Could my baby have a sore shoulder?

Unsettled babies is a common presentation to a paediatric Chiropractic practice.

“Unsettled” symptoms include a baby who cries excessively, body tension, poor sleep, ‘colicky symptoms”, and “reflux” type symptoms. These same babies may also present with breastfeeding dysfunction , difficulty with tummy time, comfort when dressing, or other triggers.

There are many reasons why a baby can be unsettled. 

Our practice uses a systematic approach to determining all factors that may be contributing to your unsettled baby. Less than 5% of babies who are unsettled have a medical pathological cause, and parents are sometimes told their baby is “normal” because no medical diagnosis has been discovered.

The shoulder dysfunction.

The shoulder dysfunction is a common examination finding at paediatric Chiropractic practices. One 2017 study looking at this, finding 75% of infants analyzed in a one year period had extremity dysfunction, with the shoulder being the most frequent.

Possible causes discussed in the literature includes birth trauma, and in utero constraint (pressure on extremity structures before birth).

A 2020 study looked at risk factors that may make shoulder dysfunction more likely. Interestingly, shoulder dysfunction was more common in caesarian births (78%), however was still high in vaginal deliveries (71%). In addition, non-first borns and babies over 3.5 kg may have increased risk of shoulder dysfunction.

Right shoulder dysfunction is more common than the left, with approximately 8/10 likely to be a right sided shoulder dysfunction, possibly due to physical stressors associated with the more common occiput anterior birth presentation.

Signs most related to shoulder dysfunction seen clinically are:

• pain behaviour
• irritability
• Fisting on involved side
• Delayed rolling, crawling, and difficulty with tummy time.
• dislikes being dressed
• head preference and plagiocephaly.
• Feeding difficulties
• Generalized muscle tension in the body
• Early development of hand preference
• Poor use of one arm

Irritable behaviour in a baby is not benign and may be associated with other morbidities such as such as lower IQ scores, fine motor delays, cognitive problems at 5 years of age, hyperactivity, maternal/paternal mental health issues.

References:

Available on request.