One of the hardest feelings as a mom is seeing your baby upset and not knowing why.
Often it’s as simple as needing food, a diaper change or a nap—basic needs that can be easily met and soothed with a snuggle.
However, sometimes our little ones are trying to tell us more, and how we respond to their cues can have a significant impact on their mental health.Infant mental health is a huge and largely overlooked topic.
Even as a society of well-meaning mothers, it’s a surprising misconception that mental health only affects older children.
But experts say mental health starts in the womb, and as moms, we wield more influence over the way our children’s minds develop than we realize.What is infant mental health?Like adults, infants can have good or poor mental health; the difference is that a younger child’s capacity to understand their emotions is still maturing.
Still, experts say that long before our little ones are old enough to talk about their feelings, their emotions—and the way we react to them—are registering important messages in their brains.A 2022 study found that almost 1 in 5 US children between ages 3 and 17 have a mental, emotional, developmental or behavioral disorder.
Yet, much less attention is paid to children under 3, which experts are discovering is a critical period of emotional development that, until recently, has been overlooked.Jean Clinton, MD, an infant psychiatrist and a clinical professor in the department of psychiatry and behavioural neurosciences at McMaster University, is one of the researchers championing a greater understanding in this area.Dr.
Clinton explains that the urgency around mental wellbeing for adolescent and middle childhood often overshadows that of infants, because the repercussions in older children can be more dire.
But the foundations for good mental health are laid much earlier.“People think that babies are cute and sweet and that they couldn’t possibly have mental health issues, never mind mental health itself,” she says. “But the brain is built very much by experience and there’s a huge amount that goes on in utero and in the first number of years.”It all starts in the wombDuring pregnancy, it’s natural to become more mindful of what we’re eating and drinking, how we’re moving and exercising and how we’re feeling generally.
But as well as keeping an eye on our baby’s growth, we should also be considering how they are developing mentally, too.Beverly Gould, Program Director at the Child Centre of NY’s Macari Perinatal Intensive Outpatient Program, says it’s important to remember that the mother and child share the same body and the same experiences in pregnancy.“Children are impacted by the intrauterine environment—by the mother’s ingestion of drugs or alcohol as well as the stressors experienced in a toxic home environment, physical illness or mental health issues,” she says.Dr.
Clinton adds that extreme stress—not everyday stresses and anxieties—can start to influence a baby’s mental health inside the womb.“Stress releases chemicals like cortisol that, [in high amounts,] we now know can go into the baby’s system in utero and can affect how the baby’s brain and other aspects actually get developed and formed,” she says.
“It’s not just our genes that make us who we are, but the in-utero environment that makes a huge, huge difference.”If this sets off an alert for you right now, try not to panic.
High levels of stress can affect development, but the developing brain is incredibly resilient.
“Even if you’ve had a highly stressful pregnancy, neuroplasticity and the opportunity to repair with attuned parenting and creating safe nurturing environments will protect your baby hugely.
Being aware and watchful is a wonderful gift,” assures Dr.
Clinton.What’s going on in your infant’s brain?Once babies are born, the work continues.
Research shows that during these formative years, early experiences shape the brain, which affects lifelong health, behavior and learning.
Clinton, who co-authored this study, explains that during the first three years of life, an infant starts to develop their view of the world and their responses to it.“People don’t really know about this,” she says.
“At the time when young families are most stressed with little ones and balancing work, that’s the time when the kids need the over-the-top, crazy-in-love, full-force attention the most.”Even in the very early months, babies are influenced by things like whether they’re picked up and soothed or abandoned.
These experiences—whether positive or negative—send pathways to the brain.“In the first year of life, we should be creating an external womb, so face-to-face interactions, picking up babies when they need to be soothed, reading their cues, being sensitive, really creating safe, nurturing nests for the children,” Dr.
Clinton says.A child’s capacity for emotion also registers much earlier than you might expect.
According to the American Psychological Association, at around 18 months, toddlers can begin to develop and understand moral emotions such as embarrassment and empathy.
A few months later, this can be followed by guilt, pride and shame.What can you do to improve your baby’s mental health?A healthy, happy baby will be content most of the time and they’ll take pleasure from being in the presence of others, says Dr.
But babies will certainly tell us if they’re not pleased, and that’s when it’s time to step in.“All the baby can do is cry to try and let you know that they’re distressed.
First of all, physically make sure they’re safe, nutritionally make sure that they’re getting what they need and then try and see things from the baby’s perspective,” she advises.Gould explains that positive emotional actions can include skin-to-skin contact, being swaddled or held in a warm environment and providing a safe environment for the baby to explore their surroundings.Other easy wins for parents, like offering eye contact, as well as talking, reading and singing aloud to your baby can encourage emotional connections, while frequent hugs provide them with essential comfort.
Gould also advocates for parents to establish a predictable daily routine to help babies feel secure and to reduce anxiety.Beyond this, it’s important to spend quality time with children and to read their unique, individual cues.
For example, if they’re interested in something, expand that interest, and if they’re tired, let them rest, adds Dr.
Clinton.As your child develops an awareness of their emotions, aim to normalize their feelings, says Maura Francis, PhD, a postdoctoral fellow in clinical psychology who specializes in clinical care for children and families at the Manhattan Psychology Group.“Regularly acknowledging and normalizing emotions to help with coping and problem-solving helps create a consistent and predictable foundation for the child to learn how to healthily regulate their own emotions,” she says.
“This also lessens the burden for the child to solely change as they continue to grow and learn through a variety of life experiences while feeling supported.”How do you know if your baby is developing a mental health condition?Sometimes an infant’s mental health may be in need of more attention, but it’s important to know that this isn’t necessarily related to something you’re doing wrong as their parent or caregiver.
However, there could be signs to suggest that a combination of factors are inhibiting your child and more support may be helpful in navigating their wellbeing.Dr.
Clinton says that while it’s important to monitor your child’s emotions, if something presents as a worrying symptom, it doesn’t necessarily mean that there’s something wrong with your child, either.“It just means that they might be a little more challenging to support getting their very best self to shine through,” she says.
Remember, help is always available, whether that’s through a conversation with your pediatrician or a child-focused therapist.Here are some red flags to look out for when it comes to infant mental health, but know that much of these present normally in babies, too.
The alarm bells should ring if a pattern becomes consistent.Not being able to be soothedNot wanting to be held and avoiding eye contactExtreme fussiness and unremitting cryingPoor sleep patternsDifficulties with feedingShowing signs of anxiety, tension, distress or fearWithdrawing from other peopleA note from Motherly on supporting infant mental healthBeing aware of your baby’s behavior, mood and temperament can help you understand their needs, but if something feels off or you’re concerned about your child in any way, seek help early on, and know that it’s never too late to seek support.And while it’s easy to get caught up in what our babies need, it’s equally important to ensure that we, as parents and caregivers, are mentally healthy too.
Poor mental health may impair your ability to pick up your baby’s cues, so if you’re experiencing persistent low mood, know that help is out there.
Reaching out to your birth provider or primary care physician is a good place to start.Postpartum depression resourcesIf you’re experiencing any postpartum mood symptoms, no matter how mild, know that help is available.
Reach out to your healthcare provider about next steps and potential treatment options, such as more support at home, therapy or medication.
If you’re in crisis, reach out to a crisis hotline or dial 988 or 911 for immediate support.The phone numbers listed below are available 24/7 to help you with suicidal thoughts or other mental health crises.
The National Maternal Mental Health Hotline: 1-833-943-5746 (1-833-9-HELP4MOMS)Available in English and Spanish and in a completely confidential line.Postpartum Support International: 1-800-944-4773 (call or text)Available in English and SpanishNational Crisis Text Line: Text HOME to 741741National Suicide Prevention Hotline: Call or text 988Available in English and SpanishFeatured expertsJean Clinton, MD, is an infant psychiatrist and clinical professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University and published author.
She is an expert in the development of young minds and is internationally recognized as an advocate for children’s issues.Beverly Gould is the Program Director of the Child Centre of NY’s Macari Perinatal Intensive Outpatient Program.Maura Francis, PhD, is a postdoctoral fellow in clinical psychology.
She specializes in clinical care for children and families at the Manhattan Psychology Group.SourcesAgency for Healthcare and Research Quality.
Child and adolescent mental health.
In 2022 National Healthcare Quality and Disparities Report.
Agency for Healthcare and Research Quality.
https://www.ncbi.nlm.nih.gov/books/NBK587182/Clinton J, Feller AF, Williams RC.
The importance of infant mental health.
Paediatr Child Health.
doi:10.1093/pch/21.5.239 View comments