Can Reflux affect Gross motor skill development?
Reflux or GERD is a condition where baby’s liquid or food content comes back up from the stomach into the esophagus. Nearly half of babies are born with some form of reflux because the sphincter between the stomach and esophagus is not fully formed.
Most families believe reflux is defined by an abnormal amount of baby spit up and unless it is an abnormal amount, they do not show any concern and rather consider it normal. However, it should be noted that there are three types of Reflux. There are baby’s that spit up but remain comfortable. These baby’s are what I like to call “happy spitters.” Then, there are baby’s who spit up an abnormal amount and may even sometimes projectile. I call these the “projectile spitters,” and then there are those that don’t spit up at all but they may be constantly congested, cough or choke (aspirate) during feeding and these baby’s have a type of reflux known as “silent reflux.”
Let’s discuss why babies may present with reflux.
TOT (tethered oral tissue aka tongue/lip ties)
Allergy or food sensitivities
Tension in baby’s fascia or Torticollis (*This is the one I help with through Pediatric Physical Therapy)
Anatomical dysfunction
Genetics
Common complications due to reflux in infants are believed to be failure to thrive, poor weight gain, increased incidences of croup/cough, feeding difficulties, aspiration, and regurgitation.
The reason I mostly want to discuss in this blog is the connection between reflux and tension. As you can see, infant reflux can happen for many reasons but if you suspect any of these types of reflux in your infant, I would highly recommend checking for possible Torticollis and lip/tongue ties.
Infants with reflux usually appear colicky, prefer postural extension patterns (arching), fisting, and overall tension. They often arch their neck and back to close their sphincter and decrease pain so the contents don’t come back up and by doing so they develop this pattern of stronger extension muscles and weaker flexor muscles.
This muscle imbalance between flexor and extensor core muscles results in a more retracted posture and can lead to a decreased motivation to cross midline with their arms or use their arms to prop in tummy time. If rotation and arm strength are weak, this can commonly result in delays rolling and achieving hands and knees crawling. Rotation is also important through their trunk to be able to side sit and transition in and out of sitting/crawl.
Inability to cross midline and/or quadruped creep can lead into deficits down the road in fine motor skills, visual motor skills, abdominal strength, emotional regulation, spatial awareness, bilateral coordination and reflex integration.
A lack of these functional skills mentioned above can result in clumsiness, reading and writing learning delays, difficulties performing ADLs such as tying shoes and getting dressed, coloring, cutting, catching/throwing, walking, running, skipping, and riding a bike. Left (language) and right sides (emotions and creativity) of the brain cannot work together; therefore, behaviors may also arise.
As your can see, reflux and tension in infants is something that can have a trickling effect if not addressed early on. I highly recommend listening to your gut and reaching out if you have any concerns about reflux in your baby. If your baby is struggling in any capacity, search for a provider that can help because early identification is key. The proper team of specialists’ including a Pediatric Physical Therapist, Gastroenterologist, a Lactation Consultant, Dentist (for lip/tongue ties) and Body Work Specialist can be very beneficial to combat reflux and tension for your infant.