How Reflux Impacts Gross Motor Milestones
As a Pediatric Chiropractor in Denver, I (Dr. Dani) frequently work with newborns dealing with reflux. Reflux can be a major source of discomfort, but did you know that it can also cause delays in gross motor milestone development as well? While this might sound all doom and gloom, no worries, there is hope! Although it may seem “woo-woo” at first, infant chiropractic can clinically help with symptom management, decrease discomfort caused by reflux, and decrease long-term implications and impact such as milestone delays.
The following cascade of events is meant to demonstrate what COULD happen if reflux is left unresolved and impacts movement patterns. This is meant to be an informative explanation of symptoms, not a guideline for fear or panic. If you are concerned about the development of a child with reflux, there are always steps that can be taken to improve current patterns and decrease long-term impact. That is to say, if there are even concerns about long-term impact!
How does Reflux Impact How a Baby Moves?
Reflux commonly creates discomfort on the left side abdomen, so babies will commonly squish down to the left through the torso to guard an area of discomfort. They’ll then rotate their little top half to the right to try to “get away” from the discomfort. This tightens the front of the hip on the left and pulls it back, while the right hip comes forward. Since we’re now scrunched on the left, the tension pulls all the way up into the neck on the left. A tightening of a muscle on the left side of the neck can then tuck the ear to the shoulder on the left and then rotate the head to the right creating a preference to look the right side. Since leaning forward is uncomfortable and increases symptoms, their little back muscles get tight between the shoulder blades which then tips their chest and ribs upwards. This then decreases the ability to contract the core AND move the shoulders forward in front of their body…
How does Reflux Impact Milestone Development?
If we can’t rotate our shoulders forward to get our arms in front of us, tummy time becomes very difficult. However, tummy time is commonly already uncomfortable with reflux so this compounds the difficulty and intolerance grows and the decreased ability to bear weight, strengthen, and stabilize through the shoulders can lead to a delay in future milestones such as reaching, shifting weight through the arms to transition, crawling, pulling to stand, etc.
The intolerance to both being on our back AND tummy time can decrease the ability to gain core and trunk strength. A decrease in core and trunk strength along with increased tension in the mid back muscles can contribute to a backwards “flinging” when working on sitting which can further inhibit building core and trunk strength. If we aren’t able to hold toys at midline (at the center of our body) while sitting due to the lack of mobility within the shoulders, this opportunity to build core stability can be lessened. That tension in the left hip can also contribute to an early roll and a preference to roll to the right as the tightness “sling shots” them to the right. That tension pattern can then strengthen and impact core activation and pelvic stability required for crawling and walking. This can then lend to “janky” crawling and suboptimal walking patterns. Lack of mobility through the hips can also prevent side sitting which can contribute to transitioning in and out of static positions and reaching milestones. Lastly, tightness through the hip flexor on the left can contribute to a lack of mobility and predisposition towards constipation.
Again, this can sound like a LOT, but this intended to be an “aha!” if you’ve had a kiddo with reflux who has struggled with some of these patterns. NOT to say that every kiddo with reflux will also present with these patterns or concerns.
How does Chiropractic Help Milestones Impacted by Reflux?
Chiropractic, myofascial work, and exercise prescription can help:
to teach infants how to access mobility and stability within in their pelvis and low back to help kick on core muscles.
decrease tension through the pelvis and hips which can improve the ability to side sit, move and transition in and out of static positions.
increase range of motion and stability through the trunk and shoulders.
allow for the ability to reach across the body and activate core for better head, trunk, and neck control as well as shoulder positioning above the hip
allow for better positioning to ensure quality tummy time, side play, and back play (also modification recommendations when necessary)
(side note) decrease commonly related constipation by providing the ability to move easily without restriction, decrease tension where GI tract exits, AND by helping with nervous system regulation (rest and digest).
