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Night 11 and the Etiology of Night Waking

March 4, 2011

Fancy title, isn’t it?

Well last night was just about terrible. Actually, it started out great. She fell asleep on the opposite side of the bed from me, and slept solidly until 11:00 or so.

But then there was the Night Waking. And I’m actually convinced there’s a physical aspect to her night waking. Last night before she went to bed her belly was ridiculously bloated. Huge. She has kind of a big belly anyway, but it was enormous last night. She was happily running around naked, and didn’t seem to be in any discomfort, but the bloated belly concerned me.

Like I said, she slept well from about 8:30 to 11, then throughout the night she shouted out in what seemed like pain off and on until we got up at 6:35. Now, before I present to you my diagnoses, I’d like to make a disclaimer. I know that people all over the world love to make a diagnosis based on some stupid article they’ve read on the internet. And we all know that the internet is an open forum–yada, yada, yada—where anyone can say anything, and there are no fact checkers.

However.

I am proud to say that I diagnosed my dog with hypothyroidism when she was 3. The vets all said she was too young, and didn’t even want to test her. I pushed for them to, and voila. She was on the extreme end of hypothyroidism. I had spent hours carefully researching her symptoms, and came to the conclusion that she was hypothyroid.

I’m not saying that I’ve diagnosed Amelia with anything, but I have some ideas that I can at least take to the doctor to discuss. The first is this: peptic disorder. My mom and I both have acid reflux, so I know it runs in the family. This article from the American Academy of Family Physicians discusses abdominal pain in children and its causes. Check out this blurb, emphasis mine:

Peptic Disorders
The peptic disorders include reflux esophagitis, antral gastritis, gastric and duodenal ulcer, and H. pylori infection. Gastroesophageal reflux in children has recently been reviewed in another article.9

As we mentioned in the section on history, the signs and symptoms of peptic disease include early morning pain, early satiety, night arousal and a positive family history. The pain may be epigastric or periumbilical and is remarkably consistent in character. Occult bleeding is frequent with ulceration and less common in gastritis.10

The major risk factor for peptic ulcer disease in childhood is genetic predisposition: 50 percent of children with duodenal ulcer have a first-degree relative with peptic ulcer disease. The prevalence of duodenal ulcer is two to three times higher in boys than in girls. Gastric ulcer occurs substantially less often than duodenal ulcer, but the prevalence is equal in boys and girls.

Amelia is positive for all of those: early morning pain, early satiety, night arousal, and a positive family history. Now, of course I know that there could be other reasons for her night waking, early morning discomfort, and the fact that she seems to get full really fast, but it is interesting to me that this fits the bill.

Duodenal ulcers (I can’t imagine what would have caused her to get an ulcer) are made worse by the presence of acid, so once the food is digested it becomes painful. In other words, duodenal ulcers feel better in the presence of food. This would explain why she wakes up and really, really wants to nurse early in the morning, when her dinner has been completely digested. She doesn’t need nursing to settle earlier in the night; she’s fine with cuddles, or rolling over and falling asleep on her own. But in the morning she seems to be in pain until she can nurse.

There’s definitely a chance that this is not what it is. She also had a ton of dairy yesterday evening. This could’ve caused bloating and gas, which could’ve kept her awake throughout the night. Like I said, last night was especially worse, and she had more dairy than usual.

I’m going to try holding off on the dairy for maybe a couple days, and see how she sleeps tonight.

But does this make sense to any of you? Have you ever had a child with an ulcer or chronic abdominal pain?

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