Being home with an infant: Take care of your mental health

I am a devoted fan of Zumba, specifically as it is taught by my wonderful teacher, who has a dedicated following. She has been out for the past month, home with a newborn and two year old. Last week, she came with her baby to try to take the class, now being taught by a substitute, also a regular member of her class.

“I need this for my mental heath, ” she confided as we walked together in the parking lot. A mother of a teenager who was also taking the class greeted us at the door.  Without hesitation, she offered to take the baby to a nearby park with her other two kids. “I’ll bring him back when he needs the breast, ” she said, and was off.

About 20 minutes in to the class, we heard the insistent cry of newborn hunger. His mom stopped her dancing and sat on the side nursing the baby, cheering the rest of us on through the new routines. A few minutes later, she was back in action, the other mom taking the baby again. My teacher was able to get a couple more numbers in before her baby demanded the second breast. Again she stopped, and settled in with him on the floor of the dance studio, where the two of them remained through the end of the class. We all wished them well as we filed out of the class.

It was a beautiful example of both  “the holding environment,” and “primary maternal preoccupation,” two ideas central to the work of D. W.Winnicott, pediatrician turned psychoanalyst.

Being home full time with a toddler and newborn is among the most difficult jobs there is. Taking care of your mental health is essential. This little scene included two important elements: physical activity that is calming, Zumba being a great example, and a community of supportive caring people.  In an ideal world, every mother would have access to such a “holding environment.” When  a mother is struggling with perinatal emotional complications, such as depression or anxiety, this is particularly important. In such an environment, a mother is free to provide the “maternal preoccupation,” that my teacher demonstrated with her unhesitating attention to her baby’s needs.

Human infants, unlike some other species,  are completely helpless and dependent for the first 8 to 12  weeks of life.   Beyond these early weeks, babies begin to have the ability to comfort themselves, for example bring a thumb to their mouth. The need for this kind of preoccupation lessens. In fact, as they grow and develop, learning self regulation by not having their every need met becomes increasingly important. But in these first few months, being highly attuned and  attentive to a baby’s needs, or “preoccupied,” while it can be exhausting,  is essential for healthy development. It lays the groundwork for self-regulation and a healthy sense of self.

Thinking about this scene led me to reflect on a post written by Kara Baskin, one of my fellow Boston Globe bloggers, about Yahoo CEO Marissa Mayer’s plans to take only a few weeks maternity leave. She writes:

I’m sure Mayer will make the situation work for her however she can, whether that means hiring an army of nannies or installing some kind of high-tech baby-cam from which she can run meetings while playing virtual peek-a-boo or, you know, trying to work flexible hours.

Baskin wonders how realistic this is considering how emotionally drained and physically exhausted a new mom can feel.  This is an important point. But at the risk of accusations of anti-feminism, I think Mayer’s idea is selfish. Recently I spoke with a very experienced maternity nurse. She observed that, more than in previous generations, for today’s new Mom the pregnancy is “all about them.”

Well, the hard reality, and also the great joy, is that it is not all about them.  At the end of the nine months, this baby needs someone to offer the kind of primary preoccupation that I described above. It doesn’t necessarily need to be the mother. It could be a father, grandparent or other relative. If it is a nanny, which in my opinion is not ideal, then it must be recognized that when that nanny leaves, it will be a significant loss for the child that will need to be processed and grieved.

Our society needs to recognize the value of those first two to three months. We need to provide a holding environment for new Moms. We need to let them know that taking time to devote to preoccupation with their newborn is among the most important things they can do. It’s not that much time. But in terms of the health of future generations, it will go a long way.

Claudia M. Gold is a pediatrician who blogs at Child in Mind and is the author of Keeping Your Child in Mind.

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