Understanding Early Trauma is the global theme of Infant Mental Health Awareness Week (June 13-19) which aims to start conversations about an often overlooked and misunderstood subject.

Nathan* was identified as a high-risk baby in utero, due to his mother’s drug use and unstable living situation.

Born premature, he was removed from his family at birth and placed with a Centacare Foster Care immediate care household, while his mother sought stable accommodation and therapeutic support.

At two months, Nathan was transitioned to a reunification specialist short-term carer in the hope he would one day return home, as his mother was making progress towards a safe environment.

Small and underweight for his age, Nathan was clingy and became easily distressed if his carer walked away.

Now aged one, he continues to struggle with separation anxiety, but has gained weight and is learning to talk.

Nathan’s specialist reunification carer provides guidance and support to his mother, who he visits four times a week, as they work towards successful reunification.

While Nathan’s story is unique, the complex trauma that underpins his early start in life sadly is not.

Of all the children that Centacare reunified with their families during this financial year, half were infants, and all have experienced some form of trauma – such as domestic abuse, parental drug use and neglect – before the age of two.

Understanding Early Trauma is the global theme of Infant Mental Health Awareness Week (June 13-19) which aims to raise awareness and community understanding of the consequences of trauma in the early years, and how it can lead to difficulties later in life.

Centacare Foster Care Manager Amalie Mannik says the week unites professionals and organisations around the world and highlights the buffering impact healthy relationships can provide infants.

A large part of this is raising awareness of the profound impact that trauma experienced during utero can have on an infant’s mental health.  

In Centacare’s case, Amalie highlights the role specialist reunification foster carers play in changing the early childhood trajectory of babies like Nathan.

“The perception that trauma doesn’t impact babies because they are too young to understand, or hear and feel what’s going on, absolutely is incorrect,’’ she says.

“We see the impact early trauma has on infants every day. If it’s not responded to therapeutically, and if the attachment between child and adult is not built, the resulting pain-based behaviours will only get worse and continue throughout the baby’s childhood.’’

A quiet infant, for example, can speak volumes about their silent struggle, explains Amalie.

“A baby might be described as a good baby on paper because they never cry, but that’s actually very concerning,’’ she says.

“It tells us they have learned that crying out won’t help them and that they are resigned to not having their basic needs met, so they stop trying to communicate what they need – a clean nappy, sleep, nurturing cuddles, food, clothing.

“We might see babies with sores or who are developmentally delayed and have different health issues, or babies that won’t settle or give you eye contact because they haven’t experienced a secure attachment with an adult.’’

To support sustained healing from adverse childhood experiences, Centacare foster carers work within a therapeutic care team framework.

This wraps support around the infant’s parents – many of whom have their own history of childhood trauma – to increase parenting capacity and forge familial bonds.

Part of the specialist carer’s role is to establish regular positive contact with parents and then co-regulate with the infant post-contact, to ensure repair work after potential trauma triggers and assist them in developing a sense of safety.

“Trauma always has an imprint and quite often it’s reactivated through smells and visuals,’’ Amalie said.

“By bringing a baby back to the family where they did experience the trauma, the carer lets the baby know that they are safe through that process. The carer co-regulates with the child after family contact to help them develop coping mechanisms and a secure attachment with their parent.’’

Centacare has emerged as state leader in the foster care sector for its reunification model, therapeutic framework, and specialised training packages for reunification carers, based on Dr Jacqueline Amos’ thesis When wounds from infancy collide, The mother child relationship as trauma, trigger and treatment.

The therapeutic framework not only informs practice, but is embedded across all facets of the program, including policy and procedure.

“We have observed when foster carers provide infants with predictable, warm, nurturing and emotionally attuned responses, the infant thrives, goes on to develop trusting relationships and starts to view themselves as worthy of love and belonging,’’ says Alicia Remedios, Training and Review Officer.

“Our teams highly skilled practitioners support carers with providing attuned responses that communicate unconditional acceptance and curiosity for the infant’s inner world which further leads to improved mental and emotional wellbeing of the infant and changes their trajectory – now and in the future.’’

*Not his real name