeding.
This case demonstrates that while the effective clinical use of classical homeopathy can sometimes feel like a daunting and time-consuming undertaking, there are also instances where it can be just as straightforward. When we have patients who are faced with potentially life-altering or life-threatening scenarios, in particular when there is little that conventional medicine has to offer to address the issues at hand meaningfully, homeopathy should be a welcome treatment modality alongside all other potential interventions. Those of us exposed to the fundamentals of this centuries-old system of medicine have the opportunity, and the obligation, to implement it to the best of our ability. It may shift the trajectory of health positively, even in our youngest patients and most concerning cases.
The purpose here is not to demonstrate or attempt to convince of the efficacy of homeopathy. Instead, I hope to inspire my colleagues who perhaps don’t utilize homeopathy regularly to trust their potential to have a meaningful impact in cases where they may not have the tools to help otherwise.
A 10-day-old with asphyxia shortly after birth experienced a rapid and clear improvement of symptoms following administration of the homeopathic remedy Opium 200C. This case demonstrates that in certain instances, anyone with fundamental homeopathic training can take the primary symptoms and themes from a case to find the simillimum and have a meaningful impact.
Dr. Blake Myers is a Naturopathic Physician and Assistant Professor in graduate studies in Integrative and Functional Nutrition at Saybrook University They graduated from Bastyr University in 2014 and from Iowa State University of Science and Technology with a B.S. in Biology in 20210. Dr. Blake’s clinical experience ranges from primary care to complex chronic illness. From 2016 until 2020, they worked with an addiction medicine specialist doing integrative addiction medicine, accelerated opiate detoxification, and served as an attending physician at The Clearing residential treatment center on San Juan Island, WA. They currently live in Spearfish, SD.
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It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.
The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making
The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution
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