How to Help Your Baby Manage Toxic Stress

 Not all stress is bad. In fact, embedded in the World Health Organisation’s definition of mental health is the ability to cope with the normal stresses of life. 

In 2005, the National Scientific Council for the Developing Child, in its third working paper, identified three types of stress: positive, tolerable, and toxic stress. These terms refer to the effects of the stress response systems on the body, not to the stressful event or experience itself. 

Positive stress:

A normal, brief reaction that is essential for development, characterized by brief increases in heart rate and mild elevations in hormone levels. Examples include the first day at a new childcare setting or the temporary fear and discomfort that can come with receiving an immunization, with a supportive relationship from an adult caregiver to help buffer against the child’s stress response.  

Tolerable stress:

More severe, longer-lasting reactions that activate the body’s alert systems to a greater degree, such as the loss of a loved one, a natural disaster, or a frightening injury. If the stress activation is time-limited and buffered by relationships with adults who help the child adapt, the brain and other organs recover from what might otherwise be damaging effects. 

Toxic stress:

Toxic stress occurs when there is excessive or prolonged activation of stress response systems in the brain and body such as physical or emotional abuse, chronic neglect, caregiver substance abuse, exposure to violence, climate-driven extreme weather events like flooding, and/or the accumulated burdens of family economic hardship, without supportive relationships to buffer against stress.

To understand the consequences of toxic stress, we need a concise understanding of the body's physiological response to stress.

There are two main physiological systems that help us react to stress adequately.

The sympathetic - adrenomedullary system (A tongue twister, I know. I dare you to repeat it 10 times, and very fast - Oh! I've activated your stress response 😂)

This is what is responsible for the flight or fright or freeze response. When the brain notices a threat, the sympathetic nervous system is activated immediately. This links with specialized cells in the inner part of the adrenal - the medulla. (You see, big names often have simple meanings in medicine)

These specialized cells immediately release adrenaline or noradrenaline (collectively called catecholamines) into the bloodstream and cause a series of changes that make us ready to respond to the perceived threat. This response could be an increase in heart rate and force of heart contraction, leading to more blood being pumped out of the heart per time; redirection of blood to the skeletal muscles; enlargement of the airways to allow for more oxygen intake, breakdown of glycogen stores in the body to make energy availability. All the body is trying to do is optimize you to fight, or run. This happens in a matter of seconds.

The hypothalamic-pituitary-adrenocortical axis (You should not be fazed this time 😉)

Here, the brain sends signal to the hypothalamus, then through certain chemicals (hormones), signal is passed to the pituitary gland, and then to the adrenal cortex which releases cortisol to the blood stream.

Cortisol is responsible for a more sustained body response to stress. Cortisol makes glucose available through different means, it also potentiates the vasoconstrictive effects of catecholamines, it regulates immune response in such a way that it's not destructive to the body and enhances memory and brain function relevant to the threat.

These responses are helpful in an acute setting, but have a deleterious effect when toxic stress sets in. 

Effects on the brain:

Hippocampus: Chronic cortisol exposure suppresses formation of new neurons and can cause dendritic atrophy, associated with impaired declarative memory and learning difficulties.

Amygdala (fear/threat processing): Toxic stress is associated with amygdala hyperactivity/enlargement. Children show heightened threat-detection, hypervigilance, and exaggerated fear responses, even to ambiguous cues.

Prefrontal cortex (executive function, self-regulation, impulse control): This region matures slowest (into the mid-20s) and is highly vulnerable. Toxic stress impairs prefrontal cortex connectivity and function, undermining working memory, attention, planning, and emotional regulation.

This is a major driver of the behavioral/learning problems seen in toxic-stress-exposed children (poor impulse control, difficulty in structured learning environments

High toxic-stress exposure also affects other developing systems and may lead to an increased lifetime risk of cardiovascular disease, diabetes, obesity, and autoimmune conditions. Toxic stress literally gets "under the skin" and shows up decades later.

Responsive Caregiving as a Protective Factor

Responsive Caregiving is the singular most important factor in protecting children from toxic stress and, in fact, reversing the effects of toxic stress.

Supportive relationships help turn off the alarm for stress response systems and restore baseline homeostasis. This in turn creates a foundation for resilience to face the challenges and stresses that may come later on in life.

As a caregiver, you play a vital role in determining your child's capacity (or any child you frequently have contact with) for dealing with stress. Be sure to offer love, attention and praise to that child.

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