In the last blog, I discussed infant mental health and how it is tied into a child’s physical health.1 They are firmly linked and crucial to a child’s development in the years ahead. To ignore one or the other is to ignore a child’s well-being and to assume that child rearing is an innate activity and that we don’t really need any help along the way. Quite the contrary, my friends. To optimize the development and well-being of our children, the physical health and the mental health must be considered at every step.
I emphasized several things about infant mental health –
- The health of our children is not merely the absence of bad or unfortunate influences but the presence of good. Concerted efforts are vital to promote positive infant mental health.
- We cannot accept the idea that infant mental health is really a spurious concept since children cannot process things well and verbally express themselves. This idea is a pernicious one and tears at the fabric of infant mental health.
- Over 80 billion neurons are present at birth and need to be nourished with “love” to form the proper connections, and the overwhelming majority of this activity occurs in the first three years of life.
- The brain is built from the bottom up and for the proper hierarchy of mature functions to occur, this process requires safe, stable nurturing relationships (SSNRs) between caregivers and the infant.
- You cannot spoil an infant with love and nurturing and to think so is to buy into a false narrative that children can independently develop. Such development would be grossly inadequate and run counter to sound science and basic humanity. The brain and its connections require constant nourishment from internal and external forces.
The list below of necessary components to enhance infant mental health is not all-inclusive but a good start. I have drawn heavily from a book that Dr. Andy Garner and I wrote (Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health).2 We are excited that the second edition is due out in the summer of 2025.
- Fulfill basic needs – it might seem obvious but too many children in the USA do not have the security of their basic needs. Air is often tainted, water can be contaminated (remember Flint MI?)3, and climate change affects temperature extremes. Food and shelter are difficult for many, and these difficulties dramatically impact the ability of the family to care and nurture for their children. Basic needs are an integral part of infant mental health.
- Prepare for natural disasters – the increase in natural disasters (hurricanes, tornadoes, floods, fires, blizzards) threaten the delicate balance that many families maintain. When they have to handle additional strain, their resources are often inadequate. And infants are very vulnerable to changes in family dynamics.
- Adequate transportation – Our society is almost totally dependent on transportation. To go to the grocery store, the doctor, or school most families rely on their cars or public transportation. Too many of us take our transportation for granted and forget about the difficulties some families have. A transportation struggle is a family stressor.
- Excellent health care – I hope that you will notice that I called for excellence in health care. Adequate health care is insufficient and neglectful in my estimation. Our health care system has exorbitant costs, multiple roadblocks (insurance coverage) and a two-tiered system (private insurance or public insurance) that fails to deliver the excellence that we all should expect. Our interventions are often delayed and therefore deficient. Other countries have better health outcomes, lower infant mortality rates and longer life spans. Our perpetual struggle to acknowledge and fix a broken system hurts our infants.
- Health promotion and prevention initiatives – Related to our struggling health care system, we must assure for all children the primary care (promoting health and avoiding hazards), universal vaccinations, and proper assessment of their needs. Just going to the doctor isn’t enough if you cannot execute a plan for the well-being of your child. Too many times in my career I have recommended different things for families only to realize in retrospect that they did not have the resources to fulfill that plan. I am embarrassed that I was so blind to their resources and abilities to do the suggested things. We can do better.
- Build a better nurturing system – if SSNRs are key to brain development and infant mental health, why do we not have a better system to integrate such concepts into our educational system and social structures? We need to better assess SSNRs at all levels (a relational health assessment) and offer tools, methods and resources to enhance the ability of all to meet the needs of our infants. We should be looking at ways that our communities can be building these structures for all, without any fear or condemnation for those that are struggling. For if one struggles, we all struggle.
- Consider less punishment, more nurturing – Our society is quick to dismiss those who violate our norms. Too many children are dismissed from daycare, Head Start or kindergarten for behavior problems. And we treat teens in a similar fashion. But considering work of Dr. Bruce Perry, we should not be asking “what is wrong with you” and immediately mete out punishment but rather asking “what happened to you” as we seek to help restore children suffering from some untoward events, to help build resilience in the future, and to help them on their journey to flourishing in the future.4 This nurturing is most consequential in infancy and in the first three years of life. More nurturing leads to less punishment.
- Provide better leadership examples – As a civil society, we look to leaders. The current divisiveness in our society does not promote good will and gives rise acrimony that is toxic to civil discourse. When we cannot respond in a caring manner to others, we poison the well for our infants. When we choose to demean or belittle others, we are setting examples for a caustic influence that erodes our core. We are then “allowed” to make fun of others (by their physical or mental attributes) and set ourselves up as the arbiters of others. Proper leadership does not now or ever do that.
- Better resources for our caregivers – As I have mentioned above, inadequate resources for those that care for our infants is a recipe for disaster. Caregivers (parents, grandparents, foster families, neighbors and others) can only give excellent care when we give them the tools that they need. For some reason, social services (services designed to provide love, care and nurturing to families in need) are too often seen as hand-outs and not as a vital part of a society. Families in crisis or in need cannot adequately nurture all under their care and are set up for potential failure. These families are not regulated (a relative state of calm so reasoned actions and thinking can take place) and not capable of providing the care needed. (Parenthetically, I wrote about my retirement hobby of building LEGOs.5 I find that this activity can help regulate me, enhancing my relationships with others and participating in actions that exhibit calm and measured reason.) Our responsibility as fellow citizens is to provide the resources for all to be able to care for their infants and these families to be regulated. Families in crisis cannot be regulated.
- Recognizing our global responsibility toward each other – Citizens care for each other. Citizens care about each other. We need to recognize that each interpersonal interaction can help build positive exchanges that encourage all to support each other and especially our infants. It is not enough to remark how cute a baby is – we must be sure that all of the resources needed for that infant are provided by us.
As I stated last time, Infant mental health is so much more than what most folks think. It involves knowing how infants develop and then how they prosper with the assistance of the parents, caregivers and society as a whole. We have so much work to do and the topics above provide some structure. Let’s accept our responsibility and assure that our infants are provided with what they truly need. We are not doing that now and will only start doing better when we accept that infant mental health is the absence of “bad” things AND the presence of “good” things.
- https://mychildrenschildren.com/infant-mental-health-part-i/
- Garner A, Saul R. Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health. American Academy of Pediatrics; 2018. 175 pp.
- https://mychildrenschildren.com/a-pediatric-profile-in-courage/
- Perry B, Winfrey O. What Happened to You? Conversations on Trauma, Resilience, and Healing. Flatiron Books; 2021. 301 pp.
- https://mychildrenschildren.com/legos-why-regulation/