PAIRS: seeing the world through babies' eyes

Think about a family you have worked with in a crisis. Describe what the baby was feeling and experiencing…why is that so difficult? A baby’s perspective can be overlooked because:

• it's hard to find words for babies’ feelings when they do not have words themselves

• the caregiver’s perspective can dominate and services, interventions and safety plans tend to focus on adults
• it's painful, sometimes unbearable, to think about the needs of a vulnerable baby.

Seeing the world through babies’ eyes helps us understand what they need at a critical time for their brain development which can prevent serious difficulties in later life. 

Babies are affected by changes both ‘outside’ and ‘inside’ of them. A global pandemic is frightening, particularly as research shows that babies (including in utero) are negatively affected by the stress of their caregivers. Bodily or developmental changes, such as teething or language acquisition can also be distressing for a baby.

Babies cannot talk about their distress nor ‘fight or flight’ their way out of a crisis, their distress is communicated through the body. Persistent crying and settling difficulties are clear signs that something is troubling baby. Not crying enough, turning away or ‘switching off’ also suggests something feels unsafe for baby (this is more difficult to spot and is mistaken for an easy or compliant baby).

A baby has its own mind which is shaped by early experiences of the world, particularly with caregivers. Babies rely on caregivers to understand and contain their distress because they have not yet learned to regulate their emotions.

In times of crisis or change just when the baby needs most emotional support, the caregiver may be least able to provide it (because of their own stress). In this way, a crisis can become a ‘relational crisis’ for a baby who cannot get their needs met.

Fortunately, the relationship between babies and caregivers is resilient and often recovers from

these crises (in fact the process of ‘repair’ in a relationship is important for a baby’s development).

However, when there are a series of relational crises at critical times or additional risk factors (such as parental mental health difficulties and a lack of external support) babies can be left traumatised by negative interactions with their caregiver. 

This is a safeguarding risk and can create long-term difficulties for the baby in regulating their emotions and forming relationships.

As practitioners, we have an important preventative role by seeing what the baby needs and responding to what we see…but how do we do it?

The first step to helping a baby in a crisis is understanding what they are feeling. 

Observation is key, and since a baby’s mind is shaped by its relationships with the world, observing baby, their relationships, and ourselves are all important.

Observation is not easy, particularly in times of crisis when it can be hard to see through everyone else’s stress.

A baby has no words yet they communicate a great deal. Noticing small details of gestures, behaviours and interactions can tell us how babies are feeling and what they may need. Our role is to be curious and to encourage caregivers to be the same. When observing think about: 

• does the baby communicate a wide range of feelings, how do they do it?

• is the baby playful and interactive with others?
  
• how does a baby respond when the caregiver approaches or leaves?
• does a baby cry a lot or too little?
• can a baby hold its caregiver’s gaze, or do they look away?
• can a baby be soothed? 

A baby who is struggling in the relationship with their caregiver may not look to them as a source of support. They may turn away, be stiff or avoid physical closeness; finding ways to soothe themselves rather than turning to the caregiver for comfort.

Babies and young children communicate their feelings through play. Observing and encouraging baby-led play is important. 

A baby that is neither playful nor curious about the world may be distressed.

PAIRS run ‘Together Time’ groups for babies and their caregivers to support baby led play.

Observing the parent-infant relationship closely, the quality of contact and the capacity of the caregiver to notice the baby can help us understand what each may need in a crisis.

In a ‘relational crisis’, the caregiver and baby may seem disconnected or out of step with each other. It may be hard for the caregiver to make space to play, communicate or experience the baby as an individual with their own mind. 

A crisis or change can stir up past difficulties or trauma in a caregiver’s own history.

Being curious about these relational difficulties can help us find the right support for the baby and caregiver.

Seeing through babies’ eyes involves observing the extended family and the relational dynamics around the baby. Research shows that the quality of relationships between caregivers can impact babies’ development.

Sometimes a baby’s needs conflict with others in the family. It can be difficult to make space for a new baby in a family under pressure or a family in conflict. Babies can be on the receiving end of ‘negative projections’ by caregivers and the extended family, being blamed for something that is not actually about them.

Things to notice include:

• what conversations are taking place between caregivers and extended family around the baby’s needs?  
• what space is given to the baby within the family? How does the baby ‘fit in’?
• how does the baby ‘fit in’? 

Being the voice of the baby

Voicing our observations of babies (to both baby and caregiver) can help bring about a shared understanding of difficult experiences.

• talk to the baby directly and get on their level (often on the floor!)

• try simple statements like “you were so worried when mummy went away to the kitchen”– these can help a baby feel heard and communicate to the caregiver the feeling behind a behaviour
• be sensitive and focus on the positive things as well as the challenges - caregivers may need help to notice babies’ distress but it can feel exposing for them.

We can also be the voice of the baby with other professionals, advocating for babies’ needs and the needs of the baby/caregiver relationship.  

Caregivers who are preoccupied with a range of stressors, including their own mental health difficulties, can struggle to see the world through their babies’ eyes. Attending sensitively and without judgement to their needs can help them to hear a babies’ distress. This may include:

• strengthening the support structures around the caregiver/baby, which may include Children’s Centres and Early Help

• making specialist referrals where appropriate. For example to PAIRS and/or IAPT (Improving Access to Psychological Therapies) and adult mental health services
• suggesting a parenting group such as ‘Circle of Security’ run by PAIRS.    

Working with babies in crisis can be painful and challenging for us as practitioners. Think about who you might go to when you need support:

• talking with colleagues in your team and the professional network can be invaluable
• supervision and reflective groups give space to think about the challenges of the work (PAIRS offer consultations to practitioners and facilitates reflective practice sessions for LEAP practitioners).

It is essential we work as a team around the baby and caregiver. No single practitioner, service or intervention can see the world through babies’ eyes. 

We all bring our own expertise and perspectives. 

Multi-agency working is also key to effective safeguarding and child protection. We often need to establish a team around the baby and caregiver for the first time. 

This can involve seeking advice or making a referral to specialist services where appropriate, for example to us at PAIRS. 

It is particularly helpful when practitioners involved with the baby are linking up with those involved with the adult caregiver.