Question:
My 2-year-old son is waking up in the night screaming and throwing a tremendous fit that is hard to calm him down from. This happens even when he is sleeping in our bed. It occurs almost every night and has been for the past 2 to 3 weeks. We also have a 3-month-old son to whom the 2-year-old seems to have adjusted fine. The 2-year-old is what "they" consider a strong-willed child; he is very independent and a busy body. It breaks my heart to see him throw such violent fits, and any suggestions would be welcome.

Answer:
Since your toddler wakes up screaming even when he's sleeping in your bed, this is unlikely to be nighttime separation anxiety, which is the usual reason for 2-year-olds waking up. Waking up in "violent fits" suggests more than just your toddler being a restless sleeper. The two most commonly overlooked causes of this problem are food allergies and nightmares. Concerning nightmares, take inventory of his daily activities. Is he watching potentially scary television? Turn off the television for a week to see if it makes a difference. In their sleep, children often distort seemingly harmless television characters, which can reappear as monsters in their dreams and cause nightmares. Have a before-bedtime mellowing ritual, such as a warm bath, a soothing story, and leave a continuous-play tape recording of various lullabies at his bedside. When he awakens, often times hearing a familiar lullaby will be enough to help him get back to sleep on his own.

In our pediatric practice, I occasionally see a child who wakes up in violent fits due to a food hypersensitivity, usually to artificial colorings or preservatives. For one week, abstain from foods with artificial colorings or preservatives and see if that makes a difference. Also, reflect on any new foods that he has recently eaten that he may be allergic to, such as increasing dairy, wheat, corn, citrus, berries, nuts or nutbutter. Usually food allergies manifest themselves with daytime intestinal disturbances and/or skin rashes, but the occasional child may show a food sensitivity only by nightwaking.