In infants and young children symptoms such as excessive crying, chronic soiling, prolonged difficulties with sleeping and feeding or failure to thrive may well be symptoms of emotional disturbance, as physical and emotional states are inextricably linked in the early years. Disturbance in the parent-infant relationship may be observed by professionals working with the family or verbalized by parents: some, for instance, will find their baby’s crying unbearable, others worry that they cannot love or feel close to their baby. Understanding the interrelationship between parental and infant mental health and between physical and emotional states is key to identifying and treating mental health problems in this age group. Infants rely on their caregivers to make sense of their emotional and bodily states and what is going on around them. When parents are preoccupied with their own difficulties it is harder for them to tune in to their infants’ needs. Relatively common conditions, such as depression and anxiety in the perinatal period, can reduce emotional availability and the capacity to register and respond to the baby’s communications. Without this support infants are easily overwhelmed. Some infants become very demanding and difficult to soothe, later having severe and prolonged tantrums as toddlers and pre-schoolers. Other infants become avoidant of interaction with others: sometimes an outcome of coming to expect that their needs will not readily be met. When young children’s needs for reliable and sensitive care-giving have not been consistently met they may show their distress in self-harming behaviors’ such as chronic head banging or hair pulling. Disturbance may also be externalized in aggressive behavior towards others. Prompt access to professionals with expertise in infant mental health is vital, yet service provision is currently limited and postcode dependent.
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