“I think families and particularly parents shy away from the term infant mental health. They think, Oh my goodness, does that mean that something is ‘wrong’ with my baby? And it does not mean that at all.”
Janet’s guest is Dr. Angela Fisher-Solomon, an Infant Developmental Psychologist and RIE Associate with over 20 years of national and international experience in the Early Childhood field. Angela’s passion and the focus of her extensive work and research is building strong adult-infant/toddler relationships from birth, no matter what the circumstances. Every infant is unique, and every family dynamic is different. Angela strives to equip parents and professionals with tools to support and strengthen their relationships while nurturing each child’s authenticity, resilience, and self-confidence.
Transcript of “Mental Health Starts in Infancy (with Dr. Angela Fisher-Solomon)”
Hi, this is Janet Lansbury. Welcome to Unruffled.
Today I’m hosting infant mental health and infant-parent relationship expert Dr. Angela Fisher-Solomon. Angela’s also a fellow RIE Associate and now serves on their board, after serving a long tenure at the nonprofit Zero to Three. Dr. Fisher-Solomon has worked on national projects on home visiting, family childcare, Early Head Start, and more.
Today we’ll be discussing what infant mental health really means. It might not be what you think. So, what is it? What is it not? Why is it important? And what can we do to nurture it? Which includes understanding secure attachment, stimulation, infant emotions, and a lot more. I’m really looking forward to this.
Hi, Angela. Welcome to Unruffled.
Dr. Angela Fisher-Solomon: Good afternoon, Janet. Thank you so much for having me. It is such an honor to be able to sit and chat with you on one of my favorite topics.
Janet Lansbury: Well, the honor’s completely mine, let me tell you. I’m so thrilled to be able to share your wisdom and many years of experience with my listeners. So thank you for taking the time to be here. Like you said, I love this topic. It’s one that isn’t a part of the conversation in parenting as much as a lot of other topics. Why do you think that is? Do you have any thoughts about that?
Dr. Angela Fisher-Solomon: I think families, and particularly parents, often they shy away from the terms infant mental health because people often think about mental health as, Oh my goodness, if you say infant mental health, does that mean that something is quote unquote “wrong” with my baby? And it does not mean that at all. Infant mental health has what we call synonymous definition, which simply means social-emotional development in babies and toddlers, and that’s all it means. It is really just the capacity of a baby or toddler to experience, regulate, and express their emotions. It’s also their ability to form close and secure relationships and really to explore the environment and learn. All within the context of biology, relationships, and culture.
And so, on one hand, that’s a big definition in terms of the field. But to parents, when parents ask me, well, what exactly is infant mental health? I often just simply say, think of it as, how is your child developing their social-emotional skills? And then that leads into attachment and what does that look like? And basically, just how is your child’s overall emotional wellbeing, what does that look like? And then as an infant mental health specialist, we break that down.
Janet Lansbury: So what are some of the important practices that parents should consider engaging in with their babies and what signs from them are showing us that we’re on the right track? Can you talk about that?
Dr. Angela Fisher-Solomon: Infant mental health, I have found, and in my research, really I link it back to what is happening to the baby in utero. Because infant mental health doesn’t just start when the baby is here, right? After the baby is born. It starts with the connections prenatally. So I often like to tell parents it starts there. What kind of pregnancy did you have? How did you feel about the baby? How were your emotions? Because we know that emotions during the journey of pregnancy are sometimes up and down, right?
Then once your beautiful baby has arrived, what is the connection? Because as soon as the baby is born, infants come into the world, as you know, seeking the connection of another human face, particularly the mother, father, or whoever is going to be that primary caregiver in the child’s life. And it often starts out with something as simple as the earliest connection, making eye-to-eye contact with the baby. Touching a newborn is like heaven. And making that up close, eight to 12 inches from the baby’s face so that they know by smells and using their other senses, they know who mom is. And a lot of research says they also know who dad is, particularly if the dad has been able to talk to the baby in the womb on a regular basis. So parents ask, how can I help my infant have a strong social-emotional capacity? I tell them, by building a healthy, secure attachment relationship, which in turn builds trust and security.
And in my research, which looks at confidence-building in babies, it’s really this —and we know this, you and I often talk about it in many different scenarios— the importance of going slow with an infant. Your language, your eye rapid movement, the tempo of your body language, babies pick up everything. And what we consider to be small nuances of how you interact with a baby, how you observe the baby. And that consistency really in fact is building the necessary skills for strong social-emotional capacity, which ultimately means you are building strong social-emotional skills, which lead to strong cognitive skills and so on and so forth. Because it is strengthening that particular developmental domain and the baby’s brain.
Janet Lansbury: Because it’s giving them that sense of calm and security that allows them to—
Dr. Angela Fisher-Solomon: Regulate.
Janet Lansbury: Yes, and then therefore have the capacity to develop cognitive skills and these other skills.
Dr. Angela Fisher-Solomon: Absolutely. I mean, everyone wants their child to do well academically. Even if a baby is, let’s say two, three days old, it’s natural for a parent to think, I want my child to be able to read before they get to kindergarten. Or, what should I do? How can I make them and help them to have strong cognitive skills? You know, we as adults, we have societal pressures. So as parents we can’t help but start thinking further ahead. And you know, Magda Gerber used to often say about being in the moment, but it is understanding, and in the world of infant mental health we zero in on: to what degree is slow. Observation, being able to understand the developmental cues, being able to identify them, being able to read them consistently, and being able to meet the emotional needs of the baby.
An example is, when we talk about regulation, if your baby is crying and you may come close, you have the best of intentions, but in fact the baby already could be overly stimulated and it turns its head away from you because it actually needs to shut down and have a little quiet time. So infant mental health is about helping parents to identify those cues and come alongside the baby, in a sense, so that the baby is dictating what it needs and the parent is better able to give them that.
Janet Lansbury: Yes. And that example of overstimulation, that’s one that’s I think so commonly misunderstood. And there are so many products that we’re offered as parents to maybe make our child smarter or learn faster or be less bored or whatever, that actually are very overstimulating. And I know that this idea of how sensitive babies are to stimulation, that got away from me a lot, even with my third baby. Because we can’t gauge that on our own stimulation needs, they’re so much more sensitive.
And it’s like what you were saying about slowing down, too. We can’t be with a baby in a way that’s really going to be helpful to them if it’s on our adult pace. Magda Gerber and Pikler talked about this a lot, and Heidelise Als, who did so much research with preemies, talked about how jarring it is for them when we’re on an adult, more rapid pace in the way that we talk to them or handle them. So I feel like those things, maybe there’s not enough information and support and reminders out there that babies are… their newness to the world and all this incredible learning potential that they have, they’re so open to the world and yes, everything is more to them. They need so much less than we think.
Dr. Angela Fisher-Solomon: You know, infants, their right brain develops much earlier than the left side of their brain. And the right brain is what controls their emotional development. Yes, they come into the world with over 70 billion brain cells. So they come into the world very, very smart. Their senses are heightened. But to your point, the one thing that is not always considered is, although they are simply brilliant and competent little people, their ability to take in information, it must be slow.
You know, parents often wonder, Why do I have to repeat myself, even to my toddler? I explained to them, because it takes them probably around the third time, sometimes the fourth time for it to register. You know, let’s say if it’s a toddler who is only speaking a few words, but if you are using hand gestures and you speak slow enough and use eye contact, even an infant, they’re going to understand you.
And I’ve had parents challenge me, that there’s no way my four month old can understand me and I give them little experiments. Yes. Why? You know, you speak to the baby in a certain way and then I begin to show the parent, Look at her eyes, look at her hands starting to open and close. Her breathing is increasing. She knows I’m explaining something. Parents sometimes think that they’re just little nuances, but they in fact have great meaning.
Janet Lansbury: Yes. That’s what I say to parents too because I often get that, Oh, what’s the point? And, They can’t understand. And I suggest, Try it. And people have come back to me and said, Oh my gosh, okay, I saw it. I saw my baby registering what I said, or I saw them responding in a way that proved to me or seemed to prove to me… It’s still freaky, right? They understood what we were talking about.
About stimulation… I was just imagining, for us it would be we’re in a stadium, really noisy, there’s all this stimulation, all this stuff going on. Which is I think how babies must feel just being there in the world. Because they’re taking everything in—every sound, every sight, everything all at once. And then yes, if we were in that stadium with all of that stimulation and all that sound and all that sight, then it’s going to take a little while for you to communicate with us because we have to tune some of that out just to be able to focus on what you’re saying. I don’t know if that’s a proper analogy, but that’s what came to my mind.
Dr. Angela Fisher-Solomon: It absolutely is a wonderful analogy. And I teach on infant brain development to college and graduate students and I often say to them that, there’s understanding brain development, you’re neuroscientists or something like that. But for a parent, they don’t necessarily need to know it to that degree. They need to know how a baby’s brain works, in that a baby’s brain literally depends on the social interaction in order for the right side of that brain to flourish and for the neurons and the connections to get strong enough. And to understand, to your point, that quieter environment, it gives the baby the opportunity to regulate itself. It’s hard, even for adults, for us to regulate our own emotions and our bodies and our senses if we’re, what did you say, in the middle of a stadium. You know, our ability as adults to be intentional, physically, emotionally. Why do we think infants are any different?
And if anything, because they haven’t been in the world that long. They’ve been inside the womb, this really safe, dark but comforting place where only they’re really dealing with their mother’s heartbeat. Even if it’s a water birth, however the child enters the world, it is still a shock. Because now they’ve got lights and they’ve got people moving around, they can’t really see clearly. So it’s a lot for their brain. And again, the right side is much more developed than the left side. The left side holds cognitive and language skills, it doesn’t really develop until closer to age one. So the right side is working a lot and babies need consistent but quieter sounds to begin to allow them to kind of regulate and get their own body rhythms. And we talk about, from Magda, telling a baby what you’re going to do before you do it and pausing and waiting.
All of those practices really help babies, it gives them time. And parents often find that if you give your baby that time and that consistency and you’re going slowly, you literally are helping them to build their social-emotional capacity. Because as they grow, everything is going to start to increase, right? And become a little bit faster. There’s such a big difference between an infant, a toddler, and then a preschooler who’s running around and jumping and going from one thing to the next because they have the capacity to do that. Between age four and five, Oh, he can sit and listen to a preschool teacher. Or the things where when you need them to wait, well, when you go slow in the beginning you’ve been building their social-emotional development, a.k.a. their mental health, they are better able to regulate their bodies. And typically it affects their sleep schedule, their sleep cycles, their feeding cycles, and their play cycles with their loving parents.
Janet Lansbury: Yes.
I wanted to ask you about something because when you brought it up, I got a little feeling of uh-oh, and I’m sure other parents worry about this. You talked about how our feelings around our pregnancy, and of course we all know —and some of us have experienced— postpartum depression, or that anxiety as a new parent or just after the birth of a baby. Well, we can’t help how we feel if we’re depressed during pregnancy, right? I had a very difficult third pregnancy. I think I was maybe too old to be having a baby, I don’t know. But I had a lot of negative feelings.
You know, there’s very extreme things that parents go through. And there are also situations where of course babies are premature, their brain hasn’t finished fully developing as a full-term baby’s would. And then there are situations where there’s adoption and the baby has, I believe, a sense of loss of leaving the person that smelled and spoke like that, that they heard in the womb, and going to someone else. What do we do if that was our situation? How can we help our babies to process that? Is it just being even more sensitive the way you’re talking about? Or can we expect certain things from them that we might not expect from a full-term baby where everybody was emotionally healthy all through it?
Dr. Angela Fisher-Solomon: Sometimes parents are not able, they don’t necessarily arrive in the best situation. Or to your point, if in this case that there is a mother going through postpartum and she may not have the capacity to give her child the nurturing that it needs. That’s why this field is so critically important because a mom or a family needs support, no one can parent in a vacuum. And if someone has gone through various levels of postpartum depression or other adverse experiences that impede their ability to parent in a healthy manner for their baby.
Babies, unfortunately, they don’t really wait. You know, they grow every day. But they are incredibly resilient. And in the families that I work with, I often explain that you meet your child where they are. There’s no such thing as a perfect parent, we all make mistakes. And whatever the situation is, if you are able to get some kind of support, like if it’s postpartum, they have the amazing Postpartum Support International, that’s doing some amazing work around the country for not just mothers, but they have family groups, they have groups for fathers, they have LGBQT groups, different cultural groups.
Because, you know, you could have one vision for how your family’s going to look when you’re getting ready to welcome a new baby or a child into your family, and it may not turn out that way. So there are many different groups that I try to guide parents to. If I’m not mistaken, there’s probably infant mental health specialists and organizations in almost every state in the country. And many times those resources are free of charge.
And then if you ask, How does that affect the baby? You can only hope that there could be someone there, even if it can’t be the mother or the father, that it could be someone who could still give that infant a nurturing experience until the parent is ready. And when the parent is ready to create the bond, it’s still going to continue to have a major effect on the child’s life. If it can be in utero, if it can be from day one, that’s fantastic, but it might not be until age three.
I tell parents, you do the best that you can and if you’re trying to strive to get better, then a child’s brain is incredibly resilient and flexible. So it is not to think that just because there’s extenuating circumstances, that Is my baby just lost if I can’t provide this slow, nurturing, comforting? No. I would encourage parents to try to get support and resources. And in the world of infant mental health, we have something called prevention and promotion because of course if we can help offset some of those challenges, it’s going to be better for the baby and it’s going to be better for the parenting journey. So earlier is always helpful. Not always possible, but wherever you get the help at whatever time, it’s about the health and wellbeing of both the adult, of the caregiver, and the baby.
Janet Lansbury: That’s very helpful. So let’s say, in my situation where I had a lot of dark moods during the pregnancy, but then once I had my baby, I actually felt really guilty about the dark moods because he was just so vulnerable and adorable and, you know, there was no way I was not going to love him. He had a lot of crying, whatever that was. Colic, I don’t know if it was his digestive system. Not during the day, but in the night he would have lots and lots of crying and I tried a lot of things, a chiropractor, my diet, all of these things.
But I sometimes wonder if, do babies express those feelings that they absorb from us in the womb or maybe in the early days after birth if we’re depressed? Are there different ways that babies express that and process it out of their system with us? Or is that just as variable as all the different types of children there are, with their different capacities? Or are there some themes? An adoption situation, maybe, where they had that loss and now they’re in this really positive situation though? Is there anything that that looks like that we could look out for? Or is it just very individual for each child?
Dr. Angela Fisher-Solomon: You know, I get asked that question a lot. And one of the reasons I chose developmental psychology is because my outlook on babies, it’s from a scientific perspective, yes, but it’s also from a holistic and a spiritual perspective. Babies do because of genetic makeup, right? And stress that’s internalized in different hormones that we absorb in our bodies and so does that then get passed to our babies in the womb? Or if it’s an adoptive baby, is that baby coming with a genetic pattern for its emotional framework? In a sense, yes, the science has shown that babies do come, in a sense, with a genetic blueprint. And that’s under the realm of biology, right? But then there’s nurture. And the research shows nurture —which is, again, giving your baby the support it needs once you’re able to identify some of the issues— is stronger.
And so let’s say with you, your son may have had these issues. Or if it’s an adoptive child, they’re going to have some residuals because they had a birth mother at some point. But what I tell parents again is that the power of love is at the core and the center of babies. I know it sounds simple on one hand, but it does have the ability for recovery. If you’re the birth parent, if you have sad feelings that heighten your level of cortisol in your brain and the hormones or stress hormones, and your baby is born extra-irritable, it just seems incredibly tense and it can’t seem to regulate. There are steps in infant mental health in identifying what’s happening. Why is the baby tense? Is it muscle tone, is it irritable? So there are different screenings. And once those are identified, then we can come up with a plan to help a parent bring the stress level of the baby down.
If babies who’ve suffered, let’s say with alcohol syndrome, they recover. It takes work, but they recover and they begin to thrive. So yes, it’s an individual’s situation for both the adult and the baby, but just because it’s not an ideal situation doesn’t mean that the baby has to be quote unquote “stuck”. Does that make sense?
Janet Lansbury: It totally does, yeah. I love that.
You brought up cortisol. What should parents know about cortisol? I know there’s a lot of mixed advice put out there around if your baby cries or if your baby cries for too long or too often, that’s a dangerous thing because of the cortisol. What is the science on that?
Dr. Angela Fisher-Solomon: Cortisol is a stress hormone. We have it, it’s in our bodies, and it’s there for a reason. It’s kind of a measuring stick and it helps to regulate other functions in our bodies. I agree with you that parents don’t quite understand about cortisol and crying in particular. But for babies, crying is healthy. It’s a way to express emotions. The challenge is understanding, where is it coming from? If all the basic needs have been met, sometimes there’s not going to be anything that you can do because the infant is also sometimes trying to regulate itself. However, as a parent, if you feel that, okay, I’ve done everything and my baby is inconsolable, then I would say call your pediatrician to make sure that there’s not anything going on internally. But crying in and of itself, again, once all of the babies’ needs have been met…
And sometimes parents aren’t quite sure as to, When should I hold my baby? Should I rock them? Should I do this, should I do that? To keep them from crying, you have to try to help the baby to regulate. And sometimes it’s taking your baby’s clothes off, warming up your hands. I’m a certified infant massage educator and what we do is called holding sacred space, speaking very quietly in your baby’s ear, looking at them in eye contact. I know you’re upset. I know it’s hard, but I am here for you. And same repeated soft motions that are rhythmic. Typically I found they work, bouncing and all of those things. If the baby is already overly stimulated, then bouncing them is sometimes only going to make it worse and then the crying becomes elevated. So the cortisol level in terms of stress has more to do with prolonged crying and not giving an infant acknowledgement or recognition that someone is there.
Janet Lansbury: And hopefully someone that can be as calm as possible, right? So we’re not adding to it with our own emotion for the baby to absorb.
Dr. Angela Fisher-Solomon: And you brought up an excellent point because when you know you’re stressed. In some of my parent-infant classes, I will say, It’s okay. Step over to the side, count to 10 or 20, take deep breaths. And I’ll give them a mindfulness exercise. And then come in. Because if you’re not regulated, it’s only going to add to the baby’s stress. If you’re stressed, then the baby’s going to be stressed. And if their baby’s not stressed, the baby will then become stressed. They basically mirror you and they mirror your emotional capacity.
Janet Lansbury: I love that you teach that in your classes. Can you talk a little about this tool that you’re developing? The FIOT, the Fisher Infant Observation Tool?
Dr. Angela Fisher-Solomon: Called the FIOT, it’s been a baby of mine for the past 20 years. I was inspired by Magda’s work in talking about confidence and then there’s some other theorists that I researched that also talked about confidence, and Dr. Pikler. I was inspired and I wanted to look at confident behavior as an action verb.
So I looked at adult insecurity. They didn’t just start that way. We always go back into the world of infancy and early childhood. And so what I did was I studied insecurity and fear. Where is it rooted? What are the elements and the factors that contribute to confident and insecure behavioral patterns? And that is the FIOT. So it is a paper parent observation tool. But I created it to empower parents because for me I said, well it’s great in psychology and nurses and pediatricians, we get all these different screening tools and most of them are not culturally sensitive. So I created the FIOT.
Janet Lansbury: You created one that is.
Dr. Angela Fisher-Solomon: I had some amazing mentors who I think are far more brilliant than I am and more experienced. And we did the research and looked at, what are the differences in parenting styles, the differences in how we see babies and what does that look like across various cultural groups? And how can we ultimately bring this into the hands of parents to empower them? So the goal is to empower parents. It’s not a measuring tool, it’s more of an identifier. If your baby scores a particular number, here are some strategies to help you at home.
So if your baby is starting to show some insecure behavioral patterns, this helps you to offset that behavior. So you don’t have to wait until your child is three to start to wonder, Why is my child so fearful? Other than separation anxiety and stranger anxiety, which are all typically developing behaviors. So the FIOT begins to identify what that looks like. And it has gone through two levels of scientific testing and it has very, very strong scores. We are now in the final phase. We’re constantly looking for funding and perhaps partners at some point, because now it’s ready to be taken around the country. It needs a larger sample population before it’s ready for publication. But ultimately that is the goal.
Janet Lansbury: Wow, you’re amazing.
Dr. Angela Fisher-Solomon: It’s been a long process.
Janet Lansbury: I mean, congratulations. Especially because it’s been a long process. So does this also help parents notice if there’s neurodivergence or other issues like that? Can they notice anything like that at the infant stage?
Dr. Angela Fisher-Solomon: Absolutely. Even though it is created for typically developing babies, people have asked me, would this be a tool if my child was on the autism spectrum? Just as an example. And what it has shown, because of the identifiers, so far is that it picks up on things that are not consistent, which in turn propels a parent to be able to wonder a lot sooner than later. And it has the chart, you know, typically developing should be doing this. And it also gives room for varying cultural groups. So how a particular culture, what their outlook is on parenting practices. It can be tweaked here and there to make room for that.
Janet Lansbury: It sounds like it might also do something that— this was one of my favorite gifts from Magda, she taught us to see this ourselves and help other parents see this. That it’s not just, My child isn’t doing this yet, it’s, But look what they are doing. They’re doing this. You didn’t realize that was a thing. Well guess what? It’s a thing. They’re sustaining attention on something. Or the way that they’re shifting their body. They’re maybe not rolling, but they’re preparing themselves to be able to do that, moving their head, extending themselves, turning on their side. You know, I love how we’re able to show parents in the classes and ease their mind that your baby’s really making some good progress here. Look at all the things they’re able to do that you never even thought meant anything.
Dr. Angela Fisher-Solomon: Absolutely. And the FIOT doesn’t make a comparison and it allows parents to, you know, you don’t take it just once, right? You could take it more than once. So to your point, it’s not as though you’re looking for anything. It’s really training parents on how to observe without judgment. It’s almost like writing in a diary. You know, if you’re anyone that’s trying to lose weight, you weigh yourself and then you might weigh yourself again two, three weeks later. Then if there’s a big enough difference, it gives you time to pause and possibly correct if you need to correct something. And so it’s really the awareness and the awareness early on would in turn help babies and toddlers before they get to preschool. So prior to the age of three, to be able to offset. So it’s the awareness, empowering parents and then allowing them to make their own informed decision. The FIOT will give parents the opportunity and the ability to identify their own baby’s cues.
Janet Lansbury: Wow. Well, I’m excited for this to come out. So keep going.
Dr. Angela Fisher-Solomon: I will be sharing it at the World Association for Infant Mental Health in Dublin. I don’t share the tool, but I will be sharing different posters about the research and all of that.
Janet Lansbury: Wonderful. Well thank you so much for sharing so many wonderful tips and your perspective and insights. I really, really appreciate it. And I of course personally enjoy talking about one of my favorite topics with an Associate.
Dr. Angela Fisher-Solomon: Yes. And if anyone wants to learn more about the FIOT, they could visit fiotbabiesconsulting.com.
Janet Lansbury: That’s F I O T babiesconsulting.com. Great. And is that where we can learn more about your work personally too?
Dr. Angela Fisher-Solomon: There are small-group classes, you know, similar to RIE classes, Resources for Infant Educators, but these classes deal with a lot of psychology, things that might come up for parents, as well as deepening cultural differences in how they see their children. So yes, there’s a whole series of components. The screening tool is just one of them.
Janet Lansbury: I want to take one of those classes. Maybe with my grandchild someday.
Dr. Angela Fisher-Solomon: Listen Janet, when we get to the next level, you would be an honored guest.
Janet Lansbury: Wow, thank you. Good luck with all of this. I feel like you’re on your way to helping even more parents than you’ve already helped and more babies. A whole generation.
Dr. Angela Fisher-Solomon: Thank you so much.
Janet Lansbury: Thank you.
♥♥♥
You can learn more about Angela’s work and resources at: FIOTbabiesconsulting.com
And please check out some of my other podcasts on my website, janetlansbury.com. They’re all indexed by subject and category, so you should be able to find whatever topic you might be interested in.
Both of my books are available in paperback at Amazon, No Bad Kids: Toddler Discipline Without Shame, and Elevating Child Care: A Guide to Respectful Parenting. You can get them in e-book at Amazon, Apple, Google Play, or barnesandnoble.com and in audio at audible.com. And you can even get a free audio copy of either book at Audible by following the LINK in the liner notes of this podcast.
Thanks so much for listening. We can do this.
Originally published by Janet Lansbury on June 27, 2023
