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Best Beginnings is the podcast for everyone working in or caring about the early years. Hosted by George Looker, CEO of Babyzone, each episode brings together leading researchers, clinicians, practitioners, policymakers and parents to explore the evidence, ideas and innovations shaping how we support children and families in the UK.
From infant mental health and attachment to workforce challenges and systems change, Best Beginnings goes beyond the headlines to have the conversations that matter most in early childhood.
New episodes drop every Tuesday.
Best Beginnings is brought to you by Babyzone, a national charity operating free, evidence-based family hubs across England for families with children aged 0–5.
00:00:00:00 - 00:00:05:10
Unknown
what was most important of everything else was a caring relationship.
00:00:05:15 - 00:00:13:22
Unknown
But it was the relationship. The absolute power of relationships is most important for both children and for parents.
00:00:14:03 - 00:00:21:20
Unknown
that isolation is as risky as high cholesterol. And I've loved pressure,
00:00:21:22 - 00:00:51:01
Unknown
Welcome to Best Beginnings, a podcast from Baby Zone. Today's guest has spent her career asking a question that sits at the heart of everything we do. What happens to a child when the earliest months and years of life are hard? And what does that actually take to change that story? Doctor Linda mays is director of the Yale Child Study Center, one of the oldest and most respected institutions in the world for research into children's mental health and the and their development.
00:00:51:02 - 00:01:23:24
Unknown
She trained as a neonatal and as a practicing practicing psychoanalyst. She runs a neuroscience laboratory that spent decades imaging parents brains to understand what attachment looks like from the inside. She also helped develop Minding the Baby, an intervention program for young families in high risk circumstances that's now federally recognized as evidence based in the United States. She's in London this week, and I'm very glad that she's made time for this conversation.
00:01:24:01 - 00:01:35:16
Unknown
The same.
00:01:35:18 - 00:01:53:00
00:01:53:06 - 00:02:02:06
Unknown
I was very interested in neonatology because first off, I was very interested in rapid change and how the body changes and physiology.
00:02:02:07 - 00:02:28:15
Unknown
But you don't work in neonatology very long till you become more interested in what happens to those babies when they leave the nursery. What's their long term outcome? And one of the things that fascinated me the absolute most was parents would come in when their 1617 year old son or daughter, they were playing soccer. They were vigorous, they were healthy.
00:02:28:15 - 00:03:03:02
Unknown
And they would ask us, could their lung disease of prematurity still come back? Was there still a vulnerability there? And so I was incredibly interested in both how development happened, but how those enduring memories, they persisted. They persisted in parents worry and started to realize that it was a it was a two person psychology, not a one. And so then I came to do another fellowship and started to do work in addiction.
00:03:03:04 - 00:03:32:03
Unknown
And how drug use not only impacts long term outcome of children, but how parents struggling with addiction still want to be parents to their children. And that's how I came to the work that that I hope will talk about today. I mean, it's fascinating observation you made around families and wanting the best for their children, even in incredibly difficult circumstances, I guess, you know, is there anything that you've been watching parents for a long time?
00:03:32:03 - 00:03:51:17
Unknown
Is there anything that still continues to surprise you? Or is there a trend that you think actually, you know, you thought you understood at the time but has taken your research, has taken the, you know, those longitudinal studies that we were talking about to actually come to a point of view and go, well, this is what's going on.
00:03:51:19 - 00:04:15:10
Unknown
Well, I think one of the things I don't know that it surprises, but moves me is how deeply, even when parents are struggling, in the case of addiction, struggling so much, struggling so much with their addiction, or struggling with all the many other challenges around them, how much they really do care for their children and they want to care for their children.
00:04:15:10 - 00:04:42:10
Unknown
And what gets in the way of reaching that goal that they have to be oftentimes a better parent than they feel they were parented. It moves me that the the motivation, the feeling that they have. And how do we how do we help them with that? How do we help them not just learn how to care for a baby, but how do we help them reach those deepest goals that they have?
00:04:42:12 - 00:04:45:06
Unknown
That that's that's what we've continued to work on.
00:04:45:06 - 00:05:29:24
00:05:30:01 - 00:05:54:04
Unknown
So. So I know there is the truism for which there is quite a bit of evidence now that we parent as we were parented, that we learn, if you will. It's not just learning that those ways of being cared for, of being held, of being fed, all of those moments upon moments of parenting, build our own templates of how then we will care.
00:05:54:04 - 00:06:22:15
Unknown
But what we're learning is how that's built then into our biology and even into genetic regulation. Can we interrupt that? Yes, we can, but but the biology of how someone becomes apparent is an incredibly fascinating area. It's not just that parents are fully formed adults. They get a baby and they just parent. Parents are developing themselves and we can help that development.
00:06:22:15 - 00:06:54:08
00:06:54:12 - 00:07:15:19
Unknown
Well, I would say one thing we know, which may not actually be terribly surprising, but one thing we know is that our brains are geared for reward and that babies are incredibly rewarding, and that caring for, caring for another, caring for a baby really activates the reward systems in our brain.
00:07:15:21 - 00:07:43:11
Unknown
You have you had the experience of walking down the street and there's a baby either laughing or even crying. You don't know that baby. You don't know that parent. But I dare say you probably at least look, maybe even pause. Caring for another. Caring for an infant activates those reward systems in our brain. Caring for an infant is also stressful, and so we balance stress and reward.
00:07:43:11 - 00:08:13:24
Unknown
And in the best of circumstances, the reward of caring helps us with our stress under much more challenging circumstances, says so many parents are dealing with whether it's economic adversity, whether it's their own traumas, whether it's just not being able to, not being sure that they can even care for their baby. That stress of parenting becomes more overwhelming than the actual reward of caring.
00:08:14:01 - 00:08:39:01
Unknown
And that's where we can help. We can help by helping parents feel more supported. We can help them by understanding that it's not that they're failing or being a bad parent, but that that distress is making it really difficult for them to pay attention to their baby to do what they know they want to do. Sounds simple, but it's actually pretty basic.
00:08:39:01 - 00:09:04:12
00:09:04:19 - 00:09:31:08
Unknown
diapers, at least in the US. I'm sure the same is true here, are incredibly expensive. You may be spending $5,060 for a supply that would be less than a week. And you may actually think, well, maybe I'd have to just reuse a diaper, wash it out a little bit and reuse it, which puts your baby then at risk for infections, all sorts of things that may.
00:09:31:09 - 00:09:52:19
Unknown
Then they may have to come to the pediatrician or the emergency room for, which is inherently stressful. Just that one thing, that one supplying a diaper or a supply of diapers, helps the parent feel like they are doing what their baby needs. And that is very important for parents. And you've
00:09:52:23 - 00:10:21:12
00:10:21:12 - 00:10:46:12
Unknown
So a couple of things. So first off, longitudinal research is I'm not I'm saying this not just as a researcher, I'm saying this as a as a human being. People change over time. And longitudinal research gives you gives all of us a way of understanding the ups and downs of development, the times when things are going really well, the times when something crashes.
00:10:46:13 - 00:11:06:11
Unknown
We're actually very, very poor predictors from one point in time to what will be later. So that's the advantage of longitudinal research. I think what we what we learned most salient is that for the children that we were that participated in the families that participated in our studies,
00:11:06:13 - 00:11:12:22
Unknown
what was most important of everything else was a caring relationship.
00:11:12:24 - 00:11:32:12
Unknown
And for some of the children, that caring relationship came from the neighbor next door, or came from an aunt or an uncle or a teacher, for some came from a mom or a dad as they as their drug use. Because this was a study of drug use in pregnancy, as their drug use decreased or they managed to be absent.
00:11:32:12 - 00:11:40:19
Unknown
But it was the relationship. The absolute power of relationships is most important for both children and for parents.
00:11:41:00 - 00:12:14:06
00:12:14:18 - 00:12:27:10
Unknown
Well, I'm not sure we've confounded it completely, but but I think what what we got, all of us got wrong is at least toward addiction and perhaps even toward other challenges that parents feel.
00:12:27:12 - 00:12:59:00
Unknown
We have a bias, and particularly around addiction. The bias is that there's something about the individual weak willed, not able to stop, not able to be strong and resist. What we understand about addiction, for example, is that it's a co-optation. It's a taking over of the reward system so that your baby is less rewarding in that moment than the addiction, the drug, or whatever the object of your addiction.
00:12:59:02 - 00:13:28:18
Unknown
What my colleagues working with them have actually found is that if you increase the salience, if you increase the relationship with the baby, if you support the mom in that relationship, you actually have an impact, positive impact on their drug use. You actually reduce their drug use as well as improve the relationship. It's the relationship is the powerful piece for healthy development, for parent development.
00:13:28:20 - 00:13:31:07
Unknown
Or another way to put it that we know quite well is
00:13:31:09 - 00:13:36:17
Unknown
that isolation is as risky as high cholesterol. And I've loved pressure,
00:13:36:17 - 00:14:04:04
00:14:04:04 - 00:14:20:10
Unknown
Well, I would like I would like them perhaps to have more, more opportunities to interact. But I would really like this when we're working with families, when we're working with parents, we often think about that.
00:14:20:10 - 00:14:51:11
Unknown
It's as simple as telling a parent, this is what your baby needs. I know you want to be a good parent and this is what your baby needs. The other part of it, though, is that the parent is growing and developing as a parent themselves, their brains changing just as their babies brain is challenging, changing. And so to be thinking about that parents own emotional life, what that parent is learning, what they're experiencing, what they want as a parent, as well as what their baby needs.
00:14:51:12 - 00:15:18:01
Unknown
Here's a really very basic example from our Minding the Baby project that you mentioned. A mom was in the third trimester of her pregnancy. Very hot month of August, as it can get hot in the United States, and she had to go up several flights of stairs to get to her apartment and was talking about how hard it was and that this, this pregnancy was making it so difficult.
00:15:18:01 - 00:15:43:03
Unknown
And this baby, she would be really glad when this baby came because it was just too hot. And there's a moment, there's a moment. Then when the clinician or the caseworker can either say, I know it's difficult, I know it's hot, but this is what you're going to need to do to care for your baby. Or she can take that, or she or he can take that.
00:15:43:04 - 00:16:21:21
Unknown
What the mom was saying and say, you're absolutely right. Why don't you tell your baby about it? And that's what she did. The mom started talking to the baby before delivery, and when the baby was born, they had a shared language and the mom felt heard, not criticized for for not quite engaging in the middle of August and he but but she felt heard and felt someone recognized her own emotional life and she learned to start recognizing and imagining her baby's emotional life, and that her baby had a mind as well as hers.
00:16:21:21 - 00:17:02:10
00:17:02:15 - 00:17:24:03
Unknown
Well, I think it is teachable. I think it's teachable for all of us. And also it's something that in the moments of high stress, we're not going to be as reflective as we might be in moments of low stress. Have you ever been in an argument with someone that you nonetheless really care about? But you're in that argument, and at that moment you really cannot take their perspective.
00:17:24:03 - 00:17:55:14
Unknown
So it's not that you have a capacity to be reflective in its stable across time, but you can learn it. So here's another example. Very, very, very common piece of parent education or parent in working with babies. So how do you give a baby a bath. And the typical ways of talking about it are holding the baby's head, being sure that the water is the right temperature, being sure the water or the soap doesn't get in the baby's eyes.
00:17:55:18 - 00:18:20:12
Unknown
Typical ways of talking about a baby bath. You can also talk about it this way. You can talk to the mom through the baby and say something like to the baby saying, look how your mom is holding your head. She's thinking about how the water really feels. Did you? And she's being really sure that the water doesn't get in your eyes.
00:18:20:13 - 00:18:46:22
Unknown
She is really thinking about how you and look. Did you see how she tested the temperature of the water on her arm? She was thinking about how it might feel to you in doing that. You're actually doing the same thing education wise, but you're transacting for the mom. That saying to her, yes, you're able to hold your baby mind in mind, in your mind, and you care about it.
00:18:46:22 - 00:18:49:04
Unknown
And here's the language.
00:18:49:06 - 00:19:24:09
00:19:24:14 - 00:19:32:04
Unknown
Oh, sure. Oh, I don't think it always has to be two years of home visiting with a team. No, at all.
00:19:32:06 - 00:19:53:22
Unknown
It's it's basically the language that I'm trying to say is to pay attention to what a parent is saying, how they feel, what a parent's goals are, how they feel at that moment of caring for their baby, how they're observing their baby is to pay attention to that as much as paying attention to the baby. It's both. It's both.
00:19:53:22 - 00:19:55:07
Unknown
They're both developing.
00:19:55:09 - 00:20:29:12
00:20:30:00 - 00:20:52:02
Unknown
So the Unafraid Center and the Child Study Center, the Child Studies Center being a department in the Yale School of Medicine in New Haven, Connecticut, we are very similar institutions. We both have been caring for children and especially in the early years, for many, many, many years. And we both think about child development. We both think about intergenerational.
00:20:52:03 - 00:21:27:14
Unknown
How do we help parents as well as children? We have something between the two institutions that we call the bridge, and that is how do we share knowledge, how do we share research, how we actually share clinical programs and education across? Anna Freud herself came to Yale many times in the 1950s and 60s, working with individuals from the Yale Law School as well as the Child Study Center, thinking about the best interest of children coming out of World War Two separation.
00:21:27:19 - 00:21:53:00
Unknown
You know, she herself focus so much on trauma and separation and loss. And she wanted to think with colleagues in New Haven about what is really best for children. How do you ensure they get the best, most flourishing outcomes? So that was her collaboration with folks at Yale, and that continued. And then I had the opportunity to be a part of the on a Freud center, being at the Child Studies Center.
00:21:53:00 - 00:22:06:15
Unknown
And we wanted to make that not only continue that historical collaboration, but be able to build something that was academically rigorous and also train the next generation so that that's really what we're doing.
00:22:06:17 - 00:22:31:14
00:22:31:19 - 00:22:40:12
Unknown
I think parenting is universal, but I think every time you take anything you've developed into different communities, you have to adapt it to those communities.
00:22:40:12 - 00:22:49:12
Unknown
That's just an inherent, an inherent experience. And yes, we learned a lot. We learned a lot about how you adapt to particular communities.
00:22:49:12 - 00:23:02:02
Unknown
For example, in New Haven, I think we were talking earlier about doing a survey of what parents in New Haven Most Wanted, and diapers came to the top of the list in another community. It might be another kind of service.
00:23:02:02 - 00:23:18:17
Unknown
So you have to adapt. And we certainly learned that. But it's been it's been a privilege to be able to take minding the baby to different communities and, and develop the evidence base of intensely working with families. But in this way that we're we're talking about.
00:23:18:21 - 00:24:06:08
00:24:06:21 - 00:24:40:08
Unknown
Well, I think that I don't function as a traditional psychoanalyst in thinking that. But understanding psychoanalysis and understanding how the mind emerges and understanding the power of internal worlds is all infused all through our interventions. Even in the examples I give you, we're thinking about experience as it's experienced internally, not just externally. I think some of the adaptations are in training because some people come with more and more training than others.
00:24:40:08 - 00:24:48:03
Unknown
To do this, you obviously have to add up to culture, all of those. But but parenting is parenting.
00:24:48:03 - 00:25:27:08
00:25:28:00 - 00:25:52:05
Unknown
So executive functioning is a is a cognitive term. It's something that we all do regularly. It's a it's a term meaning how you pay attention, how you remember in the morning where you left your keys the night before, how if you're caring for a baby, you remember where you put the baby's bag that you need to go out the door.
00:25:52:05 - 00:26:18:06
Unknown
It's all of those kinds of very everyday cognitive functions that we all do, that we have to do to make it through our day. When you're a parent, you're actually having to do it on two levels, or maybe three if and depending on the number of children you have, you're remembering your own needs. You're thinking about your own needs, and then you're sorting through those relative to your baby.
00:26:18:08 - 00:26:40:17
Unknown
It's a major task, actually, if you think about it, you're really having to multitask. But the other piece that happens is that you're you're paying attention to your own feelings as well as to the baby's feelings. So a moment when your baby is crying and you just can't get your baby to stop crying, you yourself are feeling extraordinarily stressed.
00:26:40:17 - 00:27:04:20
Unknown
Likely you're needing to bring your own emotion regulation skills and so that you can then help your baby. Maybe sometimes, if you're fortunate, maybe there is another person that you can say, could you try? Because I can't, I can't do it right now. And you go and take a deep breath. But that's that's what's happening moment, every moment of the day.
00:27:04:20 - 00:27:11:03
Unknown
And why better executive function, better emotional regulation is helpful to us all.
00:27:11:05 - 00:27:51:21
00:27:51:21 - 00:28:14:08
Unknown
text? Well, I think one of the one of the things that I in Maya, and greatly, as I've learned about what you're doing with babies on, is that you're building a social network, you're building a place where parents can come, where they feel respected, where they feel that it's not only safe, but that people take what they need and want seriously.
00:28:14:10 - 00:28:39:12
Unknown
That has an enormous impact. If you are a mom or dad living in a more isolated or feeling alone and feeling that you're the only one who is responsible for this baby and you're not feeling like you maybe can do a particularly good job to come into a place where you find several other people who are saying and thinking the same thing.
00:28:39:15 - 00:29:02:18
Unknown
That has an incredible positive impact, just to know that you're not alone, just to know that others share your worries. Maybe others have found the solution to your baby, who cries at one in the morning and you haven't figured out how to help them. Maybe you can share those. So that's that's what you're giving them. You're giving them a social network.
00:29:02:24 - 00:29:24:00
00:29:24:00 - 00:30:11:10
00:30:12:02 - 00:30:16:21
Unknown
Well, I want to take your question and and two directions.
00:30:16:23 - 00:30:52:12
Unknown
So the first is to say what we've seen in terms of the positive outcomes of finding the baby. And I don't think about minding the baby as a unique intervention. I think of it as an intervention that focuses on building relationships, on supporting parents in their own development as well as their babies. So some of the things we've seen that have carried across time is for, and this may be maybe more to the US, but lower rates of obesity.
00:30:52:14 - 00:31:26:09
Unknown
In children of minding the baby families. Why I think that's important is it's a physical outcome that suggesting that there's less stress in families because obviously and stress go together in childhood, and also that families are thinking more about what their child needs and that eating together, breastfeeding, all of that has become more of a shared social, not just an act, but something that is a relationship.
00:31:26:11 - 00:32:04:07
Unknown
The other outcome, which we were actually both surprised by and delighted by, is a reduction in dental issues as infant started to get their their baby teeth and the teeth with, again the idea being that babies weren't going to bed just with the bottle, that feeding was a relationship event and those outcomes. And there's been also other outcomes about diminished kind of aggressive or oppositional behavior in the mining the baby group, too, though you're the other part of your question.
00:32:04:08 - 00:32:35:12
Unknown
The other direction is none of our interventions, none of them binding the baby or any of those are a lifetime immunization. They are a getting a better start. They are reducing risk. But terrible things happen. Terrible things happen for families. We wish they never did. But things happen for families that will throw them off. Things happen with children that will put them on a different trajectory.
00:32:35:12 - 00:33:04:09
Unknown
So that's why it's not a one and done. It's better, it's better, it's a better start. But children need care all the way through adulthood. And there's no one solution. There is no one. The challenge. Yeah. The only thing I would bet, and I would bet a fortune on, is being sure that they have a strong social network and that they have steady relationships and consistent, caring relationships that I think we know how we get.
00:33:04:09 - 00:33:05:24
Unknown
There is another question.
00:33:05:24 - 00:33:37:23
00:33:37:23 - 00:33:59:17
Unknown
I think this is not just true about psychoanalysis and developmental neuroscience. I think there's always a gap between research, what we do, what we do, and whether it's an intervention or we do in our neuroimaging research, and then getting it translated into practical application, there's always a gap.
00:33:59:19 - 00:34:29:24
Unknown
And that gap is for a host of reasons. One is that how do we translate? How do we literally translate what we're seeing in our research into things that into ways of talking that are more useful? So that's a caveat to say that I still think that there is an enormous relevance between psychoanalysis and how we think about the emerging mind and the developing mind and what we're learning from developmental neuroscience.
00:34:30:00 - 00:35:00:24
Unknown
But an important point is this is that we learn from developmental neuroscience by groups of people. It's a learning by by numbers. It's a learning by a by groups. It's an epistemology of many. In psychoanalysis, the beauty of psychoanalysis, in a way, is that it's an epistemology of one patient is different, and we learn general principles, but we really the psychoanalysis, well practiced, is honed to individual differences.
00:35:01:00 - 00:35:13:06
Unknown
Developmental neuroscience is owned to finding trends across groups. Is it translatable? It is, it is. But but that's that's still where there will always be that that gap.
00:35:13:08 - 00:35:27:18
00:35:27:24 - 00:35:30:18
Unknown
the evidence of developmental neuroscience?
00:35:30:20 - 00:35:47:16
Unknown
Well, I think AI offers us a lot of, a lot of opportunity in how we how we can bring data together and see patterns that we haven't seen. I think there are a lot of opportunities with that. It's coming rapidly. I don't know that we've seen it yet. It's coming
00:35:47:22 - 00:35:57:18
00:35:57:18 - 00:36:02:14
00:36:03:00 - 00:36:06:21
Unknown
Every parent new.
00:36:06:23 - 00:36:34:24
Unknown
I think that every moment. Every moment with your baby. It's not to make parents feel nervous about this, but that there's not an inconsequential moment with your baby standing, standing at the in the kitchen counter. Washing dishes is a moment to say to your baby, oh, the water feels so good. Or listen to the sound of the water.
00:36:34:24 - 00:36:53:02
Unknown
Every moment is a moment to interact and build that relationship. And what is the finding from your own research? Which has changed your perspective? Changed your mind on how you think about children more generally?
00:36:53:04 - 00:37:38:20
Unknown
I would say that it actually probably the moment is I got into the the work on addiction with a very, very basic now I see as naive question and that is does exposure to a in pregnancy lead to outcome B at a later time? Incredibly naive question. Didn't allow for interaction with parents, didn't allow for the dynamic nature of development, and that I think what I would say now is that development, there's many, many opportunities for change and for recovery.
00:37:38:22 - 00:37:53:05
00:37:53:13 - 00:38:21:10
Unknown
I probably would have given a different answer six months ago than now, but I think, first off, to say, I think the UK is far ahead of the US. I mean, I think you do invest in the early years as we were speaking about, perhaps you could do more, but you invest in the early years. I think that most importantly for both of our cultures, for both of our countries, we need to seriously think how we prioritize children.
00:38:21:14 - 00:38:46:02
Unknown
Everyone will say we prioritize children, but we need to look then at the policies that we support, the policies we don't, and how those impact children across time. Because I would dare say, especially in the US, that you will see that we don't prioritize children and that is that is a lack of investment in our future and in our society.
00:38:46:04 - 00:39:12:06
00:39:12:18 - 00:39:46:13
Unknown
What still moves me moves me, both by the beauty of it and by the mystery of it, is how remarkably resilient children can be and how parents. And by resilient I mean the capacity for recovery and change, and how parents, even in the most difficult and challenging of circumstances, want what's best for their children. And I see that all the time.
00:39:46:14 - 00:39:55:08
Unknown
And that's what humbles me. It moves me. And I'm honored always to be let in some way into their lives.
00:39:55:10 - 00:40:06:19
00:40:06:23 - 00:40:08:15
Unknown
Thank you for the opportunity.
00:40:08:17 - 00:40:30:10
Unknown
That conversation is exactly why we made this podcast. Because none of what we've talked about today is abstract. It's happening right now in families in the UK, in the US, communities globally, where the odds are stacked against children before they've taken their first breath. And the reason conversations like this matter is a science is on the side of those families.
00:40:30:11 - 00:40:56:21
Unknown
If we're willing to really, deeply investigate it. If you remember one thing from this conversation, the earliest years of a child's life are so important. What happens in those months shapes the brain itself, and it means that getting it right is not just a luxury. It is the work. What doctor Linda mays has told us about how there can still be hope, despite the challenges that those families face.
00:40:56:23 - 00:41:18:11
Unknown
Prevailing winds against them should inspire all of us to invest in the future. Thank you for listening to Best Beginnings and for this podcast. For more evidence informed support on babies and early childhood. Please subscribe to this channel. If you found this conversation helpful, please share it with someone who you know. We'll see you next time. Thanks.
00:41:18:16 - 00:41:18:23
Unknown
We.