INFANT HEALTH


> are most active during the first three months of a child’s life, particularly so in the very first months of life.


Behaviour can be altered later in life; however, it becomes significantly more difficult to do so as a child moves out of the 0-3 years age bracket. The quality of relationships between a child and their primary caregiver, for example parent or guardian, is central to the process of nurturing a child’s social and emotional health during their early years. These relationships are an important aspect in providing a child with the necessary skills to be able to form and maintain healthy relationships later in life.


There are three main aspects which currently form the foundation for discussion around infant mental health. These include:


Attachment – describes the bond between an infant and their primary guardian. A strong attachment can be developed by responsive and positive behaviours from the parent or guardian. Mirrored behaviours, physical contact and proximity are examples of positive behaviours. A child with strong attachments can have the social and emotional confidence to build relationships and explore the world around them [3,4]


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Self-regulation – denotes an infant’s ability to regulate their own internal emotional states, having the ability to sooth themselves rather than relying on parental input. This in time forms the building blocks of healthy external relationships [4,5]


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Building resilience – refers to an infant’s ability to bounce-back from difficult or traumatic experiences, and have the ability to learn from these experiences. Developing resilience within the first three years of life is


important in being able to deal with difficulties later in life [4,6]


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It has been widely stated that healthy attachment develops between 0 and 3 years This is when brain development of the infant is in its optimal phase and when healthy social and emotional development begins. Key factors such as breastfeeding, skin to skin contact, mirroring behaviours, responsive parenting, and stimulating a play environment can contribute in a positive manner to the overall health and development of the child.


It has become clear that relationship building with the guardian or parent from birth has a significant impact on the ability of the child to navigate relationships later in life.


Understandably the vast majority of parents and guardians aim to ensure good mental health development and play a critical role in preventing poor developmental outcomes. This is the aim of many parents and guardians across the country.


In many cases the development of attachment, self-regulation and building resilience happens without much thought, however it can be helpful for parents and guardians to think specifically about their actions and the impact such actions will have on their baby’s development from birth.


As a parent it can be difficult to recognise the signs and symptoms of issues arising from poor infant mental health, this is in part due to the vast range of symptoms that can develop. It has been suggested that problems can manifest in a number of ways: • Issues with feeding • Poor sleep • Developmental delay • Regression in emotional development


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• Insecure attachment behaviours (of which there are many types; for example, anxious-avoidant attachment, where a child will avoid or ignore their primary caregiver, showing little emotion when that person departs or returns).


With children older than 3 years, these signs can present in many ways, for example, as aggressive or attention seeking behaviour.


It is worth noting that this area of study within health and social care is extremely complex, and generalisations should be avoided. As a pharmacist, it is important to be aware of many aspects of health and wellbeing, not just the medicines.


In practice it can be easy to focus solely on medications and the treatments available, blaming interactions or side effects as the cause of patient behaviour – often medication can be a starting point in narrowing the search for the causative issue, however the impact of healthy relationships between infants and caregivers cannot be overestimated.


Currently infant mental health services are in place across Northern Ireland and the UK. These services were set- up to try and promote the prevention and early intervention of infant and early childhood mental health conditions by reducing risk and supporting the parent/guardian/child relationship. These services aim to optimise the social, emotional, and cognitive development of infants and toddlers with their primary caregiver by connecting people with resources, providing supportive counselling, and if necessary crisis intervention [7]


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care thinking is important within community pharmacy, so that the people accessing information from their pharmacy team can feel confident and well supported.


As pharmacists, a focus on medicines and a holistic awareness of the patient including infants from 0-3 years, it is paramount that accurate and appropriate advice can be presented.


Pharmacists should feel confident in their abilities to answer questions regarding topics such as infant mental health, because although less frequently asked these issues are of concern to a large proportion of society.


Community pharmacy continues to be an ideal place for the dissemination of information to patients, and a place where patients can be signposted to accessing the health and social care services most appropriate to them. n


References: 1. Action Mental Health Website. Accessed 8th April 2016. Available at: http://www.amh.org.uk/about/. 2. UK Faculty of Public Health – The Cost of poor mental health website. Accessed 8th April 2016. Available at: http://www.fph.org.uk/the_cost_of_poor_menta l_health. 3. Barlow, J. & Svanberg, P.O. (2009) Keeping the baby in mind. Infant Mental Health in Practice. London: Routledge. 4. Public Health Agency –Supporting the best start in life, Infant mental health framework. Accessed 8th April 2016. Available at: http://www.publichealth.hscni.net/sites/default/fi les/IMH%20Framework%20consultation%20do cument_0.pdf 5. Schore A.N. (2004) Affect regulation and the origin of the self: The neurobiology of emotional development. Hillsdale NJ: Lawrence Erlbaum Associates. 6. Newman, T. With Yates, T. & Masten, A. (2004) What works in building resilience? Barnardo’s, Barkingside 7. Child and Adolescent Mental Health Services website. Accessed 8th April 2016. Available at: http://www.younghealthymindsni.co.uk/infants/


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