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Most osteopaths are trained in pediatric care, and osteopathic manipulative treatment (OMT) is avail-able for many pediatric conditions. The objective of this systematic review was to critically evaluate the effectiveness of OMT as a treatment of pediatric conditions. Eleven databases were searched from their respective inceptions to November 2012. Only randomized clinical trials (RCTs) were included, if they tested OMT against any type of control in pedi-atric patients. Study quality was critically appraised by using the Cochrane criteria. Seventeen trials met the inclusion criteria. Five RCTs were of high methodological quality. Of those, 1 favored OMT, whereas 4 revealed no effect compared with various control interventions. Replications by independent researchers were available for 2 conditions only, and both failed to confirm the findings of the previous studies. Seven RCTs suggested that OMT leads to a significantly greater reduction in the symptoms of asthma, congenital nasolacrimal duct obstruction (posttreatment), daily weight gain and length of hospital stay, dysfunctional voiding, infantile colic, otitis media, or postural asymmetry compared with various control interventions. Seven RCTs indicated that OMT had no effect on the symptoms of asthma, cerebral palsy, idiopathic scoliosis, obstructive apnea, otitis media, or temporoman-dibular disorders compared with various control interventions. Three RCTs did not perform between-group comparisons. The majority of the included RCTs did not report the incidence rates of adverse effects. Osteopathy is a branch of health care that was founded by A.T. Still during the 19th century in the United States. Since then, osteopathy has evolved to en-compass 2 distinct professions: non-physician osteopaths and osteopathic physicians; the former are generally considered practitioners of alternative medicine, whereas the latter group that exists only in the United States has the same standing, training, and regulation as conventional physicians. Both nonphysician osteopaths and, to a lesser extent, osteopathic physicians use osteopathic manipulative treatment (OMT) to treat a wide variety of pediatric conditions.

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