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Bonding and attachment in babies and young children

For babies and young children, care and development are strongly linked, and the bond between baby and parent or carer is crucial to the growth and development of the child – affecting physical growth as well as emotional and mental development and wellbeing.

Bonding and attachment in very early infancy is critical to the growth and development of baby and child; parents need to be aware of importance of interacting and communicating with their baby from the earliest days and enhancing quality of life through interaction and active play.

Children’s earliest experiences shape how their brains develop, which in turn determines future health and wellbeing. Very young children need secure and consistent relationships with other people in order to thrive, learn and adapt to their surroundings and this may also impact their ability to form good future relationships.

The Chief Medical Officer’s Report highlights the fact that infants who develop a secure attachment have improved positive interactions during play by one year of age. Insecurely attached infants are at greater risk of problems in emotional development, and children with very poor attachment experiences are at greatest risk of failure to thrive in early years and behaviour problems, lowered self-esteem and schooling difficulties in childhood and adolescence.

Research has suggested a link between deprivation, the body’s hormonal response to stress and subsequent risk of ill health, which may explain the biological links between adverse and chaotic early life experiences and subsequent high risk of poor physical and mental health. This is particularly important to social behaviour.  The impact can start as early as pre-birth with the impact on the fetus on the mothers body’s hormonal response to stress.

For some children – for example, looked-after children, children living in chaotic families and children whose parents are incarcerated – forming bonds and attachments may not be easy. Building and encouraging bonding and attachment to develop stable relationships with parents or, where more appropriate, a carer or professional can help improve outcome for the most vulnerable children.

The impact of impaired bonding in early childhood varies. Children who have been unable to interact in infancy are not able to learn how to form relationships which can cause severe social problems throughout life. Children who have some degree of impaired bonding and attachment during early childhood can experience a range from mild interpersonal discomfort to profound social and emotional problems. In general, the severity of problems is related to how early in life, how prolonged, and how severe the emotional neglect has been.

Here are some of the main indicators of impaired bonding:

Developmental delays

The bonding between the young child and their caregivers provides the experiences required to develop physically, emotionally, and cognitively. Lack of consistent and enriched experiences in early childhood can result in delays in motor, language, social, and cognitive development.

Eating

Children may hoard food, hide food in their rooms, or gorge at meals even if they have had years of consistent available foods. They may have rumination (throwing up food) and swallowing problems

Soothing behaviour

In order to self-soothe, infants may have learned primitive soothing behaviours. They may bite themselves, head bang, rock, chant, scratch, or cut themselves. These symptoms will increase during times of distress or threat

Emotional functioning

A range of emotional problems is common, including depressive and anxiety symptoms. One common behaviour is "indiscriminate" attachment. All children seek safety – some may seek attachments for their safety.

Inappropriate modelling

Children model adult behaviour by learning that the behaviour they have experienced is the "right" way to interact with others. This potentially causes problems in their social interactions with adults and other children.

Aggression

The ability to emotionally "understand" the impact of your behaviour on others can be impaired. In more extreme cases, aggression is often accompanied by a detached, cold lack of empathy. They may show regret (an intellectual response) but not remorse (an emotional response) when confronted about their aggressive or cruel behaviours.

Professionals can help support bonding and attachment through:

  • Interacting with children based on emotional age
  • Being consistent, predictable and repetitive
  • Modelling and teaching appropriate social behaviours
  • Listening to and talking with these children
  • Having realistic expectations of these children
  • Being patient with the child's progress.