Sleeping Baby

Common Infant Conditions

Common Infant Conditions

Birth can be a traumatic process. During labour, your baby is subjected to compressive forces as the uterus contracts to assist delivery. As the birthing process continues, your baby’s head undergoes “moulding” where the bones of the skull overlap and warp to allow the baby to descend through the narrow birth canal. After birth, this moulding returns to normal in the first few days of life as the baby feeds, yawns, and cries. Occasionally, moulding is persistent, particularly if there has been a more difficult birth requiring forceps, vacuum or caesarean.

Common infant conditions that Osteopaths can assist with include:

 

Colic

It is a common question of every parent of a newborn… Your baby is crying uncontrollably – is it Colic? And what is Colic anyway?

Colic is a common condition thought to affect up to 10% of babies. It is when an otherwise healthy baby cries or displays symptoms of distress frequently for extended periods. Colic usually develops in the first few weeks of life and is a self-limiting process resolving spontaneously at around 3-4 months.

 

The strict definition of Colic is a “healthy baby which shows periods of intense, unexplained crying lasting 3 hours a day, more than 3 days a week for more than 3 weeks”.

 

Many doctors view this definition as extremely narrow and consider Colic to be any baby who displays sudden, severe crying for an extended period.

Despite research, the cause of Colic remains undetermined. Some theories include:

  • An immature gastrointestinal system.

  • Stomach gas due to poor milk flow or poor burping.

  • Intestinal gas.

  • Neurologic overload – an overwhelmed/over-stimulated baby that becomes exhausted.

  • Muscular type.

Symptoms include:​

Crying baby
  • Inconsolable crying – typically in the afternoon and evening.

  • Grunt.

  • Passing excessive gas.

  • Crying after feeding.

  • Drawing up of the knees.

 

It is reassuring to know the physical effects on the newborn are minimal – the baby will continue to thrive.

Treatment is aimed at reducing musculature and joint strains via massage and gentle joint articulation. At-home management can centre on colicky babies responding to tummy pressure (lying baby on stomach when awake or carrying baby on your forearm with their tummy down during the episode), warmth and massage.

 

Infantile Reflux

Reflux is the condition in which there is regurgitation of the stomach contents into the oesophagus (the tube taking the food from the mouth to the stomach), usually due to the lower oesophageal valve not working efficiently; therefore, not closing effectively.

Mother holding baby

 

These stomach contents are acidic and they irritate the lining of the oesophagus. Most infants will “spit up” or regurgitate a little after a feed. What distinguishes normal regurgitation from abnormal is the frequency, volume, and the baby may be distressed.

 

Sometimes there are no obvious signs of regurgitation, however, the baby may still have reflux symptoms. This is known as “Silent

Reflux” and is more difficult to diagnose. Silent Reflux is the same as Infantile Reflux; however, there is no “spitting up”. The contents of the stomach only go partially up the oesophagus, or the baby swallows the contents again, making it more difficult to detect.

There is no specific test to diagnose reflux. Diagnosis is made based on signs and symptoms. It is comforting to know that reflux gets better as the baby gets older. The stomach will be able to empty more quickly and there is increased tone in the lower oesophageal sphincter.​

Symptoms include:

  • Irritable and unsettled baby (day & night).

  • Crying in pain.

  • Discomfort when feeding (arching, refusal, screaming) or comfort feeding regularly (to alleviate pain).

  • Vomiting or spitting up frequently.

  • Poor weight gains.

  • Bad smelling breath.

  • Poor sleep.

Strains and tightness in the chest and diaphragm from birth may irritate the gut and reduce the efficiency of the oesophageal valve. Treatment aims to reduce tension in the diaphragm, decreasing pressure on the valve, making it more efficient, and therefore keeping the stomach contents down. The base of the skull may also be treated using gentle massage and articulation with the aim of reducing irritability to the nerves supplying the digestive tract. In some cases, your GP may prescribe medication to neutralise stomach acid, relieving the burning feeling in the oesophagus.

At-home treatment focuses on feeding and positioning of the baby.

  • Smaller more frequents feeds.

  • If the baby is on a bottle, use thickened formula.

  • Avoid lying the baby down immediately after a feed.

  • Lie baby on tummy when awake.

 

Flat Head Syndrome (Plagiocephaly)

Often when your baby is born, they have a conical shaped head, which settles in the first few days of life. Some babies have persistent “flat spots” which are evident from birth and thought to be due to restrictive intra-uterine environment. Most babies who develop asymmetry do so after birth, becoming apparent to the parent at about 4-8 weeks of age.

 

This is usually caused by constant pressure on one part of the head. It gives us a clue that the baby may be suffering from neck restriction, leading to the inability to turn their head properly to both sides, resulting in a preference for one position.

This preference has more of an impact in the early weeks of life as the baby spends most of their time on their back – whether it is sleeping or floor play – hence, constant pressure on the one spot. Other clues your baby may have a neck restriction is sudden crying when you reposition their head and/or a preference to feed on one side.

 

Treatment is usually directed at massaging tight neck musculature and gentle articulation of restricted joints in the upper back and neck. At-home management involves reducing pressure on the affected area via repositioning and increased “tummy time”.

In persistent cases, the use of a remoulding orthosis (baby helmet) may be required.

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