Infant Mental Health Awareness Week 2024
Having spent all of my almost 21 years in clinical practice within Paediatric Occupational Therapy, I am now stepping into the Infant Mental Health (IMH) space to join the Wee Minds Matter team within NHS Dumfries and Galloway for a day a week. I am therefore delighted to be writing this blog to raise awareness for Infant Mental Health Awareness Week 2024.
So what is Infant Mental Health & why does it matter?
Infant Mental Health is often a very misunderstood subject. It involves the interaction of three key factors: an infant’s ability to experience a range of emotions without becoming overwhelmed, the presence of safe and close relationships with important people, and the opportunity to explore and learn the skills of early childhood. IMH refers to infants’ socio-emotional brain development; setting the scene for positive growth and wellbeing for life and enabling individuals to become autonomous beings and achieve their potential (Parent Infant Foundation, 2024). The ‘window of opportunity’ in infancy (the first 3 years of life) is when the most rapid brain development occurs as we begin to learn about our world. We now know that how we learn about our world in infancy lays the foundations for how we understand and relate to our world, and can influence us throughout the rest of our life.
A baby’s first language and why we should learn it!
The theme this year for IMH awareness week is aptly titled ‘speak up for babies’. Is this because babies can’t yet speak for themselves and we must advocate for them? Well yes, absolutely; but while babies don’t ‘speak’ they absolutely do have a first language. We understand this as newborn behaviour. It is the things we notice a baby do (i.e. their observable behaviour) which can help us to understand what they need.
Infants respond to their world through a complex interaction between what their internal bodily systems need, striving for safety and security and their inherent need to develop as social and connected beings. It is through this neurobehaviour that they communicate to us about what they need in that moment (Nugent et. al., 2007). They can show us through changes in how they are moving, how they position their hands, changes in their facial expression and emotional state, how awake or sleepy they are and their readiness for engagement and interaction (Nugent et. al., 2007). These are neurobehavioural cues. When we read and respond to infants’ cues much of the time, essentially learn their language, we can better understand what they are showing us that they need in that moment.
Neurons that fire together, wire together
As human beings we are typically born with all the brain structures we need to develop into self regulating autonomous individuals. However, this happens through our opportunities from our environments, mainly our caregivers as we grow. Remember, neurons that fire together wire together. As infants we are very much led by our lower brain structures which govern our basic life sustaining functions and responsible for the ‘shutdown’ or ‘fight or flight’ responses! This is closely followed by our midbrain or more specifically our limbic system (our emotional brain centre) which does a lot of the ‘talking’ in infancy. Infants are constantly striving for balance or ‘regulation’ of internal bodily functions and external environmental demands and changes that they don’t yet know about. We can understand this as homeostasis or regulation. Infants need lots of support with this as we don’t yet know enough about their world, have the language to attach meaning to it or how to use all of the skills we are yet to discover, how to ‘self-regulate’ (Seigel & Payne-Bryson 2020). At this early stage, when a caregiver reads and responds to their baby’s cues while managing their own internal regulation, we can understand this as ‘co-regulation’ or ‘attunement’ which is a vital ingredient in positive infant mental health.
As infants grow and lay down more blueprints, they will be forming lovely connections to those higher brain centres which enable more rational thought and higher order thinking skills. This can continue to occur well into a human’s 20’s! We now know that with responsive care-giving, even just some of the time, infants will mature into self-regulating autonomous individuals who can manage their own emotions, form positive and secure relationships and enable them to feel confident to learn about their world.
Keeping it real
As a parent myself (who tends to over analyse thing) it would be remiss of me not to mention that we must be realistic about what responsive parenting looks like. It is part of life and being human that we don’t always get things right every time, and on some days hardly at all! This is ok! They don’t come with an instruction manual and each and every tiny human is different! We can only do our best and notice when we might need support. Part of parenting and supporting your baby’s early and onward learning about life, is what we do when we get things a bit wrong! How we ‘repair the rupture’ can build resilience in your little one. It is important for them to learn that we all make mistakes, but that is ok. And to learn that whatever happens we will always be there to meet their needs, in the end (Hoffman et al 2017).
When challenges arise
We know that there are many varying circumstances, often out with families control, when both infants and parents may find this early stage challenging. Factors such as socio-economic circumstances, which can impact the health and wellbeing of parent and infants. Such circumstances include poverty, parental mental and/or physical wellbeing, infant health, substance use, domestic violence, grief or trauma. These factors can result in care giving being interrupted, disorganised and/or absent. It is important for families in these circumstances to be provided with the right type of support so that the needs of the infant, parent and wider family can be considered holistically.
If you know or are supporting a family that you feel may benefit from our support, get in touch. For more information on how Wee Minds Matter can help, please visit our website on Wee Minds Matter – Infant Mental Health – Dumfries & Galloway Health & Social Care (dghscp.co.uk)
What I wish I’d known when entering parenthood 14 years ago!
Notice and respond. Your baby is showing you what they need. You may not answer the need perfectly each time, but that is ok! It is important to be realistic.
Recognise that co-regulation or attunement is a parenting task in itself! With the tsunami of practical tasks that arise with parenting a tiny baby, finding time to ‘just be with’ them can seem like a luxury. Just know that you are helping your baby form those fabulous neural connections just by being together!
Taking time for self care; to meet your own basic needs as an evolving human is vital. Are you getting sufficient (ok albeit interrupted) sleep, eating well and time for rest and digest activities to top up your reserves? Who is in your circle of care who can help? Accept the help! Remember, you need to manage your own emotions to be able to help your baby regulate theirs.
Talk sense – use your gaze, voice and touch. Infants are learning about their world through their senses and already have reassuring and calming in-utero blueprints of your attributes. Your gaze from where you stand in your kitchen toward your baby in their bouncer can sometimes be enough to reassure your baby and meet their need in that moment. They will of course let you know if it isn’t! This also helps your baby practice those amazing inherent regulation skills that they are discovering together with you.
Karen Robertson is an Occupational Therapist for Children and Young People and Infant Mental Health for NHS Dumfries and Galloway
References:
www.parentinfantfoundation.org.uk
Hoffman, K, Cooper, G, Powell, B, Seigel, DJ, and Benton, CM (2017). Raising a Secure Child: How Circle of Security Parenting Can Help You Nurture Your Child’s Attachment, Emotonal Resilience, and Freedom to Explore. Audiobook.
Nugent, j.k, Keefer, C.H Minear, S, Johnson, L.C & Blanchard, Y. (2007). Understanding Newborn Behaviour and Early Relationships: The Newborn Behavioural Observations (NBO) System Handbook. Baltimore MD, US: Paul H Brookes Publishing.
Seigel, D & Payne-Bryson. T (2020). The Whole-Brain Child: 12 Proven Strategies to Nurture Your Child’s Developing Mind. Audiobook accessed 2024.
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