Module 1: Promoting Mental Health in Infancy

Distraught Mother with her BabyFamilies at Risk

Early Identification and Support

Early identification of families at risk for social and emotional difficulties enables providers to offer services that may have the potential to prevent serious problems from developing later.

Questions to Ask

  • Do you have any concerns about your baby or yourself?
  • How were things for you growing up?
  • Do you plan to raise your baby the way you were raised or differently? What would you change?
  • Are you concerned that your baby will inherit any diseases or other characteristics that run in your family?
  • Do you smoke? Drink alcohol? Have you taken drugs? Does your partner smoke, drink alcohol, or take drugs?
  • Are you concerned about being able to afford food or supplies for your baby?
  • Is transportation a problem for you?
  • Ask confidentially: Does your partner ever threaten or hurt you?

Provider Tips

  • Assess family risk factors Information appears in a pop up window during the prenatal and postpartum periods in order to provide appropriate support.
    • Unwanted pregnancies
    • Premature infants
    • Infants with disabilities or with low birthweight
    • Teenage and unmarried mothers
    • Mothers who did not complete high school
    • Social isolation
    • Parents with a history of substance abuse or mental disorders
    • Families with a history of domestic violence
    • Parents whose own lives have been characterized by separation, abuse, or neglect
    • Families living below the federal poverty level

    Source: Bright Futures in Practice: Mental Health—Volume I, pg. 35.

  • Provide additional support to parents who:
    • Missed the opportunity for early attachment with their baby due to infant hospitalization after delivery or adoption
    • May be overwhelmed by their baby’s special health care needs or prematurity
    • Have an older child with special health care needs
    • Have parenting styles and expectations differing significantly from their baby’s temperament
  • Consider referring parents to a mental health professional with expertise in infant mental health if parental concerns or infant characteristics indicate risk for early relationship problems.
  • Using the guidance listed below, suggest additional resources for families that may need special support.

Guidance for Parents who May be at Risk

  • Your community has agencies that are available to assist you with concerns such as financial help for health care expenses, food, housing, or transportation. Public health agencies are often the best place to start because they work with all types of community agencies and family needs. You may consider contacting them for help.
  • If you want to learn more about your developing baby, resources for parent education and/or parent support groups are also available to help.
  • In addition to public health agencies there may be social, faith-based, cultural, volunteer, and recreational organizations or programs available in the community to help support families.
  • If your baby has special health care needs, your local public health department is required by law to provide services for you and your baby. Contact the department for help and information about these community resources.
Provider Resources

Pediatric Intake Form PDF

Area of Concern: Teenage Parents more information

Adolescent parents face a variety of specific challenges. Along with their need to build a nurturing relationship with their infant, they also often want to return to school and attempt to reengage with their previous friends and activities. They often lack resources, including ready transportation to health care appointments.

In most cases, the adolescent parent lives with her own parents, and the grandparent shares some aspects of child care and child rearing. The provider’s inquiry into the individual roles of different family caregivers, including the baby’s father if the relationship is continuing, will provide an opportunity to discuss individual needs and expectations. The result can be especially powerful when the adolescent and her parent meet to discuss their roles, differences, and mutual goals.

Many adolescents adapt well to parenting when they have a supportive and encouraging environment. Focusing on their specific parenting strengths in front of other family members during visits and providing anticipatory guidance will build confidence as well as competence. These young parents also may be helped by parenting classes, peer support programs, home visitation programs, and other community support services. Schools with onsite child care and programs for adolescent parents are wonderful resources if they are available in the community.

Protective Factors for Families with Young Parents Information appears in a pop up window

Support and involvement of father; employment of father

Assistance and support from, but not necessarily co-residence with, the maternal grandmother

Positive, realistic, and mature expectations of parenting on the mother’s part

Delay of subsequent childbearing following an early birth

Maternal educational achievement

Maternal self-esteem and feelings of well-being

Source: Adapted with permission from Wakschlag LS, Hans SL. 2000. Early parenthood in context: Implications for development and intervention. In Zeanah CH Jr., Handbook of Infant Mental Health (2nd ed.) (pp. 129–144). New York, NY: Guilford Press.

Copyright Georgetown University Georgtown University Infancy