Q: What symptoms are most commonly seen in ‘crying babies’?
A: Most infants cry excessively or are more irritable than expected; they usually have problems sleeping; they may have discomfort when feeding—especially when breast feeding; are more comfortable when held upright and obtain relief from sucking a dummy, fist or thumb. Some infants with ear problems are extremely distressed when travelling in the car. The infants have reflux—either vomiting or ‘silent’ reflux. Most have allergies or intolerances or a family history of allergies.
Q: What treatment is given?
A: The children are individual and it is important to work with the doctor to set up a treatment program for each child.
Overall, children may need treatment of their reflux, dietary changes [for the mother while breast feeding, or change in formula for bottle fed babies]. Often the most useful dietary change is withdrawing all dairy products for a two week trial. Middle ear problems may need treatment depending on the type of problem [e.g., if the pressure is abnormal the infant may need low dose decongestants or if the ears are infected, antibiotics may be needed].
Q: Can the problems recur after treatment?
A: Infants often run a course of ‘ups & downs’ for the first months—often related to increases in refluxing, teething, colds, etc.
Q: Do children outgrow these problems?
A: Children may continue to have allergy problems but the types of allergy tend to change with age. Infants may have food intolerances or allergies; dry skin or eczema. Older children may have hay fever [called allergic rhinitis]; asthma; bowel symptoms or behavioural issues [often related to colouring agents, preservatives, etc].
Most children outgrow reflux when they are walking securely but a few continue to have reflux related to a family history of reflux. Reflux in older children is less obvious as the children are less likely to vomit or complain. They may have chest discomfort, recurrent wheezing, recurrent sinusitis, food refusals, etc.
Middle ear infections and glue ear may continue to be a problem for some children until about three, for some until about eight but usually stops before puberty.
Q: Can the child have problems later in life resulting from these problems?
A: Longer term problems are not uncommon in children whose ear problems were diagnosed late or not treated adequately. These include sleeping problems, speech and language delay, gross and fine motor skill problems and Central Auditory Processing Disorder.
Q : Can these problems be prevented?
A: We can look at the risk factors for each child and reduce some of these.
It may also be possible to reduce the risks for later infants by immunising the mother before conceiving or after the baby is born. Allergies may also be reduced by using probiotics.