Infant mental health

Babies’ brains develop more in the first two years than at any other time in their life. They recognise sounds from 15 weeks gestation. Evidence suggests that a baby’s brain increases in size 17-fold in the last 20 weeks of pregnancy. A good parent-baby connection during this time will enhance brain growth.  Touching the bump and talking to your baby will help you bond after the birth too.

When a baby is born they already have lots of brain cells but not very many connections. As a baby learns and develops their brain makes lots of connections. The cells in a baby’s brain make up to two-million connections every second. Their brain is a bit like play dough. The kind of experiences that a baby has shapes how their brain develops. The relationship that they have with their parents is the most important thing. When you build your babies brain you are building their future!

The most important thing to a baby is what you do as a parent. They are totally dependent on you. This is not just about meeting their physical needs, such as making sure that they are fed and clean. It is also about forming a close and loving relationship with your baby and communicating with them. This supports their brain development and helps them to develop confidence and feel good about themselves as they grow up. It is really important for them to learn that there is at least one person in their world that they can trust to meet their needs and keep them safe.

When children and adults feel good about themselves this means that they can play, learn and make relationships well, and make the most out of their life.

Babies have lots of strong feelings, just like adults. When they are upset or frightened, they need their parent or carer to help them to calm down. Their cry is a bit like their alarm. They use it to tell you they need your help. Ignore people who say, “leave them to cry” or “you will make a rod for your back”. A baby needs a loving adult to help them manage their feelings. Cuddles, touch, holding them close, rocking and talking can help your baby to calm down. This will help your baby to feel safe and secure and learn to trust you.

Talking and singing with your baby is really important for brain development and communication. Watch your baby and give them time to respond back to you. When your baby has had enough they will look away. They need a break as their brain is working so hard!

Babies can experience stress when they do not have a consistent loving parent or carer to help them feel safe. This can be so harmful that it damages the developing brain and has a life-long impact on learning, behaviour and health. Stress for a baby is the same as stress for an adult. It is anything that feels overwhelming. For a young baby, feeling hungry, for example, can feel life-threatening as they are totally dependent on their caregivers.

There are lots of things you can do to help your relationship with your baby. Here are some ideas:

• Remember that all babies are different. You know your baby best.
• Take time to look after yourself, whenever you can, and use your family or friends to help where possible.
• Remember that babies cry because they need you to help them. Babies are totally dependent on their parents to meet their needs and keep them safe.
• Help your baby to calm down when they are upset, for example by cuddling, rocking, holding them close, talking and singing to them.
• Don’t worry if you don’t always know what your baby needs. You will learn this over time and get better at understanding their cries.
• Think about what your baby may be feeling and communicate this to them, even if they are too young to understand the world, the calming sound of your voice will help comfort them. For example, you could say ‘Are you feeling tired? Is it time to have a sleep?’ as you are holding them.
• Holding and cuddling your baby when they are upset does not mean you are spoiling them. It helps them to feel safe and loved which is really important for their brain development.
• Feeding is a great time to build the close and loving relationship with your baby. Watch for how your baby shows you that they are hungry and when they show you that they have had enough.
• Eye contact and loving touch are crucial for building a relationship with your baby. This will help your baby release oxytocin which is a special hormone that helps your baby feel calm and loved.
• When you talk to your baby, wait and give them time to respond back. They may smile, make sounds or move their arms and legs. Watch for when your baby looks away from you. This means that they need to have a pause of stop playing and talking for a while. During this time their brain will be making lots of connections.
• Sharing books and rhymes is a great way to support the relationship between you and your baby. It is never too early to start. Every child under the age of five in North Lincolnshire can receive a free book through the post, through the Imagination Library scheme.
• Remember you can always get help from your midwife, health visitor, children’s centre or early years and childcare professional.

Our Babies First posters summarise ways you can bond with your baby. There is also a summary in your child’s personal health record (‘red book’).

If you would like to find out more facts about the importance of the first 1001 days and baby brain development, visit the 1000 Days website.

Unicef also provide lots of information about building a relationship with your baby. Some of it is included in your child’s personal health record (‘red book’). The Unicef ‘building a happy baby’ leaflet offers advice and information on getting to know your baby and developing a close and loving relationship.

Here is a useful video about caring for babies from Dr Amy Brown at the University of Swansea.

There are some things that can make forming a relationship with your baby more difficult, for example your own mental health or if your baby has been unwell.

You can always seek support from your midwife, health visitor or children’s centre about any aspect of caring for or forming a relationship with your baby.

If you are pregnant, or you are the parent of a baby or young child, and you would like help with your own well-being or mental health, please talk to your midwife or health visitor. You can also visit the ‘Every Mum Matters’ website.

The first 1001 days – from conception to age two – is a period of rapid growth when the foundations for future development are laid. During this time, babies’ growing brains are shaped by their experiences – particularly the relationships they have with their parents or caregivers.

The Parent Infant Partnership website has a wide range of resources to support the theory and practice around infant mental health.

The Association of Infant Mental Health promotes understanding of the importance of infant mental health across society, professionals and the wider workforce.

The ‘conception to age two – the age of opportunity’ report was published in 2013 by the Wave Trust and the DfE. It highlights the importance of this period of time for later outcomes. A second report presents the economic case for intervening early.

Local midwifery, health visiting and children’s centres have achieved stage three of the UK UNICEF baby friendly initiative (BFI).

The aim of the BFI families is to support with feeding and developing close, loving relationships, ensuring that all babies get the best possible start in life.

The UNICEF BFI website contains a range of videos, posters and information to support parents in developing a close and loving relationship with their baby.

The UNICEF building a happy baby leaflet offers advice and information for parents on getting to know their baby and developing a close and loving relationship. Additional ‘myth busting’ posters which are based on the booklet aim to dispel popular myths around crying, comforting and routines. UNICEF summaries of the importance of close and loving relationships for parents are also available.

The NSPCC provides an overview of the research in relation to infant mental health.

Infant mental health is closely linked to perinatal mental health. Perinatal mental health problems occur during pregnancy or in the first year following the birth of a child. The local perinatal mental health service works with women who require specialist assessment and interventions for a moderate to severe mental health problem.

The ‘Every Mum Matters’ campaign seeks to raise awareness of the importance of perinatal mental health and provides information for parents and professionals. NLaG NHS Trust employs a specialist perinatal mental health midwife and the RdaSH NNH Trust Birth to 19 (25 SEND) service has a perinatal and infant mental health specialist health visitor who both work closely together and with the local perinatal mental health team.

Responsive and reciprocal early interactions between baby and parent or carer are crucial for brain development, attachment and early communication. This is more than ‘talking to’ a baby. It requires a parent to give the baby time to initiate, respond and end interactions. In early interactions it also rests on them being able to recognise the emotional states and feelings of their baby and to respond in an appropriate way, communicating the baby’s feelings back to them in a manageable and reassuring way. This is crucial to infant mental health. Where the response described is regularly absent or not appropriate, the developing brain can be negatively impacted.

Usually parents find that this develops over time. But some parents, for example those with perinatal mental health difficulties, may find this more challenging and require support from their midwife or health visitor. The Solihull Approach to working with babies and parents also has the serve and return interactions of reciprocity as one of its underpinning concepts and can also support with this.

The Centre for the Developing Child website provides more information on the importance of these early interactions.

Professionals working with babies in out-of-home settings, including day nurseries and as childminders, are required to follow the Early Years Foundation Stage (EYFS).

The EYFS includes the need for each child to be allocated a ‘key person’ who is able to form a settled relationship with the child and their parents. Effective primary care-giving is essential to the infant mental health of babies and young children in out-of-home settings.

The ‘Conception to age two – the age of opportunity’ report gives specific recommendations for professionals caring for children aged from birth to two in out-of-home settings. It includes the need for professionals to ensure there is continuity and consistency of primary care which supports them forming responsive and sustained relationships with babies and young children in their care.

The ‘Professional love in early years’ project provides materials to support understanding of the theory and practice of the key person approach and attachment.

The ‘Solihull Approach’ promotes infant mental health. It offers support to parents to be and parents of babies and children. For more information visit the Solihull Approach to parenting website.

The Solihull Approach has a mixture of both quantitative and qualitative studies carried out by independent teams across the UK and by the Solihull Approach.

Solihull Approach in North Lincolnshire

A range of professionals in North Lincolnshire are trained to work with families and babies in the antenatal and postnatal period using the Solihull Approach. In addition to individual work with families, there are also ‘Understanding your baby’ groups for parents who need extra support or targeted intervention in terms of building a relationship with their baby, recognising their needs and meeting these in a containing and reciprocal way. These groups are run by different professionals and currently take place in family hubs. If you are a professional and would like to find out more please contact the local family hub.

Training courses

We offer local training for professionals in the Solihull Approach. To find out more contact infantmentalhealth@northlincs.gov.uk

Here are some things that local parents have said after attending our Solihull Group:

• ‘I respond differently to her now…I say daddy is here, you are safe’.
• I have learnt that they need a breather…they will tell you when they have had enough’.
• ‘My mind-set has changed. I know she is a person and an individual. I try to work out what she wants’.
• ‘To get a response out of him we have to respond to what he shows us first…like back and forth’.
• ‘It was amazing. It helped me build confidence and make friends. It’s been a big learning curve for me’

Our Babies First posters promote early relationships and communication. These were trialled with parents in the development stage to ensure that the messages are clear and understandable.

Please feel free to download and share within your organisation.

North Lincolnshire currently has a local infant mental health alliance involving a range of professionals working with families and babies during the conception to age two period. We work together to share good practice, support families and promote consistent messages about the importance of very early relationships. This is based upon national research and policy.

For more information contact us on infantmentalhealth@northlincs.gov.uk