Infant Mental Health

On our final day at the Zero to Three annual conference, we started our day with a session entitled The Universal Needs of Infants and Their Caregivers, presented by representatives from the World Association for Infant Mental Health. Speakers were Anna Huber, Ph.D., Astrid Berg, and Jody Todd Manly, Ph.D., representing work in Australia, South Africa, and the United States. This session reaffirmed our commitment to advocating for the rights of infants worldwide, which was one of our biggest takeaways from the conference as a whole (we all have a voice that can be raised on behalf of babies!), as well as supporting and advocating for families of infants. Parents of infants face unique challenges and require a true village around them to give them all the best start in life and in their parenting journey.

We were captivated as Astrid Berg shared her experiences working with at-risk mothers and babies in South Africa. Astrid developed the Basic Infant Mental Health Screen, which is genius in its simplicity and directness.  The screening consists of five questions/observations. It starts with the question, "Are you worried about your infant?" Astrid told us, "Parents worried about their child are usually right." This is where this screening method really shines, in our opinion: it begins with this very basic human connection. It is one person reaching out to another, asking, "Hey, how are things going?" One person sits with another and listens. It is in this human connection that we begin to become a village, sharing the responsibility for the well-being of this miraculous small human.

The next question is, "How have you been feeling?" This is where we begin to understand and examine the co-regulatory process between new parents and their infant. Post-partum depression, as an example, is not just a problem for mothers. It is a problem for the mother, the baby, the partner, the other children in the home, and ultimately the entire village. Observed and addressed early enough, repairing a potential disconnection between a new mom and an infant can head off a lifetime of disrupted attachment. 

Astrid shared stories of young moms with HIV and malnourished children. While these examples may not be things that nurses, pediatricians, and childcare providers and advocates see every day here in our community, the broader examples of intervention and care can and should be applied in the same way. As she spoke of an infant who had been unable to eat (and thrive) due to a failure to bond with his mother, we reflected on infants that we have worked with in childcare settings who exhibited the same reluctance to eat due to a lack of human contact and connection. Often, holding a child in your lap and directly engaging with them provides just what they need to begin to thrive in every way. In the rush of the day in a group care setting, it's vital to support this very simple but hugely important routine. What do children need? To be loved.

The needs and the rights of infants and their caregivers are universal. Through the global perspective of this session, we could see how, while the circumstances of families across the world may be incredibly different, the development of parent-child relationships and the healthy growth of infants is truly the same.

Another point that we particularly appreciated that Astrid shared was that early detection and intervention are made possible and successful by the unique characteristics of both the new infant and new parent. New parents are entering a new phase in their lifecycle. Biological changes are occurring and they are particularly open (and vulnerable) to interventions. The brains of infants, we know, are uniquely plastic and open to wiring and rewiring. This is an amazing time to establish positive patterns and connections. 

The final item on the Basic Infant Mental Health Screen is a check on "shared pleasure". Many factors can interrupt and disrupt shared pleasure between infants and caregivers. As we reflected on this piece, we thought of group care settings where we have observed infants. Even in programs that strive for overall quality and appear to be quite acceptable to parents, you may find infants who are not engaged in shared pleasure with a trusted caregiver. One of the global (basic) rights of infants, as advocated by the World Association for Infant Mental Health, is, "Right to caregiving relationship that is sensitive and responsive to infant needs." What this includes, in our opinion, is the right of an infant to be seen and understood by a responsive caregiver. Their right to have their cues read and responded to as an individual. Their right to share their needs and interests with a responsive caregiver. These are things for caregivers to really reflect on.

Thoughts? Please share with us!

Further reading: World Association of Infant Mental Health Position Paper on the Rights of Infants.