Five ways practitioners can support infant mental health

You may have heard about the developmental importance of ‘the first thousand days’ in a child’s life (Moore, Arefadib, Deery, & West, 2017). A growing body of evidence supports this thinking – that experiences in-utero, through infancy (0–12 months) and into toddlerhood (1–3 years) can have lifelong impacts, both positive and negative, for physical and mental health, literacy, numeracy and socio-economic outcomes (WHO Commission on Social Determinants of Health, 2008). These early years are vital in shaping a child’s long-term social and emotional wellbeing.

Practitioners are in a unique position to provide support to parents and help plan for children’s social and emotional development and mental health at the earliest possible stage. Here are five ways that you, as a practitioner, can support infant mental health.

To support parents and children as they navigate these early years, it’s essential for practitioners to have a baseline understanding of infant and toddler development. It’s also important to recognise that parents may have varying understandings about how children develop – what constitutes ‘normal’ behaviour at different ages and stages, and what may be signs of mental health concerns.

In the first three years of life, development is characterised by rapid physical and cognitive growth (Healthwise, 2019). From birth, infants are on a fast-track in language and communication development, as they learn to interpret and adapt to the words, sights, sounds and smells that are all around them. Physically during this period, children go from having very little control over their bodies, to crawling, standing, walking, then running (McLean, 2020).

Beyond learning to communicate and control their bodies, the major developmental challenge for an infant is to form an attachment with at least one reliable caregiver who can respond to their physical and emotional needs – a bonding experience that forms the foundation for their later social, emotional and cognitive development (McLean, 2020). This formative connection gives a young child a sense of agency in their world, and of the ‘trustworthiness’ of others – an internalised ‘working model’ that forms the basis for self-awareness, self-esteem, and emotional, social and cognitive development (DeKlyen & Greenberg, 2008).

As an infant becomes a toddler, the basic sense of trust they have in their primary caregiver – the secure knowledge that someone will be there for them when needed – supports them to explore and learn beyond their primary attachment, and in the development of their sense of ‘self’ (McLean, 2020). It is this fundamental nurturing relationship between infant and caregiver – that the child’s wellbeing is the caregiver’s top priority – that sets children up for positive mental health later in life.

Infant and toddler mental health can be defined as a young child’s capacity to experience, regulate, and express emotions, form close and secure relationships, explore the environment and learn (Zero to Three, 2023). If they are living in a setting that is responsive to their needs and stimulating to their development, most infants and toddlers learn to do all of these things and experience good mental health.

However, infants and toddlers are extremely vulnerable to disruptive and traumatic life events and parental adversities. Their wellbeing can swing from the ‘healthy’ end of the mental health continuum to ‘unwell’ very easily. When an infant or toddler’s early attachments with caregivers are disturbed or disrupted, it can impact on their willingness and confidence to explore, and therefore affect their social, cognitive, and physical development, in both the short- and long-term.

It’s imperative for practitioners to understand infants’ and toddlers’ vulnerabilities, in order to identify those children experiencing problems and provide early intervention. Current evidence advises that in situations where children are vulnerable, intervening early helps to improve their outcomes (Royal Australian and New Zealand College of Psychiatrists, 2010).

In supporting parents, particularly when mental health concerns are part of the picture, a key strategy practitioners can employ is ‘anticipatory guidance’ – providing parents with useful, relevant and practical information about ‘what to expect’ in an infant or toddler’s behaviour, growth and development in the immediate and longer term. Anticipatory guidance can equip parents with ways to provide positive experiences and environments for their infants, in turn reducing parental anxiety and promoting positive infant mental health and wellbeing.

When parents and practitioners intervene early and work together to understand development, support attachment, and mitigate risk factors that can negatively impact on an infant or toddler’s mental health, it can make a real difference to that child’s long-term outcomes.

Children’s mental health is everyone’s responsibility. When we support every child, family and community, and understand what their needs and desires for positive health and wellbeing are, we can create a healthier and fairer foundation for all children.

Emerging Minds supports practitioners and health workers in both child and adult services to create opportunities for positive child mental health. Simple changes to your everyday practice can make a big impact to the mental health and lives of the children and parents you work with.

Practitioners are well placed to recognise influences, potential risk factors, positive opportunities and parenting skills and strengths that affect infant and child mental health. Whether you work in adult-focused services, with families, or with children, you can make simple changes to your everyday practice that can help promote positive mental health for kids now and into the future.

References

DeKlyen, M., & Greenberg, M. T. (2008). Attachment and psychopathology in childhood. In J. Cassidy and P. R. Shaver (Eds.). Handbook of attachment: Theory, research and clinical applications (2nd ed., pp. 637–665). New York: Guilford Press.

Healthwise. (2019). Growth and development milestones. Boise: Healthwise.

McLean, S. (2020). Understanding child development: Ages 0-3 years. Adelaide: Emerging Minds.

Moore, T. G., Arefadib, N., Deery, A., & West, S. (2017). The first thousand days: An evidence paper. Melbourne: Centre for Community Child Health, Murdoch Children’s Research Institute.

Royal Australian and New Zealand College of Psychiatrists. (2010). Prevention and early intervention of mental illness in infants, children and adolescents: Planning strategies for Australia and New Zealand. (Report from the Faculty of Child and Adolescent Psychiatry). Melbourne: Royal Australian and New Zealand College of Psychiatrists.

WHO Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. (Final Report of the WHO Commission on Social Determinants of Health). Geneva: World Health Organisation.ZERO TO THREE. (2023). 

ZERO TO THREE’S Infant and Early Childhood Mental Health (IECMH) Guiding Principles. Washington: National Center for Clinical Infant Programs.