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  1. 1


    “feeding problems are under-identified in unsettled babies, and contribute very early on to stressed and upset behaviour.” Exactly! and there are far too many silly notions around feeding still bandied about for my liking.

  2. 2


    What an interesting article. I too am a GP and have spent most of the last 25 years specifically looking after ‘distressed babies’ in Perth.
    My experience is somewhat different and I am concerned about the information that these parents are given. After years of hearing the information that is given to parents to explain the cause of the crying I have found that a proportion of these infants have a combination of reflux and allergy [usually as intolerance of dairy protein]. This causes irritation of their Eustachian tubes and they develop ET dysfunction [i.e. negative pressure in their middle ears]. This causes pain on sucking and when lying down and often progresses to middle ear effusions and infections.
    There are many longer term implications for these infants with developmental delays, emotional and social issues. There is also a high risk for the children later having Central Auditory Processing Disorder with major problems with school learning–and this is rarely thought of as being related to the early ‘difficult’ behaviour.
    I call this condition Eustachian tube Irritation [ETI].
    The condition is diagnosed by the pattern of behaviour, the presence of reflux and atopy and the finding of an abnormal tympanogram.
    The infants respond well to treatment, but treatment needs to be started early if sequelae are to be prevented.
    Detailed information is available in the book i have written called Crying Babies & Beyond–the ins & outs and ups & downs’. there is a website at and I can be contacted at
    Dr Renee Shilkin

  3. 3


    I posted a comment above about the crying babies issue and realise that i have given an incorrect email address! How does one make a mistake giving one’s own contact address? Please note that my email contact should be
    Renee Shilkin

  4. 4


    Great article, thank you.

    1 – Please can I have a copy of the 3 publications you listed at the end.

    2 – Do you have any real-world, use now techniques that you use in consultations to help mothers feel supported, whilst steering them away from opting to try medication? Are there any online resources or help lines that you have found that will consistently give the information above?

    I find that mothers will often come to me (a GP) after speaking to another health professional and forming an opinion that their child might have reflux. It’s very hard to dissuade them from trying medication without coming across uncaring and alienating the mother – sending them to someone who will prescribe more readily.

    Charles Alpren

  5. 5


    I’ve been a dad for just two weeks, and the only thing wrong with this article is it ended just as it was getting started.


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