Sandifer syndrome (SS) involves difficult contortions of the head, neck, and in some cases, the chest. It is seen in children who have gastro-esophageal reflux with or without a stomach hernia and the abnormal postures are an attempt to relieve their symptoms. The difficult contortion of the head and neck are thought to be involuntary and consisting of a sudden extension of the head and neck with the head possibly twisted from side to side and the upper part of the spine bent from side to side.
Early findings of SS found an association of stomach hernia with abnormal head and neck posturing. However, more recently, reports have shown that stomach hernia does not need to be present even though gastro esophageal reflux is a consistent finding.
Gastro esophageal reflux (GER) is the physiologic passage of gastric contents into the esophagus. GER is very frequent amongst infants, it occurs in more than two-thirds of healthy infants during the first few months of life.
The current study involves a 11-week-old girl with reflux, digestive problems, possible seizures, and possible colic. The patient was diagnosed with SS by her pediatric neurologist and pediatric GI specialist.
She had explosive bowel movements since birth, but then became constipated going 3-5 days without a bowel movement. During her first week of life, she would scream, hiccup, and spit up constantly and would not lay flat. When she was four weeks old, she had episodes of vomiting.
A week before her chiropractic consultation, laying on her back would cause her hands to shake, eyes to bounce, face to become red, and she would scream. The patient’s hands were getting raw from chewing on them and she would always be fidgeting. She was being given Zantac twice per day and was breastfed.
At each chiropractic visit, the patient was recorded using SOAP (subjective, objective, assessment, and plan) notes to assess her progress from visit to visit. Each chiropractic visit consisted of a chiropractic evaluation and an adjustment.
The patient was adjusted using the torque release technique (TRT), which focuses on the whole spinal-neural relationship while its analysis determines the major misalignment patterns. In addition, the doctor of chiropractic utilized the Integrator, a small hand-held instrument that delivers a measured amount of pressure on a specific area of misalignment.
By the 7th visit, the patient was having frequent bowel movements, decreased reflux, decreased gagging, decreased spitting up, and was able to lay on her back. On the 10th visit, her mother reported that she had been sleeping in her crib for six hours a night and was having daily bowel movements. The patient’s right neck and tailbone were adjusted using TRT and the Integrator.
At her 12th visit, a progressive evaluation was done by asking her mother what changes she had noticed since the patient began care. Her mother reported that she was less congested, had no more episodes of shaking, was better during tummy time, fought less when eating, slept better, and had more frequent bowel movements.
After her 30th visit, she was no longer throwing her arms up when placed on her back, not congested, or having issues with laying or fidgeting. Developmentally, the patient was ahead whereas before care she was behind. Her bowel function was now every three days and her mother temporarily switched her to a dairy-free diet. The patient’s behavioral changes included having a happier mood and being less agitated. Overall, she had more energy, was happier, and more playful.
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MLA Citation: Steinberg, Bruce, & Redell Hill, Antonio. “Sandifer Syndrome: Improved Health Outcomes in an Infant Undergoing Care for Vertebral Subluxation.” Journal of Pediatric, Maternal, & Family Health. 2016.1 (2016): 35-41.