Does your baby frequently arch their back? Do they look like they are in pain or discomfort?
Seeing your little one contort their body can be alarming. You just want them to be comfortable and happy, so when they start twisting away, it triggers immediate worry. Is it gas? Are they angry? Or is it something medical?
In this article, we will break down the common reasons babies arch their backs, distinguish between normal behavior and warning signs, and show you exactly how to help.
Key Takeaways
- Communication: Arching is often a non-verbal way to signal hunger, exhaustion, or frustration.
- Common Issues: Gas, reflux (GERD), and colic are frequent culprits behind back arching.
- Red Flags: While rare, persistent arching can indicate neurological issues like cerebral palsy or infantile spasms.
- Solutions: soothing techniques, position changes, and tummy massages usually resolve the issue quickly.
Common Causes of Baby Arching Back
Most of the time, back arching is a temporary reaction to physical or emotional feelings. We will look at the most likely reasons first.
Minor Causes
1. Communication and Frustration
Babies have limited ways to tell you what they need. Since they cannot speak, they use their entire body to talk. Arching the back is often a clear signal that they are protesting something. They might be upset, overtired, or simply done with whatever activity is happening.
You will know this is the cause if the arching stops once you change their environment or meet a specific need. For example, if they stop arching once you pick them up or put them down for a nap, it was likely just their way of saying, “I’ve had enough.”
2. Gas and Digestion
trapped gas is a major reason for back arching. When bubbles get stuck in your baby’s intestines, they naturally stretch out to try and relieve the pressure. You might notice them pulling their legs up and then straightening them out stiffly while arching.
This often happens after a feed or if they swallowed too much air while crying. A good burping session or a gentle tummy massage usually does the trick here.
3. Reflux (GERD)
If your baby arches their back during or immediately after eating, gastroesophageal reflux (GERD) is a strong possibility. Stomach acid travels back up the esophagus, causing a burning sensation similar to heartburn.
Babies arch their backs to stretch the esophagus and reduce the discomfort. Look for other signs like frequent spitting up, sour breath, or fussiness during feeds. In specific cases, babies may develop Sandifer syndrome, a condition where they twist and arch their back specifically to alleviate reflux pain (1).
4. Colic
Colic is defined by the “rule of three”: crying for more than three hours a day, for more than three days a week, for more than three weeks. During these crying spells, a colicky baby often clenches their fists, pulls up their legs, and arches their back in apparent distress.
While the exact cause of colic remains a mystery, theories range from digestive sensitivity to an immature nervous system (2). The good news is that colic is temporary and typically resolves by three to four months of age.
5. Rumination Disorder
This is a rare eating disorder where an infant swallows food, regurgitates it, and then swallows it again or spits it out. During this process, the baby may arch their back and make sucking motions with their lips to bring the food back up (3).
It can be triggered by stress or physical illness. If you notice weight loss or bad breath alongside the regurgitation, consult your pediatrician.
Serious Medical Causes
While less common, certain neurological or physical conditions can present with back arching. If the behavior seems involuntary or accompanies developmental delays, consider these possibilities.
1. Sleep Apnea
Obstructive sleep apnea causes pauses in breathing during sleep. Some babies will instinctively arch their backs while sleeping to hyperextend the neck and open their airway (4).
If you notice your baby snoring, gasping for air, or constantly sleeping with their head tilted far back, mention it to your doctor.
2. Autism Spectrum Disorder (ASD)
Back arching can sometimes be an early sign of autism, specifically related to sensory processing. Some babies with ASD may arch away when held to avoid physical contact, as the sensation of being touched might be overwhelming for them (5).
However, back arching alone does not mean your child has autism. Look for a cluster of symptoms, such as a lack of eye contact, not responding to their name, or delayed social smiling.
3. Cerebral Palsy
Cerebral palsy affects muscle tone and movement control. A baby with cerebral palsy may exhibit a persistent “tonic labyrinthine reflex.” This causes them to arch their back, stiffen their legs, and tilt their head back involuntarily.
If your baby feels constantly stiff or “floppy” and seems unable to control the arching, or if they are missing developmental milestones, a neurological evaluation is necessary (6).
4. Kernicterus
This is a very rare and dangerous type of brain damage caused by severe, untreated jaundice. When bilirubin levels get toxic, they can affect the brain, causing severe muscle spasms that force the baby into an arched position (7).
This is a medical emergency. It is usually accompanied by extreme lethargy, a high-pitched cry, and yellowing of the skin and eyes.
5. Infantile Spasms
Infantile spasms are a rare type of seizure. Unlike typical seizures with shaking, these often look like a sudden stiffness. The baby may crunch forward (like a sit-up) or arch backward while flinging their arms out.
These spasms often happen in clusters and can look like colic or startle reflexes (8). If you suspect this, record a video of the episode and see a neurologist immediately, as early treatment is critical for brain development.
How to Help Your Baby
If you have ruled out serious conditions, you can usually stop the arching by addressing the immediate discomfort. Here are effective ways to help your baby settle down.
1. Change the Position
If your baby is arching due to reflux, laying them flat will only make it worse. Keep them upright for at least 20 to 30 minutes after a feed to let gravity help digestion.
If they are arching in your arms because they want to get down, listen to them. Putting them on a play mat might be exactly what they want. Conversely, if they are arching on the floor, they might be craving a cuddle.
2. Soothe and Comfort
Overstimulation is real. If the lights are too bright or the room is too loud, your baby might arch to “escape” the noise. Move to a dark, quiet room. Rock them rhythmically and make a “shushing” sound.
Skin-to-skin contact releases oxytocin, which lowers stress levels for both of you (9). A warm bath can also relax tense muscles.
Your movements and voice should be soft, slow, and gentle, instead of bouncing your baby up and down. Turn off the television, and play soft music for a soothing effect. You can even give your baby a relaxing back massage. If you have a mellow attitude and disposition, your baby will feel it and respond accordingly.
Editor's Note:
Dr. Gina Jansheski, MD, FAAP3. Burping and Massage
If gas is the culprit, you need to get the air out. Try different burping positions, such as over your shoulder or sitting on your lap with their chin supported.
You can also try the “bicycle legs” maneuver. Lay your baby on their back and gently cycle their legs toward their tummy. This helps push trapped gas through the intestines and relieves the pressure causing the arching.
4. Distraction
Sometimes, a baby is just working themselves into a frenzy and needs a reset button. A change of scenery, a mirror, or a high-contrast toy can snap them out of the arching behavior. Once they are distracted, their muscles will relax, and you can re-engage with them.
When to Call the Doctor
Trust your gut. You know your baby better than anyone else. If the arching feels “wrong” or different from their usual behavior, make the call.
Specifically, you should seek medical advice if:
- The arching interferes with feeding or breathing.
- It is accompanied by other symptoms like fever, vomiting, or seizures.
- Your baby seems to be in pain when you touch them.
- They are missing developmental milestones.
Pro Tip: Doctors can’t always replicate the behavior in the office. If possible, use your phone to record a video of the arching episodes. This visual evidence is incredibly helpful for an accurate diagnosis.
FAQs
Do Babies Arch Their Back If They Have Constipation?
Yes, constipation often causes back arching. When a baby strains to pass a hard stool, they stiffen their body and arch their back in an attempt to engage their abdominal muscles. If your baby has not pooped in a while and seems uncomfortable, this is a likely cause.
Does Gas Cause Baby to Arch Back?
Absolutely. Gas pain is sharp and uncomfortable. Babies instinctively arch backward to stretch out their abdomen, hoping to relieve the pressure in their intestines. Bicycling their legs or a tummy massage can provide relief.
When Should I Be Worried About Baby Arching Back?
You should worry if the arching is accompanied by seizures, loss of consciousness, repetitive spasms, or developmental delays. Also, if the arching makes feeding impossible or results in poor weight gain, consult your pediatrician immediately.
Why Does My Baby Arch Back When I Pick Them Up?
This can be a sign of tactile defensiveness or overstimulation. Sometimes a baby simply does not want to be held at that moment. However, if this happens consistently with everyone, it could be an early sensory processing issue or a sign of reflux pain triggered by pressure on the stomach.
Is Back Arching a Sign of a Seizure?
It can be, specifically with Infantile Spasms. However, seizures usually look involuntary and rhythmic, whereas a tantrum or pain-related arching is often reactive to a situation. If the arching happens in clusters and the baby seems “checked out” or unresponsive during the episode, seek medical help.
