Laying the Foundation for Good Mental Health in Infancy

Research tells us just how important the first 2 years of life is for infants. During this period, infant development is at its peak with brain connections being created at the rate of 1 million per second. The connections that are being formed are dependent upon the experiences and care they are being provided with. Infants learn more through their interactions with their parents or carers than any other activity. As such, having a parent or carer who can hold their baby’s mental state in mind is crucial. This ability of parents, to try and make sense of their child’s cues and behaviours in terms of their underlying needs, intentions, thoughts, beliefs and desires, has been shown to be a key mediator of child development. We also know that a strong healthy attachment to parents or carers has a lasting impact on a child throughout their later life. Secure attachment relationships are associated with higher levels of emotional resilience, reduced likelihood of mental health problems, healthier friendships and relationships, as well as a number of indicators of attainment and success. Sadly research, and my own work within the field of fostering and adoption, has also highlighted the lasting and traumatic impact of neglect and abuse on infant development. So, what are the key things to be holding in mind in parenting young infants?

It is through early interactions between a baby and a parent that infants begin to learn about themselves, their minds and the world around them. Those moments of eye contact, smiles, shared gaze, playful exchanges and labelling of things, are key. It is through this process that infants develop a sense of how things work; how to cue their needs, what response they can expect and how it works to soothe them. If this becomes a predictable pattern, and one that works to bring their stress systems down, infants quickly learn that this pattern of interaction is reliable and secure in its availability. Relationships are sensical, safe, and they are valued within them. This forms the basis of a secure attachment and a positive sense of self. This template is taken forward into future relationships. Should interactions with parents be inconsistent, confusing, hostile, or absent, an infant’s sense of self and safety is much more fragile. It may be they learn alternative ways of signalling or managing their needs; perhaps upping the ante to ensure a response is elicited. Perhaps they find it is safer to suppress their distress and learn to cope themselves. These patterns are often seen in those children who develop more of an insecure attachment. This can have a profound and lasting impact on a child, their stress levels and their emotional and social development.

While this sounds startling, and for many parents, hard to understand how this could develop, there are many reasons why things can go off track. Risk factors include poor parental mental health or well-being. When parents are struggling themselves, it can be hard to hold an infant’s mind in mind. Research shows mothers struggling with post-natal depression for example, offer a substantially lower number of initiatives to their infants. These infants have been shown to offer a substantially lower number of cues themselves in time. Early difficulties in bonding due to adjustment difficulties, health problems, feeding difficulties, high levels of stress or otherwise, can again create huge difficulties for parents trying to attune to their infant. For these reasons, seeking support early on can be particularly important. Of course, this is easier said than done. It can be so difficult for new parents to know how things should feel or how hard things should be given the inevitable shellshock of becoming a parent. It can be a real challenge to admit when you are struggling, to ask for and accept help. For many of us, there are connotations to acknowledging that we are struggling and in need of a hand. Despite post-natal depression and anxiety, and bonding difficulties becoming more recognised, there remains some stigma attached to talking about this, for both mothers and fathers. These difficulties are much more common than you may think which in many ways, is unsurprising when you consider what an all-encompassing change having children has on your life. For women, the impact and demand on their body is enormous. For all parents, their identity, relationship, day to day life, and priorities change hugely. Demands and stress increase while sleep and time to consider and manage your own well-being shrinks. Space and support to talk through, and come to terms with these things can be incredibly helpful. Many parents acknowledge that their experience of new parenthood is not as expected; perhaps they are struggling to parent in the way they would like or perhaps it has elicited strong memories and feelings from their own childhood. Therapeutic space to work through some of these things can be very useful. For those who are struggling with post-natal anxiety or depression, therapy and/or pharmacological treatment may be needed. Working through these difficulties will likely have a knock-on effect on your interactions and ability to attune with your infant, supporting your ongoing bonding and attachment with your child in time.

The following are simple but key components of attuning to and meeting your infant’s needs.

• High levels of face to face interaction. Toys and technology are no substitute for interaction with you.
• Follow your infant’s lead. It is important to notice your baby’s arousal levels and state, and adjust your initiatives accordingly so as to avoid overwhelming them.
• Offer a calm environment with a level of predictability and routine built in. Parents have very different approaches to this, from rigid sleep and meal times, to being entirely child-led. Each approach has its advantages and disadvantages which could be long debated. However, the key is for them to feel safe and reliable for the infant.
• Responsive and sensitive care. Holding in mind their mind; what does their cue signal to you about their underlying thoughts, feelings or intentions? This level of curiosity is difficult to hold on to at times, particularly when we are feeling overwhelmed. It can then be very easy to miss their cue or intention. Again, we can’t get it right all the time but getting back to this when we can is important.
• Noticing and explicitly responding to your infant’s cues.
• Makings sense of things out loud for your infant, including giving words to feelings, helps to organise your infant’s feelings and contributes to a healthy stress-arousal system which can be more easily soothed when needed.
• Soothing your infant is the basis of your child being able to soothe themselves in time. Sensitive responses to negative emotions, temper tantrums and defiance are just as important as any other time. This is not to say that clear and firm responses to tricky behaviour are not needed. However, responses are most helpful when calm, predictable and help the infant learn for next time. This includes making sense of what is going on, how to calm down and how to repair any ruptures in your interactions. 
• Again, there are many different approaches to managing behaviour as your infant develops and gets older. However, support and guidance to manage behaviour which helps them to know how to manage differently next time is important. For them to be able to learn from the experience, it is important that your response doesn’t elicit strong or extended feelings of shame.

Again, these are often easier said than done when sleep deprived and overwhelmed. We cannot get it right all the time, and infants don’t need us to be perfect parents. However, if these things are becoming are real strain, we can ask for help, whether that’s from friends and family around us, community groups or health professionals. Noticing when it is a struggle, breaking down our priorities, including thinking about our own well-being and then taking one day at a time is a useful starting point.  

If you would like to think through any of the above in more detail get in touch on jo@peterkinpsychology.com or visit www.peterkinpsychology.com for more information.