Promoting children's emotional wellbeing

Promotion of emotional wellbeing should be a priority integral to all paediatric practice. The emotional environment may determine or merely influence children's needs, but is always relevant.The root of children's emotional state is the quality of their parental attachments, consideration of which should be routine. Children's earliest experience of parental relationships determines their preconceptions of themselves and relationships, their foundations of verbal and non-verbal communication, and programming of the stress regulation system. It has a life-long influence on physical and psychological wellbeing, and on growth, development and behaviour.Recognition of the overriding priority for children of adequate attachment should ensure that establishment of secure foundations is a priority of neonatology, and that it is at the core of safeguarding children and support of recovery from neglect and abuse. Consideration of the psychological context of all paediatric problems, and seamless integration of paediatric and specialist mental health services, need to be achieved through training, practice and professional organization.Recognition of the reality of iatrogenic psychological harm should ensure that effort to prevent it is as high a priority as avoidance of physical harm.