Sandifer syndrome is an eponymous paediatric medical disorder, characterised by gastrointestinal symptoms and associated neurological features. There is a significant correlation between the syndrome and gastro-oesophageal reflux disease; however, it is estimated to occur in less than 1% of children with reflux.
Sandifer syndrome is typically not serious and usually resolves within the first two years of life without any long-term complications. However, early diagnosis is essential to manage associated conditions and treat Sandifer syndrome.
In a typical attack of Sandifer syndrome, a baby's back will arch suddenly. With their back flexed, their head and legs also splay out backward. They become stiff. Other expressions of the syndrome include nodding head movements, twisting or tilting of the head, or thrashing limbs.
The exact cause of Sandifer syndrome is unknown. Studies suggest that an underdeveloped connection between the food pipe (esophagus) and the stomach in infants allows the stomach's contents to flow back into the food pipe, which can lead to gastroesophageal reflux disease (GERD), but research is ongoing to learn more.
Sandifer syndrome is a rare complication of gastro-oesophageal reflux disease (GERD) when a patient presents with extraoesophageal symptoms, typically neurological.
Studies have shown that those with ASD are more prone to GI dysfunction with the most common symptoms being diarrhea, constipation, abdominal pain, and gastroesophageal reflux disease related symptoms.
Reflux usually happens because your baby's food pipe (oesophagus) has not fully developed, so milk can come back up easily. Your baby's oesophagus will develop as they get older and the reflux should stop.
Your child's Sandifer's syndrome diagnosis requires quick treatment to reduce their pain and discomfort. If they did not get this treatment initially, you may have a birth injury case.
The prognosis for these infants is excellent. Once GERD is established as the etiology for Sandifer syndrome, timely and appropriate treatment of GERD decreases the dystonic episodes and, over time, resolves in the majority of patients.
Symptoms of reflux in babies include: Bringing up milk or being sick during or shortly after feeding. Coughing or hiccupping when feeding. Being unsettled during feeding.
Sandifer syndrome is body stiffening due to gastroesophageal reflux, but it may look similar to the tonic spasms seen in infantile spasms. Differentiating them may require additional workup, including a pH probe and an upper GI series.
The American Academy of Pediatrics advises that the back sleeping position be recommended in the treatment of gastro-oesophageal reflux for mild to moderate cases 5. The tummy and side sleeping positions significantly increase the risk of sudden infant death for babies under six months of age 5, 6.
Children who are experiencing discomfort due to GI issues such as reflux and/or constipation, may have difficulty tolerating tummy time as mentioned above. As a result, they may demonstrate delayed gross motor skills such as rolling and crawling. GI issues may also delay a child's speech development.
Silent reflux can be just as hard to cope with as regular reflux. While there may not be sick to clean up, feeding can still be difficult. It's normal to feel disheartened, but rest assured that this phase should pass as your baby's digestive system develops.
Additionally, a medical study found that the 'non-nutritive' sucking (sucking without feeding) with a dummy can improve the rate the stomach empties and also decrease the number of reflux episodes in a group of premature infants.
The vomiting that affects many babies and children with GERD can cause problems with weight gain and poor nutrition. Over time, when stomach acid backs up into the esophagus, it can also lead to: Inflammation of the esophagus, called esophagitis. Sores or ulcers in the esophagus, which can be painful and may bleed.
Symptoms of GERD
Infants with this problem cry numerous times per day. They also act very unhappy when they are not crying. They are in almost constant discomfort. Poor Weight Gain.
Signs and Symptoms
People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention.
Dyslexia and dyspraxia
Some autistic people have: problems with reading, writing and spelling (dyslexia) clumsy movements and problems with organisation and following instructions (developmental co-ordination disorder, or dyspraxia)
If your baby has reflux, you can and should continue with tummy time. Try the positions where your baby is more upright such as on your chest, over your legs or on a gym ball. Remember to leave 20 to 30 minutes after a feed before placing your baby on their tummy to reduce vomiting and discomfort.
Sandifer syndrome may also present along with ocular manifestation, growth and developmental delay, irritability, and iron deficiency anaemia.