Many parents ask me if reflux causes the development of motor delays in infants. This is an excellent question and a common concern shared by many reflux moms and dads.
A baby with reflux may spend a great deal of time being held by a parent or grandparent. Often a doctor will recommend holding a baby upright for 30 minutes or more after each meal. When you add it up, it amounts to a great deal of holding Many babies with reflux seem to settle and calm better when held, often leading to a prolonged period of being held day and night. Other refluxers may need to be placed on their backs in a positioning device such as a wedge or carrier. While a baby is held or positioned, there are fewer opportunities to explore other positions or use muscles. Some babies may even develop a flat spot on the back of the head and have a bald spot from spending day after day on their backs. Parents often complain that their refluxer cannot tolerate being placed on their stomachs because they experience discomfort and increased vomiting.
In other cultures, babies are often swaddled and held during infancy and carried around in a sling or other carrier until they learn to walk. Babies who have been swaddled and held may have some temporary delays in motor milestones. On the other hand, there may be some "catch up" progress. Once a baby has opportunities to move, there seems to be a huge leap in skills. One day a baby is just pulling to stand and the next thing you know, she is walking. All of my babies were late walkers at 15 to 17 months of age. I am sure this is in part due to the fact that I carried them incessantly! I DID worry about the late walking and I DID compare them to the other kids who were already walking and running. Fast forward to present tense and it is hard to correlate late walking to athletic ability. Is an early walker destined to be a pro-football player and a late walker resigned to being a bench warmer? Probably not!
Many reflux moms tell me that their babies are slightly behind in learning to push up on their tummies, crawl and walk. Perhaps the need to be held and positioned left little time for the development of motor skills. It is likely that this will cause a great deal of worry and it will seem like just another bad thing about having reflux. It will be another disappointment as you look at the non-reflux babies around you (who walked at nine months) and as you hold and carry your toddler for a few more months before she learns to walk on her own.
If you are concerned about the motor development of your refluxer, it is always a good idea to discuss your observations with the doctor. While most babies will be just fine once the reflux is better and they have opportunities to move, some babies develop complications such as a head tilt to one side caused by torticollis. In a few cases, there is a pattern of muscle stiffness (called high muscle tone) or floppy (low muscle tone) that affects all muscles in the body. A pattern of high or low tone can affect large muscles needed for sitting, crawling and walking and small muscles needed for eating and talking.
The doctor may refer a baby with torticollis or muscle-tone problems to a neurologist or a physical therapist for further evaluation. However, in most cases, time and movement experiences are all that are needed to get a baby moving and developing.
A parent or doctor may also refer an infant or toddler with motor delays to the local Child Find or Early Intervention Program. There is a national network of programs offered from the county, school district or health department to screen and evaluate infants and toddlers with delays. If a developmental delay is identified, services are offered as long as they are needed. The services vary but there is never a charge to the family or to the insurance company. If you are trying to locate a Child Find service in your area, you can ask the pediatrician, call the health department or contact the local school system. Some programs are offered under the school special education system, while others are offered under the health department.
Of course, you are already good at explaining to everyone why your baby won't eat and sleep; why you are feeding her every two hours; and why she is growing slowly. So explaining why she is just fine in her sling (thank you very much and no she won't have any trouble walking when she is good and ready) will all come easily to you...right?