Unwanted, intrusive thoughts of infant-related harm

Unwanted, intrusive thoughts (UITs) of infant-related harm are a common and normative postpartum experience, particularly among first-time parents. UITs of infant-related harm reflect new parents' intense preoccupation with their infant, and may have evolved to increase hypervigilance to threat in the caregiving environment in order to protect the infant from danger. In this chapter, we will describe the current evidence pertaining to UITs of infant-related harm among new parents. Although UITs of infant-related harm, in particular intentional harm, are frequently a source of distress to those who experience them and raise concerns about infant safety among healthcare providers, there is no evidence that UITs of infant-related harm are associated with an increased risk of parental aggression toward the infant. If UITs of infant-related harm are responded to as if they are dangerous and must be prevented, they can lead to the development of mental health difficulties such as obsessive-compulsive disorder (OCD) and depression. We offer recommendations to healthcare providers with a focus on educating, normalizing, and preventing mental health difficulties that can arise as a result of maladaptive responses to UITs of infant-related harm.