mental health

Reducing a baby's stress when they start daycare

Written by Cindy Hovington, Ph.D. Founder of www.curiousneuron.com

Montreal, Canada

shutterstock_416156518.jpg

Starting daycare can be a stressful time, for both babies and parents alike. Some babies will adapt quickly, while others will cry every morning for many weeks. Does starting daycare have any impact on a child's brain? It can. This is especially true in children younger than 36 months (3 years of age). This is why research recommends that the best time for a child to begin daycare or preschool is 3 years of age. Elevated cortisol levels in children that occur frequently can alter the brain's architecture. However, the reality is that most parents must place their children in daycare much earlier than at 3 years of age. For this reason, I have included 3 important tips to help make your child's daycare integration a smooth one.  

First, a little science on stress and the brain.

Researchers measure stress in children by collecting samples of saliva since the stress hormone named cortisol (a glucocorticoid hormone) is found in saliva. When it comes to stress in children, we can't rely on behaviour alone since some children will internalize stress.

THE IMPORTANCE OF BONDING: Building a strong attachment with your child BEFORE they start daycare can help reduce their stress when they begin. You can bond by doing skin-to-skin, holding them or giving baby massages.

Levels of cortisol naturally fluctuate throughout a 24-hour day. Cortisol levels are highest in the morning when we wake up and are the lowest in the evening (the spike helps you wake up and the decrease allows you to fall asleep). This is the rhythm our body develops as of childhood. If a child is introduced to high levels of stress throughout the day, it will influence the fluctuation of their natural cortisol levels. This is what can be damaging in the long run. Internal or external stresses will cause a child's brain to activate the HPA axis (Hypothalamic-Pituitary-Adrenocortical), which is involved in regulating stress and emotions. When there is a stressful event, the HPA increases levels of cortisol. The HPA axis is closely linked to the hippocampus, which is the part of the brain involved in learning and memory. Chronic and severe (due to emotional neglect, abuse, witnessing violence) levels of stress can actually alter the hippocampus, thus causing memory issues. 

In daycare settings, studies have repeatedly shown that cortisol levels are higher in children who spend the day in daycare compared to being at home. Not only because they are separated from their parents for such long periods of time (if possible try to reduce the number of hours a child under 3 spends at daycare), but because being in peer groups at such a young age is actually very demanding on them due to frequent emotional arousal in their environment (other kids yelling, lots of movement and noise etc). The key to reducing stress in daycare is the bond your child will create with their caregiver. The stronger this attachment or bond is with their caregiver, the more it will help your child reduce their levels of stress.

 

3 tips that will help your child during their transition into daycare and lower their stress levels. 

1. Implement a very slow integration.

Researchers split the "start" of daycare into "adaptation phase" and "separation phase". The adaptation phase is when an infant starts daycare with the presence of their parent. Bringing on a new environment and a new caregiver causes elevated levels of stress for the infant. They learned that 1) the stronger the bond between mother and child (i.e. the more secure they are with their mother) before the start of daycare, the lower the levels of cortisol when they begin daycare and 2) the longer the mother stayed in the adaptation phase for integration into daycare, the better the attachment become with their mother (Ahnert et al. 2004).  

2. Choose a high-quality daycare. 

  • Low child/caregiver ratio. According to research, the best child to caregiver ratio is 4:1 (For every adult there are 4 children). Also, the number of children in a group should be no more than 8. The more children there are the higher the noise level and this can be overstimulating for children. Also, a higher the chord to caregiver ratio means that the child will have a greater difficulty building an attachment to them. If possible, try to select a daycare that minimizes the number of children in a group (Geoffrey et al. 2006).

  • Low staff turnover. Your child should develop a strong bond (secure attachment) with their caregiver. When a child is younger than 3, it is important for them not to have multiple caregivers as this means they might have difficulty creating an attachment with them. If your daycare has a high staff turnover or multiple caregivers for your child, this may increase their stress. High quality home daycares can be great since your child will one caregiver for many years.

  • A sensitive and caring caregiver. Research has shown that if a child establishes a secure attachment to their caregiver (other than their parent), then this caregiver can help the child effectively diminish stress levels in a time of stress. In order for this to happen, caregivers must provide sensitive, responsive caregiving.

3. Increase bonding time with your child.    

If your child begins to exhibit different behaviour either at home (more crying during the time their are with you, wanting to be in your arms more often, changed eating habits, changed sleeping habits etc) or at daycare, then they might be feeling more stressed. Spend more time with them when you are at home. Increase cuddling time with them. Try doing some baby massages if they are young and increase skin to skin time through this activity (which in turn helps build a stronger attachment). Contrary to popular belief, holding your baby and spending time with your child is not "babying" your child. The stronger the attachment your child has with you the more comfortable they will feel when you are not around. (Stay tuned for an article on attachment, make sure you subscribe to our newsletter not to miss it!).  

Will your child start daycare soon? Take a breath. Everything will be ok. Adaptation to daycare takes time. Some research suggests as long as 6 months. Provide lots of emotional support for your child and your guidance will help them through this change. 


PREGNANCY HORMONES OR DEPRESSION? SPEAK TO YOUR DOCTOR

Written by Cindy Hovington, PhD. Founder of www.curiousneuron.com

Montreal, Canada.

heart-blue-sports-pregnant-tummies-in-anticipation-of-the-996077-pxhere.com.jpg

This week is mental health week and several events are taking place in Montreal, including the West Island Walk for Mental Health this Saturday, May 6th. I have always advocated how important it is to openly discuss our mental health, and for the first time, I experienced my own mental health struggle. I had no idea it was happening until a few weeks had passed and I realized I was not myself. I would like to share my story with the hopes that other women who are pregnant and experiencing emotional difficulties can feel that they are not alone. The best thing you can do is discuss what you are experiencing with others and, most importantly, your doctor. 

I am 36 weeks pregnant with my second child. About 2 1/2 months ago, I started feeling sad, but I could not understand why. Nothing had changed in my life and I absolutely loved my life. However, from one moment to the next, getting out of bed was difficult, every smile was forced, all my thoughts were negative, I didn't enjoy play time, I didn't enjoy work... I didn't enjoy life. I cried several times a day and felt so... alone. If I wasn't crying, I was fighting back tears. Why was I so sad? I kept thinking it would pass. I assumed those pregnancy hormones were probably acting up. But every smile became "faker" with time. After a few weeks of this, I spoke to my husband about it and I broke down. He asked what he could do to help me but I didn't have an answer. I had no idea. Help with what? What was I going through? Did something need to change in my life? If so, what was it? Why was I feeling this way? Why was I so sad? 

After a few more weeks had passed, I decided to talk to my OBGYN about this. I tried to keep it together in his office but that only lasted about 30 seconds. He asked me a few questions about my life and work. He decided that I needed to see a psychiatrist to get evaluated for depression. Meanwhile, he suggested I stop working. He mentioned that given the number of hours I was working, my emotions could be related to stress and work overload (aka "burnout"). Then he said something that struck me. He said, "you need to be physically and mentally healthy for your kids".  There it was... mental health. I had been struggling with my mental health for weeks and I was ignoring it. I was confused by it and perhaps even unknowingly avoided talking about it because of the stigma. 

Today, after having taken a step back from work and gotten a lot more rest, I feel much better. I feel happier and I am slowly becoming more like myself. Luckily, my mental health struggle seems to have been due to sleep deprivation, being overworked and overwhelmed. I am still waiting to see the psychiatrist (long waiting lists) and I am not going to cancel that appointment. Just like we get checkups to make sure we are physically healthy, I want to make sure I am mentally healthy both before and after the baby arrives. I need to be there for my family.  

Some facts about depression during pregnancy 

Depression during pregnancy is common. It can happen to anyone. Please don't dismiss any mental health issue during pregnancy by thinking that it is just your hormones acting up. If something feels wrong, speak to someone or most importantly speak to your doctor. They will guide you into the right direction. 

Depression during pregnancy is under diagnosed, mostly because people misattribute it to a "normal pregnancy" (Altshuler et al, 2008. Archives of women's mental health). It is estimated that an average of 12.7% of women will experience a depression during pregnancy, but that number could be much higher since most women do not discuss these mental health issues. One study estimated that over 80% of women do not discuss any mental health issue with their doctor (Whitton et al. 1996. British Journal of General Practice).  In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends that doctors screen their patients during each trimester for mood disorders and anxiety because if left untreated it could be harmful to the mother and the infant. 

A 2010 study highlighted several important factors that can contribute to depressive symptoms during pregnancy, including maternal anxiety, life stress, prior depression, lack of social support, domestic violence, unintended pregnancy, relationship factors, and public insurance (Lancaster et al. 2010. American Journal of Obstetrics and Gynecology). 

I hope that if you are pregnant and you don't feel like yourself that you don't merely pass it off as hormones. Please talk to your doctor about it and get help if needed. You are not alone.

How does bonding with our children affect their brain?

Written by Cindy Hovington, Ph.D. Founder of www.curiousneuron.com

Montreal, Canada.

Although my daughter is only 13 months, she has taught me so much about life. The most important thing she has taught me is to slow down and enjoy life. For as long as I could remember, all I did was work. I regretfully never had time for friends, family or my husband. During almost 9 years of graduate studies, I worked 7 days a week and reached 100+ hours a week way too often. When I got pregnant with my daughter I had 3 jobs, 2 of which were full-time. My life has always been all about work, but now, my life is her. Although I am running Curious Neuron, I am home with my daughter during the day. I work when she naps, at night and on weekends. My life can still get a little hectic at times. However, when I am with my daughter, nothing else matters. Regardless of the many deadlines I have, I learned not to think about these when I am with her. This has been a challenge and naturally, sometimes I have a little slip. Today was one of those days. 

I had lots to do today and as I was getting her ready for her nap I was mentally planning out everything I needed to get done during that nap and I was feeling overwhelmed. She fell asleep in my arms and as I lay her in her crib she woke up crying. I picked her up and walked around with her in my arms until she fell asleep again. This time, I waited a little longer to make sure she was in a deep sleep and I thought to myself, "Please, please sleep. I have so much work to do!!". However, as soon as I lay her down she woke up and cried. I tried once more but to no avail. 

I sat down in the chair next to her crib and started feeling anxious. I had so much work to do, but then I realized that I was missing out on this precious moment. My daughter still needs me to cuddle with her. Right now, she just wants to hear my heart beat and be with me. One day, she will be older and I will long for the days where she napped on me and I could just hold her and be in the moment, forgetting about everything else. By thinking of work at this moment, I was taking something away from it. So I stopped thinking of work, kissed her head and held her as she took her nap. When she woke about an hour later, she looked up and me and smiled. 

Bonding and the brain. 

This got me thinking about the importance of bonding with our children and how it impacts both the brain of both mother and child. There is a lot of research on the hormone that is released when we bond, called Oxytocin. This hormone is released when a mother gives birth, when a baby suckles on a mother's breast, when you hold your child, and even when you look into your baby's eyes (the release of this hormone also occurs in fathers...but I will post about this another time!). When oxytocin is released in the mom or child, their stress levels are reduced and the reward pathway of her brain is activated (this gives us the feeling of satisfaction). Oxytocin also enhances social behavior (social attention, prosocial behavior, sensitivity to gaze, and sensitivity to facial expression). When levels of oxytocin are increased infants, they are more socially engaged (they activity seek parental social interaction for soothing). Interestingly, current research is starting to look into administering oxytocin to children with Autism Spectrum Disorder to improve social impairments. Disrupted levels of oxytocin in infants are also being discussed in research as possible links to this disorder. 

As parents, we always have something to do. Work, cleaning, laundry, and much more! However, sometimes a child just needs to be with their parent to feel close to them and boost those oxytocin levels, so let's be more aware of the importance of bonding and try to do it as often as we could! :)  

Why we should all learn to refrain from arguing in front of a baby.

Written by Cindy Hovington, Ph.D. Founder of www.curiousneuron.com

Montreal, Canada.

person-girl-woman-hair-photography-steam-1384125-pxhere.com.jpg

I saw something yesterday that deeply disturbed me. I was at the park with my daughter and I heard a woman yelling very loudly. I am not sure what instigated this level of anger in her, but she was yelling at construction workers on the street. Who can blame her, I live in downtown Montreal and am surrounded by orange cones and 40 min detours to get home. Who wouldn't get mad?! However, what disturbed me and literally made me feel nauseous was the fact that she was holding the hand of a little girl who was probably about 2 years old and she was also pushing a stroller with a very small baby in it.

As a parent, I can understand that there are moments when you just want to yell at the top of your lungs. However, as a brain and learning specialist, I also learned that it is important that I bite my tongue to avoid yelling or getting upset in front of my child. 

Parents should always try to refrain from arguing around a baby. 

Babies.

The infant brain is very vulnerable to stress. High stress can impact the development of the emotion parts of the brain. A baby can detect anger in a voice as early as 5 months. Parental arguing causes stress in the baby, elevating their heart rate and increasing their blood pressure. Studies have shown that parental arguing can also cause sleep disturbances in babies. Moreover, parents who have argued in front of their baby as or birth can literally alter the development of their child's brain. In a recent research study, connections between the front of the brain called the "frontal lobe" known to be involved in cognition (memory, attention and problem solving) and the amygdala (emotion hub of the brain) were "overly connected", meaning that negative emotions were hyperactive under stress. It doesn't take much arguing either. Even moderate levels of stress cause babies to react more intensely to an angry tone of voice. An interesting study called "What sleeping babies hear", showed that if a baby is exposed to parental arguing, their brain responds more strongly to angry voices even while they sleep!! 

Children.

Even if a child is older, we don't realize the impact that arguing in front of them can have, especially on their mindset when they are sitting in their classroom at school. I have worked with many children in schools, and when I talk about emotions and the brain, parental or family arguments are often brought up by children as causes of stress for them. Children hear what you are saying and it impacts them. They also learn to yell at others when they feel angry if this is what a parent is modelling. We need to think of the impact this has on them. 

Take a moment to breathe and think before yelling while your baby is with you.

Let's learn to take a deep breath before yelling at the car in front of us for cutting us off or getting mad at our spouse for forgetting to take the garbage out! Taking a breath before yelling, will not only help us learn how to deal with our own anger but it will also provide a more positive environment that will allow an infant brain to develop well and help our children learn to deal with emotions and stress more effectively later in life. 


**Thank you to Barry Morgan, host of the CJAD radio station in Montreal for interviewing us in October 2016 regarding this blog post!!