Vital Infant Years
The early years of infants are vital to mental health throughout a lifetime. Studies are showing how impactful even the first few months of growth is in babies. Those months shape how their brain forms connections and develops. This is why nations are beginning to recognize mental health for infants through initiatives such as Infant Mental Health Awareness Week, which started in 2016 in the UK and Australia.
One of our partner organizations, Mother’s Heart Organization (MHO), approaches infants and mothers holistically, helping to ensure Cambodian infants have the best possible chance at building attachment and mental health. Children in Families (CIF) does a lot of work to encourage bonding and healthy relationships in older children. While, Mother’s Heart is able to specialize in working with babies and infants. I sat down with Emily Scott, Mother’s Heart Country Director, to get a glimpse into their work.
It starts before birth at MHO. They are a crisis pregnancy center, meaning their clients are women who either have an unplanned or unwanted pregnancy.
The first step is emotional support for both married and single women with a crisis pregnancy, after which they are educated on their options regarding Cambodia’s laws and what services are available. This allows the mother to be supported to understand all the legal options and supports that are available to her, and to her baby. Many of the women at Mother’s Heart are underage or have disabilities, their pregnancies resulting from rape. Some are women who feel unprepared to parent. Stigma from the community and family can isolate and shame the mother. Rejection adds to the stresses of an unwanted or unplanned pregnancy.
In fact, Emily estimated that 30% of their clients in the past two years are pregnant due to rape, trafficking, or very difficult circumstances. About 90% of the women come from traumatic backgrounds. Their youngest mother was 11 years old. The women’s ages range from pre-teen to mid-twenties.
According to research done by the NHS in the UK on bonding and attachment, even before birth the mother’s emotional condition can affect the baby’s mental health and social behavior:
“Research has suggested a link between deprivation, the body’s hormonal response to stress and subsequent risk of ill health, which may explain the biological links between adverse and chaotic early life experiences and subsequent high risk of poor physical and mental health. This is particularly important to social behaviour. The impact can start as early as pre-birth with the impact on the fetus on the mothers body’s hormonal response to stress.”
So MHO’s pre-birth interventions give both baby and mother a much better chance at a mentally and emotionally healthy life. They also recognize that physical health is vital, providing immediate medical care.
Reconciliation, Addressing Trauma
Emotional support addresses trauma, instability from negative family relationships, brokenness, and exploitation. One of the first steps is to address not only the woman but also her family. Reconciliation over the shame both she and her family are walking through due to the pregnancy is vital. Culturally, victims of sexual abuse and rape are seen as shameful, despite their lack of choice in the situation. If this is not addressed, not only do the woman face rejection, but it is likely her unborn child will as well.
The reconciliation process opens the door for her to remain in a family context. Additionally, the family has time to come to terms with having a baby. Giving both the infant and mother hope for a future of acceptance within their community. When mothers experience emotional healing, they can learn to love in healthier ways, allowing them to bond with their babies – a love they may never have known themselves.
Partnership With Children in Families
After initial medical and emotional support, the women at Mother’s Heart usually choose to parent their babies. Emily said, “75-80% of the women will parent, while about 20% will relinquish their rights to alternative care, like foster and kinship care – where other family members will have a key role in bringing up the child.”
CIF partners with MHO in this way. We help facilitate alternative care and have families available for foster care. It’s a partnership that marries their expertise of caring for mothers and infants with ours of having solid, loving homes open to babies, with social workers to help monitor bonding and attachment.
MHO offers Day Care up to school age, so that the mother does not have to choose to leave her baby behind if she needs to work to support herself and child. And, if women cannot live within their communities or families, MHO offers them and their babies a home. They have the relief of knowing they can be there as long as needed for stability and peer support. They have independence to come and go and work freely. These services give the mothers and babies more time to bond with one another, less time trying to just survive.
After The Birth
This holistic approach does not end at birth. MHO’s midwife and social workers train women in bonding techniques pre-birth. After the baby is born, they continue to learn about developmental stages. Training includes: bathing the baby, changing diapers, caring for a sick baby, reasons for crying, etc. All of these steps encourage physical touch and healthy bonding. Social workers do home-visits, encouraging interaction and talking with the baby. The midwife also teaches infant massage to help develop attachment, relax the baby, and relieve stomach pain. MHO encourages mothers to breastfeed, for skin-to-skin contact, and quiet time to hold their babies.
According to the NHS, “The bonding between the young child and their caregivers provides the experiences required to develop physically, emotionally, and cognitively. Lack of consistent and enriched experiences in early childhood can result in delays in motor, language, social, and cognitive development.”
If the mother is unable to breastfeed, she and any helping family members learn to hold the baby whilst bottle feeding. Within Cambodia, it is common for infant. In fact, culturally it is believed babies will grow too needy if held, so they are usually bottle fed at a distance, propped up by pillow. The social workers at Mother’s Heart work to dispel these myths and encourage healthy physical interaction.
If the mother chooses to place her baby into temporary or permanent foster care, she has three months to decide on permanent care. This is where CIF’s Emergency Care steps in. Trained families are available for short-term care, offering the baby a safe and healthy beginning while decisions about the baby’s future may still be processed. If the child is placed in foster care, we arrange placements where the foster parents are encouraged to treat the baby as one of their own.
Meeting Physical Needs
MHO financially supports each mother during her baby’s first three months of life, giving her time to adjust to her new role and spend quality time with her baby. The infant is also provided for physically in their first three months for healthy development.
After three months, the baby can go to daycare. One major key to mental health and attachment in babies is consistency in routine, socialization, and positive interaction. Their daycare does this well. So that, the mother can rest assured her baby is treated well, while she is at work.
Daycare is also important in providing child protection. The staff have known many of the children in their care for years. They can monitor for signs of neglect and abuse. Because many of the mothers come from traumatic backgrounds, babies can be at risk due to addiction, unhealthy male relationships, or dysfunctional extended families.
Child Protection and Disabilities
While MHO does their best to monitor and address these issues from the womb, not all healing takes place quickly. The staff can intervene and address unhealthy exposure for babies and children quickly. Intervention gives the child a better chance to grow in positive, stable living conditions. It also allows them to monitor how the mother is doing, offering additional support if she is struggling. Children can continue to attend daycare even if the child is temporarily removed from home, they continue to attend daycare. This makes removal from their mother less traumatic since they have that familiar consistency in their lives. Bonds with the staff remain intact.
Finally, just as CIF values and works with children with disabilities, MHO has a set up to support pregnancies and early childhood care for babies born with all kinds of disability. From blindness to down syndrome, they emotionally support mothers when they learn their child may be born with delays or physical disability. They offer help through grief as families process the possibilities. They also work hard to treat mother and baby the same as all others in their care. The staff shower both with love. In a culture that does not fully accept or understand disabilities, Mother’s Heart Organization does their best to give each infant and mother the best start to life, especially in knowing they are accepted.
CIF appreciates and celebrates our partner, Mother’s Heart Organization. We recognize the importance of Infant Mental Health Awareness Week. Children may encounter difficulties such as trauma, rejection, and abuse. We all do our best to minimize the exposure and impact of this on babies and children in Cambodia, giving them a better chance at mental wellbeing, positive attachment and caregiver bonding. Because all children deserve loving families.