3 Cases from the clinic
1
Kári is a 14 month old boy.
Both parents attended the interview at the clinic. They live together and the boy is their first child.
Parents´ concern: His parents are worried about him being tired and not as happy as he used to be. They are
confused as to what to do at night.
Sleep history: He slept well when he was younger. Woke up like expected to feed until he was around 7-8
months old. He has always been sensitive about sounds in the environment, like if the parents have visitors
or a dog barking in the garden. He also always slept best if everything was in order. He likes to have always
the same thing done for him at the same time, and the same way, then everything went fine (Habitual and
easily distracted). Since he was around 3 months old he has fallen asleep at 8 pm. Always at 8 he gets tired
and is laid down in his own bed and falls asleep without any fuss, the parent go out of the room and he is
calm. The sleep difficulties started when he was around 9 months old, just before he got an ear infection and
at the same time learned to stand up and started to move around much more. Then he started waking up at
night. At first just a few times a night and it was not difficult to get him to fall asleep again.
Sleep routine now: Now he usually has a brief rousing around midnight and usually goes to sleep again
without any help. Next he wakes up at 3 or 4 am and then he stays awake for 2-3 hours (just well awake). He
is not necessarily unhappy, at first he is playing on his own in his bed, then he starts getting bored and wants
some company. The parents have tried various things; giving him something to drink, taking him into their
own bed, but it does not matter. After 2-3 hours he falls asleep again and sleeps for 1-2 hours. In the
morning he is tired and wants to take a nap after staying up for 1½-2 hours. That is usually around 9 or 9:30,
then he sleeps for 2-3 hours (this nap is getting longer and longer) then he wakes up but is not as tired as in
the morning. He takes another nap at about 3 pm and sleeps for 1-1½ hours (like he has been for some time).
Comments that the parents have had from people
 You just have to be strict. Not to respond to him at night. You reward him by giving him a bottle or
taking him into your bed.
 You could put him in a separate room and let him be.
 He sleeps too much during his day naps. You have to let him take just one.
 This is separation anxiety, just have him in your bed, he will get more relaxed and calm and start to
sleep better.
2 Helena is 6 months old. Depressed mother.
Both parents and her 8 years old sister attended the interview at the clinic.
Health: Helena is healthy. Her mother has a history of depression from when she was a teenager. Her
psychoanalyst referred her to the clinic.
The reason the parents came to the clinic: mother worries about attachment. Tiredness with the whole
family related to the night wakening.
Sleep routine: The parents tell me in the beginning that the child is always waking up during the night but it is
no problem putting her to sleep. Her day naps are fine, 2 x 1½-2 hours.
She wakes up at 7, takes a nap at about 9:30 and then again around 2 pm. Each about 1½-2 hours. In her day
naps she falls asleep with a little rocking in her pram outside. In the evening at about 8:30 pm she goes to
sleep breastfeeding in her parents’ bed. After she is asleep she is put in her own bed besides her parents’
bed. After about 1 hour she wakes up with a loud cry. Parents, usually her mother, goes to try to calm her in
her bed but usually she does not stop crying until she is breastfed again. Then she falls asleep quit easily. This
is repeated the whole evening. After the parents go to sleep (usually early) then she is in their bed and does
not wake up as frequently, or around every 2 hours and is then breastfed. This has been the routine during
the night from the beginning. There was a problem in the beginning with the breastfeeding and the midwife
recommended to have her in the parents´ bed and to breastfeed her frequently. And it’s been like that ever
since although the child is growing well and has started weening some weeks ago. Helen wakes up quite
happy in the morning but that is not the case with her parents. Although her father started sleeping in a
separate room 2 months ago, now he is going to take some time off work and they saw this as a good time to
work on getting better sleep. The parents do not agree about what is the right thing to do about that. The
father wants to be much stricter than the mother. The mother´s health is getting worse both physically and
mentally. The mother has been reading the book “Why love matters” (a similar book in Icelandic) and has
worries about the child stopping trusting her if she does not go to her right away if she cries or calls out
during the night.
Comments that the parents have had from people

You need to pull yourself together.

Let her father take care of her for a few nights and you can sleep in another house

It is all right to let her cry

She needs you, just have her in your bed and breastfeed her whenever she needs. She is so young
she really needs that.
3 Anna is a 10 ½ month old girl.
Both parents attended the interview at the clinic. They live together and the girl is their first child.
Health: Anna had colic (from 2 weeks to 5 months) and got urinary (tract) infection at 8 months; she is healthy
now and sees her doctor regularly for a checkup.
Parents concern/the reason they come to the clinic: She is always waking up during the night
Sleep history: she slept only on the mothers’ chest until 6 months of age. She never slept longer than 20
minutes at a time. The first 6 months various sedatives were tried but none of them helped longer than a few
days and then she started sleeping in 20-30 min naps, the only way for her to sleep longer was to lie on her
mother’s chest. She had a few weeks around 6-7 months when she slept a little better. Again after 8 months,
after she had recovered of the infection, her day naps got much better and she learned to fall asleep in her
own bed in the evening. At that time she started to be much happier during the day. But she continued to
sleep poorly during the night.
Sleep routine: at around 8-9 pm she is put in her own bed with a bottle, her bed is in her parents’ room.
Usually she falls asleep while drinking the bottle. If not, then she gets a pacifier and the parent holds her until
she falls asleep. If they don’t do that she stands up in her bed and starts playing, she can then stay awake for
1-2 hours. During that time her parents try various things to get her to sleep. Sing for her, stroking her back.
In the end she gets another bottle or is taken in the parents’ arms.
After she has fallen asleep, she usually sleeps for about 2 hours. She moves a lot during her sleep. Sometimes
the first few times that she wakes up it is enough to give her the pacifier and stroke her back. After 2-3
arousals she is taken to her parents´ bed. She does not sleep any better there but her parents don’t need to
get up to comfort her the rest of the night, they can do it in bed. Usually she gets her bottle 2-4 times during
the night. At around 7-8 am they get up.
She takes a day nap, usually after staying awake for 3 hours. Then she sleeps for 1½-3 hours. Then she wakes
for around 4 hours and takes a nap for 30 minutes. She sleeps in a pram during day naps; she falls asleep by
being bottle-fed in the pram. Then she gets her pacifier and is rocked. It varies how long it takes until she falls
asleep.
She is cheerful and likes to have much to do during the day. She started walking 2 weeks ago. Not shy or
withdrawn.
The parents are exhausted. No history of depression. Had worries about her health when she was younger
but don’t say that they have it now.
Comments from people

You just need to be a bit stricter with her. You are too quick to go to her when she wakes up. Be
more relaxed. Let her wait when she wakes up.

Just put her in a separate room and let her father take care of her for a few nights.

She has been ill, have her in your bed, she needs it.

Just let her take one day nap, then the night sleep will get better.