Perinatal & Attachment Disorder Pathway 

The perinatal period and the first 1000 days of life: The myth that nothing can happen to the child when in the womb during pregnancy, and that children are unfinished adults who do not need much attention have long been disproved.

Since the seminal works of Bowlby and Ainsworth on attachment, much has been learnt about the first years of life. We now know that the first 1000 days of one's life are the most important for one's brain development, in fact, what a baby does not use he/she will lose. Furthermore the ability to build a bond with a care giver is the most important factor to ensure that a child, and eventually an adolescent and then an adult, can build secure relationships with others around them.

“It is a paradox that, in the 21st century, indicators of social wealth and physical health amongst children worldwide have improved, while mental health indices in young people are deteriorating" 

- Sir Michael Rutter (known as the father of child psychology) 

The Perinatal period extends from when pregnancy begins to the first year after the baby is born. Perinatal mental health is related to the biopsychosocial functioning of pregnant women and their child. Pregnancy does not protect against the onset or continuation of mental illness – 1 in 5 women will experience mental illness during pregnancy or in the first postnatal year. The period early after childbirth is one of greater risk for severe mental illness than any other time in a woman’s life. Effective treatments are available and in nearly all circumstances the outcome is good. In recent years, perinatal mental health has been recognised as a major public health concern which impacts on individuals across the lifespan. Researchers, healthcare professionals and individuals in the general community have highlighted the huge impact of mental health problems during the perinatal period and the need for improved care in this area.

Where a woman experiences maternal mental illness, her partner is more vulnerable to ill health. Addressing partner, family and older children’s needs is essential to the woman’s recovery. Attention to an infant’s bond with his or her father and other caregivers, and the impact of paternal mental ill health on the child’s attachment and development, is core to good family functioning.

Infant mental health is the study of mental health as it applies to infants until the age of three and investigates their optimal social and emotional development. The transgenerational transmission of attachment difficulties and mental health problems is well recognised. It is mediated through wider environmental influences, genetic and biological factors. Social relationships in early life are likely to have a crucial influence on the infant brain. Basic principles of infant mental health evaluation and treatment involve consideration of the parent(s), child, and their relationship, while keeping in mind the rapid and formative development of the brain and mind in the first years of life.

Brain development is dependent on strong, early bonds with an infant’s main caregiver – most often the mother. Research identifies critical time periods in early life where specific brain pathways develop optimally. Later on it becomes increasingly difficult to bring about change. The interaction with the primary caregiver in the first years of life shapes the infant’s social, emotional, cognitive and language development, facilitating development of good mental health through childhood and into adulthood. Early intervention is therefore essential in ensuring the prevention of future mental health difficulties and is a public health concern, particularly due to increases in mental health difficulties and lack of corresponding funding allocated to services for 0-5 year olds.

There is increasing evidence to favour interventions that improve the mother-infant relationship, where mother and child face additional vulnerability. A number of specific programmes have demonstrated efficacy, an example of these include the Incredible Years by Webster Stratton.

We take our kids for physical vaccinations, dental exams, eye checkups. When do we think to take our son or daughter for a mental health checkup?’ 

- Gordon Smith

Through the attachment pathway, TAASC is offering parents and their children this unique opportunity to get assessed following the most recent evidence and to be offered expert advice where needed.

If you have any questions, or would like to book a consultation with one of our specialist  consultants, please send an email to taascmalta@gmail.com