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Cramps, pulls while crying with reflux in baby. Cause?

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Hi there, I am hoping to connect with a pediatric neurologist who will hopefully be able to ease my mind about something scary I have stumbled across online and now worry my 2 month old daughter may have - infantile spasms.

She often seems to have cramps and pulls herself forward while she's crying. She struggles with very bad reflux and is currently taking liquid zantac to help - which it does to some extent although she still cries often, for long periods of time and regurgitates. She also seems to struggle with gas pains. I'm really hoping that these factors are the cause for her body movements and not infantile spasms! The only reason I even came across this disorder on google is because we noticed that she began to turn her head from side to side frequently as of late and I was curios as to why. It seems like something she may do when she is tired, to soothe herself. Anyway, by searching that I eventually ended up finding out about infantile spasms and beginning to worry!

Her development seems normal. When she is not crying she smiles a lot and likes to listen to us talk. She follows objects with her eyes, holds her head up relatively well (and has since birth), and pushes her chest up easily when on her tummy. However, within the past few weeks she seems sloppy while taking the bottle (she used to be better at switching between the breast and the bottle, and seems to struggle with it more now at times - not always, so that is one thing I have noticed.) She also at times seems confused as to where to place her tongue when we are giving her a pacifier now, which she never did before. So, I'm not sure if that constitutes behaviour regression, as the websites about infantile spasms indicate? I have attached private links to youtube where I've posted 4 very short videos (about 30 seconds -1 minute each), that show you the movements I am worried about. You'll see her leaning forward while she is crying in two of them, doing what I hope is the Moro Reflex in her sleep in another and repeatedly turning her head side to side in another. Please advise whether we should ask our doctor to further investigate this or whether or not I am simply being paranoid because of Google!! I hope this is the case. Thank you so much in advance.

http://youtu.be/7PRFIVIMwzU

http://youtu.be/HpM98QeW8fA

http://youtu.be/OLiMIlVkzYI

http://youtu.be/Ys57lEKozjI


Category: Pediatric Neurologist

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Category: Pediatric Neurologist
 18 Doctors Online

Dear Parent,
Thank you for your query at DoctorSpring.com
I can most definitely understand your concerns. Internet can provide information that is scary and misleading.
I have taken a look at all four attached videos and they are definitely NOT suggestive of INFANTILE SPASMS.
In infantile spasms, the sudden spasms occur rhythmically in bursts. Classically in the mornings as the infant wakes up. These videos are definitely NOT SUGGESTIVE.
The rest of what you have described also does not amount to NUEROREGRESSION. This is classically what we call - NIPPLE CONFUSION. It is strictly advised not to use pacifiers because the mechanism of sucking at breasts and at a feeding bottle is entirely different. So most babies who are exposed to bottle feeding or nipple (as a pacifier) get confused. So kindly stop using pacifiers and bottle. Continue exclusive breastfeeding alone.
Regards


Patient replied :

Hello again and thank you for your answer. I felt so relieved when I read it. However, I have since seen another episode that looked much more like the videos I have seen online than what I sent you previously, and if you could please look at this I will feel so much better and be done with the matter. She had her routine 2-month immunizations today and has been upset most of the day. This particular episode happened a few minutes after awakening from a nap. She was startled by a loud noise and did a huge startle reflex, but then proceeded to do a few more moves that looked like the examples of the infantile spasms I've seen online. After a few minutes I decided to record it and I've provided you with a link to that portion - less than 2 minutes. Near the end there are two close together that to me really resemble what I've seen online, so please watch those in particular. I don't feel like she does it in the beginnign of the video at all.
I feel worried sick about this.
I should also add that she seemed to be struggling with her reflux, and after this was filmed we fed her and she spit up nearly her entire feed. Poor thing. I will be anxiously awaiting your answer. I also want to note that after this she was doing that "side to side" head movement that I sent you a video of last time as well. Do you think that is anything to be concerned about?
http://youtu.be/XHi-fGmXXBg
Thank you in advance for your patience with my worries!
Kind regards,
Krista


Dear Krista,
I understand that you are really worried. Infantile spasms are jerky spasms of the whole body which has a fast contraction phase and a slow relaxation phase.
Moreover, these spasms occur in clusters. Number of spasm per cluster can vary from 20 to even a 100. So there are multiple movement disorders of infancy that may mimic spasms. These include benign sleep-related myoclonus of infancy, gastroesophageal reflux induced Sandiffer syndrome.
GER can also lead to posturing or turning of neck from side to side and even arching of the neck. This entity is known as Sandiffer syndrome. You can read up more about this entity if you are interested.
So I am convinced that your baby does not have movements suggestive of infantile spasms. In case, movements start occurring in clusters or occur more frequently, we can review and decide regarding evaluating further.
To further clarify things, I have attached link to a classical infantile spasms video. I am sure you would have seen it as well. Nevertheless please check out this link: https://m.youtube.com/watch?v=86b9WufaQ1k
Please do not worry. Handle the baby with love. Cuddle her and shower all your love on her. Do not let her cry unattended for long. God bless.


Patient replied :

Hello again and thanks! But just to be totally clear, did you see the 2 at the end of the video? It's only at the end that I think she does it, twice, in about the last 40 seconds. I just want to be certain that you saw what I saw and still don't think it is infantile spasms. She did it about 8 times in 3 minutes (the video only capture 2 of those 8). But if you did see it and you're sure, then I will close the consultation and try not to worry anymore :) Thanks in advance for confirming this! Sorry to keep asking, I've just got myself so worried now.


Dear Krista,
Yes, I have seen the whole video with a special attention to the last part. i do not think that those movements qualify to be labelled as 'Infantile spasms'.
Please do not worry. If there is anything more that is bothering you, I would be more than happy to help.
Regards


Patient replied :

Thank you so much! I will close the consultation now.
All the best to you,
Krista



Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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