The ‘Babies Bill’ (Infants, Parents and Carers Bill), which aims to strengthen the support available to parents and infants during the first 1001 days of life, has its second reading in the House of Commons on 4 September 2026. NCSPIR Programme Manager, Claire Hopkins, reflects on the timely wisdom shared by Zack Eleftheriadou in her recent TR Together lecture on Early Development and Infant Psychotherapy drawing on the work of Winnicott, Stern and many others, to explain why the support offered to parents and babies during the first 1001 critical days of a baby’s life is so critical.
My takeaways from this densely informative workshop:
Where does it start?
Our early relationships shape our brain. Newborns are profoundly relational and depend on responsive caregivers to help regulate and make sense of their early experience. Winnicott described the heightened sensitivity of the mother to the infant’s needs as ‘primary maternal preoccupation’. By age two, the brain is around 80% of its adult size and studies of in-utero development show how babies, especially in the 3rd trimester, are impacted by trauma and maternal mental health in pregnancy. Research into prenatal development and the impact of stress, for example Rachel Yehuda’s study of the transgenerational effects of 9/11 and Nadja Reissland’s research on foetal development and maternal depression, suggest that maternal stress and mental health can influence foetal behaviour and movement in utero as well as genetic, organic and neurochemical development. If we are lucky enough to work with families during pregnancy, we can bring the baby into the room as if they were there. By exploring conscious and unconscious fantasies about their baby, we can help parents consolidate and work through imagined ideas and support them to process and work through unresolved trauma.
Dysregulation and re-regulation
Babies get used to rhythms, anticipating and predicting how they will be ‘held’. Thinking about Winnicott’s concept of ‘good enough mothering’, Zack described how it is the capacity to initially adapt to the infant’s needs almost completely in primary maternal preoccupation, and then to adapt less and less over time, which allows the development of a secure true self in the infant. From a Winnicottian perspective, temporary states of unintegration are healthy and can be understood as part of ordinary early development, supported by a sufficiently reliable holding environment. We can perhaps understand separation stress as a loss of contact with maternal regulation, a break in the dual affect regulation system (which Zack helpfully described as an orchestra) of the parent-infant relationship. An infant’s distress on separation illustrates the difficulty in this loss of contact, a necessary rupture in attunement. It is the subsequent re-regulation which presents the developmental opportunity to repair, facilitated by the plasticity of the infant’s brain in early life.
Cultural context of the parent-infant relationship
Culture is important- newborns in all cultures are relational but each family and culture has its own patterns of relating. Pat Crittenden’s Dynamic-Maturational Model is especially important in emphasising how attachment behaviours cannot be fully understood without considering the familial and cultural environment. Attachment strategies evolve across the lifespan as the brain develops interacting with changing cultural and social contexts. Cross-culturally informed Infant Observation provides an unparalleled opportunity to understand the infant’s experience, relationships and emotional states. Zack spoke about Suzanne Maiello’s observation of an African baby and his mother in their home environment in a township near Cape Town. Communication in the mother-infant couple in this context occurred primarily through tactile, kinaesthetic/rhythmical and vocal/auditory interaction and much less visually and verbally as compared with Western mother-infant dyads.
Without good enough care
When the holding environment is insufficiently secure, the infant may develop highly adaptive ways of responding to the caregiver. In Winnicott’s terms, under conditions of significant environmental failure, this can contribute to the development of a “false self” organised around compliance rather than spontaneous gesture. Babies quickly learn how to make a forecast. When the parents are unable to reliably know about their baby’s needs, they lose what Robin Balbernie has called ‘the voice of the baby’. In her lecture, Zack highlights how speaking directly to a baby allows a practitioner to invite the parent to join them in understanding a baby’s emotional state. This approach can activate parental curiosity, placing the baby onto the parents’ ‘psychological radar’. By matching the baby’s tone and stance and slowly lowering their volume, a practitioner models how to acknowledge the baby’s emotional state to ease their distress. Zack highlighted the importance of managing the tension between taking the time to build a secure therapeutic alliance and responding to the urgency of the infant’s early development. Well-funded antenatal and health visiting services are critical in providing safe and effective support to families in every baby’s early life.
Reflecting on Zack’s lecture I am reminded that while theory helps us frame our work, our most important task is to stay curious about the baby in front of us, carefully observing and attending to what is happening now in the relationship between baby and parents. Then we can begin to understand what this particular infant is communicating and what they need from us.
The recording for Zack’s lecture will be available from TR Together soon. If you receive supervision from NCSPIR and would like to watch it please contact NCSPIR.
Claire Hopkins, Programme Manager for NCSPIR and Couple and Individual Psychodynamic Psychotherapist