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Sleep Disorders

6 Month Old Has Awoken Screaming Every Hour

06/23/2009

Question:

My 6 month old daughter woke last night every hour screaming, she normally gets up 1x per night for a feeding. She used to sleep on her belly but I am finding her on her side or back. She also is arching her back and crying when nursing as well as when I stop nursing. She has been eating solids for about 3 weeks but has not had a bowel movement in 3 days. She has 2 teeth which have come up in the last 2 weeks. Also this is my 3rd child, I am well versed with sleep disturbances. Also she has just started lifting up onto her hands and knees to rock forward and backward. Do you think there may be a health concern? Or something I should do, I do not want her to think each she can make a habbit of this. Normally she naps for 2-3 hour span and she woke screaming after one hour. Thanks

Answer:

You have a lot going on! As an experienced mother, I know you are very likely aware that cutting incisors at 6 months of age is very normal. I doubt that cutting teeth is the main cause of the problem.

It may be that solid foods are causing heartburn from reflux or that possibly she has a viral infection upsetting her stomach and causing tummy pain. Waking every hour crying and back arching with feeding both sound very much like a digestive irritant or pain problem.

Beyond reflux and heartburn, one of the most common problems that cause bouts of abdominal pain is called intussusceptions. In this problem, part of the small bowel becomes trapped in the first part of the large bowel. It may be released and then reoccur. This may be accompanied by red, musousy stools, called "currant jelly" stools, as well as drawing up of the legs to the abdomen and crying in pain. Although the new vaccine against Rota virus is far less likely to provoke this problem than the earlier vaccine, there is still a higher risk for intusussception with the vaccine than without it. The potential benefits from the vaccine are substantial but there is always the rare case of a side effect as described. If your daughter received this vaccine recently (many children get it at around 6 months of age) and the problem of bouts of crying are still happening, I think a call to your baby's pediatrician is in order.

If you do find a red stool in her diaper (and she has not been given beets or other red foods), keep the diaper and proceed to the nearest pediatric emergency room to have her evaluated. If your baby stops nursing, vomits, especially if it is forceful, or has large amounts of diarrhea, the pediatric emergency room is the place to go to avoid the risk of dehydration.

It’s also possible that the cause of her discomfort or pain may not be related to her gastrointestinal tract at all. It's worth making sure there are no long hairs or strings constricting a finger or toe and looking to see if she has any scratch marks on her face that might signal a corneal abrasion. Each of these problems causes bouts of crying in pain.

She is lucky to have an experienced, observant and caring mother. I hope these suggestions prove helpful.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University