This may be a reluctance to go to sleep or frequent waking. Babies and children do not always sleep and wake at the times a parent might expect. This may cause disruption to the child and family routine. Over a prolonged period it may cause parents to become overtired and under stress. Dr Rundle has specialised in advising and counselling parents about their child's sleep disorders for many years - it is one of the leading reasons many parents and children come to her clinics each year.

Filmed research shows that babies who are perceived not to sleep actually wake up the same number of times as those who are perceived to sleep all night. "The difference," says Dr Rundle, "is that poor sleepers don't learn to to settle themselves because their mothers tend to do something, like rock them to sleep." If possible Dr Rundle sees the baby at home "to understand the sleeping arrangements and atmosphere", studies the medical, development and feeding history, and does an examination. "I need to rule out physical causes for not sleeping." Then she asks about the mother's pregnancy. "It's important to know if she has had stillbirths or miscarriages. The more treasured the baby, the more concern if he/she cries and the less inclined the mother is to leave the baby to settle." She asks about the mother's health. "Mothers with postnatal depression, for example, often imagine faults in their babies."

Mothers should not reward the baby for waking, says Dr Rundle. "No feeding (babies do not need night feeding after five months), cuddling or playing during the night. I suggest a deadpan approach without too much emotion." All the baby's carers should act consistently. Dr Rundle then agrees a contract with the mother, "She may check the baby every five minutes or simply leave him/her. The longest the baby could, theoretically, be left to cry would be all night." For the first week, many mothers opt for checking the baby frequently. Thereafter they often leave the baby to cry, which usually gets faster results. "Usually babies cry for two or three hours the first night, an hour the second and for a minimal period on the third."

Dr Rundle sees babies from eight weeks to children of up to twelve years, mostly of first time parents. "First timers have a higher incidence of sleep disordered babies because of the parents' inexperience. Some come with subsequent babies and children. "Often their earlier children haven't slept and suddenly they can't cope with three children not sleeping". There tends to be more sleep problems with "precious" children who have medical complications, were premature or hard to conceive.

The relationship between mother and child often improves with treatment.

In a few cases, Dr Rundle sees families where the baby's crying results in more serious consequences - the mother may have suffered depression and been admitted to hospital, the marriage or relationship with her partner may have broken down because of the effect on the relationship of the baby's overwhelming needs, or at worst where the baby's crying has led to abuse of the baby. "People always want to solve the difficulty themselves, but if it takes the support and counselling of a third party to prevent such outcomes, it's worth it."

Sleep, baby sleep - how to have an unbroken night. See Dr Rundle's checklist.

Back to the top of the page