Infant mental health, also called “early childhood mental health,” refers to the mental health of young children from birth to age five.  Very young children need lots of help from their parents and closest caregivers to learn how to express and manage their emotions in healthy ways. For this reason, parents’ relationships with their children play an important role in the mental health of infants and young children.     

A new baby is exciting - and stressful! Parents often worry about everything they need to do and wonder if they're doing it right. Parents help to support the mental health of their babies by doing small things, such as talking to their baby, responding to their baby’s smiles or cries and comforting their baby when the baby is upset or scared.  All of these actions that parents do, often without thinking, help babies to build trusting relationships with their closest caregivers.  We now know that when infants and babies feel secure in their relationships with their closest caregivers, this can help support their overall mental health as well.

The relationship between young children and close caregivers is sometimes called an “attachment” relationship.  An attachment relationship refers to the special emotional bond between an infant and caregiver, whom the infant most readily turns to for comfort when he or she is hurt, upset or frightened.  Likewise, this special caregiver, sometimes called an “attachment figure”, plays an important role in supporting infants’ and young children’s curiosity for play and exploration. 

Infants and young children can form close emotional bonds with many important loved ones. But they often form the closest bond with the person they spend the most time with. Depending on the situation, that person could be the mother, father, grandparent or another caregiver. The person may be related to the child or not.

Signs that a parent or caregiver and infant have a secure attachment are when the infant:

• comes to the parent when hurt, needing help, or comfort
• shows affection
• greets the caregiver after they have been apart
• goes out to explore and also interacts with their parent while exploring (for example, looks back and makes eye contact while playing)
• is more comfortable with the caregiver than strangers

Attachment relationships form in infancy and early childhood and there may be many reasons why young children may not demonstrate the types of behaviours listed above.  If parents or caregivers have questions or concerns about their baby or young child’s mental health or their relationship with their child it is recommended that they speak to their family physician or primary care provider to find out where they can go for more information or help if needed.

Here are some signs that an infant may be at risk for mental health challenges.

• The child has problems with sleeping or feeding

• The child has problems with sleep or feeding
• The child over-responds or under-responds to things around them
• There is poor attachment between an infant and their parents or other caregivers 

Can an infant be diagnosed with a mental illness?

Yes. But it can be difficult to diagnose because infants can’t tell you how they feel or what they think. It’s also important to remember that normal development will look different in different infants. Changes, like the birth of a new brother or sister, can cause a lot of stress. The stress may affect the way the infant acts, but it isn’t a mental illness in itself. A doctor can work to see what else may be causing or adding to the infant’s problems. This can take a long time, but it’s important. A diagnosis will help to connect with treatment options and take action early.

Infant mental health is about getting help early. It's always a good idea to talk to your doctor as soon as you notice a problem. There are many different things parents can do. Here are a few suggestions:

Parent education

• teaches parents or caregivers how to recognize an infant’s cues and take action
• may be informal, using things like fact sheets, videos or websites
• may include more formal meetings with a child care professional

Home visits

• visits from a mental health worker, like a community care nurse, may help identify problems early
• may help a family feel less alone
• sometimes helps professionals take action if a family has social problems like low income or poor housing

Parent training

• looks at the way a parent and child interact
• uses coaching, videos, play time and other tools to teach positive parenting
• helps parents learn to sense what a child needs
• increases attachment between the parent and child
• can also include talk with a therapist about past issues that may affect how parents deal with their child
• based on the idea that a change in the parents will lead to a change in their infants

Encourage good attachment - Tips for Parents

• make eye contact, talk, sing, smile and laugh with your infant
• respond to your infant’s needs. Learn what your infant’s cues (like smiles, cries and cooing) mean and respond to them quickly
• provide basic needs like clothing and food
• give lots of love and attention, especially if your infant is sick, hurt or upset
• take care of your own health. If stress or difficult situations affect your relationship with your infant, it's best to talk to a mental health professional about your own health.

Poor attachment may be a risk factor, but it doesn’t guarantee a mental health challenge or illness will occur. And, good attachment may give a child protection from a mental health challenge or illness. Parents can't control some of the things that cause mental health challenges or illnesses. But they can provide things that promote good mental health, like a safe home, healthy relationships, good support and attachment.

An infant or very young child can't tell you they have a problem, but there are warning signs.

It is best to see a doctor if the infant:

• does not want to be held
• cannot be comforted when upset, or is upset for longer than seems right
• has a lot of problems eating and sleeping
• won’t make or keep eye contact with the parent or caregiver, or avoids eye contact with others
• doesn’t seem to interact with others
• doesn’t make noises very often, like cooing or babbling sounds
• doesn’t use language as expected for their age
• loses skills they could once do 

Looking for more information on this topic? Connect with a parent peer support worker at the Kelty Centre to discover additional resources, learn more about support and treatment options, or just to find a listening ear.