A turbulent beginning !

 A rose flower as it emerges from a bud, thrives on bright sunshine, moist soil and protection from Beatles who feed on the petals. 

An infant in the first six months after birth, thrives on a parenting environment of breast feeding, playful engagement, intimate body contact with the care giver and attending to the regular needs of the infant. An infant who grows up in such an environment, develops the attachment process and builds on that emotional bonding to move on to attain the developmental sequences of infancy. 

How does an infant learn the source of sound! It is because the baby hears sounds repeated and develops an orientation response to that sound with similar tone in the environment. Every mother while cuddling her baby would use sounds and voice to engage the infant to  establish facial contact. Why does an infant turn the head from side to side by about two to three months? It is because the baby gets oriented to human face associating with the voice. Why does the infant around three moths lift head or steady the head when carried! It is because an infant by about three months sees till about 2 meters, locates sound and associates sound and sight when they are constant and frequent. 

A mother holds the baby close to her and the baby feels warm, secure and comforted. An infant sleeps faster in mother's arms than when placed on a couch. The way the baby is fed on breast, changed when wet and carried when feeling cold or frightened by large sounds or bright light, gives the baby an emotional nearness to the care giver. It is a habit of most mothers to sing to the baby, carry the baby for short or long periods when awake, and use sound makers or visually engaging toys to give the first time experience with the toys. The secure feeling when the baby is wrapped up in warm clothes, is a comforting experience. Usually an infant by six months gets exposed to the father and other immediate family members and behaves in a familiar way when they engage the infant. 

All the above first time experiences will be lost for the few infants below six months, when displaced from their home following the landslide in Wayanad last week. I am yet to be sure if those few babies are bereft of mother, father or other immediate family members. 

An infant by six months is now in a new environment in a relief camp, without the familiar couch, physical space and comfort of the home. With parents and family in distress, the parenting response would be different from what an infant was used to. 

An infant usually expresses discomfort by crying, which cannot be easily consolable. Such babies cries till they, in exhaustion goes to sleep, but with interruptions without the regular sleep time of two to three hours after a feed. 

I wonder if the relief camp would have a quiet space, preferably a room where mothers can come to feed their infants! I wonder if the available care givers who were familiar with the baby alone attends to a baby in this transition time as too many unfamiliar care givers unsettle the emotional nearness, an infant needs to feel secure. 

For most infants, around six months of age, six to eight weeks will be a transition time to become familiar with new care givers. If mother is unavailable or breast feeding gets discontinued, to get the baby to be fed artificially will be another transition stress to the infant and the care givers. 

An infant is conditioned to experience stability of environment, which was what an infant had for nine months in the mother's womb and in the first few months of infancy.  

Now if the infant has been displaced of the home environment, following the landslide, what is needed is to create another stable environment to which the infant can get readjusted!

The photo of the rose flower above is a symbol- it is fragile, fragrant, and fresh. Its life as a flower is a short time. 

An infant too is similar in the first six months. Most of what is to follow during the next six months till the first birthday is a continuation of the experience of the first six months. 

Let this thought occupy the attention of all those who are involved in caring for infants around six months- a stable, constant, playful, comfortable environment to give continuity of emotional, physical and 

soil environment!

It is necessary to weigh such infants in transition every week, observe their bowel habits to know if they are adequately fed, and a keep diary of their sleep rhythm  to observe if there is a structure that is emerging for the day time and night time behaviour. An infant turns over from back to front by six months. So care to give safety of space for moving in the bed !

I wish a nurse or doctor familiar with infants will observe the infant's behaviour once every five days to look for anything unusual. When an infant is displaced, the immunisation schedule can get dislocated. This needs attention. If the infant is artificially fed, the strict protocol of sterilising the feeding vessels ought to be monitored. If formula feeds are used, the planning to give sufficient calories as the weight increases is another crucial factor!

A displacement from the warm and familiar environment for an infant of six months is a traumatic experience. Our efforts are for lessening the impact of that separation arising from displacement from the familiar environment and to restore semblance of stability and continuity! 

There might be other mothers who are still breast feeding their infant, who might offer to breast feed the infant, if the mother is not available. Whether this is suitable is a medical decision, to be taken jointly by the health care professionals and the family of the infant. 

An infant is in transition by six months as important developmental sequences follow on, between six months and the first birthday. 

The parents of the infant, if they are present, bear the brunt of displacement. They with their other upheavals are vulnerable to anxiety, insomnia, and anorexia. They need support and enablement to adjust amidst their loss and grief. 

If the mother is breast feeding, there might be a sudden reduction in the quantity of breast milk. That calls for attending to take care of the mother, monitoring her food intake, hydration, sleep and emotional state!

The professionals in the relief team would need support for their own wellness as they are listeners and providers in this stressful situation. A weekly debriefing and a break of one day every five days would be desirable.

A psychosocial team, attending to the needs of the professionals will be necessary to safeguard the wellness of the professionals, as the situation is highly stressful for every one in the relief camp.

M.C.Mathew(text and photo)