Questions About the Impact of Reflux on Motor Development

Is there a relationship between reflux and motor development?

Yes, in our experience there appears to be a relationship between reflux and delayed or different motor skills for some children.

What about tummy time? Infants with reflux in general do not like to be placed on their stomach. Because of this many infants avoid or fuss during tummy time. In turn, because parents do not want to aggravate their often irritable baby, tummy time is often avoided by both parents and infants with reflux. So why would that be a problem? Well, effective motor skill and feeding skills are dependent on the core strength and stability that flexor motor patterns develop.

What about extensor muscle tone? Extensor patterns of movement are often dominant in an infant with reflux. How does this happen? Every time your baby arches, extends his head back or extends his arms out, he is practicing extensor patterns of movement. Over time, the repetition of extensor movement patterns can become the standard pattern of movement. Dominant extensor muscle patterns can interfere with typical motor development and can negatively influence the entire feeding system.

What about low muscle tone? Children with low muscle tone can be at greater risk for reflux. Children with low muscle tone have poor trunk strength and may avoid movement that requires trunk rotation. It is suspected that they circumvent rotational activities to avoid the increased abdominal pressure that accompanies trunk rotation. They compensate for the lack of necessary trunk rotation by scooting around and/or reaching forwards to acquire the desired object. Avoidance of rotational activities can also influence the development oral motor skills for feeding. For example, as reflux is addressed and adequately managed, and the child develops trunk rotation, lateral tongue movements are more easily stimulated in feeding therapy. The acquisition of lateral tongue movements enable chewing skills to emerge as lateral tongue movements are necessary to transfer and maintain food on the lateral biting surface (teeth or gums depending on age). Often, the development of trunk rotation and lateral tongue movements for chewing go hand in hand.

What about precocious motor skills? Yes, there are some children with reflux who develop motor skills more quickly than age matched peers. Because of the reflux, these children prefer to be upright and therefore spend a lot of time standing and squatting. The squats strengthen their quadriceps. With strong quads and reduced upper body strength due to the of the avoidance or limited tummy time, these children tend to spend little time or skip crawling altogether. In turn, they tend to walk earlier than developmentally expected. Although a young walker will turn heads, spending limited time crawling or skipping crawling all together is not advised as working core is more important than early walking. The rotational and reciprocal movements that crawling facilitates is also found to be important for brain growth and learning.

There are many ways that reflux can influence motor development and motor development can influence reflux. Be a good investigator and if you are concerned, seek professional advice!