Jane Elliott BBC News Online health staff

Babies react to their mothers' mental health problems

Asaf is a young Kosovan mother who had trouble bonding with her daughter, who had been conceived after repeated rapes.

An asylum seeker, she lived in a climate of fear and insecurity and was haunted by the ghosts of her past.

She was unable to come to terms with the brutal death of members of her family and felt unable to cope with her baby.

The sound of her daughter's crying left her feeling paralysed and unable to respond.

Asaf told health visitors she found the crying "unbearable".

She was referred for parent/infant mental health therapy as there were fears her negativity could impact on her baby's mental health development.

Experiences

Through sessions with a psychotherapist, Asaf was able to work through the horrors of her experiences and gradually saw that the baby's cries for attention reminded her of her own cries for help.

Because no-one had helped her, she had felt unable to help her baby.

Therapy helped her gradually mourn her losses and, in time she could recall memories from her own childhood of being loved.

As these memories came to life, she became gentler and more responsive with the baby.

Treating the mother-baby relationship rather than the mother alone, offers the opportunity for the mother to recover quicker and this is of enormous significance for the baby. Dr Trudie Rossouw

Asaf is now attending English classes and attending a local mother-baby group.

Dr Trudie Rossouw, consultant child psychiatrist with the North East London Mental Health Trust, which helped Asaf, said: "Studies on infant development show that if a baby's mother is unwell - psychiatrically, emotionally or physically - then the development of the baby can be severely compromised.

"Recent research offers compelling evidence that treating the mother-baby relationship rather than the mother alone, offers the opportunity for the mother to recover quicker and this is of enormous significance for the baby.

"We set up the Parent-Infant Mental Health Service to address this gap because we recognised that babies show their difficulties in many different ways - feeding problems and failure to thrive, sleeping difficulties, difficulties being comforted, recurrent infections due to a suppressed immune system."

Colleague Amanda Jones, a parent/infant psychotherapist, said that the period following the birth was often difficult.

"We find that if a mother has a history of unresolved trauma such as loss, sexual abuse or physical abuse something about the birth can in a way bring to life those ghosts."

She said that as many as 10% of mothers have some sort of depressive incident, or suicidal feelings, following the birth of their child and some feel unable to care for their children.

Messages

"From the baby's point of view, if a mother's eyes reflect coldness, fear or anger too often then that will have an impact on the baby's core sense of self. Touch and eye contact are critical forms of communication."

"By the time the baby can speak quite a few years have gone by. So I would argue that it is very important to keep the baby involved in the process.

"We get a much better change if we work with the parent and baby together."

She said that during the psychotherapy, video film is taken of the mothers with their babies, and then the following week this is used to help mothers talk about the interaction.

The scheme, which previously covered one borough of London, has been expanded to cover much of North East of the city and the team expect to get about 150 to 200 referrals a year from health visitors, midwifes, paediatricians and social services.

Feelings

Roger Truelove from Barnardo's, who manages the Sure Start programme said the mental health scheme is addressing a serious problem.

"A mother's illness, whether it is mental, emotional or physical, can severely compromise a baby's development.

"Treating the mother and baby together can help the mother to recover more quickly and has greatest benefit for the baby, helping to prevent mental health problems further down the line.

"Child mental health services have tended to focus on older age groups, by which time the problems can be ingrained.

"Our aim is to intervene as early as possible, and the key to this is midwives and health visitors, who have the most contact with new mothers.

"Most of the mothers who use our service initially report suicidal feelings.

"Our research shows that more than 83% said they felt much better, and the symptoms of distress in their babies had disappeared."