As parents, we can get anxious over the smallest things.
So when you start noticing your baby arching back while sleeping, you might think nothing of it at first, until it happens again!
What could it mean?
There are dozens of reasons why babies arch their back, some more serious than others.
Fortunately, it’s usually just a result of gas, reflux, colic, or even a combination of all three! (If you’re really unlucky.)
This movement isn’t dangerous by itself, and it could just be your baby developing her back muscles, but you should pay more attention if there are any other symptoms, which could indicate a more serious issue.
A baby with gastroesophageal reflux disease might arch her back to try and relieve some of the discomfort in her tummy, but this condition can also cause poor weight gain, so treating it is essential.
I’ve put together this comprehensive list of why your baby boy or girl could be arching, either while asleep or awake).
This is a great starting point if you’re trying to learn more about this behavior, but as always, your doctor should be your first port of call if you have any serious concerns.
Causes Of Baby Arching Back While Sleeping
Back arching can happen to your baby at any time.
The time it occurs can be a good indicator of the underlying cause behind the problem.
If you’ve noticed your baby arching back while sleeping, it might be a sign of conditions such as acid reflux and sleep apnea – more on this below!
1. Acid reflux
Also known as gastroesophageal reflux (GER), reflux is very common among babies, regardless of whether they’re breastfeeding, bottle-fed, or formula-fed.
Symptoms of GER usually appear before a baby is 2 months old and resolve before their first birthday.
It happens because babies have poorly developed esophageal sphincters, which are in charge of preventing the food inside the stomach from moving back up the esophagus.
Gastroesophageal reflux disease (GERD) is a more serious form of GER, where the symptoms are more severe (such as poor weight gain or even weight loss) and last for a longer period of time.
One of the most obvious signs of GER is a baby spitting up during or after a feed, but be sure to pay attention to see if your little one displays any of the following symptoms as well:
• Baby arching back while sleeping, lying down, or during/after a feed.
• Coughing while feeding.
• Frequent spit-up.
• Fussy while feeding.
• Feedings are difficult.
Keep in mind that some babies have silent reflux, which is when they don’t throw up the contents of their stomach, but swallow it back down again.
This means that even if your baby isn’t spitting up all the time, it doesn’t automatically mean she doesn’t have GER.
Why does back-arching occur during the day or when a baby sleeps?
The answer is that acid reflux is very uncomfortable – if you’ve ever experienced it yourself, you already know how unpleasant the sensation is.
Babies can’t do much to relieve the symptoms of GER, but by arching the back they can at least try to ease some of the discomfort.
So, what can you do to help your baby?
First off, if you suspect that your baby might have GER or even GERD, visit your pediatrician to see if this is the correct diagnosis, or if something else is the matter.
Common treatments include:
• Adding rice cereal to breast milk or formula.
• A special formula for acid reflux .
• Keeping your baby in an upright position for half an hour after a feed.
• Feeding your baby more frequently, but with smaller portions.
2. Sleep apnea
Sleep apnea, as the name suggests, is a disorder which impacts breathing while your baby is asleep.
It can be divided into two categories – obstructive sleep apnea (OSA) and central sleep apnea (CSA).
If you’ve noticed that your baby arches her back while sleeping, it could be because she’s trying to keep her airways open, especially if she returns to the back-arched position after you try to move her.
According to the American Academy of Pediatrics (AAP), around 2 percent of children have apnea – and the majority of these cases are undiagnosed.
In addition to the baby arching back while sleeping, here are some other common symptoms of apnea in children:
• Sleepiness during the day.
• Breathing issues at nighttime, such as pauses in breathing, choking, or gasping for air.
Premature babies are usually at greater risk of having apnea, while babies who were carried to term are less likely to have it.
If you suspect that this could be the cause behind your baby’s back-arching, pay a visit to your health care provider.
Treating apnea may involve surgery, so it’s necessary to talk to a medical professional about your options.
Colic is one of the biggest fears of all new parents.
Although it’s not a dangerous health condition, it can be incredibly difficult to deal with, especially if you’re a first-time parent.
If your baby girl or boy has colic, you’ll probably notice the following symptoms:
• Excessive crying, more than three hours per day.
• Back arching.
• Moving the legs towards the stomach.
• Clenching of hands into fists.
• Episodes of crying at a specific time each day.
A doctor will diagnose your child with this condition if she cries for at least three hours a day, for at least three days a week, for at least three consecutive weeks.
Doctors haven’t been able to determine what causes colic yet, although a strong case could be made for the following:
• Some babies are more sensitive to different foods than others. Your baby might have an allergy to cow’s milk protein (if she’s formula-fed) or something that you ate (if you’re breastfeeding).
• Gastroesophageal reflux.
• Exposure to tobacco, either while in utero or after birth.
Unfortunately, there’s no magic treatment for this condition.
Although it does go away by itself (usually by 3 months of age), there’s unfortunately nothing else you can do but be patient and ride out the storm.
Some parents who are bottle-feeding their baby try different bottles, as certain brands such as Dr. Brown and Philips Avent have specially designed bottles that might help reduce the symptoms of colic.
Others try gripe water, which is an old, natural remedy for cranky babies.
If your baby is formula-fed, you might want to look into using a gentle formula brand or even try hypoallergenic formula.
Make sure to cuddle your baby as much as possible and keep her close, as she might be craving close contact with mom or dad.
Baby carriers make this easier, and also keep your hands free so you can get other things done at the same time.
In any case, this phase won’t last forever, even though it might seem like it when you’re in the thick of it – so hang in there!
4. The Moro reflex
The Moro reflex is completely normal during your baby’s first few months of life.
It’s also called the startle reflex.
Between the ages of 3 and 6 months, your baby will likely outgrow it.
The Moro reflex is activated by a startling sensation, or when the baby thinks that she’s falling down.
As a result, the baby arches her back and straightens her limbs.
Gas is often mistaken as colic, especially because gassiness can cause significant discomfort in a baby’s digestive system, leading to irritability and crying.
Still, even babies that don’t have colicky symptoms can get gassy from time to time, and when they do they might want to stretch their tummy and arch their back to get some relief.
If you’re formula-feeding, you might discover that certain brands make your baby more gassy than usual, so it’s best to go with formula that helps with symptoms of gas.
You might also want to burp your baby twice – once during the feeding, and once after the feeding to reduce the amount of air that goes through her digestive system.
Gas drops and probiotics can help too.
6. Baby is trying to communicate with you
Babies have limited options when it comes to communicating their needs or desires, so your baby arching her back could be her way of using body language to communicate with you.
When your baby does this, she might want to let you know she’s not happy with whatever is going on – maybe she doesn’t want to be fed anymore or is being held by someone she’s not comfortable with.
7. Baby is upset
Your little one might be some way off throwing full-on toddler tantrums, but that doesn’t mean she doesn’t know how to arch her back and cry when she’s unhappy.
This is perfectly normal and expected behavior.
Newborn jaundice is a condition that makes the baby’s skin tone yellowish.
According to the AAP, it can take up to one month to clear for breastfeeding babies, and up to two weeks for formula-fed babies.
It’s caused by high bilirubin levels in the blood.
This chemical is normally removed by the liver, but in some cases it takes time for the infant’s liver to “learn” how to get rid of bilirubin, which leads to jaundice.
Most of the time jaundice resolves on its own, but in cases of severe jaundice, the bilirubin levels get so high that they lead to kernicterus, a condition that can cause brain damage.
One of the symptoms of kernicterus is back-arching, in addition to:
• Poor feeding.
• High-pitched crying.
• Baby is constantly sleeping or seems to constantly be awake.
• Floppy muscles.
The good news is that this condition is rare – if your doctor notices your baby’s bilirubin levels are becoming too high, they will prescribe a treatment – usually phototherapy or formula supplementation.
One of the signs that a child has autism is back-arching.
However, this symptom usually appears alongside others, such as:
• Lack of eye contact.
• Lack of smiling.
• Delayed language development.
Naturally, these symptoms will be much more pronounced in older babies and toddlers, so if you have an infant it will be difficult to determine whether autism is the real cause of your baby arching back while sleeping or being awake.
10. Cerebral palsy
Cerebral palsy is a serious condition typically caused by brain damage during pregnancy or childbirth.
Babies with this condition may arch their back, have poor motor skills, exhibit poor muscle tone, and show other developmental delays.
Most of the time a doctor is able to make a diagnosis around the time the child is one or two years old.
11. Infantile spasms
Infantile spasms, also known as West syndrome, is a disorder that causes short seizures usually lasting no longer than two seconds.
Unfortunately, this condition is often diagnosed later on as the symptoms of infantile spasms might be confused with colic.
The first instances occur when a child is three to eight months old.
They usually appear in clusters of multiple spasms.
Parents are encouraged to make a video of the spasms so that the child’s healthcare provider can make the proper diagnosis.
12. Nerve damage
Nerve injury or damage, particularly in the shoulder and neck area, may cause your baby to arch her back in a pronounced way simply because those muscles are stronger than the ones in the neck.
These kinds of nerve injuries are usually accompanied by a variety of other symptoms, such as one arm or hand being weaker than the other.
13. Rumination disorder
Rumination disorder happens when food is regurgitated from the stomach into the mouth, re-chewed, and then swallowed again.
Although in some cases, the baby will spit it out.
This rare disorder is more frequent among babies between three months and one year of age.
It’s accompanied by symptoms like chapped lips, tooth decay, unpleasant breath, stomach pain, and back-arching.
What You Can Do
Whether you’ve noticed your baby arching back when sleeping or awake, it’s natural to feel a little anxious, especially if you have a gut feeling that there’s more to this behavior than meets the eye.
If you believe there may be a serious cause behind this, be sure to make a note of every time your baby arches her back, including details such as the time, whether she was asleep or awake, if it happened after a feed, and any other symptoms you might have noticed.
During your next well-child visit, let your pediatrician know what you’ve noticed.
In case of seizures, it’s good to have video footage so the doctor can see the symptoms with their own eyes.
Let the doctor know if you have already tried any remedies, and how your baby responded to them – this might help them rule out certain conditions or remedies.
That being said, I don’t want you to panic – most of the time back-arching is normal and doesn’t indicate anything dangerous.
It’s likely to just be gas or your baby is working hard on strengthening those important back muscles!
If you have a colicky baby, don’t forget to give them lots of cuddles and look into all the things that could be a trigger for those long crying episodes.
Perhaps getting a new bottle or feeding your little one a gentle baby formula could be just what the doctor ordered!
When it comes to GER, feeding your baby in an upright position or adding rice cereal to your baby’s milk could help with keeping the food down and prevent your baby from spitting it back up.
It’s important to familiarize yourself with symptoms of GER and the more serious GERD, so you can seek medical attention on time.
Thankfully, you’re still at the stage where you’ll be making frequent visits to your pediatrician, so even if you miss something (although I’m sure nothing escapes your watchful eye!), the doctor will probably notice it.
The Bottom Line
There’s no escaping the fact that there are some serious conditions that could be causing your baby’s back-arching.
The good news is that they are usually rare and accompanied by other symptoms you can easily notice.
Back-arching usually appears as a consequence of gas or reflux.
Your baby will often try to stretch out her tummy so it doesn’t feel so uncomfortable, but there are a number of things you can do to help ease these symptoms, such as feeding her in an upright position or burping her twice in case she gets too gassy.
In rare cases, however, it could indicate developmental delays or even seizures.
If you suspect this to be the case, you should record a video to show to your pediatrician and make logs of when this behavior takes place.
Don’t forget to attend all of your well-child appointments so your doctor can make sure your baby is growing at a healthy rate, and there are no underlying health issues.
Noticing them in good time is essential!
I hope you found this article helpful, and now feel more confident about what your next steps are going to be!
• American Academy of Pediatrics. 2012, November 26. Sleep Apnea Detection. Healthy Children website.
• American Academy of Pediatrics. 2017, June 19. Jaundice in Newborns: Parent FAQs. Healthy Children website.
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