4mo arching back and pulling off while nursing--what is this?

[Anonymous]

I know it can be a sign of reflux, but there are no other symptoms of that (and even silent reflux doesn't seem like it fits).

My EBF four-month-old periodically nurses for a few seconds and then goes stiff, arches his back, and pulls off, crying out. He goes right back to the breast a few seconds later so he's clearly still hungry, but often will repeat this a dozen times in a ten-minute nursing session. We've tried dark rooms, etc. to make sure it's not just a distracted baby, but I don't think that's it since he's not looking around at other things. It's really more like something hurt him and he's reacting, but then going back for more anyway. Once he finally gets going he seems fine, and no signs of distress after he's finished eating. If I pick him up and distract him he's all smiles so whatever it is doesn't seem to last. This doesn't happen every nursing session, but I haven't found a pattern to when it does and doesn't happen. As far as I know, I have no obvious issues with oversupply or fast letdown.

Anyone experience this and know what could cause it? He has a cough and is sneezy (started around the same time, I think---but no congestion) so I thought possibly an ear infection, but ped thinks that's unlikely absent other symptoms. Only other odd change is that his poop is sort of a soft peanut butter consistency (yuck!) without the "curds" it used to have in it---but otherwise normal color, frequency, etc. As of his four-month checkup, he was gaining beautifully. Any other thoughts? Thanks!

[Anonymous]

My DS is 3 mos and he does this sometimes when he gets a gas bubble. He's clearly still hungry but repeated comes off crying bc he is uncomfortable. A good purp usually helps us!

[Anonymous]

back arching is classic reflux. I'd try a prescription for xantac and see if it helps.

[Anonymous]

When my infant did this it was this:
http://www.llli.org/faq/foremilk.html

[Anonymous]

My son's behavior when nursing was very similar. He was diagnosed a bit late with reflux at 5 months. He did the back-arching thing, but also had a number of respiratory symptoms. We didn't think the breathing stuff had any connection to reflux, but were later told that sometimes it presents with respiratory symptoms as well. Since we have asthma in the family, we never made the connection. Hope you get it figured out. I wish we had realized it was reflux sooner. Maybe meds would have eased our little guy's discomfort. By the time, we realized that was what it was, he was starting to outgrow it, given that he was sitting up and starting to eat some solids. Good luck.

[Anonymous]

This is exactly what happened with mine at around 2.5 months. Has never been a spitter, but he did have some dry coughing and sounded a little congested. Also stopped sleeping well. Turned out it was silent reflux - zantac has helped tremendously.

[Anonymous]

Thanks all! I had no idea respiratory issues were among the silent reflux signs--we had issues with breathing and congestion up until a few weeks ago (IDed as just floppy/easily irritated airways by ped, and he does seem to have outgrown it...) so maybe we should probe reflux more as a cause. It's been a non-starter with his doctors since he has no other symptoms, but I'll call again...

[Anonymous]

What you're describing is called Sandifer syndrome- it's the baby's way of reacting to pain- usually reflux. There is a good chance that your child will outgrow this by age 1, but a small yet significant chance that this will set up all kinds of problems down the road with associating food with pain. Please take this very seriously.

[Anonymous]

Your baby sounds exactly like mine when she was about 1.5 to 4 months. I saw ped plenty of times telling them I thought she had reflux but they never thought that was it. Gave me Zantac, did nothing so I quit that. Saw 2 different GIs one at children's one at fairfax and both said no reflux. I thought then maybe dairy but elimination diets didn't curb it either. By 4 months it was gone and she nursed without issue every time. Who knows? Glad she outgrew it though, I'm sure yours will too

[Anonymous]

We had a similar experience with DS. Doctor thought it was reflux, and we treated with meds for awhile without seeing much difference. Eventually he outgrow it. In retrospect, I think the reflux dx was probably right.

[Anonymous]

OP again---thanks! Will call our pediatrician again Monday. Oddly, he takes a bottle with no complaints at all, but possibly that's because he's sitting more upright for that...? I was all excited that we were finally over our many early nursing issues (latch, vasospasms, etc.---all unrelated to this, at least it seems). Argh.

[Anonymous]

Do you have oversupply or does the milk come out too fast maybe? could be why he is OK once he's a ways in (milk flow slower). Both my kids did this - w/ DD I coudln't figure out why and she gave up nursing - same as your DC, she had no issues w/ bottle. W/ DS it was much more sporadic for a few weeks and then disappeared. the milk supply issue was one an LC suggested as we were trying to puzzle it thru.

[Anonymous]

My DD did this and two things helped. First, I nursed her in more of an upright position, using a pillow to prop up my arm. I made sure her head was at about a 45 degree angle higher than her feet. Secondly, when she pulled off the breast I burp her and then put her back on. Both of those in combination seemed to eliminate the issue.

[Anonymous]

OP again--no oversupply that I know of; no choking, etc., and after taking careful note of the patterns since posting, I noticed that about half the time the arching actually starts before he's even latched on, which is weird. We're trying the angle, smaller more frequent feedings, and lots of burp breaks, though not sure it's helping much. About one feed out of three is completely fine (as are all bottle feeds) and the rest range from fussing before finally latching to fussing so much that he never does latch long enough to get much. I do notice lots of wet burps, though, so beginning to think maybe this is reflux after all. Other big concurrent symptoms are the dry cough and going back to frequent night wakings, and sounds like those could be related if it is reflux.

I did look up Sandifer's syndrome but the videos I found demonstrating it look like what I thought was normal baby behavior--flapping arms and legs, startling. Is that not usual behavior for a 4mo? (FTM here hoping I haven't been ignoring some big red flags!) How would I know the difference? Thanks!

[Anonymous]

When this happened to us around the same age, I thought it was reflux but I think what it turned out to be was a growth spurt. DS was getting mad that he couldn't eat fast enough, I think. He would arch and twist (ouch!) and then pop right back on. We were both frustrated but fortunately after a week or so it seemed to resolve. I never had any supply issues and he always gained plenty of weight, but I guess at some point he just wanted more more more Good luck and hang in there!