How first experiences impact the infant development
Two days after my daughter was born, in Milan, Italy, I was in the hospital nursery room. When I was there, another baby girl was ready to go home with her parents, when her dad said, loudly (in Italian), “Can you see how all the other babies and parents are happy to see you go finally, so they can stop hearing you cry? We cannot hold you all the time darling, life is painful, so you’d better get used to it”.
I found these words very stressful, and, although it may have been an isolated episode for a new parent, I started to think about what this girl could experience going forward, if this style of parental relationship continued. She most likely would not feel understood, listened to, or supported by others. This episode reminded me once again of the importance of sensitive parent-infant relationships starting from the very beginning.
I am psychologist, with a PhD in perinatal psychiatry at King’s College London, and my work has always focused on the mother-infant relationship and infant development. In the past few years, I have worked on different research projects on perinatal mental illness, investigating both risk factors and the potential impact on the mother-infant relationship and the infant's development.
I have previously written about these topics in Inspire the Mind, and was also inspired by the birth of my own daughter two years ago, and so I have decided to launch this column (the Perinatal Journey - Walking through the first years of life) dedicated to parenthood and infant development. As I explained in my interview with fellow researcher and ITM writer Zuzanna Zajkowska, this column will focus on the perinatal period and the first years of life, a time so incredibly important for infant development.
Why sensitive parenting is so important
Research has now documented how the first 1001 days (from conception to around age two) are an extremely sensitive period for a child’s future development. During this time, babies are growing very fast, and their brains are being shaped by the experiences they have with their parents and the environment around them.
Babies are in fact highly dependent on their caregivers. The type of relationship they develop with their parents early on will be internalised and will guide their future development and relationships, as well as their mental and physical health. This may seem a strong statement to make, but we indeed know from many studies that sensitive parent-infant relationships sustain offspring’s physical and mental health, through childhood, adolescence and adulthood. For example, sensitive relationships predict better infant social and cognitive abilities, good (secure) attachment towards the caregiver, lower risk for problems at school, and for mental health problems in childhood, as well as better development during the lifetime. Conversely, infants who have not experienced a sensitive relationship are at greater risk of less optimal mental health outcomes during their lifetime.
How early relationships affect infant development
Using simple words, in a sensitive parent-infant relationship, the caregiver (usually a parent) values, understands, and responds appropriately to the child’s signals and needs, adjusting her behaviour to comfort the infant and reduce her distress and disengagement.
The experience of a sensitive and consistent relationship with a caregiver will make the infant feel content, understood, and secure. As time passes, the infant will be able to use this relationship as a “secure base”, from which to explore the environment and open-up to the world, but also a place to return for comfort and reassurance, certain that the caregiver will be there to help in case of need.
Because of this early positive relationship with their caregiver, the infants’ internal representation of themselves, the world, and others will generally be positive and, therefore, they will be more likely to be able to explore and interact successfully with other adults and children, to show empathy and social-emotional engagement and have good self-esteem. Growing up, the child will also be more likely to successfully deal with negative emotions and stressful situations independently, while also be able to return to the caregivers if needed.
In adult life, these characteristics will remain.
Therefore, adults who had sensitive parents will generally be more likely to have good self-esteem, to form positive intimate relationships, to succeed in their studies and career, to manage stress and emotions, and to remain resilient in the face of difficult situations, reducing the risk of suffering from both mental and physical disorders.
Of course, this is not a deterministic, univocal association, as many other factors influence the course of development. Some resilient adults might have had a difficult childhood, and some adults who grew up in optimal parental conditions may manifest mental health vulnerabilities. Nevertheless, the association between sensitive parenting and better health is undeniable – this is why it is so important that everyone knows about it.
The crucial but demanding role of the “good enough” caregiver
Responding to a baby in a sensitive and consistent way is crucial for the infant. Common advice given, such as: “don’t hold the baby too much, don’t respond to her every time she cries, otherwise she will be spoiled and will never be independent”, is now considered false. There is no scientific evidence supporting the idea that a mother can respond “too much” to a baby. In fact, the opposite is true: the more an infant receives consistent and sensitive responses to their needs, the more they will be able to grow-up as an independent adult.
Of course, it is important to highlight that the caregiver does not need to be perfect but just “good enough” for the child, using the words of the paediatrician and child psychoanalyst, Dr. Winnicott. There are in fact many practical life situations where the caregiver cannot always respond in the best way to the baby. It is the caregivers’ repeated, regular failure to respond to the baby that can generate problems.
It is also important to mention that taking care of a baby in a sensitive way is a demanding job for a parent, even in the best of circumstances. All of this is a process and requires time for adjustment, and this is why the role of the support network is essential for a family when a baby is born. As another ITM writer has reminded us, “it does take a village to raise a child”.
When a supporting intervention is needed
Difficulties in the parent-infant relationship can develop even in the best of circumstances and are even more likely when vulnerability factors are present.
Many factors can increase the risk of parent-infant relationship difficulties, by directly affecting the interaction or, indirectly, by increasing the probability of maternal mental health problems, such as depression during pregnancy and in the postpartum period. Depression can represent a risk for the mother-infant relationship and the infant secure attachment, particularly when the illness is prolonged and severe.
Other factors include the caregiver having a difficult relationship with their own parents in childhood, or with their current partner, lack of support, socio-economic disadvantage, stressful events, and severe pregnancy/delivery complications. In these situations, it can be harder for the parent to provide an attuned response to the baby, and the more vulnerability factors are present, the more difficult it can be.
When difficulties arise, it is important to intervene as early as possible with supporting interventions dedicated to improve the mother-infant relationship and infant security. We will discuss possible interventions in one of the next articles.
“Good enough” parenting is a strong protective factor for infant long-term development. If you would like to know more about this – to receive compassionate, evidence-based advice on parenting – come back to my monthly column!