As a pediatrician, one of the reasons I am becoming increasingly cautious about insensitively using the cry-it-out approach to get
babies to sleep longer is that doctors and parents automatically assume that a
nightwaking baby has bad sleeping habits and they miss underlying painful causes
of nightwaking. Suspect a medical cause for nightwaking if:
- baby awakens with sudden colicky-type abdominal pains
- a good sleeper suddenly becomes a restless sleeper
- baby has not slept well since birth
- there are other signs or symptoms of illness
- baby cries inconsolably
- your intuition tells you something is wrong
- no other cause is apparent
Here are the most common painful causes of nightwaking and which are often
"hidden" because they are not as obvious as ear infections, teething, or urinary
1. Gastroesophageal reflux (GER)
When baby lies flat, irritating stomach acids are regurgitated into the
esophagus, causing pain that adults call "heartburn." Mention this possibility
to your doctor, since GER can often be successfully treated with smaller, more
frequent feedings, elevating the crib 30 degrees, and medication.
2. Food allergies,
such as an allergy to formula
or to the cow's milk breastfeeding mothers drink. Suspect if baby is restless
most of the night and is generally gassy.
3. Ear infections
Suspect an ear infection if
baby has a yellow discharge coming from her nose and/or eyes.
Suspect in the toddler or older child who
is waking up with scratch marks around the anus, other family members have
pinworms, or you see tiny white-thread-like worms around baby's anus or in the
bowel movements at night.
Infants who awaken frequently because of a medical cause are also more likely
to be colicky and fussy during the day, but not necessarily. If you suspect a
medical cause, in partnership with your doctor, keep investigating until you
find the cause and the treatment.