Your baby isn’t gaining weight properly, sleeps poorly, spits up or frequently chokes when feeding and suffers from repeated lung infections – and worse of all; is making seizure-like movements of the back and neck. Could it be Sandifer’s syndrome?
Sandifer’s syndrome is a stomach disorder that can cause a baby to make disturbing and seizure-like movements that resemble an epileptic attack. These symptoms will usually be seen in children from shortly after birth up to adolescence in some cases. But, it’s most commonly seen in children from 18 to 24 months of age.
When the symptoms are seen in older children, they are typically mentally impaired, suffer spasticity or already have other neurological disorders.
According to an article in the journal Pediatrics International, Sandifer’s syndrome is a rare disorder that affects about one percent of children and is often misdiagnosed as some neurological problem because the symptoms don’t look like a stomach problem.
What is Sandifer’s syndrome?
Sandifer’s syndrome isn’t a disease, it’s a collection of symptoms that can be caused by acid reflux, and these symptoms may include:
- Torticollis, which is an involuntary and chronic movement of the child’s neck
- Dystonia, twisting and writhing movements that place the child in an abnormal posture because of involuntary muscle contractions
- Head nodding (the baby tips the chin down)
- Gurgling noises
- Back arching
Chronic acid reflux in children is usually called gastroesophageal reflux disease or GERD.
Signs of GERD
According to recent research, the common warning signs of the GERD that may create the symptoms of Sandifer’s syndrome are:
- Being frequently irritable
- Difficulty swallowing or choking spells
- Holding breath for short periods
- Back arching and head jerking
- Unusual eye movements
More severe warning signs are frequently contracting lung infections (pneumonia) which researchers believe is the body’s reaction to the pain of acid reflux or irritation of the esophagus. Feeding difficulties and not gaining weight on schedule are two other warning signs that a baby is dealing with the discomfort and pain of gastrointestinal problems.
What Causes Sandifer’s Syndrome?
Sandifer’s syndrome is a poorly understood health issue. Research hasn’t yet discovered what cause the symptoms of Sandifer’s syndrome. What doctors do realize is that the symptoms frequently come with stomach acid moving back up into the esophagus (acid reflux). The esophagus is the section of a child’s digestive tract that brings food from the mouth to the stomach. The theory is that the pain of stomach contents, acid or gas coming back up the esophagus could be the cause of Sandifer’s syndrome symptoms.
Treating Sandifer’s Syndrome
Doctors will focus on treating the symptoms of Sandifer syndrome and trying to fix whatever is causing the child’s persistent acid reflux problem, which the doctor may also call gastroesophageal reflux disease. The best way to treat this problem depends on the child’s symptoms and stage of development.
The doctor could prescribe:
- Feeding changes
- Antacid medicines
- Even surgery
There are various methods a pediatrician could use to correct the problems that may be causing the symptoms of Sandifer’s syndrome.
Feeding Changes for Sandifer’s Syndrome
According to currently accepted recommendations, a doctor could begin treating the child’s acid reflux issues by asking parents to change the way they handle feedings.
Changes may involve:
- Not overfeeding
- Keeping babies upright for a half hour after feeding
- Using a predigested protein formula for a few weeks if sensitivity to milk proteins is suspected
Parents could also be told to mix some rice cereal with the baby formula to help buffer the stomach acid that might be causing the Sandifer’s symptoms. If the child is still experiencing acid reflux after the feeding changes have been made and yet has problems gaining weight, growing, feeding or sleeping well, the next treatment could be antacid drugs.
Medicine for Sandifer’s Syndrome
Drugs that the doctor could prescribe to treat acid reflux and resolve the symptoms of Sandifer’s syndrome may include antacids like; Tagament, Pepcid, Axid or Zantac. There is also a class of drugs that inhibit stomach acid production called proton pump inhibitors that could be used. Proton pump inhibitors include Nexium, Prilosec, and Prevacid.
When Surgery is Required
Sometimes the acid reflux issues that result in Sandifer’s syndrome require surgical intervention. When surgery is recommended, the procedure that may be used is Nissen fundoplication. This is the repositioning and stitching of the upper part of the stomach around the spot where it attaches to the stomach.
In Nissen fundoplication, the surgeon wraps the top of the stomach around the bottom of the esophagus. Doing this tightens the opening of the food passage to fix the problem that could have let stomach acid back up into it.
What’s the Prognosis for Sandifer’s Syndrome?
The Mayo Clinic says that it’s uncommon for GERD and the symptoms of Sandifer’s disease to continue after the baby reaches approximately 18 months of age. The acid reflux that may be causing Sandifer’s symptoms is almost never a serious medical problem and typically becomes less of an issue as the child grows older.