Premature infants with a birthweight below 1500 gram often suffer from delayed meconium evacuation and associated problems such as gastric residuals, a distended abdomen and delayed food passage. Osteopathic treatment with the emphasis on the relationship of the structural and functional integrity of the body and with its variety of therapeutic manual techniques seemed to be an approach to solve the problem. The present paper investigates the impact of visceral osteopathic techniques on the meconium evacuation in very small premature infants. The study focusses on the effects, side effects and problems associated with the application of such techniques on the very tiny body. Furthermore the authors give an overview over the recent literature published in the field of osteopathic manipulative techniques in infants.