Hello, AAAAA

I believe we have met before. How do you do? I have viewed your question and will attempt to answer both the sub-questions posed by you.

A baby's sleep hours continue to decrease as she grows. From an average of 16 hours in a day at birth, a normal baby will sleep for 12 hours or less by the time she is a year old. However, like most parameters, individual babies behave differently, and there will be some that will sleep even less than 9 hours in a day. To assume, therefore, that any baby that sleeps less than a given average is "abnormally" sleeping less is not correct.

The episodes of screaming when awake are not necessarily a sign of distress or pain, as this may be a form of wanting and demanding continuous attention, or a way of vocalisation, a process that would ultimately lead to normal speech. Crying, also a physiological event, occurs in up to 30% of normal infants, esp. before and at the time of sleep. It may be an indication of tiredness or sheer boredom with the monotony of waking-feeding-sleeping-waking etc.

I would recommend that you first consider that there might be something that is causing her to be restless and crying, and to check her out - look at her ears (for secretions, smell or perhaps a buzzing gnat or mosquito), her genital area (for a rash or peeling or redness of the skin ... all sufficient to cause extreme irritation), her clothes (too many, too tight, or causing allergy) and her stomach (distended if gas, or taut, if there is pain due to any reason). Also make sure there is no nose block (due to a cold) and cough (due to a sore throat or a respiratory infection). If all these are all right, I would rest easy. If anything is found, well, you need to take her to a pediatrician for further checking.

About the acute fall-back of her head against your shoulder ... did she have anything like a sudden bout of crying or was she is much distress? If not, leave it. Just examine her neck area for any swelling or areas of pain when touched. These are signs that there may be XXXXXXX injury .. so, if her movements are free, and she has no crying or pain on touching, it is highly unlikely that she has any issues from the incident.

Thanks for the question, and I hope you are satisfied with the answer.

With warm personal regards,

Dr. Taher

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Dear AAAA

Thank you for the appreciation. I am glad that my advice has been helpful to you. You may ask me future questions directly if needed by visiting my profile and clicking on "Ask me a question".

Back to your concerns: I am almost 100% sure that there has been no brain injury. However, sometimes, there is a microscopic shift of XXXXXXX brain structures and fluids, so technically, there could have been an insignificant trauma --- which can be usually ignored. Watch out for any symptoms in the next 72 hours, the necessary observation period for all head injuries. Symptoms such as vomiting and any change in behaviour or consciousness would require urgent attention.

Hearing tests are often asked by parents who find a difference in their child's hearing behaviour. Distraction test is often used for babies of 5-6 months or older. For younger babies, doctors rely more on what is called "auditory brain stem evoked potentials (BEP) test". This is a high tech test performed on babies whose initial screening tests are found abnormal by an ENT doctor. In your case, I suggest that you keep checking her response with sounds of different kinds (frequencies) and intensity; infants with some form of hearing problems will have difficulties perceiving some frequencies but not others. However, in view of the fact that she does respond to most sounds seems to rule out a major hearing problem.

If she continues to "ignore" sounds, you might want to take the BEP under the guidance of a pediatric ENT specialist.

Take care, and accept the answer if no further questions. I would be grateful if you took out some time to rate my answer and to write a review.

Thank you.

Dr. Taher

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