Parents, caregivers, environments ‘powerfully shape’ infant mental health

The concept of infant mental health, which is gaining prominence in Africa, is powerfully shaped by positive mental health outcomes of both infants and primary caregivers. For this reason, hearty experiences during infancy are critical to enabling the life-long mental health and well-being of toddlers, children and, ultimately, young adults.

The University of Cape Town’s (UCT) Dr Simone Peters shared her views on this important concept and the crucial role the caregiver’s mental health and overall wellness play in the development process of infants and young children. Dr Peters holds a PhD in Psychology and is currently a postdoctoral research fellow in UCT’s Department of Anthropology in the Faculty of Humanities. Her current research on infant mental health is carried out under the auspices of UCT’s Professor Fiona Ross. Professor Ross holds the AW Mellon Chair in The First Thousand Days of Life project, which is being undertaken in collaboration with colleagues at Stellenbosch University and King’s College in the United Kingdom.

This Mental Health Awareness Month, Peters shared valuable insight on the theory of infant mental health, how it presents itself and why maintaining it is absolutely essential to infants’ well-being in the long-term.

Niémah Davids (ND): Please unpack the theory of infant mental health.

Simone Peters (SP): Most people have an intuitive understanding that the way we care for infants is significant to their well-being. Interdisciplinary scholarly research shows that this is true. Experiences during infancy play a critical role in enabling life-long mental health and well-being. As babies form their attachments to carers, they develop their capacities to experience, regulate, express emotions, form close and secure relationships and explore and learn from the environment.

“The field of infant mental health focuses on healthy development rather than solely on pathology.”

Trying to find ways to develop these processes require drawing from diverse disciplinary fields, not just those historically associated with mental health. The field of infant mental health focuses on healthy development rather than solely on pathology. This is a very important shift.

ND: How aware are South Africans of the concept of infant mental health?

SP: There is definitely a growing awareness of the significance of infant well-being in the country. The theory has even been recognised by the Western Cape Department of Health with their focus on the importance of the first 1 000 days of a child’s life.

Most research locally and globally focuses on maternal health because generally women in low- to middle-income countries experience more adverse mental health outcomes than those elsewhere. This is mainly the result of difficult living environments. While the field of infant mental health is well-established in the Global North, it remains a largely foreign concept in South Africa.

ND: Typically, why do infants struggle with mental health challenges?

SP: Infants often struggle when their parents and caregivers are not supported on an emotional, mental, spiritual and financial level, especially in the early days of an infant’s life. If this changes, then the likelihood of positive outcomes for infants is greater. Therefore, the first 1 000 days of a child’s life lays substantial foundations for lifelong health.

ND: What role do parents and caregivers play in this process?

SP: Parents and primary caregivers play a critical role in creating environments where infants can flourish. Primary caregivers who create secure attachments for their infants and who meet the physical, psychological and emotional needs of infants are helping to produce the conditions that enable babies to adapt and flourish.

ND: Talk to us about the role that fathers play in maintaining good infant mental health.

SP: In listening to students who observe infants and reading existing research on infant mental health, I found that the paternal bond with the infant has not really been a focus in this area. Much focus is placed on the infant and mother attachment or the infant and its primary caregiver, which is often the maternal grandmother, sister or domestic worker in the South African context. So, there is definitely a gap when it comes to the role of fathers in this area. From the little research that exists, we can see that fathers play a crucial role in the infant’s first 1 000 days. Research revealed that a present and actively involved father reduces maternal depression and helps to create better nourished babies, especially if fathers encourage mothers to breastfeed for longer and take on roles generally associated with the mother if and when necessary.

“These findings challenge simplistic assumptions about gendered roles and suggest that it is important to look closely at how relationships are formed and managed.”

These findings challenge simplistic assumptions about gendered roles and suggest that it is important to look closely at how relationships are formed and managed. As a postdoctoral fellow on this project, my role is to create an archive of information by conducting observations of how students unpack the observational methods that are core to training new practitioners, creating a literature archive of relevant texts and conducting interviews with past students involved in the project. My research has revealed the importance of the first 1 000 days of a child’s life and the importance of making sure that primary caregivers of children are well-equipped to care for their infant’s needs.

ND: What does the First Thousand Days of Life project and your work with Stellenbosch University entail?

SP: My project forms part of Professor Ross’s Research Chair in The First Thousand Days of Life project, which explores three core focus areas: formations of life (how life takes form under given conditions); genes, technologies and genealogies (the relations of life and technology); and nutrition and food security (social relations and bodily experiences around nourishment). My current work crosscuts these areas. Currently Stellenbosch University is the only university in South Africa that offers formal qualifications in infant mental health. Our aim with this research project is to help the course convenors, Professor Astrid Berg and Dr Anusha Lachman, reflect critically on the problems and possibilities that arise when models developed in the Global North are implemented in the Global South. We want to understand how infant mental health practitioners are trained, explore their experience of the fit between model and the realities that shape people’s lives. Subsequently, we feed our observations back into the research project to try and create a synergistic and reiterative pedagogy that is adaptive to local contexts. 

ND: The concept of infant mental health is well understood in the Global North and therefore their policies and practices largely inform work in the Global South. How do we work towards changing this and ensuring that they are relevant to a local context?

“We are aware that many of the models of well-being originated in the Global North and do not necessarily accord well with local forms of life.”

SP: We are aware that many of the models of well-being were originated in the Global North and do not necessarily accord well with local forms of life. By carefully recoding these models and providing the necessary feedback, it allows local knowledge to take root and grow; and helps shape a process through which universalist norms are shifted to the specificities of our context and the forms of social dismay and repair we face. This localises knowledge in pragmatic ways, contributing to a supportive consideration of what the World Health Organization means by “nurturing care”.

Furthermore, a decolonial approach interrogates the founding presuppositions in relation to broader contextual factors frequently left out of the domain of analysis. We also offer a supportive yet critical stance on understanding infant mental health in one of the world’s most unequal countries.