By: Dr. Harleen Hutchinson - Infant Mental Health Specialist & Executive Director of The Journey Institute, Inc.

The birth of a baby is an exciting time in a woman’s life and the anticipation of a new child is often marked by feelings of joy, delight, and anxiety. However, at the same time, the emotional turmoil that a woman encounters can create other feelings such as sadness, lethargy, confusion and anger, based on their current family dynamics and life stressors taking place during the prenatal development. Mothers who are depressed, stressed and/or engaged in substance abuse, and domestic violence relationships are often not able to handle the tasks of motherhood.  These tasks include being able to provide consistent, loving, responsive, positive interactions, and sensitive care for their baby.  While some mothers may be able to do these tasks, others struggle, leaving the infants disengaged and fussy. When parents begin to understand how emotional unavailability, past or present trauma and neglect or abuse influence their ability to care for their baby, then they are more likely to comfort and protect their baby. The way babies are held, talked to, and cared for, teaches us about ourselves, and shapes who they will become.  Therefore, the first days, months, and years of life are when the caregivers in a baby’s life can promote positive mental health.

Often, when we hear about a person’s mental health it is in the context of behavioral concerns at school or at home. Furthermore, these discussions are limited to older children; so we ask, can babies, experience mental health issues?   Infant Mental Health refers to how well a child develops socially and emotionally from birth to five, or the developing capacity of the child from birth to five years of age to form close relationships, manage and express emotions, and explore the environment and learn (zero to three).  So the key to enhancing mental health in young children is to recognize the cues in their behavior from an early age.  If you are concerned that your baby is not meeting expected milestones or is not developing skills at expected stages, schedule an appointment with your child’s pediatrician to discuss your concerns as soon as possible.  With some developmental delays and disorders, early diagnosis and intervention are important in avoiding severe outcomes.  If your child’s pediatrician encourages you to “Watch and Wait”, follow up with a call to 211 Broward-Help Me Grow to obtain a list of community providers who are skilled at conducting developmental and/or attachment evaluations to help alleviate your anxiety.

Additionally, recognize that your child’s behavior has meaning.  If you suspect regression in skills due to some traumatic events or disruption in the attachment relationship, seek professional help.  An innovative treatment approach in our community to address the mental health of young children who are exposed to trauma or have had a disruption in their attachment relationship is Child Parent Psychotherapy (CPP).  This is an evidence-based trauma informed therapeutic intervention for children from birth to five, and their primary caregiver who have experienced at least one traumatic event (domestic violence, the sudden or traumatic death of someone close, exposure to violence, abuse neglect, medical complications, problems with behaviors, attachment or disruption in placements)  The primary goal of this intervention is to support and strengthen the relationship between a child and the caregiver as a vehicle for restoring the child’s sense of safety, attachment, appropriate affect, and improving the child’s cognitive, behavioral, and social functioning (Lieberman & Van Horn, 2004;   Lieberman et al., 2005). As we bolster positive mental health in young children, the key ingredient is ensuring that we integrate mental health services where they spend their time, which is their home, childcare centers, school and/or doctor’s office.  So, how can we promote our child’s mental health? Starting from birth, parents and caregivers can begin to tune into their babies’ cues, facial expressions and learn how to follow their cues through consistent caregiving.   When a baby is responded to consistently and in a timely manner, it let the baby know that their environment is safe, and that their feelings are recognized and is important. As parents or caregivers, we can begin to understand that behavior has meaning for young children.  Therefore, when we are better able to understand what drives young children’s behavior, then we are better able to meet their needs. As a community, we can help parents and caregivers recognize the importance of early positive relationships and their impact on the future mental health of young children. Strengthening on-going partnerships with community agencies specializing in early childhood populations, and other services that support the child’s development and provide intensive support for families from a range of cultural backgrounds is an excellent way of recognizing baby’s mental health from the start.

Dr. Harleen Hutchinson is the Executive Director of The Journey Institute, Inc. She is a psychologist, an Infant Mental Health Specialist, and the Chair of the Broward County Infant Mental Health Workgroup.