Allostatic load refers to the persistent dysregulation in physiologic systems that occurs in response to severe, frequent or chronic stressors. Childhood maltreatment has been associated with physical health problems, neurobiological changes and long-term emotional and behavioral difficulties. This article utilizes the framework of allostatic load to examine the impact of maltreatment in infancy through the case of an infant who experienced severe abuse and neglect by her biological mother and a traumatic separation from her foster mother. Children involved in the child welfare system are especially vulnerable to allostatic load because of disruptions in caretaking, frequent abuse or neglect and inadequate medical and mental health care. Allostatic load provides a way of conceptualizing the impact of severe maltreatment and disrupted attachment on neuroendocrine, cardiovascular and immune function and how these experiences may contribute to impaired physical health and premature death in very young children.
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