How Chiropractic Helps Babies with Reflux

/

It is normal for babies to spit up after eating a little too much or changing positions quickly. We expect this and that’s why we burp babies and have spit up blankies! However, where do we draw the line between normal spitting up and excessive reflux?

A diagnosis of GERD (GastroEsophageal Reflux Disease) can be made based on symptoms including: if an infant has more than 5 episodes of reflux per day, regurgitates approximately 28 g (= 2 Tbsp) per episode, refuses or has problems with feeding, problems gaining weight and demonstrates increasing irritability. Other ways to diagnose GERD is with intra-esophageal pH monitoring, scintography, intraluminal esophageal impedance and inflammation testing, although these methods of diagnosis are more invasive and unnecessary.

Complications of GERD include chronic or recurring sinus or ear infections. If GERD is unresolved, it can lead to esophageal ulcerations or eventually Barrett’s esophagus - a condition where the chronic irritation of esophageal cells leads to cancerous proliferation.

When evaluated by a medical doctor, a prescription for a Proton Pump Inhibitor such as Omeprazole or Prilosec is often made. This can be effective, however, like many medications, there are consequences from long term use including increased risk of infections and decreased magnesium and calcium absorption, leading to a loss of bone density (1).

If your baby does not meet the diagnostic criteria for GERD, it may be wise to still get them checked out. Other signs to address baby’s reflux include:

  • Spitting up between feeds

  • Large amounts of spit up or multiple productive spit ups after feeding

  • Distended belly

  • Crying or distress after feeding

  • Baby does not want to feed

  • Crying or arching their back when feeding

  • Frequent waking at night

  • Excessive intestinal gas

So, what do we do?

#1

We always start by taking a history, including asking questions about diet. Is there a family history of allergies or food sensitivities? If baby is formula fed - what are the ingredients? We recommend a hydrolyzed, low allergen formula, free or minimal in gluten, soy and dairy.

If baby is breastfed, how is mom’s diet? If there is a family history of food sensitivities or allergies, removing that item is a good start (2). Otherwise, in our experience, dairy is a common perpetrator.

#2

We perform a complete exam: This means we check the head and skull for asymmetries or flat spots, check the mouth, lips and tongue for ties, check the jaw for joint restrictions, check the spine from the neck to the pelvis, and look for abdominal tension.

A few things we often find in babies with reflux include:

  • Upper cervical restrictions which may affect the nervous system’s communication with the digestive system

  • Jaw restrictions which make feeding more difficult and causes baby to suck in more air while feeding

  • Thoracic restrictions which may restrict the diaphragm from contracting and relaxing, which may affect the stomach and esophagus

  • Tension in the abdomen and diaphragm which may be aggravated from distressed crying

The esophagus passes through a hole in the diaphragm to the stomach. When infants are in pain and uncomfortable, they cry more, exercising their diaphragm more and causing diaphragmatic tension. This in turn can affect the stomach and esophagus as they pass through the diaphragm, and may contribute to reflux symptoms.

By correcting our findings, we allow more musculoskeletal ease and improved nervous system function. This leads to an improvement in reflux symptoms and in baby’s overall comfort.

#3

Chiropractic treatment for a baby looks MUCH different than treatment for an adult. We use as much pressure as you’d use to squeeze a tomato to check its’ ripeness. There is no popping or twisting. Every time Baby comes in, we may adjust them in a different position based on what is comfortable for them - sometimes it’s while holding them, while laying on mom or dad or while laying on their back in a pillow. 

We will often see baby 2-3 times a week for a couple weeks to make our adjustments and to make sure they “stick” and are integrated. Then, we re-evaluate. We want to resolve the issue as quickly as possible to make sure your infant is out of pain, able to thrive, and the rest of the family can enjoy a better sleep.

  1. O’Neill, LeAnne et al. “Long-Term Consequences of Chronic Proton Pump Inhibitor Use”, US Pharmacist, March 2013 https://www.uspharmacist.com/article/longterm-consequences-of-chronic-proton-pump-inhibitor-use

  2. Gordon, Morris et al. “Dietary modifications for infantile colic.” The Cochrane database of systematic reviews vol. 10,10 CD011029. 10 Oct. 2018, doi:10.1002/14651858.CD011029.pub2

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394439/pdf/CD011029.pdf

  3. 3. Alcantara, Joel, and Renata Anderson. “Chiropractic care of a pediatric patient with symptoms associated with gastroesophageal reflux disease, fuss-cry-irritability with sleep disorder syndrome and irritable infant syndrome of musculoskeletal origin.” The Journal of the Canadian Chiropractic Association vol. 52,4 (2008): 248-55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597889/pdf/jcca-v52-4-248.pdf

Shantai Watson, DC