Sandifer syndrome typically starts in infancy or early childhood, most commonly affecting babies between 2 months and 2 years old, with a peak around 18-36 months, linked to acid reflux (GERD); however, in rare cases, it can appear from the newborn period or extend into adolescence, especially with developmental delays.
So what is Sandifer's Syndrome?
Typically, Sandifer syndrome is observed from infancy to early childhood. Peak prevalence is in individuals younger than 24 months. Children with intellectual disability or spasticity may experience Sandifer syndrome into adolescence.
Children diagnosed with Sandifers Syndrome will quite often grow out of it by 18-36mths, unless the child has severe mental impairment or similar conditions, in which case the child may continue to have spasms into adolescence. Typically, Sandifers Syndrome is not life threatening.
Most of the time, Sandifer syndrome goes away within the first two years of a baby's life. Given the link to gastroesophageal reflux disease, treatment revolves around treating the reflux itself. This can include changes to the baby's diet and eating habits, medication, and surgery.
Sandifer syndrome is typically not serious and usually resolves within the first two years of life without any long-term complications. However, early diagnosis is essential to manage associated conditions and treat Sandifer syndrome.
“Most commonly, babies may arch their backs when they are crying or repositioning. Many infants will arch their backs with feeds or right after feedings, indicating discomfort from reflux, which is a very common and normal phenomena in most infants, or some gassiness in their bellies.
How do you treat Sandifer syndrome in babies? Management usually involves treating the underlying GERD through dietary changes, such as adjusting feeding schedules or changing formulas, and medications like antacids or proton pump inhibitors.
More than half of all babies experience reflux. It usually begins at 2 weeks of life and peaks at 4 to 5 months of life. Most infants who spit up are healthy and sometimes referred to as “happy spitters,” even though it might not seem like they are all too happy about it at the time.
Throwing their head back is typically part of typical exploration and is a normal part of their physical development. This behavior is often linked to the baby's physical capacity to control their head and neck muscles. As babies grow, they become more aware of their bodies and how to manipulate them.
Thus if signs and symptoms are not properly evaluated then Sandifer syndrome may be incorrectly diagnosed as epilepsy, congenital torticollis, trauma, and various pathological conditions of head, neck, and CNS.
The prognosis for these infants is excellent. Once GERD is established as the etiology for Sandifer syndrome, timely and appropriate treatment of GERD decreases the dystonic episodes and, over time, resolves in the majority of patients.
Foods that can trigger reflux:
Other common triggers include green apples, onions, garlic, nuts, bell peppers (especially green peppers), cracked pepper, tomato, cucumber, and processed meat, (such as cold cuts and bacon). Chewing gum and sucking on hard candy cause your child to swallow air, which causes burping.
The exact cause of Sandifer syndrome is unknown. Studies suggest that an underdeveloped connection between the food pipe (esophagus) and the stomach in infants allows the stomach's contents to flow back into the food pipe, which can lead to gastroesophageal reflux disease (GERD), but research is ongoing to learn more.
Clear Indicators Your Toddler Is Not Autistic
They may initiate and respond to social cues, such as smiling, making eye contact, and showing interest in others. Additionally, they may demonstrate an understanding of basic social rules, such as taking turns and sharing toys.
Standard signs and symptoms of reflux:
Arching back or crying during or after feedings. A raspy or congested sound in the baby's throat. Gagging or coughing.
Is acid reflux worse for babies at night? When babies are suffering from acid reflux they prefer to be held upright. Fussy behavior from reflux can occur all day, rather than just at night. However, if acid reflux is uncomfortable it can cause restlessness in your baby and difficulty sleeping at night.
In conclusion, GER appears to be a significant cause of infant death and SIDS. Infants at the highest risk for death can be identified with extended esophageal pH monitoring and the definitive elimination of GER can prevent some SIDS deaths.
Understanding Newborn Communication
You may notice your baby's back arched when they seem hungry, frustrated, or are in pain. This natural response usually goes away at around nine months when your baby begins to communicate in new ways. But an arched back might also be a sign of a health condition.
It's been suggested that pacifier or 'dummy' use after feeding can help soothe babies with reflux and reduce crying and fussiness, however, there's not enough research to support this10. Pacifiers are a personal choice and they're not something to feel guilty about if it helps your baby.
Most cases of Sandifer syndrome resolve with time and development, within the first 24 months. Initial interventions should be directed at the following lifestyle changes: Modification of or attention to feeding habits. Adjustment of feeds (whether breast milk or formula)
Red flags for a 7-month-old include not rolling over, not sitting unsupported, poor eye contact, lack of babbling or responding to sounds, extreme stiffness or floppiness, not bringing objects to mouth or swapping hands, and showing no reaction to caregivers' emotions, which warrants a call to the pediatrician for developmental concerns.
Many autistic infants are different from birth. Two common characteristics they may exhibit include arching their back away from their caregiver to avoid physical contact and failing to anticipate being picked up (i.e., becoming limp).
The Period of PURPLE Crying is an evidence-based program describing a normal period of crying in the first few weeks and months of life that ALL babies go through. The Period of PURPLE Crying begins at about 2 weeks of age, peaks in the second month, and becomes less in the third to fifth month.