Sandifer's syndrome in a breast-fed infant

Sandifer's syndrome is a rare manifestation of gastroesophageal reflux (GER ) in children, occurring in association with abnormal movements of the head , neck, and upper part of the trunk. Out of 65 children with Sandifer's syn drome described in literature, only 2 were breast-fed. We report on a 15-da y-old breast-fed girl affected by Sandifer's syndrome. Pathological GER was diagnosed with 24 h pH esophageal monitoring. In our patient, all the symp toms of Sandifer's syndrome disappeared when she was cow's milk formula-fed . The role of food allergy to dietary proteins ingested by a lactating moth er is discussed.