Promotion of Mental Health as a Key Element of Pediatric Care [jamanetwork.com]

Personally I would never sleep train a baby.  Certainly not during early breastfeeding.  Some babies need to wake at night.  

Attachment Parenting is a set of 'paleo' parenting practices.... close to LLL advice... and it  makes complete sense to me to follow them, from a child development point of view.

Someone should study the outcomes of kids raised by attachment parenting moms and La Leche League leaders.  I suspect the rates of MI would be very low.  You can attend a LLL conference and see hundreds of perfectly peaceful, chill, happy babies and toddlers.

I would really like to see CME with the AAP and ABP cover this problem.  I would like to see QI projects designed to cover this problem. I would like to see pediatric education cover this problem (and not just consider an ACEScore - that’s not enough).   To use pediatrics most effectively the place to put the most effort is on this problem.   We see mom’s and babies sometimes at delivery and always soon after in the nursery and at Well Child Checks. How can we help with this problem? 

I know that being triggered to fear/terror/near rage by a crying infant is incredibly difficult, confusing and shame provoking  but ignoring this and considering it too difficult to even attempt to tackle does not make it go away.  So many innocent kids continue to suffer as we don’t even educate doctors on how massive and complicated a problem this is.  (Disorganized attachments happen in the worse cases and trying to recover from this is nearly impossible.  We don’t understand this in Peds. We have zero education.  I want to know about how neglect in infancy really effects the developing brain, sense of self, memory recall and personality.  There is information out there but not in our training. Please, No more leaving out critical information on human development that we need to do our jobs).  So many mom’s and kids have to suffer having no idea what is happening and we have no idea what to tell them. 

In our Harriet Lane, the place we learn about Child Development... it says to train babies to sleep through the night at 4 months. Is that safe?   Can not holding or rocking or picking up a crying 4 month old harm development?  It’s all left really vague so doctors are left googling childcare information to give to parents because we don’t know. I don’t think this should be happening. Am I wrong? 

It's a chicken/egg situation, for sure.  The Nurse Family Partnership does a good job of helping the at-risk Moms and breaking the cycle.   

Yes, but many parents with attachment difficulties have these difficulties because they are dealing with their own flashbacks and traumas. Birth brings repressed memories and flashback. So while a new mum is meeting her baby and desperately wanting to attach and bond, she may also be dealing with a new onset of trauma. To help children’s mental health, we must first have emotionally well and safe parents. Help the parents then your helping children’s well-being. 

Before there are child mental health problems, there are attachment problems.  Start by teaching mothers of newborns how to parent in ways that inculcate attachment.  By the time there is a mental health issue to notice, intervention is very late.