When we hear about a person's mental health, it's often in the context of a problem -- a colleague is struggling to handle stress at work, a friend's child is having behavioral problems at school, or a family member has received a diagnosis. And almost always, these discussions are limited to older children and adults. So it begs the questions: when does mental health begin? Do babies have mental health?
As babies, the way we are held, talked to and cared for teaches us about who we are and how we are valued. This profoundly shapes who we will become. The first days, months, and years of life are when the adults who care for us can truly promote strong, positive mental wellness.
Let's look at the world through the eyes of 3-month-old, Shayla, who is hungry and communicating this through her cries:
When I let you know I'm hungry and you come with food, that tells me that you understand my needs and will respond to them. That makes me feel loved and important, and lets me know I can trust you and that the world is safe. I love being cuddled while I eat. But I also love to explore -- find out what's going on around me. So I may pull away to see who else is around, or to find out where all the noise is coming from. I'll also want to grab your fingers and your clothing, or just look up at you with an ear-to-ear smile. When I coo at you, and you coo back, I learn about the power of connecting and communicating. Mealtime is about a lot more than just food for me.
What Shayla and her parents are learning is like a dance -- an intricate dance of development. She and her parents become attuned to each other's cues. She learns to communicate what she needs, and they learn to read her cues and answer them. And in the process, a delightful rhythm emerges as they form the relationship that we call attachment. What they are really building is a strong foundation for Shayla's social and emotional development -- a positive beginning for her mental health. It is on this foundation of mental health that all of Shayla's future learning and relationships will be built.
Children's Mental Health Awareness Day, celebrated on May 7th, is an important opportunity to recognize that mental health is not something that pertains only to adults or older children. Babies have "mental health" -- they are deeply feeling beings who are developing a sense of who they are, their value and worth, from day one. This process begins with the dance that takes place during everyday moments, like feeding, which are actually quite extraordinary when you look at them through the eyes of a young child.
So how do we, as parents, caregivers, and professionals, promote a baby's mental health?
Engage in loving, responsive, positive interactions. Early experiences matter -- a lot. Research shows that parents' attunement to their babies' cues, and sensitive response shapes the architecture of babies' brains and has long-term impacts on academic and social competence. Babies who experience sensitive, responsive caregiving are more likely to develop stronger problem-solving and critical thinking skills, to become effective communicators, and to learn to understand and manage feelings.
Seek to understand the meaning behind young children's behavior. All behavior has meaning. The better we understand what drives young children's behavior, the better we are able to meet their needs. Picture a parent who has learned that her baby is slow-to-warm-up in new situations; so she introduces him to new people from the safety of her arms to give him time to feel comfortable before expecting him to engage. Or a parent who tunes in to her toddler's hard time with transitions, so she alerts him when a change is going to happen, and helps him find a way to cope, perhaps by bringing a special book to look at in the car when heading to childcare. Understanding the root cause enables us to respond in an effective way that teaches good coping skills and reduces shaming and making kids feel they are "bad"--which is detrimental to their mental health.
Recognize that challenges and stress are a natural and important part of a baby's growth. The ability to manage stress and muscle through challenges builds self-esteem and self-confidence. Again, let's picture a toddler playing with a sorting toy. You might see her work on fitting shapes in the holes, turning them, pushing them, until she finds the matches. Making mistakes, also known as failure, is a critical part of learning, as it leads to problem-solving and the building of new knowledge and skills. Experience with managing everyday stressors also helps young children learn to cope with frustration and disappointment -- like not getting ice cream before dinner, or having to leave the playground before they are ready -- gives young children the tools necessary for getting along with others, and ultimately succeeding in school, work, and life. And let's not forget the feeling of pride and accomplishment when the block falls through the correct hole.
The good news is that nurturing strong mental health in young children is not a specific undertaking in which parents need to engage -- as if it were a "job" or task. It is how parents are with their babies that matters -- providing comfort when fussy; responding to their child's efforts to communicate first by facial expressions, sounds and gestures, and later words; engaging them in joyful play and exploration by following their interests and lead; coaching and supporting them to persist with challenges; providing appropriate limits to help children learn to manage when they can't have everything they want; and most of all delighting in the joy of young children's daily discoveries, and in the power of the bond they are building together. This kind of responsive care builds babies' trust and sense of security, and makes them feel adored and loved -- the key ingredients for positive mental health.
We can and should do much more to support parents in their all-important job of getting their babies off on the path to good mental health. For example, paid parental leave would give new parents and babies the gift of time to become adept at the developmental dance that shapes the person a child becomes. We also could offer more parenting support--after all, it is our future workers and citizens for whom they are laying the groundwork. Finally, reaching parents through home visiting, pediatric visits, and early childhood programs such as Early Head Start, could help them build their support network and find mentors along the way.
So, as a society, we are left with a choice. We can support young families as they master that critical dance of development. Or we can wait to address the mental health problems of older children and adults down the road, which is not only draining for them, but also expensive for society. Why not recognize where the foundations of mental health are laid and seize the opportunity to promote a good start?
This blog post is the first in a three-part series exploring the mental health needs of very young children. Stay tuned for future posts on strategies to prevent mental health problems in young children, and effective treatment for those with diagnosed mental health disorders.