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5.11 Health and Wellness

To this point, we have discussed the importance of mental health in pregnancy and during the postpartum period for the mother and infant. However, we have not discussed the potential direct effects on the child. In this section, we will discuss the effects of maternal mental health on cognitive, language, and physical development during infancy and toddlerhood. Then, we will introduce the topic of child abuse. Following this section, we will continue our discussion on the importance of nutrition and access to healthy foods. Finally, we will end our health and wellness section by discussing immunization recommendations and healthcare, followed by a safety section, and a discussion of strategies to encourage a healthy cognitive, physical, and language development.

Effects of Maternal Mental Health

Maternal mental health is a very important factor that can influence children in positive and negative ways. As mentioned in Chapter 4, research shows that stress, anxiety, and depression during pregnancy may affect the neurodevelopment of the fetus, specifically cognitive and socioemotional outcomes (Wu et al., 2022). Furthermore, many studies have linked maternal mental health to language development. For example, a study by Bendini and Dinarte in 2020 found that maternal depression is detrimental to a child’s vocabulary at age 5, although the effects do fade out by age 8 (Bendini & Dinarte, 2020).

Research also suggests that maternal depression has an effect on an infant’s growth, particularly during the first year of life (Farias-Atunez et al., 2017. Children of depressed mothers not only had a higher chance of being underweight and stunted in the first year of life, but also their linear growth was affected.

Case Study: Ashley and Jesse

How can caregiver mental health impact a young child’s development?

Jesse’s start to life was a bit rough due to his mom’s postpartum depression. While she was able to meet Jesse’s basic needs of food, shelter, and safety, Ashley struggled with engaging and did not play much with Jesse or sing songs as often as she imagined she would. She was still recovering from her C-section and certain positions were painful or uncomfortable. Sometimes Ashley would set Jesse down in the bassinet for extended periods of time while she rested or maintained the household.

There were very few resources to support new mothers in Ashley’s small town, and those that were available were completely booked or managed by someone she knew. Ashley kept her postpartum symptoms a secret from her family and friends. Because she was a young mother, it was important to her to maintain an image of someone who had it all together. Jesse’s temperament was fairly easy and agreeable, which made it easier for Ashley to manage.

When Jesse was 3 months old, one of Ashley’s friends moved back into town. She also had a young child, and she spent much of her time at Ashley’s house during the day while her husband was at work. This arrangement became a saving grace for Ashley, who now had some support and a person she could trust with her feelings. Ashley learned a lot from watching her friend and the ease with which she played with the children. This was a time full of laughter, music, and growth.

Depression and other mental health conditions can affect a range of behavioral and physical symptoms in children and mothers, including changes in sleep, energy level, appetite, daily behavior, concentration, and self-esteem. Therefore, maternal depression can interfere with a mother’s or caregiver’s ability to bond with their infant, the ability to pick up on cues related to the needs of their infant, the ability to play with their infant, the ability to nurture their infant, and so on and so forth. All these factors influence cognitive, language, and physical development and other developmental domains, as we will learn in other chapters. Therefore, it is crucial that healthcare professionals closely examine not only the infant, but also the mother during the postpartum period for at least the first year.

Child Maltreatment

Child maltreatment, an umbrella term for various types of abuse and neglect, is a major public health concern. Examples of different types of abuse include physical, emotional, and sexual abuse, as well as neglect of any kind. Although experiencing abuse at any age can be detrimental, this is especially harmful during early childhood. Child abuse has serious and often nonreversible effects that can last a lifetime. In this section, we will explore the effects of child abuse on cognitive, language, and physical development. However, as you will learn in other chapters, these long-lasting effects influence every domain of development.

An abundance of research shows that child abuse impacts the developing brain, body, and mind. Regarding cognitive development, it is well known that abuse and neglect are associated with lower cognitive abilities in infancy and negative long-term educational and employment outcomes in young adulthood regardless of race, sex, birthweight, family income, maternal education, and many other important factors (Strathearn et al., 2020). As you can imagine, child abuse and neglect also have an impact on language development. For example, young adults who experienced prolonged child abuse had lower scores on a vocabulary test at age 21 (Strathearn et al., 2020).

Finally, physical development and physical health are also hindered by child abuse, and the quality of life of those who experience child abuse is lower overall. For example, a longitudinal cohort study found that children who experienced child abuse had a reduced adult height at age 21, even when adjusting for parental height. Additionally, child abuse was associated with high fat intake, a risk factor for obesity, poor sleep quality in men, and asthma at age 21.

Nutritional and Social Factors

Have you ever heard someone use the term “brain food”? In fact, these two words hold much truth, as the developing human brain and body require certain essential nutrients to develop appropriately and function efficiently. Infant and toddler development depends on adequate nutrition. Children need fruits and vegetables to access important nutrients for growth and immune support. Unfortunately, a report shows that one in two children under 5 years old did not eat a daily vegetable and one in three children did not eat a daily fruit (Hamner et al., 2023).

Poverty is a social problem that impacts millions of people. It can be extremely difficult as a parent to provide the nutrition required when you live in a low-income household or do not have access to healthy foods. According to the U.S. Census Bureau, over 10.5 million children live below the federal poverty line in the United States, which is one in five children (U.S Census Bureau, 2020). This means that a high number of children are growing up without access to the most basic necessities, such as food, shelter, and healthcare. Research shows that children who are not given sufficient nutrition have an increased risk of developing impaired cognitive skills (Roberts et al., 2022).

Children experience poverty at high rates (U.S. Census Bureau, 2023). These rates are further compounded by race and structural racism. Children of color, especially those from BIPOC communities, are overrepresented in poverty statistics. This means that they experience higher rates of poverty than their White peers, even though they make up less of the overall U.S. population. For example:

35.5% of Black people living in poverty in the U.S. are below the age of 18. In addition, 40.7% of Hispanic people living below the poverty line in the U.S. are younger than age 18, and 29.1% of American Indian and Native American children lived in poverty in 2018. In contrast, approximately 21% of White people living in poverty in the U.S. are less than 18 years old (APA, 2022).

Licenses and Attributions for Health and Wellness

“Health and Wellness” by Esmeralda Janeth Julyan is licensed under CC BY 4.0.

“Case Study: Ashley and Jesse” by Terese Jones and Christina Belli is licensed under CC BY 4.0.

“Nutrition and Social Factors” by Christina Belli and Esmeralda Janeth Julyan is licensed under CC BY 4.0.

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Understanding Human Development: Prenatal Through Adolescence Copyright © by Terese Jones; Christina Belli; and Esmeralda Janeth Julyan is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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