Supporting Infant Mental Health From Day One

Warm smiles. Gentle rocking. Bedtime songs.

Simple interactions like these between a parent and baby may seem minor, but the minute moments form an essential emotional bond, called relational health. Experts say this bond lays the foundation for the child’s emotional and psychological resilience, helping to prevent mental and emotional problems in the future.

“Children with poor relational health are more dysregulated, more vulnerable to stress, and more likely to develop mental health issues later on,” said Marian Williams, PhD, a Children's Hospital Los Angeles (CHLA) psychologist who has spent more than two decades working with young children and families. “It’s not just about emotional health — these early experiences impact physical health, school outcomes, and even employment down the line.”

Positive relational health translates to positive infant mental health, which is the ability of kids under 3 years old to express emotions, form relationships, explore, and learn. Strong attachment bonds also benefit parents by increasing confidence and helping them better respond to their child’s needs.

But medical challenges can impede relational health. Hospital stays, painful procedures, and developmental delays can interfere with bonding, especially in the earliest months of a child’s life.

“In infancy, the brain is developing rapidly. And parents’ brains are also changing. Stress and trauma have a huge impact on both,” Williams said. “It’s a critical time, a window of opportunity when both parents and their babies are open to intervention.”

This concept is at the heart of a new program designed to support the mental health of children from birth to age 3 who experience medical challenges. Currently in pilot testing, the Stein Tikun Olam Early Connections Program at CHLA will include universal screening for children 3 and under who are hospitalized or treated in outpatient clinics. The idea is to intervene at the earliest possible time during distress to help prevent mental health issues later on.

“We want to help build those strong relationships in the context of pediatric medical traumatic stress that families are going through,” Williams said.

Depending on the family’s needs, a range of supports will be available from experts in infant mental health. Some parents may just want a listening ear, Williams said. Others may benefit from tip sheets or videos about sleep routines or feeding challenges. Some may join peer groups for support from other parents navigating similar situations. And for those who need it, the hospital offers home visits and more intensive psychotherapy.

Pediatric providers and hospital staff also learn how to support early relational health during everyday interactions with families.

“It’s not just the specialists in infant mental health who can help,” Williams said. “We’re training the broader care team — nurses, social workers, rehab specialists, physicians — to recognize signs of relational stress and respond in supportive ways.”

While the program is still in its early stages, CHLA is already working with researchers at the University of Southern California to track outcomes and refine their approach. The hospital hopes to continue expanding access and raising awareness about infant mental health.

“People still don’t always realize that babies can have mental health needs,” Williams said. “But the earlier we can intervene, especially when medical challenges are present, the bigger the difference we can make. We’re shaping a child’s path from the very beginning.”

In response to the Make America Healthy Again (MAHA) Commission’s report on child health, the Children’s Hospital Association highlights the ways children’s hospitals are helping children live longer and healthier lives by confronting the root causes of chronic illnesses.