In this presentation, we will dive into the world of infant mental health and explore the unique ways that providers promote relationship development in families and communities for the first five years and beyond. We will discuss the basic philosophies and strategies used in the field of infant mental health, then engage together in an interactive and thought-provoking case study. Somatic techniques, reflective strategies and cultural considerations will be woven throughout to deepen learning and curiosity-- bringing the concepts to life and promoting the integration of infant mental health concepts into your daily practice.

Hospitalization of a baby in a Neonatal Intensive Care Unit (NICU) has been described as a traumatic experience for both parents and baby leading to higher rates of postpartum depression and posttraumatic stress disorder in parents and to adverse developmental, cognitive and behavioral outcomes in their infants. The focus of care in the NICU has been broadening and evolving to emphasize the importance of supporting the family-infant relationship, since ultimately, the well-being of the family affects the well-being of the baby. Research documents that NICU parents both desire and benefit from psychosocial support from NICU staff, yet many staff, including neonatologists and neonatal nurses, do not feel they have adequate skills to support these needs. NICU staff need knowledge and tools beyond what typical healthcare education provides. Interdisciplinary recommendations for work toward best practice around psychosocial support of infants/parents and staff are presented.

Interoception is a term used to describe our nervous system's awareness of the sensations from the gastrointestinal and visceral system, as well as the primary sensory part/input to baby's Autonomic Nervous System. ANS function and regulation underlay all automatic processes of the body, from heart beat to breastfeeding and digestion function, as well as maintaining a calm state in order to engage in social interaction or to transition easily in and out of sleep. More simply put, interoception is "feelings from the body". In addition to visceral information, interoceptive pathways carry information related to affective touch, itch, temperature and pain and are delivered to a separate area of the brain, the insular cortex, which also contains a map of the body, similar to the well known homunculus. Interception plays a large role in dynamic equilibrium and autonomic regulation of tissues of the body. Interoceptive information and the processing is the basis of all important activity to optimize energy utilization. This system is often compromised in babies who present with complex oral dysfunction, tethered oral tissues, postural asymmetries, fussiness, gas, reflux or other dysregulation in function. How babies feel is mirrored in how they function, compromised function equals compromised interoceptive processing. This talk covers the basics of this system and practical clinical applications for precrawling babies to optimize neurodevelopment and breastfeeding abilities.

Sleep deprivation and disruption of an individual’s circadian patterns in the postnatal period are frequently cited as contributing factors in the development of postpartum depression, anxiety (PPD&A) or postpartum post-traumatic stress symptoms (P-PTSS). These factors are increased for the birthing parent of twins, triplets or more, who is more likely to bring two or more newborns home after experiencing perinatal complications and related interventions, and infants’ preterm birth, low birth weight and other complications, often resulting in neonatal intensive care unit stays. Even for a relatively ideal multiple pregnancy and birth, caring for two or more newborns – each having as many needs as any single-birth newborn – round-the-clock parenting generally leads to profound and often long-term sleep deprivation. When significant sleep deprivation affects a parent’s daytime behavior, all family members are affected. Yet current “safe sleep” recommendations or nighttime strategies promoting better sleep for parents and a single infant, including safer bedsharing techniques, are more difficult logistically to implement. These recommendations and strategies may also be less safe to implement with multiple infants. This session will examine the factors contributing to disruptive sleep for parents of multiples and develop strategies that meet both infants and parents needs for adequate sleep.

The Kangaroo Mother Care (KMC) Method is primarily targeting the preterm and/or LBW infants once they are stabilized and adapted to extra-uterine life. KMC has three mayor components: kangaroo position (KP) or direct skin-to-skin contact between the mother and the baby; the kangaroo nutrition (KN) based on exclusive breastfeeding and the kangaroo discharge policies: early discharge in KP at home or in a KMC ward under strict follow up. KMC is a tool for humanization at all levels of neonatal care. There is sound scientific evidence for the effectiveness and safety of KMC in terms of mortality, early infectious morbidity, development, promotion and maintenance of breastfeeding. Also, there is evidence for the beneficial effects of KMC on establishing healthy bonding between mothers and infants. Many health professionals consider KMC as a means of protecting the immature brain when it is the most fragile and the results of our long term follow up are supporting this hypothesis.

How a child is cared for in the earliest months and years of life, pre-birth to three or so, can foster the implicit development of what will be seen as self-discipline in the preschool years and later. In this workshop, participants will have the opportunity to connect the dots between respectful, attuned caregiving, self-initiated activity, authentic communication and the development of self-regulation, the necessary precursor to healthy self-discipline.

We will explore the basics of Dr. Allan Schore’s Regulation Theory, which integrates Bowlby’s classical Attachment Theory and modern interpersonal neurobiology, as well as practical ways to put it into practice in the home or anywhere infants and young children are being cared for. The Educaring Approach, which will be referred to, offers replicable strategies and tools for building the secure relationships that form the basis for children to develop into to peaceful, cooperative and confident people who exhibit the benefits of self-discipline.

Sensitive or orchid individuals make up about 20% of the population, children included. These individuals face what we call ‘differential susceptibility’ based on their environments, child-rearing included. In environments that are not well-suited to their sensitive nature, they face higher rates of disease, mental health disorders, and other negative outcomes. In contrast, when in environments that are supportive and well-suited to their nature, they thrive and can have outcomes that surpass those of their less sensitive counterparts. The problem for most parents is that the advice and techniques common in our culture are at odds with what these children need, putting parents in a difficult spot of either not knowing how to parent such a child (but knowing the advice seems wrong) or giving in and finding themselves in ongoing struggles with their child. This talk will review the research on sensitive/orchid children and how we can use this information to help families identify parenting methods and techniques in the areas of general parenting, sleep, child care/schooling, and discipline that will provide the type of foundation these children need to thrive.

The most talked about discussions amongst parents or professional groups across the world is post frenotomy wound management. In the last 15-20 years of development, the field of oral restrictions has yet to see an evidence-based approach or even just a global consensus on approaches and their efficacy in wound management. Therefore lactation consultants, dentists, and surgeons have been using their clinical reasoning to choose the methods and protocols for individual breastfeeding dyads. Nevertheless, the current unregulated wound management protocols have been often reported as traumatic experiences for infants, parents, and care providers. Additionally, a physical oral examination of an infant during the assessment, evaluation, and treatment, and rehabilitation of oral restrictions is essential and vital in an IBCLC clinical practice. It's often seen as a ‘necessary evil’ in clinical work. Some infants may be at risk of reattachment and/or trauma which can have lifelong impacts such as triggers for past memories, anxiety, distress or discomfort, or even PTSD. This can lead to oral aversion symptoms, complete refusal to latch and breastfeed, turning away from food, and gagging, coughing, and choking. Therefore, a respectable trauma-informed approach to oral examination and wound management is based on the fundamental principles of respect for bodily autonomy ensuing a sense of safety, trust, and connection.

Though so obvious, the sense of smell is quite integral to well-being and human connection. As the loss of smell has been highlighted as one of the main symptoms of COVID, it invites a deeper understanding of the functional impacts of olfactory differences in children and caregivers. In this presentation, we will learn about the cultural history and neurological basis of olfaction. We will explore how smell plays a role in feeding, interpersonal relationships, and safety as well as olfactory strategies to promote physical health and co-regulation.

IMPORTANT: In this presentation we will do experiential work, so please have a journal, the following scents and food available:

One Citrus Scent (e.g. lemon, lime, orange)
One Woodsy/Earthy Scent (e.g. leaves, rocks, soil)
One article of clothing worn by someone you are close to (e.g. spouse, child, close friend, parent)
Carrot or other raw vegetable to eat

Out of desperation to improve the morbidity and mortality rates of premature infants in Bogota, Colombia, innovative neonatologists developed the concept of kangaroo care . Since then, it has been modified to skin to skin care in NICU’s across the world. In recent years, the benefits of this care have been demonstrated and extended toward use in the full-term infant. With a fresh perspective, application of principles from infant development, anatomy, and physiology, are integrated to realize advantages of incorporating skin to skin through 12 weeks of age. When done correctly, skin to skin time serves as tummy time, minimizes the incidence and severity of acquired plagiocephaly, and provides a gentle treatment for torticollis. Learn how to engage, educate, and empower new families to succeed with this breastfeeding friendly intervention.