When your baby wakes at night and cannot settle to sleep, one of the thoughts that will go through your head is whether she is ill. If your baby is usually a good sleeper and suddenly has a few very bad nights, it is certainly a reasonable concern and worth looking into. If your newborn is never sleeping longer than 45 minutes to an hour day and night – it is also possible that health issues underlie the poor sleep. If your toddler has been a great sleeper and can self-sooth to sleep but starts waking and being unable to fall back asleep, you may need to look at health issues. 

The following health issues can really disrupt sleep:

• Reflux (regurgitation of milk curds) can burn the oesophagus and causes discomfort when lying horizontal. This is more prevalent in younger babies and if your baby is unsettled and never sleeping for long periods you need to rule this out.
• If your baby’s sleep has gradually degenerated and she is unsettled at night for a period of time you will want to rule out chronic health issues, such as glue ear, iron deficiency and allergies. 
• Teething can cause sleep disruptions but usually only for a few nights as your baby’s teeth erupt. Beware of blaming long-term sleep issues on teething. 
• Acute illnesses or periods of hospitalisation wreck havoc with sleep. Your baby will sleep poorly and need more comfort when feeling off colour, especially if in hospital. You will notice symptoms of the illness during daylight hours and this is usually accompanied by poor feeding. Sleep issues that arise as consequence of illness and hospitalisation need to addressed once your baby is well. 
• Worms can affect your toddler and if your toddler has a worm infestation, she will be very unsettled as she wakes at night. Deworm your toddler once older than 2 years of age. 
• If your baby is on medication of any type and her sleep is poor, ask your doctor if the medication can affect sleep. Some medications have a stimulant effect and lead to difficulty falling or staying asleep. 

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Meg Faure

Megan Faure OTR, is an Occupational Therapist who has worked with babies in the USA and South Africa. Meg co- authored Baby Sense, Sleep Sense and Feeding Sense and in 2011 wrote The Baby Sense Secret. In 2004 Meg founded the Baby Sense company and developed a range of baby products and a smart phone Application called Baby Sense Day-by-Day. Megan runs practice in Cape Town, treating babies and toddlers with sleep problems and sensory processing difficulties. She is married with three children James (16), Alex (13) and Emily (9).

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