Infant Mental Health: What It Is and Why It's Important

When you think about managing mental health, what comes to mind? Perhaps you think of a therapy couch, box of tissues, and feeling loads better after getting some things off your chest.

Or maybe you’re a big believer in a bubble bath or a long run as a form of self-care.

Whatever your mental health management routine, it probably involves taking specific action to care for and nurture yourself. After all, your life is complex. You have a job, relationships and finances to manage, family obligations, and social events to attend.

And if you’re a parent, your life is even more complex because you have the lives of other people to manage as well!

Luckily, your infant’s social calendar is pretty empty, so you can’t imagine they have a lot to stress about. Aside from feeding, sleeping, and pooping, there’s not much on their agenda... So they can’t possibly have mental health that needs attending to, right?

Wrong!

Believe it or not, even your infant has mental health needs! Yes, even before your little one is babbling or crawling, walking or talking, their mental health is being shaped by the world around them—and their relationship with you.

Loving parent that you are, you’re doing everything you can to provide love, affection, and protection for your child.

So where do you start with their mental health needs? And what does infant mental health even mean?

What Is Infant Mental Health?

You can think of infant mental health as infant brain health.(1) Brain health is crucial to an infant’s development, and it all starts when the baby is still in the womb.

Previously it was thought that as long as pregnant women avoided harmful substances like drugs or alcohol and ate enough nutrients, they’d give birth to healthy babies.(2) But research shows that when the pregnant mother is stressed, the fetus is negatively impacted.

Risks of Prenatal Stress

Prenatal stress is associated with altered brain structure and function.(3) A child may be at an increased risk for developing ADHD or conduct disorder, having impaired cognitive development and emotional issues if a mom is stressed, depressed, or anxious during pregnancy.(3)

People stressed during pregnancy are more likely to deliver preterm or before 37 weeks.(4) Low birth weight is also associated with maternal stress during pregnancy(4) and complications can arise later for preterm babies, like chronic lung disease, learning disorders, or developmental delays. Babies who are stressed out in utero are also more likely to develop chronic health problems as adults, like diabetes, high blood pressure, or heart disease.(2)

Because prenatal stress can have a lasting impact on an infant’s health, neurocognitive development, and immune system functioning, it’s important you take care of yourself as best you can if you’re pregnant.(3) Work with your healthcare provider and social network to develop a plan to help you cope with the stresses of pregnancy.

The Impact of a Child’s Environment on Their Brain Development

Stable, nurturing, positive relationships with parents and adults help babies develop strong, healthy brains. So does stimulation, love and caring interaction.(5)

But the opposite is also true.

If a parent or caregiver is frequently absent or unable to regulate their baby, toxic stress can occur.

What Is Toxic Stress?

Toxic stress—or the prolonged activation of the body’s stress response—overloads a child’s developing systems. And it can have lifelong consequences for children.(6) Persistent negative experiences means fewer brain connections will form. And those that do will develop at a slower rate.(5)

A child’s environment helps determine which synapses are used more or less. For example, if a baby is talked to or read to often, their language development synapses are activated more often.(8) But if a baby and his family has to face severe, prolonged, or repetitive adversity, and the parent or caregiver is unable to relieve the child’s stress response, an abnormal stress response develops.(7)

The Effects of Toxic Stress on Child Development

The prolonged activation of stress hormones in infancy and early childhood can reduce neural connections when they should actually be multiplying.(6) Children who experience toxic stress in early childhood are more likely to develop long-term negative health problems that may not show up until adulthood. Poor coping skills and stress management capabilities, mental illness, and physical disease are all more likely for children who experience toxic stress.(7)

We can avoid toxic stress if the environments children are growing and developing in are stable, nurturing, and engaging.

Signs of Infant Mental Health Concerns

Raising an infant comes with challenges—there’s no doubt about that. And every parent does the best they can with the resources they have available to them. But sometimes, infants seem to struggle more than “normal.” And since infants aren’t able to communicate their needs with words, it’s important to look for signs that they may be struggling with their mental health.

Seeking support from an expert in infant and early childhood development can be helpful when challenges become chronic.

Here are some warning signs that your infant’s mental health may need some tending to:(10,11)

• They don’t want to be held

• They’re not comforted when they’re upset

• They avoid eye contact

• They have feeding and sleeping difficulties

• They cry persistently

• They’re restless

• They display distress, fear, anxiety, and/or tension

• They aren’t gaining weight

• They have intestinal disturbances

• They aren’t meeting developmental milestones

Understanding Infant Behavior and Development

Sometimes a parent or caregiver is unable to provide consistent, reliable care to an infant despite their best efforts. This may be due to their own mental illness, their own history of neglect or abuse, or a lack of social support, especially for single parents. Financial stress, relationship conflict, and alcohol or drug abuse can all contribute to a parent not being able to consistently meet their infant’s needs.(9)

Raising kids is hard work. There’s just no way around that. But there’s support available if you know where to look for it.

Consider the following tips to better understand your infant’s behavior and development:

Connect with an Infant Mental Health Specialist

There are actually professionals trained in newborn behavioral observation, which can be extremely helpful! Seek out an infant mental health consultation if you’re looking for insight into how to read your infant better, understand their cues, bond with them, and interact with them in ways that will encourage your relationship to thrive.(9)

Learn About Attachment Theory

An attachment is an emotional bond that forms between two people, and children seek closeness with their attachment figures to find safety and comfort. When an adult responds to an infant’s needs in an appropriate way, secure attachment becomes possible. Learn about the four attachment styles to understand your own way of relating to others and to know if your child is securely attached to you (or not).

Seek out Your own Mental Health Resources

Often times, the way we were raised impacts the way we raise our kids. It can be helpful to seek your own therapy to understand your family of origin and process any mental health blocks you may be facing that’s impacting your ability to be there effectively for your child. There’s never any shame in asking for help!

Interested in Learning More?

Check out this podcast episode on infant brain development. You’ll get a deeper look at the topics covered in this blog and much more! Tune in to get a basic overview of your baby’s brain—how it’s growing in and out of the womb and what makes them kick—plus dive into Piaget’s stages of cognitive development and how this theory can help you understand your infant better. You’ll also learn about how many neurons your baby’s brain has when they’re born—hint: it’s as many stars as there are in the Milky Way!

Equip yourself with knowledge and tools to help your child thrive. Subscribe here to the Genius Little Minds podcast so you never miss an episode!

References

1. Clinton, J., Feller, A. F., & Williams, R. C. (2016). The importance of infant mental health. Paediatrics & child health, 21(5), 239–241. https://doi.org/10.1093/pch/21.5.239

2. https://www.webmd.com/baby/features/fetal-stress

3. Glover, V. (2019). The effects of prenatal stress on child behavioural and cognitive outcomes start at the beginning. Encyclopedia on Early Childhood Development. https://www.child-encyclopedia.com/stress-and-pregnancy-prenatal-and-perinatal/according-experts/effects-prenatal-stress-child

4. (2019, October). Stress and pregnancy. March of Dimes. https://www.marchofdimes.org/complications/stress-and-pregnancy.aspx

5. https://www.firstthingsfirst.org/early-childhood-matters/brain-development/

6. Toxic Stress Derails Healthy Development. (2011, September 29). [Video]. YouTube. https://www.youtube.com/watch?time_continue=26&v=rVwFkcOZHJw&feature=emb_logo

7. Franke H. A. (2014). Toxic Stress: Effects, Prevention and Treatment. Children (Basel, Switzerland), 1(3), 390–402. https://doi.org/10.3390/children1030390

8. http://www.urbanchildinstitute.org/why-0-3/baby-and-brain

9. (2021, April). Styger, K., Zadroga, J. Infants have mental health needs, too. Mayo Clinic. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/infants-have-mental-health-needs-too

10. Stapert, E. Infant mental health – what is it and why is it important? Manhattan Psychology Group. https://manhattanpsychologygroup.com/infant-mental-health-what-is-it-and-why-is-it-important/

Secure Attachment with Your Infant: What It Is and How to Develop It

Whether you’re a first-time parent or have kids already, one thing is certain — you love your children and would do anything for them. But there’s a lot of noise about how to do this parenting thing “right” — so how do you determine what to tune out and what to tune into?

Tuning in to your infant’s needs is really at the core of attachment theory.

What Is Attachment Theory?

An attachment is an emotional bond that forms between people.(1) We create bonds with all types of people throughout our lifetime — friends, loved ones, and family. Evolutionarily, attachment serves a purpose. An infant who stays physically close to her primary caregiver is generally more likely to survive.(2)

Children naturally seek closeness with their attachment figures to feel safe and be soothed. Infants especially need trustworthy adults to feel a sense of well-being and safety.(3)

Think of a time in your own life when you were particularly distressed and you reached out to someone for comfort. Knowing someone was there for you was soothing, right?  

It’s the same thing for babies. It’s soothing to be seen. 

We aren’t born with the ability to self-regulate — this is a behavior learned from caregivers.(4)

When an adult responds appropriately to an infant’s needs, secure attachment becomes possible. A baby is more likely to securely attach to someone who responds to their needs with sensitivity, calm and regularity. Lack of consistency and responsiveness is very distressing, especially for infants.

You can follow every trick in the book — breastfeeding, skin to skin contact, co-sleeping situations — there’s so much parenting advice out there, it can be hard to know what’s what! But at the end of the day, the most important thing is the relationship you’re forming with your baby. And tuning in to your infant’s needs is crucial to developing a secure attachment.

Biological parents aren’t the only ones a baby can securely attach to. A secure attachment can be formed with a mom, a dad, an aunt, a grandparent — however your family looks, forming secure attachment is possible. 

The Four Attachment Styles

Psychologists Bowlby and Ainsworth developed a theory that there are four attachment styles: secure, anxious, avoidant, and disorganized.(5)

1.    Secure Attachment

If a child is brought up in an environment where the caregiver is responsive and attuned to their emotional needs, a secure attachment is formed. The child learns that if they need something, someone will be there for them. Their needs are met and their emotions are acknowledged, so they feel supported and loved, and learn they can trust others. If the infant has a safe, predictable, attuned relationship with at least one caregiver, neural structures in the brain that contribute to infant well-being will form.(6) This doesn’t mean mistakes won’t be made! But if a parent does misinterpret an infant’s cue — trying to feed them when they want a nap, for example — it doesn’t mean a secure attachment won’t form. The parent just has to make a repair attempt and try again to understand their baby’s needs.

2.    Anxious Attachment

Anxious attachment is formed when a parent or caregiver is intrusive, inconsistent, or misattuned.(7) Sometimes they’re responsive to the infant’s needs, sometimes they aren’t. The infant becomes confused and doesn’t know what to expect. Will someone be there when they cry and need soothing? Will they be fed when they’re hungry? Will they be changed when they’ve soiled their diaper and are uncomfortable? When a child becomes anxiously attached, they desire closeness, but they also have a fear of abandonment. This can cause issues later in life in their adult relationships. Researchers estimate that parents only have to understand their baby’s cues a third of the time for secure attachment to be possible.(8) So anxious attachment is more likely if there’s chronic misattunement or intrusiveness.

3.    Avoidant Attachment

Avoidant attachment, on the other hand, happens when a parent is emotionally distant.(9) When the baby is crying or seeking connection, especially when they’re distressed, the parent rejects that bid for closeness. The parent might be irritable or emotionally rigid, so the infant learns not to seek comfort from others when they’re anxious. Over time, a person with avoidant attachment learns to be overly self-reliant. They become uncomfortable with closeness because they’ve learned it’s not safe to depend on others.

4.    Disorganized Attachment

Disorganized attachment is formed when a child depends on someone who also scares them. It’s often found when parents physically, emotionally, or sexually abuse their children.(10) But that kind of trauma doesn’t have to be present for this type of attachment to form. Chaotic (but not necessarily abusive) dynamics can also cause disorganized attachment. With disorganized attachment, the caregiver is unpredictable and frightening, so the child learns being close to others is unsafe.(10)

How to Create Secure Attachment with Your Baby

You’re probably wondering how you can develop secure attachment with your infant. Here are five things you can do to promote secure attachment and wellbeing within your relationship.

1.    Learn Their Cues

Pay attention to and learn your child’s cues. Every baby is different! What worked for your first born may not work for your second child. Think of yourself as a sensory sleuth trying to figure out what your baby is communicating with their facial expressions, movements, coos or cries. Understand when your baby needs to be held versus played with. Learn what kind of touch comforts them and what type of environment they enjoy. Do they like peace and quiet or soft music playing in the background? Do they want to be rocked when they’re fussy or is motion not comforting?(8) Have patience with yourself because learning these cues will take time! And remember, even if you get a cue wrong on the first guess, if you make an attempt to repair the disconnect and figure out what your baby needs, you can still be on track to building a secure attachment!(8)

2.    Mirror Your Baby

Mirroring, playing with and laughing with your baby also help form secure attachment. Mirroring is a psychological term that means reflecting the affect, behavior or body language of another person.(11) So when you smile at your baby and she smiles back at you, you’re engaging in mirroring. Mirroring is so important for children because it gives them the experience of being seen and makes them feel validated.(12) Even though your infant won’t remember playing peek-a-boo with you, or how you giggled at her so she would giggle back, she will remember how you made her feel. Mothers who are securely attached mirror their infant twice as often as mothers who aren’t.(13)

3.    Create a Mutual Relationship

Mirroring is part of creating a mutual relationship with your child. Don’t let the relationship be dominated by what you need — put what the baby needs first. Remember when I talked about intrusive behavior from the caregiver? If you’re initiating play with your infant when all she really wants and needs is to take a nap, that’s intrusive. You’re making it about your needs, not hers. And she probably won’t be much fun if she’s exhausted, anyway! Don’t be smothering. Go along with it when your baby initiates interactions or play. Creating a mutual relationship becomes more possible as you learn cues and get in tune with her. All of which comes with practice and time and the monitoring of your own needs.(14)

4.    Do Your Own Internal Work

Taking care of yourself is so important when you have children. It may feel impossible to take care of your own needs when you have a newborn because you’re on constant sleep, feed, and diaper change duty. But as your children grow up, you may find yourself reflecting on how you were parented as a child and whether or not you want to parent your child the same way.(12) Doing your own internal homework can help you navigate the messages that were sent to you as a child by your parents and whether you want to send the same messages or say something different.(12) The more space you have to be present with your own experience, the more you’ll be able to be present with your child.(12) And learning about your own family of origin and attachment style can be useful when trying to figure out how to parent.

5.    Be as Consistent as You Can

Respond to your baby’ distress as consistently as you can. Babies whose needs are met consistently are more likely to develop higher self-confidence and better self-image later in life. They learn they are respected, worthy, and lovable, which impacts their relationships and the way they navigate the world as they grow.(15) Research shows that children who form a secure attachment early in life score higher in agreeableness and conscientiousness and lower in neuroticism.(16) The reverse is also true. Children with insecure attachments early in life score higher in neuroticism and lower in agreeableness and conscientiousness.(16)

Interested in Learning More?

Check out this podcast episode on Attachment Theory. You’ll learn surprising facts about whether breastfeeding, natural birth, and taking space from your infant helps or hurts secure attachment. Plus so much more!

Equip yourself with knowledge and tools to help your child thrive. Subscribe here to the Genius Little Minds podcast so you never miss an episode!

References

1. Cherry, K. (2022, May). What is attachment theory? The importance of early emotional bonds. Very Well Mind. https://www.verywellmind.com/what-is-attachment-theory-2795337

2. McCleod, S. (2017, February). Attachment theory. Simply Psychology. https://www.simplypsychology.org/attachment.html

3. (2021, April). Infants have mental health needs to. Mayo Health Clinic. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/infants-have-mental-health-needs-too

4. (2018, October). How emotional attunement can transform your relationships. Emotional Enhancement. https://www.emotionenhancement.com/single-post/how-attunement-can-transform-your-relationships

5. Li, P. (2022, April). Attachment styles — how they affect your parenting. Parenting for Brain. https://www.parentingforbrain.com/attachment-styles/

6. Li, P. (2022, April). Dismissive avoidant attachment — what it is, causes and signs. Parenting for Brain. https://www.parentingforbrain.com/dismissive-avoidant-attachment/

7. (2022, February). Anxious attachment style: causes and symptoms. Attachment Project. https://www.attachmentproject.com/blog/anxious-attachment/

8. Robinson, L., Saisan, J., Smith, M., Segal, J. (2020, October). Help Guide. https://www.helpguide.org/articles/parenting-family/building-a-secure-attachment-bond-with-your-baby.htm

9. (2015, April). Building a secure attachment with your baby. CAPPA https://cappa.net/2015/04/18/building-a-secure-attachment-with-baby/

10. Li, P. (2022, April). Disorganized attachment: understanding how it forms and how to heal. Parenting for Brain. https://www.parentingforbrain.com/disorganized-attachment/

11. https://dictionary.apa.org/mirroring

12. (2013, October). How to parent with attunement and creativity. The Attached Family. http://theattachedfamily.com/membersonly/?p=4214

13. Kim, S., Fonagy, P., Allen, J., Martinez, S., Iyengar, U., Strathearn, L. (2014). Mothers who are securely attached in pregnancy show more attuned infant mirroring 7 months postpartum. Infant Behavior and Development, 37(4) 491-504. https://doi.org/10.1016/j.infbeh.2014.06.002

14. (2016, May). Five ways to create a secure attachment with your baby, without sharing your bed. PsychCentral. https://psychcentral.com/lib/five-ways-to-create-a-secure-attachment-with-your-baby-without-sharing-your-bed#3

15. Cuddling does kids (and parents) good. Children’s Hospital Los Angeles. https://www.chla.org/blog/rn-remedies/cuddling-does-kids-and-parents-good

16. Young, E. S., Simpson, J. A., Griskevicius, V., Huelsnitz, C. O., & Fleck, C. (2019). Childhood attachment and adult personality: A life history perspective. Self and Identity, 18(1), 22–38. https://doi.org/10.1080/15298868.2017.1353540