OBJECTIVE: To review the literature on insomnia in small children, its aspects related to effects on parents, pediatric approach and treatment. DATA SOURCES: A survey of publications indexed in Medline and Lilacs between the years 1998 and 2008, searched through the combination of the descriptors "sleep", "insomnia", "child", "depression", "mother-child relationship", besides thesis and chapters of books concerning the subject. DATA SYNTHESIS: The small child insomnia, defined as repeated difficulty in initiating and/or maintaining sleep, is a common complaint in the pediatric clinic, and usually entails repercussions on parents related to sleep deprivation. At about two to three months of age, there are already biological conditions for consolidating sleep hours during the night. Parental behavior is associated to difficulties to establish this process. Studies point out that baby's insomnia and mother's depression are closely related. Probably, the insomnia is a sign of the difficulties in the small child's psychic development in the context of mother-child relationship. CONCLUSIONS: Rhythmic sleep in babies can and should be established early in life; sleep habits should be built on rules of sleep hygiene. Mother's depression, which may contribute to baby's insomnia, should ideally be detected by pediatricians, thus preventing such suffering for mothers and babies.
sleep; sleep initiation and maintenance disorders; child; depression; mother-child relations