Dr Andy Raffles
Behavioural Challenges in Young Infants
Updated: Feb 12, 2020
Every baby is unique and develops their motor, cognitive (learning), visual and auditory and speech and language skills at their own rate. Likewise language and social interaction is very individual. Within the context of family, culture and race, if a person - an adult or a baby - does not act as expected, this is considered abnormal yet normal development has a huge range.
What defines abnormal behaviour? – certainly not just acting outside the normal for your family and life experience. When considering baby development, behaviour that does not seem 'normal' may be labelled as problematic. This way of defining something as a problem to be investigated, tested and treated is very dependent on the normality around the baby. To assess an individual baby’s development more accurately requires detailed knowledge of the life experience and expectations of those closest to the child, with responsibility for the love and nurture of the individual.
The most frequently occurring behavioural issues that cause concern to parents and carers are sleeping, crying, eating and excreting – particularly poo related problems – too much, too little! Parents and carers visit health professionals more often in the first 9 months after birth than at any other time in the next 25 years. Some behaviours are normal at some ages, but if they persist beyond a certain time frame they may be considered abnormal. A problem behaviour is one that is persistent and repetitive and results in disordered interactions between the baby, baby’s carers and possibly peers. It can be in any aspect of the baby’s development, so could be a motor skill, a visual skill or a language or communication skill, or a social skill – all can lead to behavioural challenges.
Many factors operate on a baby's development to influence behaviour. These can be nature – genetic – or nurture . After genetic influences the next most important is the nurturing environment because a child learns to behave in ways determined by experience and then modified by responses from those around. This learning process begins before birth and continues from the first moments after birth. If carers are having a tough time and a baby's environment is disturbed, then the reaction may be that of difficult behaviour or behaving inconsistently. It is also true that a baby's personality is already established to some degree at birth and babies play a major role in determining the behaviour and the communication between themselves and the people around them.
Some of the more common 'unusual' behaviours are covered here. If you are concerned that your baby is behaving unusually it may be useful to talk to your health visitor or doctor. You may also find it useful to take another look at the huge variation in 'normal' behaviours in babies throughout this very formative stage. Some parents discover that what they think is problematic behaviour is actually normal behaviour that does not quite fit with their expectations. You will find out how powerful expectations can be, and how they can sometimes confuse and challenge your relationship with your baby. Additionally conflicting advice from well meaning professionals, relatives and friends will further confuse you!
This rarely occurs before the age of 6 months. A baby for whom hair pulling is a problem constantly pulls and twists hair, breaking it off to leave a bald area or patch of short stubs, and perhaps eating it. Normally this causes no health problems, although swallowed hair may become a tight hair ball (bezoar) and could cause digestive problems. Cutting the hair is not often a solution, for as one habit is sorted another often replaces it.
Head Banging, Rolling and Rocking
Head banging and body rocking are normal behaviours in children under the age of 3 years, who seem to find the rhythmic back-and-forth movements a soothing way to fall asleep. Head banging can start as early as 4 months or as late as the 2nd year and can last for several months. Some babies bang their foreheads or the back of their heads against the cot’s headboard, while others are partial to the crib railings.
Head banging can also soothe a child in pain. Infants and toddlers are more likely to bang their head when they’re teething or suffering from an ear infection. Head banging apparently helps them feel better, perhaps by distracting them from the discomfort in their mouth or ear.
While it may look painful, your child won’t get hurt head banging themselves to sleep. Head banging in babies and young toddlers is generally not a sign of any behavioural or emotional problem, and you don’t need to take any precautionary steps for your baby’s sake. Some parents find that their child will stop if they put a ticking item such as a clock in the bedroom; the rhythmic sound seems to soothe and distract. If the sound of your child’s head banging bothers you, try moving the cot away from the wall, or putting down to sleep on a mattress on the floor.
If your child’s head banging starts after 18 months talk to your paediatrician. Strong head banging that lasts longer than 10 to 15 minutes and recurs throughout the night may be a sign of behavioural problems. These habits are often associated with sleep related issues, and may require the help of a sleep specialist
Hitting, biting or pinching
As your baby grows older, gets more mobile, more social and mixes with other children, hitting, biting or punching may begin. These behaviours are a way of an infant communicating and defending territory, and the need to explore the boundaries around them as they learn about space and gets used to the reality of being an individual. If there is an aggressive or angry undertone, it may help to remember that anger is an integral part of normal human behaviour. Being aggressive may be a regular part of your baby’s experience at home or in a place of childcare.
Expert Child Psychologists believe that in the science of parenting it is very important that parents are there to ‘contain’ their children with their big emotions such as anger or fear.
If you feel that your child is learning about excessive anger from carers you may alter the balance. Your child is exploring what is and is not acceptable and if you are clear about your own boundaries and express them in a loving way, you may offer support as they discover how their personality works, learns how to cope with other people's boundaries and create their own.
When your baby bites, you should give a clear vocal expression of dissatisfaction and make eye contact as you show disapproval with your face. Doing this consistently will normally stop the behaviour over a period of time. Laughing and saying “No” will not, while reacting with your own tap or slap is likely to augment, rather than reduce the behaviour. There are many ways to use discipline without using physical contact.
Genital touching - masturbation
This is common in both boys and girls who may enjoy the feeling of touching their genital areas or the sensation they get by rocking or rubbing against something. This is nothing to worry about and demonstrates the natural urge to explore, discover and experiment. This type of gratification is not sexual, at least not at this age, and should be seen as normal.
Thumb and finger sucking is extremely common - in fact around 50% of babies seek comfort in this way. Some babies are seen on ultrasound scans doing this in the womb and may even be born with sucking blisters. Sucking is usually associated with getting calm and is not harmful. Even so, this behaviour may concern you because of the way it looks and you may worry about teeth development. Thumb sucking generally subsides of its own accord. It normally stops before the appearance of the second teeth and cannot harm their alignment before they emerge.
It is best not to make your child feel conscious about sucking their thumb. Corrective measures usually backfire. Pulling the thumb out of the mouth is likely to result in rebelling against this restraint and continue the habit more forcefully.
Needing a security blanket
Security objects, such as blankets are used by toddlers to relieve tension and anxiety. They are called transitional objects and are usually soft, cuddly things, something that a baby can hold close to the nose and the mouth. Children seem to need them most when they are going to sleep or feel insecure, or when they are away from their parents.
Babies experiences the mother as an extension of themselves and being with her is to be with their favourite thing. A transitional object serves a mother-like role, providing familiarity and comfort when there is no contact with mum. Not all babies use such an object, but many do find them extremely comforting.
As babies grow and gradually realise that they are independent and not an extension of their mother, the security object may become extremely important. It allows them to hang on to familiarity without losing the chance to explore and is a positive, rather than a negative, attachment. Your baby may not show an interest at 3 months, but enjoy snuggling into it around 5 or 6 months. Some babies need their comfort object only at vulnerable times, such as sleep time, during illness or when they are angry or upset, and some need to hold one almost constantly.
What might cause a worrying behaviour? Or what happens
Unusual behaviour in a baby is frequently a physical manifestation of an underlying emotion or a physical discomfort. For instance, persistent crying may be an emotional expression or a signal of pain. It may also be a response to the family environment, the way a day is structured, the amount of sleep a baby has (and when) and what and when is eaten. Worrying behaviour may be triggered by unsettling change, such as moving bedroom, moving house or going on holiday. There is no doubt that some babies are more “difficult” than others and the underlying cause is not always easy to spot. An unusual behaviour can sometimes indicate an underlying problem and your baby may need a developmental check with your Health Visitor or Doctor.
What about parental responsibility?
No baby is born to misbehave unless there is a developmental problem where the behaviour is normal for baby but not what is expected by others. Your baby’s personality determines behaviour and it is modified by the ability to learn. Every baby has inherent reflexes and rhythms, including hunger, sleeping, communicating, mirroring other people and crying. This is influenced by the environment and by the parents and carers.
Understanding how behaviours develop can help you guide, accept baby’s natural personality, and accept your part in baby’s development. As a parent you are your child’s chief guide and who needs consistency and regularity to learn. Babies do need boundaries, and so do parents and creating and modifying them is certainly one of the challenges of parenthood. It is important to acknowledge that your baby also guides you. The balance between who is guiding and who is being led will change from day to day.
As babies get frustrated, angry, tired and irritable, so do parents. And when parents are upset or irritated, their babies often follow. Babies in pain can exert large amounts of power but so can parents in pain. A baby who is unhappy after birth may contribute to a mother’s postnatal depression - equally a mother who is depressed may be confronted by baby’s behaviour. There is a 2-way, mirroring relationship.
The most visible behaviours - feeding, sleeping and communicating are inextricably linked with other subtle and powerful behaviours - expressing emotions, demanding attention, wanting to have one’s own way. Both obvious and subtle behaviours can be influenced but not determined by the parents. Some parents find it easy to “tune into” their babies and others find it more difficult and may need help - which in itself, can be a hard thing to accept.
Approaching difficult or challenging behaviour
If you have looked into your baby’s behaviour and are no longer concerned, then it is fine to accept it as part of the uniqueness. If you are still worried, as you may be with hair pulling, hitting or head banging, the first step is to look for a possible cause. You may need the help of the rest of your family or your Health Visitor to get an objective view. If there is emotional stress in the family it may be difficult to acknowledge, face and work through it. It is important to accept your responsibility but not to shoulder the entire responsibility for what is happening.
Whether or not you discover and approach a cause, if you are not happy about your baby’s behaviour you may be able to take some steps to alter it.
Make sure that your doctor has examined your baby and checked that there is no underlying condition causing the problem – especially a hearing problem resulting from frequent colds
Give your baby plenty of love, praise and quality time each day
Make sure that day activities are fulfilling and that your baby is not bored
See if your baby is sleeping and eating as well as they can. Introducing a structure may help you take a fresh look at your boundaries
Make a fuss of good behaviour - babies love attention
Ignore bad behaviour if it is not harmful - babies are tuned to get attention and often abandon activities that go unrewarded.
If the behaviour is harmful (licking outside walls, for instance) gently remove your baby from the situation every time it happens
Provide alternative activities to distract when behaving inappropriately
Try not to be angry if behaviour is difficult. Be firm and consistent.
Do not force your baby to do something when does not want to do - this can have negative effects on self-esteem and on your relationship and may reinforce any difficult behaviour that you are trying to minimise
Sometimes babies will challenge as they express themselves and explore boundaries. This is an important sign of normal human development. Try not to jump to the conclusion that your baby is difficult
Above all, be consistent and be kind. Make sure that any carers know the boundaries you have set and that you have also considered their viewpoints
Seek professional help when you feel the need. Your first point of contact is your health visitor or GP
Long term outlook
If a behavioural challenge is impacting on your life, or the life of family members – partners, other children, and appears to be reducing socialising skills then that is a time to seek help – which may come in the form of reassurance, or assessment and possible diagnosis of a developmental concern. If a behavioural difficulty highlights an area of imbalance in your family it can be an opportunity for positive action and a thoughtful approach to the way relationships, structures and attitudes have formed since the pregnancy began, and since birth. How a behaviour is approached will influence you and your baby’s sense of value and acceptance, and gentle solutions are usually the best for all concerned. It is an important part of a family education. Many behaviours fade quickly and of those that don’t, few continue beyond the age of 5. Your child needs plenty of love, support and reassurance whilst integrating these changes in life.