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The very important reasons for #IncludingInfants in children and young people's mental health

Posted on: 9 June 2021

This Infant Mental Health Awareness Week (7-13 June), the GP Care Group is lending its voice to calls for mental health support and early intervention for infants.

The Parent Infant Foundation, Association of Infant Mental Health, and International Training School for Infancy and Early Years (ITSIEY) all emphasised the importance of including infants in children and young people's mental health services.

The GP Care Group's Health Visiting team is backing these calls. In recognition of Infant Mental Health Awareness Week, Lola Oloko, Kate Oxlade, and Kemi Adediji (Perinatal Infant Mental Health Champions) within the Health Visiting team have written on this topic and highlight the many benefits of mental health support for infants.


What does good infant mental health look like?

Good mental health has a very strong impact on the outcome of an infant's development, their health and wellbeing, right from conception, infancy, early years, and childhood, up to adult age. It can even influence the inter-generational transmission of parenting, attachment patterns as well as how they contribute positively to the community.


What is good infant mental health?

Zeena and Zeena 2009 cites in ITSIEY (2011) define it as: "The young child's capacity to experience, regulate and express emotions, to form close and secure relationships and explore the environment and to learn. All these capacities will be best accomplished within the context of a caregiving environment which includes family community, and cultural expectations for young children. Developing these capacities is synonymous with healthy social and emotional development."

Not all infants can achieve this. Some infants would need support and early intervention from infant mental health services to promote attachments, healthy relationships with the caregiver from early infancy to reduce risks or delays to the social and emotional development in their infancy and later years.

In fact, according to the International Training School for Infancy and Early years, the health of the infant starts from the mother's wellbeing before she even gets pregnant. A healthy environment from the prenatal period supports the full genetics part of the brain to be expressed, with lots of nutrients, free from toxins and healthy habits from the future mother. However, where there is an adverse prenatal period, this can affect the brain by altering the genetic makeup of the brain. (Harvard Centre for Childhood Studies).


Why should we include infant mental health support in existing children and young people mental services?

Including infants within children and young people mental health services is crucial for early intervention in order to break intergenerational disadvantage; promote good parenting with positive outcomes and development for the child. Where there is adversity, trauma, an unhealthy environment, and other vulnerabilities such as domestic violence, paternal and maternal mental health, physical ill-health, poverty, inequalities, and others, we know these could have effects on the social and emotional development of the baby. It is known that in a developing child, 80% to 90% of the brain develops during the first 1001 critical days.

Getting it right and ensuring infants have a better start in life can only be achieved when they are included in mental health services. This will ensure that parents and infants can get the services they need as early as possible to address and support the interventions required as early as possible.


The Healthy Child Programme

As Health Visitors, we are responsible for promoting the wellbeing and development of children up to the age of five through the Healthy Child Programme (HCP). This is an evidence-based programme designed to give every child the best start in life.

'The universal reach of the Healthy Child Programme provides an invaluable opportunity from early in a child's life to identify families that need additional support and children who are at risk of poor outcomes. Health Visitors have a crucial leadership, coordination, and delivery role within the Healthy Child Programme. We work with key partners to deliver a comprehensive service'.

In Tower Hamlets, we work to achieve this through our mandated contacts: antenatal contacts with women between 28-32 weeks of pregnancy, new birth contact when baby is between 10 and 14 days old, 6-8 week postnatal reviews (checking on the emotional wellbeing of both parents and baby and the wider family), 3-4 month development review focusing on how to set good habits for a lifetime around eating and exercise as well as identifying any further support and identifying appropriate early interventions, 8-12 month development review and 2-2.5 year review looking at school readiness in particular.

Families today are formed in many diverse ways. The traditional family – a heterosexual married couple with biologically related children – is just one example of how a family structure can exist. The HCP is designed to embrace every type of family and there should be no discrimination against families who do not meet the typical 'nuclear' family description.


The COVID-19 Impact

It goes without saying that the COVID-19 pandemic has had an impact on everyone's lives. The 'Babies in Lockdown' report (highlights several challenges identified by families during this time:

  • Almost 7 in 10 (68%) parents felt the changes brought about by COVID-19 were affecting their unborn baby, baby, or young child
  • A third (34%) of respondents believed that their baby's interaction with them had changed during the lockdown period.
  • One quarter (25%) of parents reported concern about their relationship with their baby, and one third (35%) of these would like to get help with this.
  • Almost half (47%) of parents reported that their baby had become clingier. One quarter (26%) reported their baby crying more than usual.


Mental health support for everyone, including fathers.

Consideration should be given to the emotional wellbeing of the father or partner, and services should be inclusive, involve fathers and partners in discussions about child development, encourage fathers/partners to be involved in their children's lives to see how rewarding this experience can be. Services should provide reassurance to the family but also ensure that barriers are removed to enable parents to access appropriate support for their infants in a timely manner.

Just like mothers, fathers often experience wide-ranging and complex emotional changes during the perinatal period. When considering mental health in the perinatal period, the mental wellbeing of fathers should be considered equally.

We should also be able to educate fathers and partners about perinatal mental illness so that they can access help if they notice any signs and symptoms in themselves or their partners. We need to ensure that fathers and partners have adequate support systems in place if the mother has a perinatal mental illness. It's important to note that maternal depression increases the risk of depression in fathers.

In addition, outcomes for children can be affected where one or both parents have a history of mental illness. By identifying all of this, and working towards healthy infant mental health, children really can have the best start in life.


Visit the Health Visiting page on the GP Care Group website.