ABSTRACT
The clinical pathway in a paediatric hospital shapes the therapy, out of the need to find interventions for distressed infants who are often in a medical crisis with chronic or severe problems. Many parents have significant health or social problems. Infants may be referred when they are in intensive care, or failing to thrive, or need a specific area of expertise such as speech pathology. A therapist's emotional responses or countertransference can provide invaluable clues. With an infant's distress communicated somatically the therapist's countertransference may be affected in specific ways. When mothers experience shame, disgust, anxiety, rejection, or anger during breastfeeding, one aim would be to help them find some pleasure to meet their baby's erotism. Including the infant in the intervention is likely to contribute most to increased reflectiveness. Reflective interaction with the infant seems likely to restore the infant to the parents as, above all, more meaningful.