Saturday, March 07, 2015

Dr. Sears, I Don't Buy the "High-Needs Baby" Theory...

Babies are all high-needs at first.  But they are simple creatures.  They don't send subtle messages.  They don't have complex emotions.  They don't get offended at your word choice; they get hungry.  They aren't passive-aggressive; they're just helpless.  But they WANT to be quiet, to be happy-- because they WANT to be clean, dry, comfortable, safe, warm and fed.  If they cry, it's for a simple reason: something is wrong.  Most parents learn to run down the list of what could be wrong very quickly:  dirty diaper, too hot, too cold, lonely, hungry, needs to burp, frightening noise, tired... But there are babies for whom nothing "works"-- clean, dry, held tight and loved, they cry and cry and cry.

This is where the estimable Dr. Sears and I must part ways.  He would have us believe that some babies come out of the womb "high-needs;" naturally a bit more demanding; having a narrower spectrum of "comfort" or perhaps just a little ticked off that the world is so bright & cold... and that this is a normal personality variation.

Those of you who've worked nursery or held many children are probably holding up your hands right now, wanting to tell me-- just wait a minute, Christina, there ARE some kids like that!  And I agree.  Yes, there ARE babies who are more "difficult," more "demanding," who cry more and sleep less easily.  Where I differ with Dr. Sears is the assumption that these children are healthy.  These children don't have "high needs personalities;" they are in pain.  While "attachment parenting" can do these babies a tremendous service of ensuring that their needs are met in babyhood, it can also do them a tremendous DISservice of encouraging their parents to stop there-- to meet their needs and no more-- instead of working to correct whatever underlying issue is causing the crying, the fussing, the sleeplessness.

It seems to be common sense that babies would be designed to want "happiness."  Who doesn't want to have their needs met and be pain-free?  Babies are designed to cry until they get what they need from their parents.  If a baby keeps crying, it's because he still doesn't have what he needs.  If he keeps crying, he's in pain.  If he doesn't nap except in snatches, if he doesn't smile, if he seems tense, if he has reflux, if he doesn't want to be put down ever, then your mommy intuition is probably right:  something is off.   (I would extend this to children, too.  If a child is consistently whiny, fussy, defiant, unreasonable, angry, and unpleasant, my first question would be whether they feel well-- physically, then emotionally.  I am snappy and harder to live with when I have a headache!  This could be an entirely different post, but, barring turmoil and inconsistency in the home life, I would be suspect food allergies, vitamin deficiencies, subluxations and other neurological stress.)

But back to "high needs babies."  Having had two who seemed to fit that bill but who actually had underlying medical conditions I've been mentally compiling a list of possible reasons for "colic," "causeless crying" or "high-needs babyhood" over the past 4 years.  They are:

1. torticollis/ subluxation
2. tongue tie
3. other pain/discomfort- digestive, headache or earache- all related to food intolerances
4. neurological damage 
5. overtiredness
6. hunger
7. parenting style

Taking each of these in turn:

1. Torticollis/subluxation- either in the womb or during birth, some babies' spines are "kinked," especially their necks.  Some get into an odd, asymmetrical position during their last few months of development (especially twins), some have a strange presentation during birth or even birth trauma due to caesarean delivery, forceps or vacuum usage or pitocin-induced contractions (often far stronger than natural contractions).  Go back mentally to the last time you had a neck-ache... often it hurts to look or bend to one side, and at times nerves are actually pinched.  In babies with torticollis muscles on one side of the neck are shorter than the other, causing tension and pain of many kinds, or discomfort when a baby tries to turn its head one way.  As a speech pathologist friend once told me-- "We are designed to be pretty symmetrical.  Whenever a baby isn't, that's a sign of a problem."  One of the major nerves that goes through the neck and is easily affected by even slight tension is the vagus nerve, which affects digestion and heart rate (and mood).  In a baby, vagus nerve compression can cause sucking and digesting issues.

Hints that torticollis or subluxation is an underlying problem:

- baby holds its head always tilted the same way
- baby prefers to nurse only on one side
- baby prefers to lay on same side
- known birth trauma


- chiropractic care- you can find a certified pediatric chiropractor in your area here. Many chiropractors will come to your home days after delivery and adjust baby and mama.  A few testimonies of children helped by chiropractic care here and here.  The pressure used to adjust babies is the same amount you use to check a fruit for ripeness-- nothing scary or potentially damaging! Find a pediatric chiropractor here.
- craniosacral therapy - this therapy focuses on making sure the fluid that surrounds the spine and brain can flow correctly, without any pressure or difficulty.  Practitioners use a light touch-- some are licensed massage therapists, some are chiropractors, and some are occupational therapists.  Some success stories here.
- stretching as directed by a health care provider, and in some cases, physical therapy

2. Tongue/lip tie-  As you may know, this played a huge part in my son's disposition.  There are the obvious ways a tongue tie can cause issues-- baby gets too fatigued eating so he stops before he is full, then wakes up crying, or baby can't coordinate sucking and swallowing so he chokes-- again, leading to crying-- and with a lip tie, he can't get a good seal, so he often swallows air, leading to painful gas, and/or reflux again leading to crying. But tongue and lip ties also cause a fair amount of tension due to the restriction they impose on the lips, tongue and whole mouth.  This tension can lead to tension in the whole body.  I am on the Tongue Tie Babies Support Forum on Face Book and have seen some truly remarkable before & after pictures, of babies whose whole bodies were tense all the time, and after revision became the relaxed, happy infants they were meant to be.  Often, tongue-tie release (frenulectomy) goes hand in hand with bodywork (chiropractic care, CST, as described above).  It is the recommended follow-up to laser or scissor revision according to most care providers (including our son's doctor, Dr. Larry Kotlow).  Many children with tongue ties struggle with sensory integration and anxiety-- especially if they haven't had bodywork following their revision, or have not had a revision. One mom's testimony here.  Another here.

Hints that a tie is an underlying cause:

any of these symptoms
- a visible or felt tie.  Check for one yourself here.  Many of the preferred care providers on the TTSG list will also allow you to email in pics of your child's mouth and will give a preliminary evaluation based on that and a description of symptoms.
- baby being called "a lazy eater" 
- baby nursing frequently yet never seeming full- this also usually interferes with sleep


- complete tie revision by a knowledgable practitioner (usually dentists, a few ENTs) - usually done by laser but some providers use scissors
- "bodywork"- CST and/or chiropractic care
- suck training (sometimes occupational therapy, other times speech therapy)
stretches, massages and other strategies

3. Other pain-  This includes tummy pain due to indigestion, often due to imbalanced gut flora (too much "bad bacteria or yeast" and too few "good guys"), or could be migraines due to food allergies (yes, even babies can get them), or it could be pain from food sensitivities-- my son reacted to onion, echinacea, nutmeg and potatoes in my milk.

Hints that pain is an underlying problem:

Liam's bright red allergy-cheeks, 3 mos
- baby seems averse to nursing (and a tie has been addressed or been ruled out by a knowledgable practitioner)- he could be reacting to something in your milk and know it instinctively
- eczema or bright red cheeks following nursing (keep a food log to track these)
- gas, burping, drawing up of legs when crying, noisy belly, constipation followed by blow-outs
- baby popping on & off the breast, never fully draining a feeding
- visible signs of thrush in baby or yeast in mom; pain while nursing 


- have baby's ears checked.  Some babies (especially those with dairy intolerance) have constant low-level ear infections, which are painful but don't always manifest with a fever.  Natural treatments (such as garlic oil or onion; we use an ear oil similar to this one) of ear infections are often very effective in children, as are dietary reduction of sugar, salt and pasteurized cow's milk (all these tend to create mucus).  In cases where diet doesn't help, tubes may be recommended.  See below on probiotics & ear infections.
more allergy break-outs at 10 months old
- chiropractic adjustment- this specifically can help recurrent ear infections.  I've personally felt my ears drain following an adjustment as an adult!
- probiotics.  If baby's gut flora is off, she can't digest her food properly, causing gas and constipation and this hurts. In one study, L. reuteri was very successful at reducing crying time in "colicky' breast-fed & partially breast-fed babies. BioGaia drops have specifically been studied and found helpful (you can buy on Amazon).  Probiotics are also helpful at preventing and treating ear infections.  In another recent study, l. rhamnosus was used to treat anaphalactic peanut allergies, with promising results.
- be checked and treated for yeast.  Helpful resources here.  One friend's baby never nursed for longer than a few minutes at a time, popping off the breast and nursing around the clock, even at night.  She was also very very hard to soothe to sleep. These behaviors all greatly improved when her mom was treated for yeast.  Remember that mom AND baby should both be treated simultaneously, even if one seems to be asymptomatic.
- essential oils or herbs- many blends are helpful in digestion, often including chamomile, ginger, peppermint and fennel.  Oils would be diluted in a carrier oil and applied to feet or on belly.  Herbs would be made into a tincture or strong tea and fed in very small amounts (1/8 -1/4 tsp of tinctures, teaspoons of tea) to baby via dropper or in a bottle.
- elimination diet for nursing mom or solid-eating toddler - read Doris Rapp (MD)'s "Is This Your Child?" on diagnosing and treating food allergies.  As a child gets older, the GAPS diet may be useful in healing the gut and curing many pervasive chronic conditions, including food allergies and sensitivities.

4. neurological damage- this is the most controversial category, and potentially the most broad. Signs of neurological damage include an inability to sleep long stretches, difficulty regulating breathing, and sensory integration issues.  Several factors that could cause neurological damage include EMFsmetals in the environment (including mercury-contaminated fish in pregnancy), or other known toxins such as pesticides, both before and after birth.  Exposure to plastics- even pre-birth- like BPA can also cause a healthy person's DNA to have impaired methylation, as if they have a MTFHR mutation (more on this mutation later).  Highly recommended reading:  Gut and Psychology Syndrome (Dr. Natasha Campbell-McBride) and Healing the New Childhood Epidemics (Dr. Kenneth Bock).

One big potential for neurological damage is vaccinations.   One vaccine is routinely given at 12 hours old:  the Hepatitis B vaccine.  This vaccine aims to protect against a disease that is mainly sexually transmitted, and includes yeast and .25 mg of aluminum. Read the vaccine inserts for all possible reactions-- they include encephalitis & encephalopathy (brain swelling), migraine, multiple sclerosis, neuritis, neuropathy, paresthesia, Guillain-Barré syndrome and Bell’s palsy, optic neuritis, paralysis, paresis, seizures, syncope, and transverse myelitis.  (source) One such reaction to the vaccine is here, another here. In these cases the result was death, but there can be a whole spectrum of adverse reactions due to neurological damage, including the following.

My friend Megan M. has allowed me to share a bit of her son J's story:
J was a sweet healthy newborn who nursed well, slept well, and had a lusty cry the few times he let us hear it (such as his heel prick).  However, just before discharge at 2 days old he was vaccinated with the Hep B vaccine.  Immediately he screamed a high-pitched strange scream... and didn't stop screaming.  For the next day he screamed and nursed, sleeping in snatches of 5-15 minutes instead of the peaceful several-hour chunks he'd slept before.  When he finally fell asleep after 24 hours, I was so relieved.  He seemed to sleep deeply, finally.  However my relief turned to terror as after 4 hours I could not awaken him.  He remained limp and non-responsive, even as we undressed him and had ice on his feet.  As I tried to wake him up, he suddenly convulsed, his eyes flew open, and he stopped breathing.  I will never forget his face as long as I live.  I screamed to my mom, a nurse, to help.  She started CPR while I called 911.  By the time EMS arrived we had managed to get him breathing again.  We were rushed to the hospital where every imaginable test was run; blood tests, x-rays, even a spinal tap.  Every test was the same-- inconclusive.  No one could tell us why our perfectly healthy little boy had suddenly stopped breathing.  In the hospital he again had episodes of apnea (not breathing) but each time we were able to "get him started" again.  We mentioned the vaccine repeatedly but each time were told "the Hep B vaccine is safe."  After two days of testing, we were sent home with the diagnosis "unexplained life-threatening event," and given the rather empty assurance that "it probably won't happen again."  However, J stopped breathing multiple times for the next few months.  We slept with him on our chests so we could wake up and pat him until he would start breathing again.  He also never again slept long stretches-- he'd sleep half an hour and be awake the next 1.5 hours around the clock.   He did not sleep through the night until 17 months old.  As a concerned mom, I began to research the Hep B vaccine J had received and found that all but one of his symptoms were listed as potential effects on the vaccine insert.  Why, then, had his doctors been so adamant that it could not have been responsible?  

J was a very "high-needs" baby, and became a high-needs toddler;  sweet and happy, very smart, yet very intense, clingy and anxious when faced with change like separation from mama, with repetitive behaviors and odd fixations.  This past year we received an autism spectrum diagnosis.  Thanks to many strategies and therapies he is thriving in our homeschool; at age 6 he has nearly completed 3rd grade and is learning so well.  J's story is far from over, however, we will never know what his beginning would have been like without the Hep B vaccine."

It is a fact that at least some children will have an adverse reaction to vaccines; they are legally classified as "unavoidably unsafe"-- thence the establishment of the National Vaccine Injury Compensation Program to provide for & make reparations to families of children injured or killed by CDC-suggested vaccines.  Unfortunately, very little effort has been made to ascertain what risk factors could predict which children are most likely to have an adverse reaction. (you'd think with massive vaccine campaigns this would be important!) "...research suggests that most individuals who experience an adverse reaction to vaccines have a pre-existing susceptibility. These predispositions can exist for a number of reasons – genetic variants (in human or microbiome DNA), environmental exposures, behaviors, intervening illness or developmental stage, to name just a few, all of which can interact. Some of these adverse reactions are specific to the particular vaccine, while others may not be. Some of these predispositions may be detectable prior to the administration of vaccine; others, at least with current technology and practice, are not.” – Institute of Medicine, 2012 (source)

However, there are a few factors that might raise risk:  a tongue-tie or other midline defect (sacral dimple for ex), because it can be a symptom of a MTFHR mutation, which impairs remethylation, crucial for detoxification (this blogger sums it up well and has done her research well); personal history of overactive Th2 branch of the immune systemeczema, food allergies, seasonal allergies; family history of same; family history of vaccine reactions; anything GAPS related; personal history of mild to moderate vaccine reactions (high fever, high-pitched scream, lethargy, catatonia).  Many children who end up with a serious adverse reaction to vaccines had one or several "mild" but increasingly serious reactions to prior vaccines, especially vaccines in the same series.  This is an area where there are glaring gaps in research:  "The committee found that evidence assessing outcomes in subpopulations of children, who may be potentially susceptible to adverse reactions to vaccines (such as children with a family history of autoimmune disease or allergies or children born prematurely), was limited and is characterized by uncertainty about the definition of populations of interest and definitions of exposures or outcomes.” – Institute of Medicine, 2013"  (some research is being done but it is very limited)

Vaccinations during pregnancy are another factor to consider.  While the CDC currently recommends several vaccines to all pregnant women, the vaccine inserts themselves caution that there is no safety data regarding use in pregnancy (and breastfeeding, in some cases) and caution that the drug should only be administered "in cases of real need."  (See all inserts here.)  The flu shot is particularly controversial, firstly because in its injected multi-dose form it does contain mercury (thimerisol), but secondly because viral antibodies & fever during pregnancy increase the risk of autism and other neurological damage in the baby.  The point of vaccines it to trigger antibody production. If antibodies are a factor in autism, why risk anything that intentionally creates more?

Hints that neurological damage is a root cause:

 - change in disposition or sleeping habits soon after vaccination
- family history of vaccine reactions
- known MTFHR mutation in family or child (very helpful summary of MTFHR)
- family history of autoimmune or chronic disease (for ex. type 1 diabetes, eczema, serious food allergies, asthma, ADHD, ASD, lupus, rheumatoid arthritis, childhood cancer, celiac disease)
- mother vaccinated during pregnancy
- family home near cell towers or high-voltage power lines
- high degree of EMFs in room where child sleeps
- known interaction with pesticide or other environmental toxins


- avoiding further vaccination at least until child's neurological condition has resolved
detox baths to aid in detoxification
GAPS diet in children, best done under the supervision of a certified GAPS practitioner
- switching from vitamins and foods fortified with folic acid to the natural form, folate
- glutithione supplementation and eating foods high in glutithione (ex. avocados)
- coming under the care of a DAN! doctor, who look at chronic conditions in children from a multi-faceted biomedical model

Well, that sums up the first 4 medical reasons why a baby might be labeled "high-needs." That was pretty long; kudos to you if you're still reading! :) Tomorrow I will attempt to tackle the last 3 contributing causes which sound so much more ordinary. :)


Brita Long said...

I think I had the first one, although it was recognized and treated immediately. My parents or another family member had to hold my head straight for 20 minutes a day for the first 4 weeks or so after my birth. I was a twin--and a really big one--so that doesn't surprise me.

Two friends of mine have their 17-month old on a gluten-free diet. The dad has Celiac's, so their son is more at risk for it. They're going to wait until he can verbalize how he feels before they introduce gluten. Babies cry when there's a problem because they can't say their tummy hurts!

Eowyn's Heir said...

Absolutely! Brita I thought of you when I wrote the torticollis section! :) The crazy thing is for some babies it's an "easy fix" to get them to stop crying-- fix the torticollis, adjust the spine, give probiotics-- yet so many parents are told "oh, some babies just cry a lot." Poor lil guys.