The 8-month-old baby was still waking up several times a night, leaving his parents exhausted. A few years ago, his mother and father would have had to tough it out and hope for the best. Today, they can turn for help to an infant psychiatrist -- one of the most recent additions to the mental health field.

Techniques of psychotherapy are now being used almost from the moment of birth. Infant psychotherapists try to help infants in intensive care nurseries cope with their threatening environment. They treat uncontrollable temper tantrums in toddlers. They deal with sibling rivalry, trouble with toilet training, eating problems, separation anxiety and severe cases of the "terrible two's." In addition, they testify in divorce custody battles and contested adoptions.

"We deal with interactional kinds of difficulties," Dr. Theodore Gaensbauer, an infant psychiatrist in Denver, told a workshop last month at the American Academy of Child and Adolescent Psychiatry's annual meeting. "We help parents who feel that they are not in control with what's happening, who feel like the child is running the show or who may have trouble setting limits."

But as a new and relatively unknown specialty in mental health, the field suffers from a serious identity problem. "When people hear that I am an infant psychiatrist, they smile and look puzzled," says Dr. Martin Drell, chief of child psychiatry at Louisiana State Medical School in New Orleans. "They often ask, 'What does an infant psychiatrist do? Do babies have mental problems?' And then I get the joke about analyzing infants on couches."

If the average parent is surprised to learn that infant psychiatrists exist, many health professionals, including general psychiatrists, also don't "have the vaguest idea of what an infant psychiatrist does," Drell told the workshop at the American Academy of Child Psychiatry annual meeting.

Among the duties of an infant psychiatrist: Helping a premature infant in an intensive care unit cope better with the 24-hour-a-day bright lights, the numerous caretakers and the pain of invasive medical procedures. "We could suggest narrowing the group of nurses that care for the child," says Dr. Clifford Siegel, co-director of the Infant Psychiatry Clinic at the University of Colorado Health Sciences Center. "We could limit procedures performed on the baby to certain times of the day." Easing the emotional trauma from a serious mishap, such as a car accident or a dog bite. One 2-year-old girl began having nightmares after a dog attacked her. "She started being afraid around all dogs, and then around all animals," says LSU's Drell. A few sessions in play therapy with stuffed animals eased her fears, he says, and stopped the nightmares.Easing the return of an infant who has been kidnaped either by strangers, such as in the widely publicized cases of Jeremiah Thate and Kendall Kearns, or by a parent who doesn't have custody. How much help an infant and family require "would be very much dependent on the circumstances of the abduction and how well the baby was cared for in the interim," says Dr. Lee Haller, a Rockville child psychiatrist and author of a chapter on kidnaping in the Handbook of Child Psychiatry. If the child has developed a strong attachment to the kidnaper, a return to the parents "could be traumatic," Haller says. Helping a court decide the best place for a child to live. During a contested adoption case, one 14-month-old girl was taken from her adoptive parents and returned temporarily to her biological mother.

Before going back to her biological mother, "the child had been developing normally and was very attached to her adoptive parents," says Dr. Justin D. Call, chief of adolescent and child psychiatry at the University of California College of Medicine at Irvine. "She was lively, engaging and talkative."

Ten days after being with her biological mother, the child was returned to her adoptive parents by another court order. "She had anaclitic depression," Call says, a condition found in children who are separated from their parents.

Her adoptive parents were instructed by Call to indulge in the child's regression. She was allowed to sleep with her parents for a while. No strange babysitters cared for her. Over six months, her eating and sleeping improved, she interacted better with other children, but her language was still delayed and she was very suspicious of strangers.

"She still was quite anxious of losing contact with her {adoptive} parents," Call says. "But 15 years ago, we wouldn't have been able to prescribe the same things for this child."

Infant psychiatry has its roots in studies of the 1940s, which showed that institutionalized babies -- even those well-cared for -- experienced depression and didn't thrive as well as infants who stayed with loving families.

The field has grown into a full-blown discipline during the past 10 years, thanks to research on normal infant and early child development. "We know more today about the normal development of infants than we do about 50-year-olds," says Dr. Stanley Greenspan, author of "First Feelings" and former chief of the Clinical Infant-Development Research Center at the National Institute of Mental Health.

Infant psychotherapists are often child psychiatrists. "But the field isn't restricted to just psychiatrists," says Greenspan. "We have trained pediatricians, social workers, nurses, psychologists and educators to do this work, too."

Treatment for infants and young children is usually brief. "We're not talking about years of treatment for babies," says Siegel. "Sometimes just a couple of sessions will do it."

Often those sessions are attended by both the mother and father as well as the baby, since a problem with an infant can signal some kind of broader trouble within the family. Should that be the case, the infant psychiatrist treats both parents and child.

Treatment can be unusual. Baby toys and mirrors are standard fare in the infant psychotherapist's office. "If I'm evaluating a child with an eating disorder, I'll schedule an appointment for a meal time and have the mother bring in a high chair and feed the child in my office," says University of Colorado's Siegel. Some, like University of California's Call, make home visits.

For the future, infant psychiatrists are attempting to better describe the disorders that afflict children under age 3, similar to the way adult mental disorders are categorized in the "Diagnostic and Statistical Manual."

"We want to be thoughtful and careful about the best ways to classify or describe these different problems that babies have," says Greenspan, who chairs the committee attempting to write these new guidelines. "We think this will give a new language to talk about these difficulties."