Infants, crying, and acid reflux make up one of the most debatable trilogies of our time. There are definitely two distinct camps. On the one side are those who say you should try to comfort an infant who is in pain at night, and then there are those who say infants should be able to comfort themselves back to sleep. In Part I of this SharePost, I present some of the ideas to consider and questions to ask as you decide which camp you belong. In Part II, I will present some of the latest research on infants, pain management and providing comfort.
1) If your infant is crying (or screaming) more than you think he or she should be, then the first thing you have to decide is whether or not there is an issue such as acid reflux which is causing physical pain. The problem here, is that humans sometimes don't do so well with abstract thinking. In other words, there are some who have decided that if you can't see the problem, it's not there. If you have determined that your infant is in physical pain related to acid reflux, you have to decide how you (and your medical team) would treat your baby if you could see the burning on the outside of his or her stomach. If your medical team could see the wound, would they advise you to let her "cry it out" by herself at night?
2) One of the worst times for someone with acid reflux is night time. Just take an informal survey of a few of your adult friends who have acid reflux. Ask them when their reflux bothers them the most. My guess is that they will say about three hours after a meal, and at night. This one isn't rocket-science. Reflux can feel worse for an infant or an adult at night, because once they lay down in a bed, gravity is no longer helping to keep their stomach contents out of their esophagus.
3) Medications have a limited half-life. A medication's half-life is simply how long it takes for half of the medicine to be eliminated from the bloodstream. So in an adult, a half-life of Prevacid may be less than two hours. However, the metabolism of an infant can be higher than that of an adult, so the dose of reflux medication you give the infant at 8 p.m. may no longer be working at 3 a.m.
4) Chronic pain can be a challenge no matter what your age. Coping skills are developmental - they happen with age and experience. A 45 year old who is in pain in the middle of the night is able to get up and take pain medication without waking anyone else up, but may not be able to get back to sleep without pain medication. A six year old in pain may be able to tiptoe to his parents' bedroom for comfort at night without waking up his siblings, but still may still need his parents' support or more medication in order to go back to sleep. So from a developmental standpoint, is it realistic to assume that an infant with stomach pain will have the emotional and physical skills needed to comfort him or herself back to sleep in the middle of the night?
In Part II of this SharePost I will share with you some of the latest research on infants and pain management.
Published On: October 22, 2008