Dear Lactnet Friends:
Fabulous new paper. Does anyone have access? I've emailed the author, but
the email bounced back.
Med Hypotheses. <http://www.ncbi.nlm.nih.gov/pubmed/15780481#>
2005;64(5):887-98.
Excessive crying and gastro-oesophageal reflux disease in infants:
misalignment of biology and culture.
Douglas PS<http://www.ncbi.nlm.nih.gov/pubmed?term=Douglas%20PS%5BAuthor%5D&cauthor=true&cauthor_uid=15780481>
.
Source
Centre for General Practice, University of Queensland Medical School,
Herston Road, Herston, Queensland 4006, Australia. [log in to unmask]
Abstract
Excessive crying is the most common problem presenting to the doctor in the
first months of life in western industrialised societies, affecting up to
30% of infants. There has been an exponential increase in the diagnosis of
gastro-oesophageal reflux disease (GORD) in babies who cry excessively over
the past few decades, and many parents believe their crying infant "has
reflux". This paper proposes that culturocentric assumptions have confused
interpretation of research into GORD, and re-examines the findings of GORD
research from the perspective of evolutionary biology. Evolutionary
biologists argue that the human infant is an exterogestate foetus for at
least the first six months of life, dependent on maternal co-regulation for
optimal physiological function. However, infant-care practices in western
industrialised societies shifted towards an emphasis on infant autonomy at
the time of the Industrial Revolution. From the perspective of evolutionary
biology, a misalignment between western culture and the biological
expectations of the infant developed over two million years of evolution
may result in excessive crying in less adapted babies. The key biocultural
factors that impact on infant distress are feeding management, parental
responsiveness, sensory nourishment and sleep management. When the concept
of the human infant as an exterogestate foetus is integrated with the
findings of GORD research, a hypothesis and its corollary emerge. This
hypothesis proposes that infant GORD is a physiological manifestation of
misalignment between biology and culture, and proposes, as a corollary,
that if the impact of biocultural factors upon the physiology of otherwise
well crying babies is not addressed in the first months of life,
populations of infants who cry excessively may be predisposed to GORD after
three to four months of age. If this hypothesis is correct, an integrated
clinical approach to crying babies less than three to four months of age
that considers feeding management (e.g., frequent feeds, breast- or
bottle-feeding technique, referral to a lactation consultant, cow's milk
allergy), parental responsiveness (e.g., prompt response to infant cues),
sensory nourishment (e.g., sling or backpack, walks, massage) and sleep
management (e.g., nocturnal co-sleeping) should, firstly, decrease crying
when applied to infants less than three to four months of age, and
secondly, decrease the incidence of GORD in these infants once they are
older than three to four months of age. Thirdly, if this hypothesis is
correct, combining the integrated approach with pharmaceutical intervention
should improve outcomes in infants diagnosed with GORD.
WOW!!
warmly,
--
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com
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