Most care treats the mother in one clinic and the child in another, and the two providers rarely speak. Dyad care evaluates the relationship itself. Your sleep, your mood, your baby's feeding and regulation, and the way the two of you settle each other are assessed as one clinical picture, because in the first years of life they genuinely are one. This is psychiatric evaluation and medication management, not talk therapy.

Your child is a patient. Children from birth through age five are enrolled in their own right, with their own chart, their own diagnostic evaluation, and their own plan of care. Your care and your child's care are coordinated deliberately, but they are two courses of treatment rather than one.

A parent or legal guardian with authority to consent to mental health care must enroll the child and be present for appointments. If custody is shared or there is a court order affecting medical decision making, we will ask for the relevant documentation before the first visit. This protects your child and it protects you.

Your child should be on camera, and we are not looking for good behavior. A toddler climbing the couch during the visit is useful information. So is a baby who will not settle. We ask to see your routine as it actually unfolds at home, because that is the only version we can assess. There is nothing to prepare or clean up beforehand.

Yes, using frameworks built for this age group rather than adult criteria applied downward. There is an established diagnostic classification system for ages zero to five that describes emotional, relational, and behavioral presentations in infants and young children on their own terms. A diagnosis at this age is a description of what is happening in the relationship and the nervous system right now. It is not a life sentence, and it is not a label your child carries forward by default.

For many women, yes, and the honest answer depends on the specific medication, the trimester, and your own history. Untreated depression, anxiety, and obsessive-compulsive disorder carry real risks for both mother and baby, so the comparison is never medication against nothing. It is medication against an untreated illness. We walk through the actual data for your situation, including lactation, and you make an informed decision with the numbers in front of you.

For infants and children under four, no. At that age the work is assessment, not prescribing. We identify what is driving the dysregulation, whether it is sensory, medical, relational, or developmental, and we coordinate with your pediatric provider.

For children aged four and five, we consider it case by case, and behavioral and relational treatment always comes first. If your child needs a medication evaluation that falls outside what we offer, we refer to a pediatric specialist and tell you exactly why.

As long as your family needs, which is rarely continuous and is often measured in decades rather than months. An episode of care with us is concentrated: focused work to reach diagnostic clarity and stability. Then life moves and you go live it. You come back when it changes. The mother we stabilize at six weeks postpartum is the same woman we see through her second pregnancy, and the baby whose sleep we untangled is the child we evaluate at seven when school raises new questions. We are built to be the practice your family returns to, not the one you graduate from.

Often, yes. Treating the mother and the infant together as one clinical picture is the foundation of this practice, and that logic does not stop at the first year. Siblings, a second pregnancy, and a mother's own mental health across midlife all fit within our scope. We will tell you when a family member is better served by a separate clinician, and we will help you find that person.

We are in-network with major commercial insurance plans in the states where we practice. We do not currently accept Medicaid or Medicare. We also offer private pay packages, and superbills generate automatically through your patient portal if you plan to seek out-of-network reimbursement. You can check your specific plan before booking.

Care is delivered by secure video. You need to be physically located in Maryland, Washington, D.C., Nevada, New Mexico, or Arizona at the time of your appointment. That is a licensing requirement rather than a preference, so it applies even if you normally live elsewhere and are visiting.

Intrusive, unwanted thoughts about harm coming to your baby are one of the most common and least discussed features of postpartum anxiety and obsessive-compulsive disorder. They are distressing precisely because they run against everything you want, and that distress is itself clinically meaningful. Naming them is what allows them to be treated. If you are having thoughts of harming yourself or your baby that feel like intentions rather than intrusions, that is an emergency, and you should call 988 or go to your nearest emergency department rather than waiting for an appointment.