Child Care Ebook

Single Parenting Becoming the Best Parent For Your Child

Single Parenting Becoming the Best Parent For Your Child

Parenting is a challenging task. As a single parent, how can you juggle work, parenting, and possibly college studies single handedly and still manage to be an ideal parent for your child? Read the 65-page eBook Single Parenting Becoming The Best Parent For Your Child to find out how. Loaded with tips, it can inspire, empower, and instruct you to successfully face the challenges of parenthood.

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Smart Parenting Guide

This ebook from Daniel Dwase gives you the very best tips and information about how to raise your children in such a way as to get smart, responsible, caring, and loving children. If you have problems disciplining your children, this is the book for you. You don't have to be concerned about your children running amok; Dwase gives you the insight that you need to make sure that your children turn out well in the end. This ebook lets you give your child the best gift that you ever could: a loving, nurturing, healthy and loving childhood. By building a quality relationship with them, you will be able to raise a child that continues that relationship into adulthood. Building a quality relationship is the best way to give your child a healthy future and a loving family. You will both empower your child to succeed and reduces behavioral problems Start building your child's future today!

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Author: Daniel Dwase
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Coping with Your Childs Reaction

Despite your best efforts to prepare your child and consider her feelings, the arrival of a newborn in the house is likely to shake up your child's world. Some children will regress a bit. They may go back to needing diapers, for instance, even though they have been using the potty for a while. Don't be surprised if your big boy or girl acts like a baby for a few weeks, clinging to your side, wetting the bed, or demanding to breast-feed or have a bottle. If this happens, it's wisest to let your child regress, at least for a while, humoring him through it while reminding him of all the things he can do that the baby can't. The child-care author Penelope Leach put it this way You want him to feel that while the baby gets a lot of things he does not normally get, she is not getting anything he cannot have, but only things which he has grown out of.

Choosing and Working with Your Childs Doctor

Parents-to-be often have an image of the ideal doctor. Warm, wise, knowledgeable, and unhurried, this pediatric paragon would mix the best of Einstein and Oprah. Although you may not find this perfect creature, it's worth looking for someone whose personal style, attitudes, and approach to child rearing mesh well with yours. You'll find it easier to work with such a person, and you'll feel more secure about entrusting your child's health to him or her. If you're lucky, your child's relationship with this doctor may last 10 or even 20 years, longer than some marriages. You want someone you can rely on, in sickness and in health.

Starting the Search for Your Childs Doctor

In some cases, the list of primary care providers may be limited, with few or no pediatricians. If you feel you need an out-of-network doctor (perhaps if your child has complex health care needs), you may be able to persuade your health insurance provider to make special arrangements.

Helping Your Child Play

Promote your child's development through play by following these tips Think like a child, be imaginative, and play with your child. Keep toys at your child's eye level, and rotate them to avoid boredom. It's also important to give your child a chance to play with other kids while reaping the benefits of physical exercise. Playgrounds are designed specifically for this purpose. Baby exercise classes, playgroups, and preschool classes are also perfect settings for your child's first experiences with socialization. A side benefit of these organized venues is that through your child, you get to meet other parents who have similar interests and concerns.

Fun Games to Play with Your Children

One of our readers wrote in to remind parents that children don't always need the big things. They tend to remember the little things like books you read together, games you play, and trips to the zoo. We think this is excellent advice Here are some ideas for little things that you can do with your child, one on one Paint with feet Spread out a large piece of paper. Pour nontoxic paint into a large shallow tray. Hold your child's hand and let her step into the paint then walk across the paper. You can also make handprints this way. Kickball Roll a large ball toward your child's feet as she stands still, and have her kick it back to you. This helps develop good reaction skills and encourages her to stand on one foot. Pasta art Help your child string ziti or other fun-shaped pasta onto a shoelace, paint them with finger paint, and glue them onto paper. Puppet show Provide your child with puppets and a minitheater stage made out of a cardboard box. Together, you can act out a scene from...

Tailoring Your Approach to Your Childs Temperament

Children seem to come into the world with a constitutional makeup, or temperament. They may be hardwired to have certain tendencies, to be gentle or rambunctious, calm or easily irritated, shy or outgoing, lighthearted or intense. Generally, these kinds of traits are difficult, if not impossible, to change, so it's best for everyone if you try to work with your child's natural temperament. As a result of different temperaments, even children in the same family may need to be raised differently. Your discipline style, in particular, needs to be compatible with your child's unique personality. Equally important, understanding your child's temperament gives you an opportunity to reflect on how his tendencies may affect you and your perception of him. For example, if a father with an aggressive, physical personality has a son who is naturally more passive, shy, and gentle, the father may be embarrassed by his son and try to force him to change. Such temperament conflicts can seriously...

What if Your Child Is Overweight

Many healthy infants and toddlers alternate between looking pudgy and looking thin as they grow. But even if your child seems to be consistently overweight, don't restrict his food intake without first consulting his doctor. You may be advised to control his food consumption enough to slow or stop weight gain as he grows and let his height catch up with his weight. Like the child who seems to never eat meals, an overweight child may be overdoing consumption of juice, milk, and nutritionally empty high-calorie foods. Another common factor Your child may not be getting enough physically active play. Recent research indicates that genetic factors play an important role in a child's tendency to gain weight excessively. For more information on obesity in children, see Chapter 32, Health Problems in Early Childhood.

What Should Your Child

By the time your child is two years old, he should be getting almost all of his nutrition from solid foods. Like an adult, a child should eat a variety of foods, with balanced amounts of grains, vegetables, fruits, and protein-rich foods such as cheese, meat, dried beans, nuts, and tofu. One useful guide to choosing foods for the whole family is the Food Guide Pyramid, prepared by the U.S. Department of Agriculture. Keeping the Pyramid in mind can help you make healthy choices, even if you don't follow it exactly. (An illustration of the Food Guide Pyramid is provided in Chapter 1, Prenatal Care.) The serving sizes listed here are supposed to apply to children ages four or older, as well as to adults. For children ages two and three, a serving should be smaller about one-half of the amounts listed here. The only exception is in the milk group, where children from ages two to six should all get full-size servings. (For adults, increase the number of servings of grains, fruits, and...

Cleaning Your Childs Teeth

Even before your child's first tooth emerges, you should wipe her gums daily with a clean, damp washcloth or brush them gently with a soft, infant-sized toothbrush and water. As soon as the teeth emerge, brush them with water. This early cleaning routine not only may help prevent decay, it also will get your child used to the idea that cleaning the mouth and teeth is a routine part of the day. Start using toothpaste on your child's teeth when she gets old enough to spit it out, usually around age three. Use toothpaste that contains fluoride, which is absorbed into the tooth enamel. Use only a pea-sized amount, and teach your child to spit it all out. Some children seem to regard toothpaste as pudding in a tube if yours is among them, keep it out of reach to avoid extra doses. Early flossing is also a good idea. If you have difficulty doing it in that little mouth, ask your child's dentist for advice. Later, you can give your toddler a small piece of flavored floss and encourage him to...

Health Insurance and Managed Care Is Your Child Covered

Today, nearly 14 percent of U.S. economic production is spent on health care. This makes ours the most expensive health care system in the world and makes it imperative that you have health insurance coverage for your children. About one in six children will be born with or develop one or more chronic (and potentially costly) health problems. And although most kids make it through childhood with just the usual assortment of minor illnesses and injuries, even the cost of the recommended routine health care for children in the first years of life (frequent checkups, immu In what follows, we'll discuss the various forms of health insurance that may provide coverage for your child and family and the advantages and disadvantages of these plans. We'll also offer tips to help you navigate the health care system to obtain the care your child needs, regardless of your insurance coverage. (See Chapter 33, Caring for Your Child with Special Health Care Needs, for additional information on the...

Getting Specialty Care for Your Child Insurance and Managed Care Issues

In the current predominantly managed care environment, it's not always easy to get a referral to the specialist of your choice. Insurance companies exert significant influence on the referral process and may require that you see only those specialists who are in their network. In many cases, the network for specialists is more limited than for primary care physicians. For example, if your child has severe asthma and her primary care doctor feels that she should be seen by a specialist, you may be referred to one of the five in-network pulmonologists, only to find out that none of these physicians is certified in pediatric pulmonology. This may not be a major problem if you take time to collect some information on these doctors' experience. You may find that at least one works primarily with children and can competently care for your child. But if you find that none of the in-network specialists has the required expertise to treat your child, you may need to find an out-of-plan...

Getting Your Child Ready to Go to the Hospital

The best way to prepare your child for a hospital stay is to reduce the fear of the unknown. Many hospitals now offer preadmission tours of the hospital and the operating room for children who are going to have a scheduled surgical procedure. During the tour, children have the opportunity to see the operating room's equipment as well as the way operating room personnel are dressed. Make sure that your child (depending on his age and ability to comprehend) has a clear understanding of the medical reasons why he is going to the hospital, and assure him that everything that is going to be done is to make him better.

What to Do When Your Child Has Pain or Discomfort

Having your child in the hospital can be stressful enough by itself, but seeing him in pain can be difficult for both of you. Even small procedures, like having blood drawn or starting an IV, can be scary for a child. If something is going to hurt, say so if you lie about it, you will undermine his trust. Instead, tell him how long it will hurt (3 seconds, 10 seconds), and count with him. Knowing that it will be over soon is often the best way for a child to cope. Ask the person who is administering the procedure about how long it will take so that you don't underestimate the time. Pain after surgery is often an issue of concern. If you suspect that your child is in pain, let the nurse know. There are different kinds and strengths of medicines that can relieve pain, and some may work better for your child than others. In addition, you can help your child cope with pain by doing your best to keep him calm and distracting him with a favorite toy, game, book, activity, or TV show if...

Other Supports for You and Your Child

It is normal for you to feel overwhelmed when your child is hospitalized. It is not easy to hand over the care of the most precious person in your life to strangers. No wonder parents find it incredibly stressful The hospital staff realizes that patients and their families sometimes need extra support from people who are outside of their network of family and friends, and so within the hospital, there are many professionals to support you. These include hospital clergy, social workers, patient advocates, case managers, and counselors. If the financial concerns of paying for medical care are an issue, the hospital social worker and billing office can work with you to find alternative sources of funding or make payment arrangements. Many hospitals offer support group meetings of various types where you can share your feelings and experiences with other families who are going through similar experiences. In children's hospitals and hospitals with large pediatric programs, a child-life...

When to Call Your Childs Doctor

Call your child's doctor if your child shows any of the following signs Food or formula intolerance. Some infants who appear to have colic actually may have a formula intolerance, so your baby's doctor may suggest that you try switching formulas if your baby is fussy. Be sure to check with the doctor before changing formulas. If you are breast-feeding, your baby may react to things you have eaten. Caffeine and certain medicines can get into the breast milk and make a baby irritable, so check with the doctor if you are taking any medicine and plan to breast-feed. If your child has a food intolerance, avoid the offending food (and check with the doctor about if and when you should try to reintroduce the food). this type of fussiness aside from giving your child some extra tender loving care. Acetaminophen or ibuprofen can help if the fussiness is related to a high fever or general aches from the illness. Ear infections and urinary tract infections can cause pain that leads to crying. A...

How to Give Your Child Medicine

There are a few safety tips you should follow before you put that medicine spoon into your child's mouth. Keep these in mind Before leaving the pharmacy, make sure you have the right prescription by checking the name and the dosage against your child's doctor's instructions. If there are any discrepancies, ask the pharmacist for clarification. Read the entire label each time you are going to give your child a dose. Ask about any common side effects that your child might experience. If you have any questions, ask the pharmacist before you leave the store, or call your child's doctor or pharmacist after you've returned home. If your child's liquid medicine contains a dropper, wash it with hot, soapy water after every use before putting it back in the bottle. If you have more than one child, you might want to keep separate OTC liquid medicines for each. Check the expiration date of all medicines before you buy them and before giving them to your child. Throw away all OTC medicines that...

Can Alternative Care Help Your Child

Many parents turn to a cup of chamomile tea or ginger as a first line of treatment against the flu or nausea. Anxious children can learn to relax with the help of meditation or yoga. Such alternative therapies complement traditional care, and they can help your child feel better. If you want to try alternative medicine for your child, you should first discuss the proposed treatment with your child's doctor or talk to your pharmacist to make sure it is safe and will not conflict with any traditional care your child receives. Your child's doctor can also give you information about treatment options and perhaps recommend a reputable specialist. By coordinating alternative and traditional care, you don't have to choose between them. Instead, you can get the best of both.

Caring for Your Child with Special Health Care Needs

Being your child's best advocate After the initial shock and heartbreak you may experience in learning that your child has a chronic illness or disability, you'll need to set about the task of providing what your child needs to have the healthiest, happiest, and most successful life possible. Caring for your ill child with a chronic illness may involve frequent hos-pitalizations and doctor visits, exhausting caretaking duties, battles with health insurance companies, financial worries, and relationship strain. But your load can be lightened if you gather knowledge and support from health care providers, social workers, advocacy and support groups, clergy, friends, and family. This chapter is intended to give you an overview of some of the challenges you may face and some suggestions on how to best manage the care of your child with special needs.

Talking About Your Childs Illness

Explaining complicated medical information and technology to a child can be difficult, but by keeping your child informed, you help her to feel she is in control and to understand the purpose of her various treatments. Communicate medical information clearly and honestly in an age-appropriate manner. With an infant or young child, reassurance or a soothing tone of voice can help your child feel more comfortable and relaxed. If your child is older and has verbal skills, use correct medical terms so she can talk about her concerns and be understood by medical professionals. A forthright approach may seem frightening to a parent, but to a child with limited context, the words malignant or cancer are just medical words. Earn your child's trust by explaining her treatment, where it will take place, who will be there, and the discomfort she may feel. If a procedure or treatment will be painful or uncomfortable, don't lie to your child say exactly how it will feel and then reassure her that...

Coping with Your Childs Emotions and Feelings

Your child may go through a range of emotions as he faces coping with a long-term illness. Mostly, your child probably just wants you to listen to his fears and concerns. Refrain from offering explanations or reassurance right away simply be a good listener and let your child get it all out. Ask questions about how he feels about specific treatments, discomfort, and limitations. Although you can't always promise that everything is going to be fine, you can allow your child to acknowledge the reality of the situation and reassure your child that you're always there if he needs you. If your child finds it difficult to talk about his emotions, other modes of expression like music, drawing, or writing may give you a view of what he is thinking. Your child needs to hear you say that he is not responsible for his illness. He may feel guilty for causing the disease and for its impact on the family. Say loud and clear and often, This problem is not your fault.

Fostering Independence in Your Child

Part of all parents' job is to foster independence in their children. But how can you accomplish that when your child with special needs is so reliant upon you and on health professionals Here are a few guidelines Give your child the tools he needs to express himself. By helping your child understand medical terminology and procedures, you enable him to explain to health professionals himself how he is feeling and what his medical concerns are.

Caring for Your Child Dependent on Medical Technology

To care for your child effectively, you'll need to familiarize yourself with the specific medical technology used to keep your child healthy. Because medical technology is constantly advancing, you may find it difficult to keep up with new research and new methods of treatment. Although every child will have individual needs, here are several basic pieces of medical technology that you may encounter in your child's care and treatment.

Bringing Your Child Home

Even if your child is dependent on medical technology, she may not have to stay in the hospital. You and your child's health care team may decide that she could receive better physical and emotional support at home. Once you've made the deci- If you have a child who is dependent on medical technology, you must have a working telephone nearby in case of emergency. But did you also know you could notify your phone company that your child is on life support If you do so, your phone company will have on record that your phone lines must be working at all times in case of medical emergency and will respond to your service requests immediately. For further backup, have a cellular phone available, and don't forget to keep a list of emergency phone numbers by each phone in your home. sion to bring your child home, however, you have a lot to prepare for and consider. Quality home care depends on family caregivers and a backup team always being prepared and well informed. You and your family...

Managed Care and Your Child with Special Needs

Managed care plans place limits on the amount, type, and frequency of health care, and this may create problems in your attempt to meet your child's health care needs. (For more information, see Chapter 27, The Health Care System for Children.) Even if you have no battle to wage with a managed care company, health plan literature can be confusing and intimidating. But arming yourself with the knowledge of your child's benefits will help you to be prepared. But unless you take an active role in choosing a health plan (if you have a choice) and selecting your child's primary care doctor, you won't be guaranteed that certain benefits will come your way. So ask as many questions as you need to and don't settle until you have all the answers. Here are some tips Make a list of every doctor and specialist your child uses. Include the office address and phone number for each provider, and indicate how often your

Preparing Your Childs Health Record

Keeping your own record of your child's health information is a good idea. It can help in an emergency, if you're traveling, or if you have to see a new doctor in fact, anytime a medical issue arises and your child's medical records are not immediately available. (Besides, when your child is grown, his health record can be one more, albeit slightly offbeat, memento of childhood. Someday it will look quaint.) Creating a health record is easy. Keeping it up to date and easy to find is more difficult. To make sure you have it when you need it, it would be ideal to keep one copy at home, one in each parent's car or office, and one in each parent's bag or wallet. Give a copy to your child's day-care center or babysitter. Take it along to medical appointments, and update it on the spot, then update or replace all the copies. Have it on hand when you call the doctor's office for medical advice. Your child's full name and date of birth The name and phone number of your child's doctor Your...

Types of Child Care

There are many types of child care today, including family members who will babysit, child-care centers, corporate day care, family- or home-based day care, nannies and au pairs, and parenting co-ops. Some parents use a combination of several types they may leave their child with Grandma a few days each week and in their company-sponsored day-care center the other days of the week. In-home care means a family member or a nanny or au pair will take care of your child at your home. Many parents prefer this arrangement. Your child will stay in a familiar, comfortable environment with his own toys, his own bed, and his own food. It also may give you greater flexibility you can accept overtime or attend late meetings at work because your caregiver is at home until you arrive, usually working 40 to 60 hours a week. If your child is sick, he can stay in his own home and recuperate without disrupting your work schedule. (Sick children are generally not allowed at day-care facilities, so...

Preparing Your Home and Family

Preparing your home for a baby can be an important part of preparing yourself to be a parent. Your child-to-be, and your new role, will begin to seem more real. Whether you're pregnant or adopting, getting ready will help you pass the time until your baby arrives and will make your life easier afterward. Plus it can be a lot of fun

Six Useful Things to Do to Get Started

Use the time before your baby arrives to talk with your partner. Talk about your hopes for your child, your parenting approach, your view of your role in the family, and your own experiences as children good and bad. You'll get to know each other and yourself better, and you may become aware of sensitive areas that you'll want to keep thinking and talking about. Reading books or articles about raising children or talking with friends who have kids can help spark these discussions. But don't try to work out every hypothetical issue (should Alex play soccer ) in advance. You don't know your child yet, and you'll need to be flexible so you can respond to your child's particular needs and nature. 4. If you're going to need full- or part-time child care within a few months of the baby's arrival, or think you may, start your search now. (For more on choosing child care, see Chapter 25, Choosing Child Care.) 5. If you haven't been planning for your family's financial future, this is a good...

Big Brother or Sister Is Watching

Before your child knows there's a baby on the way, talk about the concept of families, and point out the siblings of your child's friends or cousins. This will assure your child that siblings are a common part of life and not a diabolical plot you invented as a form of torture. No matter how young your child is, tell her ahead of time that your family is getting a new member. If your child is old enough to understand (say, age three or four), tell her at the same time you tell the rest of your family. You don't want your child to hear the big news from someone else or suspect there's a big secret in the house. Because most children have trouble understanding time, put the arrival date in terms she'll understand, such as when it gets hot again, or just after your birthday. This is also usually a good chance to explain with more or less detail, depending on your child's age where babies come from. When you talk about the new baby's arrival, try to be both reassuring and honest. Don't...

Stocking Your Home with Baby Gear or How Much Stuff Does One Baby Need

Stores, catalogs, and Internet sites teem with gear and gadgets for the youngest among us. Much of it is unnecessary, especially in the beginning, when your infant is fully engaged in eating, sleeping, and encountering his body and the few inches of world just beyond it. But well-chosen baby gear can make parenthood more pleasant for you and safer for your baby.

Looking At Your Lifestyle

Your baby is constantly monitoring your stress levels by the amount of stress h ormones that cross the placenta into the fetal blood supply. The more stress hormones there are in your baby's blood, the more the outside world will appear to be a stressful place. A highly stressful pregnancy will affect the womb environment and mold stress circuits in the fetal brain. These altered stress circuits will affect how your child deals with stress as an adult.

Isnt the decision different for everyone

We all approach parenthood from our own unique position, so does that make it more difficult for some than for others Most social studies of depression in women point to being at home looking after a child as putting you at greater risk for psychological ill-health, especially depression. Problems are not inevitable and having readily available forms of social support can be very useful. Ante-natal or parenting classes bring people together with other parents-to-be and these contacts with other people in the same situation are probably more useful than the explicit aims of the group. Having a baby is probably one of the most stressful life events that many of us will deal with. Our life, how we view ourselves and how others see us will radically change. There are social, emotional and financial costs involved in raising children so maybe it is not surprising that it all becomes too much at times and mothers especially are more prone to psychological...

Background And History

Public Health Service Expert Panel on the Content of Prenatal Care issued its report Caring for Our Future The Content of Prenatal Care. In it, contemporary goals of prenatal care were outlined (Table 1-1). In addition to setting goals for the pregnant woman and her infant, the panel broadened the objective of prenatal care to encompass goals for the family as well. These included the explicit mention of parenting skills, family violence, and child abuse or neglect. In recommending that a woman planning a pregnancy should have a preconceptional visit and that primary care providers of various backgrounds should be prepared to make appropriate recommendations to optimize the conditions in which pregnancy begins, the panel also broadened the time frame encompassed by prenatal care. While expanding its view to include the period prior to pregnancy, the panel also extended its vantage point well beyond pregnancy, asserting that services delivered during prenatal care can...

When pregnancy doesnt happen

However, whatever your age, if you are absolutely set on having a baby, then you may see every period that arrives as an unexplainable failure. Many women expect to get pregnant from the first month of trying. Often in a couple one partner is more uncertain about parenthood and therefore may take much longer to be willing to identify a problem.

Prenatal Care To Reduce Psychosocial And Environmental Risk

Domestic violence, in addition to jeopardizing maternal and fetal physical well-being, generates stress and anxiety in pregnant women. Evaluations of the effectiveness of prenatal care have generally focused on the biological and physiologic aspects of pregnancy, but the psychosocial environment also may have a significant impact on pregnancy outcome as well as maternal and familial welfare. Thus, prenatal care offers an opportunity to attempt to decrease psychosocial stressors. By assessing the need for and then offering social supports, from classes that help women prepare for childbirth and those that provide health education to referrals to social service agencies and programs such as Women, Infants and Children, providers may have a substantial impact on not only the biological outcome of pregnancy but also the health and happiness of an entire family. For example, childbirth education classes have been shown to diminish maternal anxiety and the need for medication and other...

If Theres a Problem at Birth

If you know your baby will need special care after his birth, you can visit the NICU or special care nursery in advance and meet the team that will care for your child. The team may include a neonatologist (a pediatrician specializing in care of newborns), a pediatric anesthesiologist, and a pediatric surgeon, as well as neonatal nurses and nurse-practitioners. A social worker should also be available to help you find services your child may need, and counselors may be able to help you with the emotional turmoil, grief, or fear you may be feeling.

What does it mean to be a mother Changes for women

The role of 'mother' is therefore ever changing and this uncertainty for society about what exactly a mother is can make it more difficult for the individual woman to assume the role. This may add to or generate a sense of insecurity in late pregnancy. What exactly does it mean to become a mother Is a mother someone who works outside of the home Do mothers go clubbing Do they instinctively know how to care for a newborn baby In effect, women construct for themselves the role of 'mother', being influenced both by the wider society and their own needs, preferences and responses to their baby. Your early interactions with the baby will shape your perception of yourself as a mother if your baby is born of very low birth weight your experience will be very different to a mother who gives birth to a 9 lb baby. Your view of yourself as a mother is not static it will change as you have good times and bad times and as your child displays different needs and demands. Rosemary came for help with...

Possible Complications of Circumcision

To avoid complications, circumcision should not be performed under some circumstances. It should be performed only when it is clear that the infant is in stable medical condition, usually after the infant has reached 12 to 24 hours of age. Circumcision should not be done in the delivery room. The procedure should also be delayed if your child's doctor feels the infant might have a bleeding problem or if certain abnormalities of the penis are present because the foreskin may be needed for use in future surgical repair of the defect.

Lactation Consultants

Lactation consultants, or LCs, teach couples about breast-feeding and help solve problems that may arise. They may be nurses, nutritionists, childbirth educators, midwives, or lay people with training. Some work out of hospitals or childbirth centers some are affiliated with pediatric practices some have independent practices or work for lactation centers. The most widely recognized credential is certification as an International Board Certified Lactation Consultant (abbreviated I.B.C.L.C. after the person's name). Usually, hospital staff or your child's doctor can recommend a lactation consultant, or you can get names from the International Lactation Consultant Association, (919) 787-5181. Ask about a consultant's training and experience. If your child's doctor refers you to a consultant, it may improve the chances that your insurance will cover it, but don't count on it.

Nursing an Adopted Infant

Others may feel that going to such lengths to breast-feed gives too much weight to the biological aspects of parenthood and adds tension to the adoption process. Parents who are adopting, especially after a difficult period of infertility, need to remember that millions of people revel in parent-child love, closeness, and bonding without breast-feeding. It doesn't take breast-feeding to make a real mother.

Miranda Hayer MSc RGN RM

Juliet worked on neonatal units and a paediatric oncology ward before qualifying in HIV nursing. She then attained a Diploma in Tropical Nursing at the London School of Hygiene and Tropical Medicine. More recently, she has graduated from Brunel University with an MSc in the Social Anthropology of Children and Child Development. Juliet won the medical category of the Barnardo's Children's Champion award for 2005.

Soothing and Connecting with Your Baby

Premature babies and those with medical difficulties may especially respond to infant massage. Many books and videos cover the subject discuss with your child's doctor which one you think might work for you and your baby. Be careful, however babies are not as strong as adults are and can't take anything like the pressure or manipulation of a regular adult massage.

When should I start maternity leave

Inevitably as you prepare to leave work there is recognition that it will never be the same again. Even if you intend to return to work full-time as soon as possible, the situation will not be the same.Work is different when you have a baby to get home to. Although women are now 'free' to return to work, it is usually mothers who drop off and collect children from child-care. There can be a great sense of loss while preparing to finish at work. What will it be like not having to get up and go to work Although we may at times resent the routine of work, routines are in fact very important for our psychological well-being. Work generally is very protective against depression working women are less likely to be depressed than the unemployed or homemakers. Work provides a social world and for some their social life. Even where there are conflicts at work, this may still give a

The Blues and Depression

In rare cases, however, serious postpartum depression can occur, sometimes two or three months after a birth. Fortunately, it is very treatable. If you are depressed most of the time for two weeks or more, you should get medical help promptly. Some signs of depression include losing interest in activities you usually enjoy, sleeping too little or too much, feeling jittery or drained of energy, feeling worthless or guilty, and being unable to concentrate. If you have thoughts about death, suicide, or harming your child, get help right away. You can start by calling your doctor. In an emergency, call 911 or go to a hospital emergency room.

The Best Advice I Got Was L

When trying to determine if your baby has colic, the first thing to do is rule out illness as the cause for the crying. Colicky babies have a healthy sucking reflex and a good appetite. Usually, babies who are ill won't have the same strong sucking reflex, and they'll drink less milk. Colicky babies usually like to be cuddled and handled. Ill babies may not like to be handled despite their fussiness. Colicky babies may spit up from time to time, but if your baby is actually vomiting or otherwise seems sick, you should call your child's doctor. Even if your baby doesn't have symptoms of illness,

For Dads Reacting to the News

Honey, I think I'm pregnant You hear the words that millions of other men before you have heard and you feel pure joy and excitement. Well, not really. You probably also feel some concern, even fear, for the future. Rest assured that these feelings are completely normal. You may be concerned about how parenthood may change your relationship with your partner. You may be concerned about how parenthood could change your life in general. You may worry that you and your partner won't be able to support a family financially, or that you won't be a good parent. Just keep in mind that your partner's feelings about having a baby aren't all that different. She's probably having a few worries herself. So talk to her about what you're both feeling. Sperm, of course, is only the first contribution you make to the project. The support you provide the mother during pregnancy is at least as important. Just as pregnancy is a time of tremendous change in a woman's body, so is it a time of tremendous...

Limiting the Guest List

Because your baby's immune system is immature, it's a good idea to limit his exposure to lots of visitors in the first weeks. Ask your child's doctor when it is appropriate to take your baby into crowds, such as taking a trip to the shopping mall. If a friend or relative has an infection, it only makes sense for that person to delay visiting until he or she is better. If a member of your household becomes ill, limit his or her contact with the baby. (Make sure this person doesn't cough in your baby's face or kiss your baby until he or she is recovered.) Everyone in the household should, as always, practice good hygiene, washing hands thoroughly before touching your baby.

83developmental considerations for the adolescent

Erickson proposed the developmental tasks of teenagers as accepting body image, determining and internalizing sexual identity, developing a personal value system, preparing for productive function, achieving independence from parents and, finally, developing an adult identity 8 . Pregnancy, planned or unplanned, has a tremendous impact on all of these tasks, both positive and negative. How does a young woman accept a body image that is changing every week How does she deal with a rapid weight gain in a culture that is fraught with skinny images and advertisements for weight loss products It has been reported in the literature that lesbian and bisexual young women are at higher risk for pregnancy compared with their peers, although it is unclear why this is the case how do their attempts to internalize their sexual identity impact on this risk 10 Some young women may plan their pregnancy to demonstrate their complete rejection of their parents' value system (thus stating their own) and...

Pediatric Nurse Practitioner

In our experience, some parents may feel somewhat reluctant to have their child receive care from a pediatric nurse-practitioner perhaps they are concerned that the PNP is less extensively trained in the health care of children than the pediatrician is. These feelings are largely unwarranted. In fact, the presence of PNPs in the practice can have advantages that most parents will appreciate. Parents often find that these nurse-practitioners spend more time with them than the pediatrician does discussing child care and explaining how to handle illnesses. If the pediatric nurse-practitioner encounters a more complex medical problem with your child, he or she is trained to consult the pediatrician, when necessary. Most practices, however, will honor your request if you wish to see only the pediatrician or if you feel that the pediatrician should be consulted after a pediatric nurse-practitioner has seen your child.

What You Should Ask the Finalists

What are the office hours You may prefer a physician who offers weekend and evening hours. Do daytime office hours begin early or end late enough for you to get your child there before or after work 2. Is this a solo or group practice In a solo practice, you know that your child will be seen by the same doctor for most visits and that you will be dealing with the personality and philosophy of only one physician. But, if your child needs attention at night or on weekends, you may often have to deal with an unfamiliar doctor who is providing coverage for your doctor when he or she is not on call. If you are considering a solo practice, find out the details about these coverage arrangements, including the qualifications of the covering physicians. Group practices are becoming increasingly common. In some, your child may see only one doctor in the group for routine care in others, your child's care may rotate among the members of the group so that all the doctors become acquainted with...

Jane Scullion BAHons RGN MSc

Despite the considerable advances in maternity care, and world-class maternity services provided by highly trained and motivated health care professionals, good maternal health is not a given or a universal right even in countries with high quality functioning maternity services with their attendant very low maternal mortality and morbidity rates. And whilst we would all hope that pregnancy, birth and the early weeks of parenthood would be enjoyable and relatively comfortable experiences for new mothers, babies and families we know, sadly, that this is not always the case.

Tips for Building a Better Partnership

You can become a more effective advocate for your child's health by following certain ground rules in working with your child's doctor and the practice's office staff Let the doctor know that you trust him or her to make recommendations regarding your child's health care based solely on what is best for your child. This doesn't mean that you are giving up your rights and responsibilities as a parent. But it's a good idea to inform the doctor up front that you don't want his or her care decisions to be influenced by a perceived need to please you. Make it clear that you expect antibiotics or other treatments to be prescribed only when they will help your child, not you, feel better. If you feel you need to get your child's doctor's opinion about an article on a child health issue, it would be better to mail, email, fax, or drop off a copy to the doctor before the office visit or phone call you make to discuss it so that the doctor has time to review the material in advance. It is also...

Assessment of Development

Children who show delays in their physical, emotional, behavioral, or social development may have treatable medical conditions that need attention. That's why your child's doctor will check for these things during routine checkups. Many types of developmental screening tests are available. The most commonly used in a primary care office is called the Denver-II. It includes questions for the parent about the child's skills, knowledge, and behavior. (See Chapter 17, Growth and Development, for more information.) Parents may be asked to fill out pre-screening forms to answer some of these questions. The doctor or nurse will also observe as your child performs certain tasks (hopping on one foot, drawing, etc.) or responds to questions (Which line is longer ). Keep your own record of your child's measurements, along with other data such as immunization dates and screening test results. Some doctors give you a small booklet for this purpose. If there's an emergency and you're too stressed...

Physical Examination

The elements of the physical exam, and the order in which they are done, will vary based on your child's age. With infants and young children, observation is particularly important Your child's doctor can learn much about your child's health from her overall appearance, activity, responsiveness, and interactions with her environment. When it comes to touching your child, the doctor might start by doing the things that are least threatening, such as listening to the heart with a stethoscope. The parts of the exam that tend to be more distressing to young children, such as looking in the ears and throat, are generally saved for last. With older infants and toddlers, who are naturally somewhat fearful of strangers and too young to understand the need to be cooperative, parents (or others familiar to the child) can be of great assistance. The doctor may wish to perform much of the exam with your child on your lap or in your comforting arms. You may also be asked to help by gently...

Counseling and Guidance

One of the major reasons for well-child visits is so you can receive advice and information to help you raise a healthy, happy child. You should expect your child's doctor, nurses, and other staff to devote a sizable portion of the well-child visit to providing you with this information. They should thoroughly and clearly answer any specific questions you have about your child's health. Although this is mainly accomplished through face-to-face conversations, most practices and clinics will also have printed information sheets, pamphlets, booklets, and the like. These can give you more detail, offer suggestions about how to find additional information (such as books, reputable Web sites, and support groups), or help you remember The topics covered at your child's visits should include what pediatricians call anticipatory guidance. This means telling you about physical and emotional changes you are likely to see in your child before they happen. You'll talk about things like how to...

Making the Most of an Office Visit

To get the most out of an office visit, it helps to be prepared. This is especially true if your child's doctor is pressed for time or if you must see an unfamiliar person. Keep a list of questions and concerns as they come up between visits. Before the visit, go through the list and put them in order of priority. Ask the important ones first. (Studies have shown that people often save the questions that really matter to them until the end of a visit. By then, your child's doctor may be halfway out the door.) Don't be shy about reading from your written list. Remind the doctor of your child's medical history, especially if she has had any problems such as asthma or seizures. Be sure to mention any medications, prescription or nonprescription, that your child is taking. Don't count on the doctor remembering or having just reviewed the medical record. Bring along paper and write down any important instructions (or any useful notes, for that matter). If you don't understand something or...

The Office Sick Visit

Most office sick visits are similar to well visits except that the evaluation is focused on the child's illness. After you arrive at the office, a nurse or medical assistant will usually weigh your child and take her temperature, heart rate, breathing rate, and, in some cases, blood pressure. If your child appears seriously ill to the nurse, the doctor will be notified immediately so she can be seen right away. The medical history and physical examination performed by the doctor will focus on the aspects relevant to your child's illness. For some illnesses, this may take more time and require more detailed questioning and examinations than is usual at a well visit. After your child has been evaluated, the doctor should give you a thorough explanation of the findings and recommendations. Depending upon the problem, this might include lab tests, X-rays, a variety of treatments in the office, prescription of medications, a visit to the ER, or admission to the hospital. Many offices will...

Things You Can Do to Help

You can help your child manage her fear by encouraging her to express her feelings. Don't say, Oh, there's nothing to be afraid of. Don't cry. Instead try, I know that visiting the doctor sometimes makes you cry, but I will stay right next to you the whole time to help you feel better. Always use words that she understands, and focus on the positive. Before you arrive at the office, take some time to prepare your child. The following tips will help. Equally important, if your child is going to receive a shot at the visit, be sure to tell him up front and that it might hurt a little bit. Not telling a child will only violate his trust, resulting in a more lasting pain that will affect how he handles future visits to the doctor. Address Any Guilty Feelings Your Child Might Have If your child is going to the doctor because of an illness or other condition, he may have unspoken guilty feelings about it. Discuss the illness or condition in simple, neutral language, and reassure him that it...

Health Screening Tests

Which ones should your child have hen it comes to health measures, screening tests are humble heroes. They seem so simple, usually taking only a few drops of blood or urine. But they can shout a warning about hidden medical conditions that could harm your child if not diagnosed and treated early. Not surprisingly, screening tests are an important part of pediatric preventive care care that aims to keep your child healthy and developing normally.

Newborn Screening for Hereditary and Metabolic Diseases

Another blood sample may be taken at your child's first visit to the doctor's office, depending on various factors. For example, the initial test results may be unreliable for some conditions if your baby is premature or if your infant's blood was drawn before 24 hours of age. Because the results of newborn screening tests can take several days to come back from the laboratory, make sure that the hospital knows how to contact you and your baby's doctor after discharge. A recently developed technique called tandem mass spectroscopy has made it possible to screen newborns for a much larger number of metabolic diseases than was previously possible from a small blood sample. At the time of this writing, most states have either begun offering this test or are considering adding it. If the test is not yet available routinely from their state program, some parents are electing to pay for the test themselves. Speak with your child's doctor about your options regarding this test.

Signs of a Possible Hearing Problem

Screening for hearing problems should be a part of your child's regular checkups right from the start. Before your child is old enough to cooperate with more formal hearing tests, your child's doctor will be looking for other signs that might indicate a hearing problem. Some of the signs that you and the doctor should look for include the following Your child doesn't imitate some sounds or say some single words like Mama or bye-bye by 12 months of age. Your child's speech is delayed or difficult to understand. Your child's development is delayed in other areas such as sitting and walking. Your child seems to hear certain types of sound but not others. Your child has trouble telling where a sound is coming from. The quality of your child's voice is unusual. Your child doesn't notice when people enter the room unless he sees them. Your child doesn't respond when you call or doesn't listen to your instructions. Your child has problems with learning or attention. Your child seems to need...

Managing Ear Infections

Ear infections in young children are common. If your child has symptoms (see the section on ear infection in Chapter 30, Childhood Infections), his ears will be examined. This will also be done at routine checkups. If an ear infection is detected, usually an antibiotic is prescribed. Your child may be examined again after the course of medication is completed to make sure the infection has cleared. If, after treatment, your child's ear examination findings have not returned to normal as expected, your child's doctor may perform a test called a tympanogram to evaluate how well the eardrum and the middle ear are functioning. To perform a tympanogram, the person doing the test places the soft rubber tip of the testing device in your child's ear to deliver air pressure and sound into the ear. The goal is to see how much of the tone is absorbed or reflected off the eardrum as the pressure changes. This test causes a sensation like the clogged ears feeling when going up in an airplane, but...

The Teen Sex Debate Unhinges

Among teen-sex lobbies, these questions mattered less and less. In previous decades, right-wing anti-sex-education troops had floated all kinds of lurid tales. Even so, I argue, information issued by the Alan Guttmacher Institute (AGI) and Planned Parenthood remained largely cautious and reasoned. For example, former AGI director Jeannie I. Rosoff acknowledged in 1990 that most of the programs we have had have been preaching sex education even though we now know increasing knowledge does not necessarily affect behavior. The claim that sex education is the remedy for teen pregnancy persists, she said, because sex education is something we know how to do.3 Indeed, reviews of decades of research found none of the dozens of studies by sociologists, psychologists, and educators has discovered that sex education

Evaluation by a Pediatric Ophthalmologist

If a problem is identified, your child will probably be referred to a pediatric ophthalmologist. This is a physician who treats medical and surgical diseases of the eyes and has special training in the evaluation and treatment of eye diseases affecting children. During eye exams, your child's doctor will look for the following Eye alignment. The doctor will shine a light toward your child's eyes and examine the alignment by observing where the light reflects off the front of the eyes. In older children, alignment may be tested by covering one eye and then the other while the child views an object (cross cover test).

Mistaken Belief That the Danger Is Gone

Often parents believe it isn't necessary to immunize their children because almost everyone else in the United States has gotten shots and so there is no one to spread the disease. We live in a global environment today, however, where we and people from other nations move freely around the world. Diseases move just as freely. As long as diseases such as polio or measles exist anywhere on the globe, your child is at risk and vaccinations are necessary. Potential epidemics are just a plane ride away. And in the case of tetanus, even vaccinating every other child on the planet won't protect your child from getting this disease. That's because tetanus is caused by bacteria in soil that can contaminate a wound.

Hemophilus Influenzae Type B Hib Vaccine

You know how important it is to immunize your child, but your heart aches when the shot causes fears and tears. If only there were a way to immunize your child without needles, it would be so much easier, right Researchers are currently working on needle-free injection devices that would not only reduce the amount of pain involved but would also be able to deliver multiple vaccines at once. The most common type of needle-free device is the jet injector, which works by using compressed gas or a spring that delivers a vaccine in a stream that's fast enough to penetrate the skin. The vaccine is given at ages 2 months, 4 months, and 6 months. At ages 12 to 15 months, a child receives a booster shot. The possible side effects include fever and soreness at the site of injection. Your child's doctor will probably advise delaying the vaccine if your child is sick with anything more serious than a cold or if she experienced an allergic reaction after an earlier Hib dose.

Why Are Married Teens Having Fewer Babies

Nor would it be easy for interests, despite vigorous official efforts to strengthen marriage, to explain why strong trends toward unwed parenthood continued unabated among both teens and adults. In fact, one would think welfare reformers, social policy interests, and culture warriors had united to destroy marriage. Given the contrary realities evident in solid vital statistics reports, all interests squared their shoulders and resolutely ignored reality. This was yet another crucially important trend that privatized social policy interests simply were not positioned to deal with. Thus, interests dominating teen pregnancy discussion effectively banished unwanted realities from media discussion not by overt conspiracy, but simply because no one would profit from talking about them. Unmoored from rational, scientific discussion, the teen-sex and teen-pregnancy debate has continued its post-1990 drift toward narrowness, unreality, and meanness.

Growth and Body Mass Index BMI Charts

Want to learn more about how your child compares to other children her age Then check out the growth and body mass index charts provided in Appendix B. Don't get too caught up in following your child's growth on a standardized growth chart. A child's growth in length height is not completely smooth and constant. Some healthy children may not increase their height for weeks or months and then go through a catch-up period of more rapid growth. Some research indicates that children's growth rates may be seasonal they seem to grow a bit faster in the spring. It's not uncommon for healthy children (particularly during the first two years of life) to temporarily grow faster or slower than most other children their age and to change their position on the standard growth charts. For example, infants of

Getting Those Words

As many as 25 percent of children 18 months to seven years old go through a stuttering phase. Getting your child to relax is the best way to help break the habit. Maintain eye contact, listen quietly, and speak in calm, simple sentences. If these signs of stuttering continue for six months or more, consult your child's doctor, who may refer you to a speech and language pathologist for further evaluation. In addition to professional therapy, you can help your child by doing the following Avoiding the impulse to correct your child's speech or finish sentences for her Not forcing your child to speak or read aloud when she doesn't want to Not telling your child to start a sentence over or to think before she talks Talking slowly and clearly to your child to provide a model of slow speech Encouraging activities that do not require speech at times when your child is having more difficulty speaking fluently

Developmental Milestones

The following lists describe some of the characteristics and skills young children will display at different ages. For each age level, the milestones are grouped by specific area of development. In general, most children will have reached each of these milestones by the end of the age range indicated. For each age level, there is also a talk with your child's doctor if. . . section intended to give you some guidance when you have possible concerns about your child's development. This information should not take the place of the developmental assessments that will be performed at the doctor's office at your child's regular checkups. You should not hesitate to seek advice from your child's doctor if you think that your child may have a problem. Trust your instincts.

Fitness Exercise and Sports

Throughout the ages of childhood, your child can be physically active in many different ways. In infancy, the pastimes of stretching out arms and legs, of rolling over, and of learning to crawl and walk are all physically demanding and part of Two- and three-year-olds thrive on unstructured physical play such as running, swinging, climbing, playing in a sandbox, and participating in carefully supervised water play. By age two, your child should be able to jump with both feet, skip, and run. By age three, when in motion, your child should be able to change directions (from left to right, from forward to backward) comfortably.

Share and Share Alike

Sharing can be difficult for many toddlers, who aren't able to see things from another perspective and need time to learn. If your child is reluctant to share, help her understand the concept of sharing by doing the following Set an example by sharing with other adults (hosting a carpool ride or giving your neighbor a cup of sugar, for example), and explain to your child how happy it made you and the other adult feel when you shared. Offer your child choices about what she can share It's OK for some items to be off-limits for sharing (like her favorite blanket) and other toys and objects to be available for sharing with other kids. For more information about teaching your child to share, see Chapter 19, Temperament, Behavior, and Discipline. Concentrate on your child's successes rather than her failures. Praise what your child does well, and provide plenty of opportunities for her to succeed. Try not to draw too many comparisons between your child and other children. As long as she is...

TV Computers and Other Media

The average American child spends three to five hours in front of a TV per day. In fact, 70 percent of child-care centers use TV during a typical day This is not necessarily a bad thing TV can be a great educator and entertainer. But there's also no doubt that there's a negative side to TV viewing. Potential Negative Effects of TV on Your Child Children's advocates are divided Many want more hours per week of educational programming others assert that no TV is the best solution. And some say it's better for parents to control the use of TV and to teach children that TV is for occasional entertainment, not for constant escapism or babysitting. To help you teach your children good TV viewing habits, observe the following guidelines suggested by the AAP and other experts Set limits. You can limit the number of hours your child spends watching TV by moving the set from the most prominent room in the house to a side room and by keeping TVs out of bedrooms and turned off during meals....

Developing a Philosophy of Discipline

Close your eyes and imagine this scenario Several times you've told your three-year-old daughter not to pick flowers from your neighbor's garden. Yet she's done it again, and this time your once-patient neighbor has come over in a huff and demanded that you get your child under control. What would you do How you answer may help you understand your own natural tendency as a dis-ciplinarian and how you may need to adapt to provide the best home environment for your child. Parenting styles vary widely and can have dramatically different effects on children. Chances are, you'll tend to fall into one of three primary parenting styles defined by Diana Baumrind, a leading specialist in this area. If you primarily value your child's freedom and self-expression, even if it means a few more picked flowers from your neighbor's garden, then you probably tend toward a more permissive philosophy of discipline. To discipline, you may tend to take your daughter aside and reason with her, focusing...

44 First Trimester Of Pregnancy

Increased Concern For Financial and Social Problems. Paying for a child, losing a job, or losing a second income for a while, the cost of child care, loss of freedom to come and go, and the requirement for a total commitment that may prevent her from performing social obligations may all be concerns for the new mother.

2133 Vinca alkaloids and structural analogs

There are at least 13 case reports on etoposide (Han 2005, Rodriguez 1995, Arango 1994, Horbelt 1994, Brunet 1993), including two reports describing Lhe delivery of healthy children after exposure during the first trimester (Avilcs 1991). Development of these two children was normal up to the ages of 3 and 8, respectively.

2138 Cytotoxic anthracydine antibiotics

In a review, Germann (2004) analyzed 160 case reports published between 1976 and 2001 50 cases involved daunorubicin and 99 cases involved doxorubicin. Some of these have been quoted above. About 30 of the 160 patients received treatment during the first trimester and gave birLh to 20 healthy children 3 newborn infants showed malformations.

Dealing with Common Behaviors and Misbehaviors

As your child grows, he will do things that may worry or confuse you. In this section, we take a look at behaviors that are often of concern to parents. At the core of sibling rivalry is jealousy, and this jealousy is never about the things that your children may fight over ultimately, the clothes issue is about the need to feel as loved and important to parents as a brother or sister. In many ways, your children are fighting for your love and they may purposely drag you into their fights just for the attention and support.

Good Behavior Bad Behavior

When disciplining your child, remember that praise or rewards for good behavior are important than punishment of bad behavior. Giving this recognition provides the groundwork for happier children with higher self-esteem. Tell your children that you don't expect them to be best friends all the time you understand that they are different people. But you do expect them to learn how to share, respect one another, and talk things out. Never compare your children or hold one of them up as an example to the other questions like, Why can't you be more quiet like your sister can be devastating and hard to forget. At some point between 12 and 18 months children learn the concept of object permanence. That means they know that just because they can't see something doesn't mean it doesn't exist. Until that concept is understood, however, your child has no idea that you still exist when you walk out of the room. No wonder he screams when you try to leave him This fear of losing you is called...

Patient During The Third Trimester

Men undergo far less social preparation than women do for parenthood. With a close, supportive family relationship, the father can receive help in his adjustment if needed. Essentially, there is nothing to prepare him for pregnancy per se. There are no doctor's appointments, baby showers, or the physiologic changes of true pregnancy, although some men have expressed having some of the physical discomforts.

21310 Folate antagonistic antimetabolites

Ten articles describe pregnant women who had received methotrexate as part of cancer therapy during the first trimester. It is notewor thy that 16 healthy children were bom in this high-risk group (Zemlickis 1992, Aviles 1991, Feliu 1988, Dara 1981, Pizzuto 1980) 1 child had inguinal hernia (Giannakopoulou 2000), there was 1 spontaneous miscarriage (Giacalone 1999), and 1 stillbirth without malformations (Peres 2001). Only 1 child had characteristic malformations (Bawlc 1998) this child's mother had been treated for breast cancer with a weekly dose of 80 mg MTX from weeks 8-29. Moreover, she had received irradiation treatment from weeks 16-25, with the fetal dose estimated at 14 rad. In contrast to these publications, there are case reports of 14 healthy children whose mothers had a dosage of between 7.5 and 15 mg per week (Ostensen 2000, Donnenfeld 1994, Feldkamp 1993, Kozlowski 1990), 4 spontaneous miscarriages (Ostensen 2000, Kozlowski 1990), and 2 induced abortions without...

21312 Pyrimidinederived antimetabolites pyrimidine antagonists

5-Fluomuracil (5-FU) also interferes with DNA and RNA synthesis by displacing uracil. Five healthy children have been reported following local vaginal application of 5-fluorouracil during the first trimester (Kopelman 1990, Odom 1990). Case reports about treatment during the first trimester in conjunction with other therapeutic drugs describe four healthy children (Andreadis 2004, Peres 2001,

6 Bipolar Disorder And The Postpartum Period

Sleep loss may be a contributor to the development of hypomanic and manic episodes in the postpartum period (115,118,119). For women who have primary responsibility for the care and feeding of their newborns, sleep disruption might be as frequent as every 2 h. This is a significant component of the psychosocial stress from the adaptation required to meet the requirements of parenthood (16). Whenever possible, women with bipolar disorder should be helped to minimize sleep deprivation during the postpartum period (112-114).

Bedwetting Nocturnal Enuresis and Daytime Wetting Incontinence

The bed several times a week, and a small number may not stop until early adolescence. Most children outgrow bedwetting with time and patience. Different theories exist about why children wet the bed. In some cases, it may be due to an immature arousal mechanism that does not signal the child to wake up in time to get to the bathroom. Bedwetting is not intentional and is not your child's fault. Punishing your child for wetting the bed won't solve the problem and will only upset your child. If your child is dry during the day but has never been dry for more than a few nights in a row, don't worry your child will probably become dry soon. However, if your child has previously been dry at night and starts to wet again, it could be due to stress or a medical problem such as a urinary tract infection or diabetes.

The Family Bed Debate

In the United States, it is common for older babies and children to sleep separate from their parents. Most U.S. child-care experts say this promotes better sleep for parents and children, builds independence and a sense of confidence for children, makes intimacy easier for parents, and, in the preschool years, avoids heightening the normal Oedipal conflicts (the conflicts that children feel over their love for the parent of the opposite sex and their rivalry with the parent of the same sex).

The First Three Months

These changes will disappear in most (about three-fourths) of these babies by one to two years of age with no other treatment than rotating the infant's head position frequently. It may be helpful to alternate an infant's head position in the crib (from one end to the other) in case a window scene or other distraction encourages the infant to turn in one direction. In about one of five infants with the condition, the use of a helmet or other device for a few months is recommended to treat the head deformity. Surgery is rarely required. In some cases, physical therapy exercises involving the neck muscles may be recommended. Speak with your child's doctor if you have any concerns about this issue.

Popular Books On Teen

The Hurried Child Growing Up Too Fast Too Soon (2006, 2001, 1988, 1981), by David Elkind, professor of child development at Tufts University and long-time Parents magazine columnist, may be the best-read work on youth issues. In my view, Elkind has been a major generator of demeaning myths about adolescents for decades. His 1970s notions (mostly gleaned from reading some diaries) that adolescents, unlike adults, suffer delusions of

Nightmares Monsters in the Night

Preschoolers generally can understand that nightmares are not real and cannot hurt them but may still feel deeply frightened. If your child calls out in the night, comfort her with hugs and reassurance, reminding her that nightmares are not real and that you are there to protect and love her. Don't belittle her fear let her know that everyone gets scared by nightmares sometimes. You will probably need to sit with your child for a while, perhaps until she falls back to sleep. Nightmares often peak in the preschool years, along with fear of the dark. Sometimes nightmares mirror upsetting events that happen during the day. If some task, such as learning to use the toilet, seems to be causing heavy stress, you might ease up or delay it a while. You can also encourage your child to talk about feelings he finds frightening, reassuring him that everyone has such feelings and helping him distinguish between feelings and behavior. If your child's nightmares or daytime fears seem excessive to...

Other Sleep Related Problems

Some children develop rhythmic disorders associated with sleep, such as head banging, head rocking, and body rocking, which involve movements that range from mild to seizurelike thrashing. Other rhythmic disorders include shuttling (rocking back and forth on hands and knees) and folding (raising the torso and knees simultaneously). During the rhythmic movements, your child may moan or hum. These movements seem to occur during the transition between wakefulness and sleep or between one stage of sleep and another. There is no known cause for this type of disorder, but medical or psychological problems are rarely associated with it.

Healthy Eating Patterns

Help your child embrace healthy eating patterns to last a lifetime Encourage your child to develop a taste for water, not soda, and for whole, not processed foods apples rather than apple-flavored breakfast toaster pastries. It may mean contradicting the models set by grandparents or friends and changing the way you shop, cook, and eat so that you are a better model yourself. If your child is in day care, check out the menus and try to get them changed if they are not to your liking. If your child is home with a caregiver, make sure that person understands and follows your approach to feeding your child.

Foods to Avoid at First

Some foods are more likely than others to cause allergic or other adverse reactions in babies. Among these foods are cow's milk, eggs, soy, peanuts, and wheat, as well as shellfish, other nuts, and corn. It is best not to give these to your baby until she is older than one year and is eating the cereals, fruits, and vegetables mentioned earlier as good first foods. If food allergies run in your family, talk to your child's doctor before giving any of the allergy-prone foods. Delaying them may reduce the chance of developing allergies. Here are tips on some potential problem foods Cow's milk. Because its concentrations of protein and minerals are too high for young infants, cow's milk should not be given until your baby is one year old. Even after that age, your child may be better off drinking iron-fortified formula rather than cow's milk if she is not eating enough iron-rich food, such as meat or iron-fortified cereal. Talk to your child's doctor about this. If you do give cow's milk...

Baby Vitamin Supplements

If your baby has been breast-fed, her doctor may have already suggested that you give her drops that contain iron, vitamin C, and vitamin D. If your child has dark skin or does not get out in the sun every day, her body may not produce enough vitamin D. Because most infant formulas are fortified with vitamins, formula-fed babies generally do not need supplements. like medicine keep them out of reach, and never pretend they are candy. And don't think supplements can take the place of a good diet. Supplements do not help your child get healthy amounts of many key nutrients, including fat, protein, carbohydrates, and fiber.

Nutrition for Ages Two to Five

How much should your child eat As much as it takes to keep him growing at a healthy rate. The growth charts in Appendix B of this book provide some guid ance, but because healthy children can veer from these curves, parents should speak to their child's doctor about this issue. Monitoring a child's growth is one of the main tasks of routine checkups in the early years. Children six months to one year old typically need 700 to 900 calories a day total, from food and nursing combined. A two-year-old should consume 1,300 or 1,400 calories add 100 calories with each year. At five and a half years, he may be eating 1,700 calories a day, as much as some smaller, less-active adults. But a child's needs vary widely with size and activity level. In almost all cases, there's no need to count calories if your child is eating regular meals and snacks.

Dealing with the Picky Eater

Parents often worry that their child isn't eating enough when he shows a toddler's normally slower growth rate and his appetite drops off. He lives on air, they say. If you're concerned about this, watch to see if your child is filling up on juice or milk. If so, try switching him gradually from juice to water for most of that sipping. If he's drinking whole milk, try moving to a lower-fat version. That may leave him with more of an appetite for solid food. 'Cook one completely new dish for dinner each week. This will help your child to be more open to different kinds of food. Over the long run, it will help to ensure that your child eats a wide variety of foods (the best way to ensure a balanced diet).

The Voice of Experience K

Also, check if your child is eating too many chips, candy, cookies, ice cream, or other sweets. These foods are low in nutritional value but so high in calories that relatively small amounts can fill up a child. A couple of desserts and a fatty snack can contain half a day's worth of calories. An occasional ice cream or cookie is no problem, but such foods should not be built into the everyday routine. At least in the beginning, kids won't expect dessert unless someone continually offers it. Avoid conflict. If trips to the supermarket turn into tussles over candy, try to shop without your child. You should never try to force, bribe, or badger your child into eating certain foods or into eating, period. But you don't need to cook special meals either. Accommodate your child's tastes by offering meals that include one or two healthy items she is likely to eat bread, for instance, or applesauce. If peanut butter sandwiches are a current passion, include a half or even a quarter of a...

Milk and Other Dairy Products

Quate calcium, which is essential for strong bones now and later in life consult your child's doctor. On the other hand, dairy products tend to be high in fat some children do not tolerate them well, and some vegetarians shun them. So we have included in this group some nondairy sources of calcium.

2 Antenatal Needs Of Women With Schizophrenia

Preparation for pregnancy classes or support groups for women with schizophrenia of childbearing age (15) require a focus on the importance of prenatal care should pregnancy occur, available options when the pregnancy is unwanted, education about child development, pre-pregnancy folate supplementation, explanation about the mandate and authority of child welfare agencies, information about obtaining appropriate family housing, and help with budgeting in preparation for the financial obligations of single parenting.

How to Prevent Tooth Decay

Can you prevent your child from becoming infected with the Strep mutans bacteria that causes decay In theory, this should be possible. Children generally get the bacteria from family members most commonly, Mom or caregivers. To prevent transmission, some dentists advise against sharing spoons, toothbrushes, or other utensils with a child or kissing children on the mouth. But others think this is unlikely to prevent transmission because it appears that by age seven virtually all Americans have been infected with Strep mutans. It will take a vaccine, they say, to block the bacteria and researchers are working to develop one. To protect your child's teeth from early decay, take these actions Never put your baby to bed with a bottle of formula, milk, juice, or anything but water. These liquids can pool in your child's mouth, bathing the front teeth (especially the upper set) for hours in decay-promoting sugars. The results can be dramatic The front teeth can decay so badly that they have...

Paging the Tooth Fairy

Out first, although it's not unusual for the permanent lower incisors to start pushing through even before the primary ones fall out. Once a tooth starts to loosen, it can take several months for the roots to dissolve and the tooth to fall out. In a healthy child, there's usually no need to hurry the process. If you have any doubt about whether a primary tooth is loosening normally or is wobbling because of a possible injury, consult your child's dentist.

A time of intense and rapid adjustment

Often books on pregnancy seem to trail off after the sections on childbirth and perhaps many parents-to-be are not interested in reading much further during pregnancy. However, it does seem important to emphasise that the emotional experience of those first few days may be very intense. The labour and the birth of the baby are an important part of the transition to parenthood but only a part. A time of high emotion and rapid adjustment continues in those first few days. It would be wrong, however, to give the impression that this is necessarily a negative experience. The difficulties are almost always outweighed by the joys. What is remarkable is to see a woman who, in labour, was feeling intensely distressed, half-an-hour after the baby is born sitting contentedly holding the baby as if she had been doing it for years. Two hours later the same woman may be in tears at her struggle to 'latch the baby on' to the breast. The first few days are about all of these conflicting feelings,...