In this paper, we will describe patterns of emotional matching and mismatching in adolescent mothers and their infants which relate to developmental risk. These patterns of interaction will be discussed in relation to emotional development and availability, affect attunement, and the affective core. Previously, emotional communication and signalling in infancy were understood as secondary to drives. However, more recently, they have been shown to be important for adaptation in the infant-caregiver relationship. Cases will be presented to illustrate three risk patterns of negative affective exchanges between young mothers and infants and a contrasting pattern of positive, reciprocal exchanges. Positive affective exchanges between parents and infants are very important to facilitate growth and development. We believe that early preventive interventions targeted toward both internal and external environmental factors for the infant, mother, and relationship are very important to encourage positive growth.