Question: Hi, My sister has a four month old son. He is a high needs baby in that he has acid reflux, horrible gas, and issues defecating and tooting. He's on a probiotic for babies, antacid medicine and gets pear juice frequently during the day.
Lately, as in the past week, he has woke up screaming. Not the "hold me" scream but this horrible scream as if he's in terrible pain. It sounds the way I'd imagine a cat on fire would sound. He wont even be completely wake when he starts screaming, he'll take in this huge breath and then start screaming.
He'll do that for a while until he's completely awake and then he usually normal cries for a bit till she can get him soothed. My sister video taped it if a video would help let me know and I'll send you it through a private email. She is close to having a nervous breakdown because of this.
Anything you suggest looking into? I thought maybe he has night terrors but his eyes will still be closed, or perhaps one of the sphincters in his intestinal tract doesn't close right and stomach acid burns his esophagus (he's only really happy and smiley when his sitting upright and doesn't like being laid down), it could be many things but we don't even know where to start. HELP!!
Heidi's Answer: Dear Shanley,
I am sorry to hear about your nephew's problems and it must indeed be quite tough on your sister. Very good of you to help her, it is important to have good support in times like these.
Yes you can send me the video.
I must repeat though that I am not a medical professional, I do not give medical advice. If you believe that the screaming is due to serious medical issues, you must see his pediatrician.
Has your nephew been tested for sleep apnea? Talk about that to your doctor as well. The fact that you mention that he takes a huge breath before he starts screaming may be a hint in that direction. You can read an intro to apnea on the sleep apnea in infants page.
To start you would have to try and check if he stops breathing from time to time, and for how long. Don't let your sister worry too much about that though, it is rather rare but just important to do the check and to ask your doctor to make sure.
Good that you mention that he is happy when upright, that definitely complies with the acid reflux. You may already do that, but keep keeping him upright as much as possible, especially during feeding and the first 30-60 minutes after a feed. Do a diaper change before starting to feed, to avoid lying him down shortly after.
Refer to the infant reflux tips page for all tips, I suspect your sister already does these but you never know, one extra tip can help.
Teething can also be very painful for many babies, so it is important to avoid any discomfort from that, check for the best teething remedies.
And yes, it can still be night terrors, even with eyes closed, but I may see more in the video. Ask your sister to also check the night terrors page in case she hasn't already, just to see how much she recognizes.
The waking him up a couple of minutes before the screaming awake time (as I describe towards the bottom of that page) is usually very efficient to avoid night terrors so she should definitely try this at least a couple of times to see what happens.
As you say, there can be many causes and different things can play at the same time. But reducing reflux and teething discomfort to a maximum, and checking for night terrors are good first things to work on. Then also sleep apnea should be ruled out.
One question: is the pear juice on doctor's recommendation and what exactly is it for?
Meanwhile, it is important for your sister to think of herself too. Your support is important, and that of any other family member or friend.
Babysitting the little boy for a few hours every now and then can help her recharge batteries, maybe by catching up on some sleep or simply have some relaxing time by herself. A few hours like that every now and then can make such a difference and help her cope much better.