Infant Mental Health for the Pediatric Nurse Practitioner

Toxic Stress
Stress is a normal part of life even for babies. The body responds to stress by producing cortisol. Toxic stress lasts over weeks and months rarely allowing the cortisol level in the body to return to baseline. Toxic stress occurs in situations of chronic neglect, on-going abuse, and poverty. Toxic stress in childhood can negatively impact brain development, cardiovascular health, and increase insulin resistance. 

The White House’s tactics to reduce toxic stress and its aftereffects include: more home visiting programs like the evidence-based Nurse-Family Partnership, increasing the number of Infant-Toddler Mental Health Specialists, and instituting early screening to assess for maladaptive situations and behaviors.

References and Resources:

American Academy of Pediatrics Policy Statement Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science into Lifelong Health:

Getting it Right from the Start - Trauma and the Brain:

Nurse-Family Partnership:

The Toxic Stress of Early Childhood Adversity: Rethinking Health and Education Policy:

Harvard Center on the Developing Child – Three Core Concepts in Early Development:

Scared Sick: