When Babies Get the Blues

To a greater degree than ever before, psychologists and family therapists are focusing on the emotional well-being of babies.

The reason: Even infants can experience physical and emotional stress just like adults, but they lack the coping mechanisms years of living bring.

And often those stresses can be traced to parents who lack the needed caregiving skills.

It may seem strange to worry about the mental health of little children.

"This conjures up the image of babies sitting on a psychiatrist's couch," says Dr. Jeffrey P. Brosco, a pediatrician and medical historian at the University of Miami. "But that's not it at all."

Children under the age of 3 can suffer from such classic signs of depression as disruptions in eating and sleeping patterns. Researchers have even discovered that babies can struggle with post-traumatic stress disorder.

"We now recognize that zero to 3 is an age where children learn and grow at rapid rates and can be touched by traumatic circumstances," says Robin H. Gurwitch, an associate professor of pediatrics at the University of Oklahoma. "Recognizing that it's a vulnerable period allows us to pay more attention and intervene."

Interest in the inner world of babies is nothing new. "In some ways, people have been talking about infants and their development for centuries," Brosco says.

In the past five to 10 years, however, "lots of medical research has shown that some really spectacular things are happening in babies' brains," Brosco says. "What we know is that [the brains] are physically changing every day, depending on what their environment is."

For their brains to develop properly, babies need tender, loving care and a secure relationship with at least one parent, experts say. They should have "secure attachments" in which they seek out their primary caregiver for "feelings of comfort, safety and security" but feel free to explore their environment, says Constance Weil, a pediatric psychologist at Children's Memorial Hospital in Chicago.

Parents don't usually need a class to learn to connect with a baby, Brosco says. "The vast majority of parents have been doing this for generations. Most of it is talking to your baby, holding your baby, singing, the stuff we do by instinct."

But when stability is missing -- perhaps an absent or emotionally distant or depressed parent -- babies struggle to cope and start to show symptoms that something is wrong.

"Kids can have what we call regulatory disorders -- difficulty regulating their emotions or their behaviors," Weil says. "They can be oppositional, they can be aggressive, they can be withdrawn or have low tolerance for frustration and cry frequently. They may have difficulty with transitions and adapting to change."

There are other possible symptoms, too. "You may have problems in terms of more aggressive behaviors, temper tantrums," Gurwitch says. "Oftentimes, these kids may look a little bit more hyperactive, they have problems with attention and concentration, they seem to be on the go all the time."

What should a parent do if he or she suspects a baby is having emotional problems?

"Ideally, they would first talk with their pediatrician, because children in the zero-to-3 range are still seeing their pediatrician on a regular basis," Weil says. "The pediatrician should be able to do a lot of counseling as to what's appropriate developmentally and be able to handle age-typical behavioral concerns, feeding programs and sleep problems."

In many cases, families then have no choice but to turn to therapy to better understand how to care for their babies. While teens, adults and even dogs and cats can take antidepressants, they aren't an option for babies.

"Prozac cannot make you feel worthy of love" as an infant, says Alice Sterling Honig, professor emerita of child development at Syracuse University. "Only an individual who is individually cherishing you, attuned to your particular temperature, your needs. Only that kind of attuned adult can develop a secure attachment with a child. In the first three years of life, medicine cannot provide that."

During therapy, family members learn how to understand and relate with the child. "The therapy is designed at improving the emotional well-being of everybody in the family," Brosco says. "How do you read a baby's cues, how do you read that the baby wants to be held or fed."

If troubled babies and their families don't get treatment, experts agree, the consequences can last a lifetime.

"In college, the way you behave with your boyfriend or girlfriend is very much attuned to what happened to you in infancy," Honig says. "If you felt you could never get attention when you needed it, you may be very insecure, wondering: Do you really love me? Why were you looking at that girl in Spanish class?"

Therapists must often teach parents to compliment their infants instead of criticize them and make sure the kids feel safe in times of stress, Honig adds.

Helping infants handle the challenges of life will pay off down the line.

"The biggest myth is that it doesn't make a difference what you do in the early years, that people's traits are genetic and you can't have a favorable influence," says Dr. Stanley Greenspan, a child psychiatrist at George Washington University. "That's not true."

More information

To learn more about infant mental health, visit Zero to Three and Health Canada. For parenting tips, visit the National Library of Medicine.

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