Is my child eating right?

What do women discuss when they congregate? One of the subjects surely is the eating habit of their children. Not only mothers are disturbed about their children’s eating behaviour but also fuss around it. The fact remains that no child stays hungry. But, we have to ensure that the children are eating well, after all growing kids need more nutrition. Dr Rajeev Chabbra, consultant Pediatric and Neonatal Intensivist at Artemis, Gurgaon says, “Roughly children’s meals should be divided as: morning breakfast, mid day snacks, lunch, afternoon snacks, dinner and post dinner feed.”

“Offer your children milk, as soon as they wake up and before they retire to bed,” advises he. As it has been proven in the studies that if a child is given milk before sleeping they have sound and peaceful sleep. Breakfast of cereals is good as it contains complex carbohydrates which provide slow release of energy to sustain longer, the other options being poha, paranthas, sandwich,idli etc.

• Mid day snack portion may contain fresh fruits, handful of dry fruits


• Lunch should have a portion of vegetables, bowl of pulses/legumes, chapati/rice along with salad so as to fulfill the requirement of carbs/proteins/fats and fibres.


• Afternoon snack may include a glass of juice or some snacks which may be puffed rice/bhel puri/sweet potato/sweet corn/steamed peas,etc.


• Dinner should be the same as that of lunch and one should change the dal as different dals contain different proteins. If you are child eats non-vegetarian, give him/ her chicken and fish.


• To increase protein intake especially in growing kids, 5 eggs per week is recommended or for vegetarians cheese slices/cubes should be consumed.

Picky eaters

“Children who are fussy eaters are most of the time otherwise normal and it is always a behavioral problem. Stop fussing over their eating pattern,” Dr Neelam Mohan, consultant incharge Pediatric Gastroenterology at Ganga Ram.

Try to make mealtime a joy time for the family and as far possible sit together and eat same type of food.

Avoid offering food alternatives to the child. You should be firm but polite in your rules. Once a while junk food should be allowed but not regularly. Try to eat everything yourself as your child is watching you and will follow your eating behaviour.

Do not eat in front of the TV. If the child refuses to eat don’t shout or scream, just remove the food from there and do not offer any other alternative.

What should I buy?

The market is flooded with various milk food drinks for children. Each brand promises much more than the other, which leaves the consumers (in this case harried mothers) very confused. “Despite the tall claims made by each manufacturer, a closer look at the ingredients in these drinks shows they are more or less similar for all. They all contain milk solids, malt extracts, a sugar source (liquid glucose, dextrin, etc), flavouring, and are fortified with vitamins and minerals. Almost all the drinks are fortified with the B- Complex vitamins - thiamine, riboflavin, niacin, vitamin B6, and B12. The common property of B- vitamins is that they are essential for the metabolism and proper utilisation of energy, carbohydrates, proteins, and fat,” says Dr. Mohan.

Sail through the school interviews

These days there's a lot of hype surrounding the school admissions process. Entering into the school life is one of the many exciting milestones of childhood. However, it can also be a stressful time for both children and parents. When it comes to getting children admitted to formal schools, most parents take it very seriously. No wonder, you feel anxious about how you and your child will perform in the interview.

Admission at nursery level is generally based on an oral test of the child and interview or the parents. The main objective of the oral test is to observe the child to see what all qualities the child has; whether the child is active and really interested in studies: whether the child has got the capabilities to understand what the other person says and if so, how much receptive the child is, etc.

Known and unknown syllabus

• Identification of alphabets, colours, etc.


• Identification of birds and animals, vegetables, fruits


• Identification of common objects like household articles such as table, chair, pen, pencil, car etc.


• Recitation of one or two nursery rhymes


• Finding out missing alphabets and numbers: a, b, _, d, e, _ and 1, 2, 3, _, 5,6,7, _, 9, _, 11.


• What is your name?


• Name the days of the week, etc.

Preparing for the day

Get tension free

Your child will be judged according to her speech, perception of the world, and basic skills of reading and writing. So, do not take tension. Talk to your child enthusiastically about the big school, her admission and positive aspects in an interesting and friendly manner. Your worries will travel to her. Remember it is the first and not the last interview. So don’t punish her and always try to encourage with positive motivation.

Licensed to think

Preparation for the school interview is not an overnight activity. Interview or no interview; let your child express herself freely. Children shy away from neighbours, guests and relatives. This tendency should be curbed. The child must be able to express her thoughts and knowledge well, of course without being overconfident. This will ultimately help her to create a good impression in the 15 to 20 minute short interview.

More interactions

Make your child alert to the environment around her. Give satisfactory answers to her questions. Habits like greeting visitors, shaking hands with new acquaintances, saying hello to neighbors, wishing a New Year to a loved one, will help the child to not only do well in the interview. But these will be lifetime gifts.

Be neat and clean

Teach cleanliness as a matter of principle. Be strict with the child when it comes to maintenance of hygiene. Teach the child to clean hands before and after every meal. Do not allow her to fancy long nails. Stop him from spitting in public places.

Handle with care

Teach the child to take care of her belongings and manners. She should know the importance of discipline and punctuality in her life.

Before you hit the school

• Listen for any expressions of anxiety.
• Talk with your toddler about their feelings.
• Brainstorm with them to find things she can do to feel better.
• Make sure she is getting enough sleep.
• Make sure you are not over scheduling her.

Inputs Dr. Arti Anand, consultant clinical psychologist, Sir Ganga Ram Hospital, New Delhi.

What’s your child surfing?

The Internet has become an indispensable element of life for most people in the contemporary world, and children are not excluded. It’s a place where your kids jumble with others and enhance their social life. While it's a valuable resource for schoolwork, communication, recreation--and learning essential computer skills—there’re dark sides too. As a parent it is important to assume the responsibility for your child's online computer use, at home, at school, and even in the library. Sujaya Guha reveals more on this.

There are roughly 30 million children using the Internet today. It has brought the world into our living rooms, and in doing so has provided the opportunity to meet and communicate with people from all over the world. Today there are many sites contain areas where children and teenagers can post personal information about themselves including their name, age, location, photographs, contact details and in some instances their sexual preference. In many cases the predators attempt to gain a child’s trust by pretending to be the same age as their victim.

Dr. Arti Anand, Consultant Psychologist, Sir Ganga Ram Hospital, New Delhi expresses, “Internet bullying occurs more frequently with children. Threats, harassment and psychological torment via email or in a virtual chat can have a devastating effect on your child.”

Warning bells

• You find pornography on your child's computer.
• She is spending a large amount of time on the Internet.
• Receiving gifts, phone calls or mails from people you do not know.
• When you enter the room she changes the screen or turns the computer off.
• Increased aggression, poor school performance, fear, etc.

Steps towards safe surfing

Block out
Get to know the services your child uses. If you don't know how to log on, get your child to show you. He may not reveal everything but it’s a good start - at least he'll know you're interested. Find out what types of information it offers and whether there are ways for parents to block out objectionable material.

Right place
Locate the computer in a common room such as in the playroom or in your bedroom rather than in your child's bedroom. Children will be less likely to seek out inappropriate information and you can more easily monitor the website they are visiting.

Select the site
Discuss with your children what kinds of sites you feel are okay for them to explore, and which sites are not. “Tell them that not all web sites are friendly and if they encounter a site that makes them feel uncomfortable, they should leave the site immediately,” suggests Dr. Arti.

Avoid meeting
Never allow your child to arrange a face-to-face meeting with another computer user. If a meeting is arranged at last, make it in a public spot, and be sure to accompany your child. Be very careful about any offers that involve your coming to a meeting or having someone visit your house.

No chance to chat
Discourage your child from entering chat rooms. If there is a chat room on a topic your child would like to participate in, enter into the chat room together.

Be cool
Dr. Arti Anand shares, “Don't panic if you discover any record of inappropriate pictures or conversations on a computer after your child has used it. Talk to her if you're worried and explain that she shouldn't give out personal information to people she meets on the internet. Try to control your temper and handle the situation warily.”

Watch out

• A survey shows that more than a quarter of 11 to 18-year-old people visit adult websites, while 27% of them interacts with strangers online.
• Most children that fall victim to computer-sex offenders spend large amounts of time on-line, particularly in chat rooms. They may go on-line after dinner and on the weekends.
• Computer-sex offenders work very hard at driving a wedge between a child and her family or at exploiting their relationship.

When thumb sucking refuses to go

Your baby sucks thumb. This worries you. Take heart. Almost all babies suck thumb, in their initial years. It is a normal response to anxiety or hunger. Research shows that even unborn babies, who won’t experience hunger, suck their thumbs. My Health Guardian finds more about this childhood habit.
Thumb sucking is known to peak between 18 and 21 months and more than 80 percent children give up this habit before the age of four to six, on their own.

Thumbs down

Normally children outgrow thumb sucking. But if the child persists with thumb sucking beyond the age of 4 years, parents need to worry.

“A strong thumb sucking habit by a child beyond the age of five or six can alter the jaw line and result in ‘buck teeth’ where the front teeth may be pushed out of alignment. This can alter the shape of the face and lead to an open bite”, says Dr. Shilpi Tandon, dentist with Max Healthcare.
Dr. Tazeen Kidwai, consultant paediatrics with Max Health care says, “Children sucking their thumb are at increased risk of gastro-intestinal infections. Speech problems may interrupt the normal flow of conversation in such children and they begin to mispronounce ‘t’ and ‘d’, lisp and thrust out the tongue when talking.”
In fact, thumb sucking leads to a ‘cause and effect’ kind of scenario. “Friends can take jibes at such children, which in turn can increase her anxiety levels and lower her self-confidence. In a bid to soothe themselves, they begin sucking their thumbs and try to hide this from parents and peers”, points out Dr Arti Anand, consultant psychologist with Sir Ganga Ram Hospital.
In extremely rare circumstances, children continue with thumb sucking even in their teen years. “For them counseling helps”, informs Dr. Arti.

No more thumb sucking

1. Give stars. “You might mark a star on a calendar when the child goes without thumb sucking for each period (such as a day or week). Reward her by counting the stars she gets at the end of the week Then again give her some bigger gift as well more stars at the end of the month. Thus the child will be motivated to leave thumb sucking automatically,” shares Dr. Arti.
2. Divert her mind. While your child is watching TV, have toys available for her to play with. Sit with your little toddler during this time and give a hug to help her not to suck. Lots of praise and support should prove as an ally to help your child. In the car, give some toys to distract her attention from sucking the thumb.
3. Bitter bite. Your dentist or paediatrician can prescribe a bitter medication to coat the thumb. Apply this before she gets sleep or whenever you find her sucking her thumb.
4. Bind the thumb. Put gloves on your child’s hands or wrap her thumb with a bandage or a cloth. Explain her that it is not for the punishment but to remind her to get rid of thumb sucking.

Always keep in mind that nagging will not help, but patience and perseverance will.

St-ut-ter-ing in children

Stuttering is fairly common in children and more boys stutter than girls. This speech disorder scars the confidence of children and the sooner speech therapy is resorted to better it is for the confidence of the child. Dr. Asha Agarwal, eminent speech therapist working at Sir Ganga Ram Hospital writes----

The first time when I met Madhukar, he had come to my clinic with his mother. He was tugging at her sari while she talked to me and I saw a six-year-old boy with a thick mop of unruly black hair and sad eyes. His mother shared that Madhukar didn’t like to go to school these days. She was quick to clarify that he was a good student who usually got ‘A’ in all his written work at school. But, he had become a loner, refrained from meeting with his friends and was reluctant to participate in oral tests at school. Whenever Madhukar would open his mouth to answer, normally he would take a second longer to speak the word which gave an opportunity to his teacher to correct and his fellow classmates to sneer.

Like Madhukar, hundreds of children lose confidence in their capabilities because of stuttering that hampers their development. Learning to speak is a liberating experience for a child as it allows him to express his feelings. But speech becomes a deterrent to his development when each time he opens his mouth he fears that someone is going to correct him or people will make fun of him. Stammering usually gets detected in children by the time they turn 3 to 4 years old, because this is the time when they develop a vocabulary of words. But, I have come across episodes of stuttering in a two-year-old child. Initially stuttering is episodic; it comes and goes.

Contrary to myths, one cannot outgrow stuttering. In fact, if it does not get cured it can leave psychological scars in the child’s mind. Children with stuttering begin to lose confidence and resort to gestures to communicate. Studies have time and again reiterated that stuttering runs in families.

Boys stutter more than Girls. In 30 years of my experience as speech counsellor, I have seen thousands of cases and ratio of boys to girls is 70-30. However, girls stutter at an earlier age than boys. Emotions and stammering connect. Often, children who speak normally might stammer if they are agitated, afraid or under stress.

How speech therapy helps

Speech therapy helps in lowering the stutter by using various techniques to develop fluent speech that reduce anxiety levels of children, which helps them to talk more fluently and confidently.

• Relaxation – To co-ordinate breathing and reduce oral pressure.
• Phonation – co-ordinate breathing with articulators with soft contacts
• Automatic speech – to practice technique effortlessly
• Reading – short stories in simple sentences with voice continuity.
• Reading and Narration
• Conversation in close-set with strangers.
• Telephonic conversation
• Conversation in different situation like public gathering, presentation etc.
• Maintenance and follow up
• Parents involvement

Coming back to Madhukar, he regained his confidence when he learned to speak without stammering. Sometimes he does stammer when he is too angry and for these moments his mother hands him a glass of water to cool off. He looks forward to go to school and has huge gang of friends.

Raise confident kids

Self –confidence is a feeling of trust in one’s abilities, qualities, judgment, and value. Some children seem to be born with coyness and a lack of self-confidence. Dr Arti Anand, consultant psychologist with Sir Ganga Ram Hospital says, “A shy child will hesitate to make new friends and clings to the mother when she meets new people or in new situations. She will not talk to people who come at home.” Regardless of the cause, you can help your child build a healthy level of self-confidence. It helps your child to develop mentally and emotionally.

Positive parenting means responsibility of a parent to help a child grow with self-confidence. Dr Anand points out, “Such children become back benchers and resist to respond to teachers because they are afraid of any spot light shining on them.”

Road to confidence

1. Be proud parents. Be proud of your kids and show that pride. Be proud of what your child is and express that pride. Knowing that you’re proud of her, she will always refrain herself from going on a wrong path and will never hurt your expectations. This will definitely build her self-esteem.
2. Trust her! Trust, as we all know is “earned”. You must start building trust between you and your children. Nothing builds confidence in human beings like trust. Though it is not always easy for a parent to feel sure of their children’s abilities, start with small and realistic steps that are agreed upon and carried out.
3. Praise her. Appreciation works more than criticism. Parents often speak without thinking. Statements such as, “You’ll never get it right,” or “Don’t be so stupid,” may seem harmless when spoken, but they send a negative message to your child that contributes to a low self-image. Dr. Anand advises, “Build your child’s self-confidence by providing frequent, genuine statements of praise. Tell your children they are special, that you love them even when they fail.”
4. Perfect role model. Children learn a great deal by watching the role models in their lives. Parents are the first and the most important role models. Do not put yourself or your spouse down in front of your children. Be the perfect role model for your little angel.
5. Help them to choose right. Give your child choices. Being able to make decisions is something that your child will have to do all throughout life. Such decision-making skills will give your child confidence in her ability to make her own choices, as she gets older.
6. Admire your toddler. Respect your child's interests, even if they seem boring to you - take a genuine interest in your child's friends, and what's happening at school, and comment to show you're listening. “All the children should be given a chance to participate in plays, sports etc. Teachers should be polite and kind while expressing a failure rather than shouting and screaming at them,” suggests Dr. Anand.
7. Self-dependent kids. Don’t do things for your child that he or she can do alone. Children need to learn to take care of themselves and they learn this through hands-on experience. By knowing appropriate developmental stages of your toddler, you can identify which tasks he or she can safely do without your help. In the end, this will help build self-confidence.

My ear hurts.....

It can be difficult to tell, but if your child has a cough or runny nose and then suddenly develops a fever for three to five days, it may be caused by an ear infection. Ear infections are among the most common illnesses of early childhood. Three out of four children have had at least one ear infection by age 3, according to the National Institute on Deafness and Other Communication Disorders. Dr KD Gupta, Consultant ENT Surgeon with Sir Gangaram Hospital discloses, “The ear cavity internally opens into the upper part of the mouth cavity - one on each side by a tube like structure. This tube allows ventilation of the ear cavity. In young children the tube is short, wide and straight and this allows easy spread of infection from nose, nasopharynx (upper part of mouth cavity). This is the reason that young children are prone to ear infections.”

However he is quick to mention that children most affected are between 3 to 7 years of age. This is because babies are often fed improperly (whether breast fed or bottle fed). Dr. Gupta even points out, “ During feeding a baby's head should be raised. If babies are fed lying flat, milk regurgitates easily from the mouth into the ear and an infection sets in.”

Symptoms

Ear infections can be hard to detect, especially if your child is too young to say, "My ear hurts." Children with ear infections may:

• Tug or pull at their ears
• Cry more than usual
• Have trouble sleeping
• Fail to respond to sounds
• Be unusually irritable
• Develop a fever
• Develop fluid that drains from the ears
• Have headaches

Treatment options

Your child's treatment decision depends on several factors including:

• Your child's age
• History of previous infections
• Whether your child has any underlying medical problems

Most ear infections safely clear up on their own without any antibiotics.

“By 7-10 years of your baby the Eustachian tube (the tube mentioned earlier) becomes larger, narrower and less straight. Hence there is a less chance of ear infections,” Dr Gupta adds.

Normally, treating the pain, steam inhalation and allowing the body time to heal itself suffice. Curing the infection may need a dose of antibiotics. When giving antibiotics to young kids, follow the dosage, schedule and your doctor’s advice strictly.

Watch out

Dr. K.D. Gupta warns that recurrent infections can impact hearing. He says, “Children with persistent ear infections do run the risk of hearing loss. If a child turns the volume of TV high and does not respond properly are warning signs for parents warranting an evaluation of the ears of the child by an ENT specialist.”

Prevention

• Protect your child from secondhand smoke. Keep your child at bay from smoke. Stay in smoke-free environment.
• Breast-feed your baby for at least six months. Breast milk contains antibodies that offer protection from ear infections.
• Ask your child's doctor about the pneumococcal vaccine (Prevnar). Studies indicate that it slightly reduces the risk of ear infections as well.
• Try to limit the use of any group childcare. Children in childcare settings can easily spread germs to each other.
• Washing your hands often. Hand-washing stops infection from spreading by killing germs.

Fighting tooth and nail

Accidents happen without notice! Same with dental emergencies, but if you are updated on ways to handle an emergency situation, it can spell the difference between a ‘lost’ and reclaimed ‘tooth’.

Handling dental emergencies

1. Broken tooth
Seeing your child with a broken tooth can be a gut-wrenching sight. Keep patience and do the following—

• Carefully rinse the tooth in water. Make sure that you do not touch the root of the tooth with your hands. The root is the portion of the tooth embedded in the gum and not normally seen.
• Attempt to place the tooth back in its socket and secure with a wet wrap. If this is not possible or if you are afraid that your child might swallow the tooth, place it in a glass containing either saliva or milk.
  See your dentist immediately.

2. Chipped tooth
Check to see if your child is experiencing pain or sensitivity in the tooth. If so call your dentist to seek dental treatment immediately. In case your child is fine, contact your dentist to see whether or not your child should be seen. In most cases of chipped teeth, you can simply schedule a future appointment to replace the lost portion of the tooth with a porcelain veneer or with bonding material.

3. Bitten Tongue or Lip
Clean the area gently with a cloth and then apply cold compresses to reduce the swelling. If the bleeding does not stop, go to a hospital emergency room immediately.

4. Objects Caught Between the Teeth
Try to gently remove the object with dental floss and avoid damaging the gums. Do not use a sharp instrument. The best item to use is a plastic toothpick that has an angulated tip. If not successful in removing the object, visit your dentist.

5. Toothache
Rinse your mouth with warm water to clean out the area. Make sure there is no food or any other object lodged around the tooth. Use dental floss to clean the area thoroughly.
Never put aspirin or any other painkiller on the gums or around the painful tooth because it can burn the gums, thus causing more harm than good.

Preventing dental injuries

The best way to prevent a dental emergency is to properly protect your child. Increasingly, dentists are recommending that children engaged in sports wear mouth guards. Once only used in football and ice hockey, mouth guards are now being recommended for other sports as well. Most mouth guards are made of plastic and cover the lower teeth.

Not only do mouth guards protect teeth but they also protect lips, gums, and cheeks. Commonly there are two types of mouth guards:
Another way to reduce the risk of dental injury is to watch out for situations that commonly lead to injury. These are some of the more common:

• Trips and falls - Falling into furniture and down stairs often causes dental injury. This is most likely to occur when children are first learning to stand using furniture to maintain balance. If you have a baby childproof your home before he learns to walk.
• Water fountains - Often kids injure teeth by ramming them into the spout of water fountains as they drink. Sometimes kids behind them accidentally bump into them causing them to injure their teeth.
• Forks and Spoons - Believe it or not, some injuries are self-inflicted when people, not paying attention, crack or chip their teeth with spoons or forks as they eat.
• Bottle Caps - Tell your child to never open a bottle cap by teeth.

If you have young children at home make sure that your dentist has after hours coverage, which means there will be a qualified dentist available to take care of emergencies and keep the phone number handy.

Dr. Ramesh Mathur, Chairman Max International Dental Academy

Living with autism

Two-year-old Minal hardly spoke for her age. She is fond of symmetry, babbles few words, which her mother can comprehend and is a stickler for symmetry. Most of her waking hours are spent in stacking her toys in a specific fashion. When she is not stacking her toys, she is flapping her arms like a bird, and if she hears her name, she avoids eye contact. Minal is autistic.

Autism is greatly misunderstood. “It is a developmental disorder in young children that affects three important aspects--development skills,social skills, communication skills and these children have repetitive or restrictive activities”, says Dr. Raghuram Mallaiah, neonatolgoist at Fortis La Femme hospital, New Delhi. The symptoms of autism are present in the child from birth, but they become apparent between 18 months to 3 years—a time when social development begins to occur and language skills are learnt. “Diagnosing autism is difficult”, mentions Dr. Mallaiah. Not only, is it a complex condition to diagnose, but also there exists low awareness levels on this disorder. A number of children with autism may have normal IQ and the only problem that is apparent is their poor social skills and language development skills or repetitive and obsessive behaviour. Since genetic and blood screening is incapable in divulging autism, investigations by a trained psychologist only could offer clues on it.


Causes
“Autism is multifactorial, but a larger number of evidences have begun to nudge towards the genetic link, as more than one child is born with autism in one family”, informs Dr. Mallaiah. There has been a good deal of debate if autism is linked to MMR vaccine. Dr. Mallaiah says, “ The evidence to support the link is very weak and the most likely explanation was the fact that MMR is given at 15 – 18 months, round about the time when autistic behaviour starts becoming apparent to parents. There have been large studies that have denied these associations. The medical fraternity on the whole would recommend all children to be vaccinated.”

Spectrum
Incidence of autism in developed countries where there is better awareness of the condition is said to be about 1-2/1000 children. These numbers include milder forms of autism too, says Dr. Mallaiah.

Earlier autism was dismissed in India. "From one in 10,000 children ten years ago, the prevalence is 3-4 per 1,000 live births now," says Mythili Chari, Founder-Director of the Institute for Remedial Intervention Service (IRIS) and member of the Expert Committee (Mental Retardation) under the Rehabilitation Council of India. Mythili adds wryly. "Those who dismissed it as a low-incidence disorder are now being forced to sit up and take notice.”

In India concrete steps towards autism happened with the Action of Autism—a society set up by Merry Barua in 1991. Parents can detect traits of autism in their children, if the child shows two or more of the following symptoms, says she.

1. Absence of warm and joyful expression
2. Does not respond to his/her name
3. Refrains from making eye contact
4. Babbles incoherent phrases, has unusual voice quality, tone and pitch.
5. Does not show and tell.
6. Indulges in repetitive behaviour.
7. Has a special fondness for symmetry

“Autism can’t be treated with medicines”, says Mythili. Dr. Malliah agrees, but, behavioural and speech therapy help moderate the severity of symptoms. “Children with autism do not benefit with learning by rote method. They need instructions based on applied behaviour analysis with a strong focus on structured teaching and experiential learning”, says Barua. Caring for a child with autism is resource intensive and often these children need to work upon the skills they possess. “However, these children might need special care and attention through out their lives”, says Dr. Mallaiah.

Societies for autism in New Delhi

Open Door
url: http://www.autism-india.org/afa_opendoor.html

School of Hope
CPWD Complex
Near Chinmay School
Vasant Vihar
New Delhi 110 057
tel: 26143853, 26151572
e-mail:tamana@mantramail.com

Action For Autism
Pocket 7 & 8
Jasola Vihar
New Delhi-110025
Tel: 91-11-65347422
Tel: 91-11-40540991, 40540992
Email: actionforautism@gmail.com
url: http://www.autism-india.org/index.html

Well-behaved kids

You can learn many things from children. How much patience you have, for instance.
Franklin P Jones

All children have episodes of bad behaviour, some more frequently, severely and others less. It’s just a fact of life! As parents you can’t escape scenarios when your child will act in annoying or hurtful ways and refuse to co-operate with your requests. It’s normal for parents to fly in rage at such instances, but rage does not help, instead complicates the matter further. A good understanding of normal problematic behaviour can help you respond appropriately and more sensitively to your child at a time when she needs you most.

There is a growing epidemic of bad manners among school children. Teachers are complaining that their students, some as young as seven, are speaking to them in the same familiar way they speak to their friends. Dr Arti Anand, consultant clinical psychologist with Sir Ganga Ram Hospital says, “Young children imbibe behaviour of parents. If parents behave badly, children are going to learn that.”

Tell-tale symptoms

• Using bad language
• Behaving aggressively or violently
• Destroying property
• Lying
• Stealing
• Refusing to cooperate with necessary tasks, such as getting dressed in the morning, going to bed at night or doing schoolwork.

Causes

Why my young one is becoming difficult these days? If the question bothers you, experts have answers. Children try to grab attention, wrest power and sometimes seek revenge through their bad behaviour. Rude behaviour is also a garb for lack of confidence and feelings of disappointment.

Seven steps towards better-behaved children

1. Explain limits. When your child doesn't understand what you expect, explain your reasons. Make polite requests for changing misbehaviour, and be specific and concise. Say, "Please play with the ball outside, not inside, because something might get broken."
2. Provide a reminder. When your child forgets a rule, tell him the rule again. Explain what happens if the rule is not followed. After you have reminded her of this rule, place her in the stroller if she breaks the rule again.
3. Take your time. If you find yourself angry or frustrated with your child, "take time." Take a deep breath, count to 20, or give yourself five minutes away from your child to cool down before you respond.
4. Aggression hurts. Never strike your child in anger. This teaches your child that aggression is okay. Dr Arti points out, “ Sometimes the teenagers become aggressive and out of control if their demands are not met. Again if parents do not spend quality time with their children or are unable to communicate with them, children tend to be frustrated and aggressive.”
5. Time out. Learn to use the "time out" method to help your child regain self-control. Give your child some time alone, not as a punishment, but as an opportunity to recover from a bout of misbehaviour. Try to discuss the behaviour problem constructively with your child.
6. Take a break. Allow for some breaks in routine to reduce boredom. This gives children a chance to experience fun and variety, and still lets them return to the security of familiar routines afterwards.
7. Just ignore. Ignoring misbehavior is an effective way to deal with fighting between siblings and misbehavior that is directed at getting attention. Children do need attention. Children, who do not get enough positive attention will settle for negative attention, e.g. yelling, brought on by misbehavior.

As parents we strive to give our children what we didn’t have in our growing years. Sometimes in this struggle, children miss out on what we had in our growing years—time of parents. Children are malleable and inculcating good behaviour is not difficult after all, but like all episodes of parenting it is going to test your patience. Amen!

Scouting for summer camps

Summer vacations are here. With schools closed and long summer days outstretched before us, parents are in look out of activities and engagements to keep their children busy, and what better way to do that than to enroll them in a summer camp. Normally, schools offer summer camp for their students, but the neighbourhood children are also welcome to enroll. While some schools like Excelsior American School allow students to invite their friends and cousins to enroll in the summer camp. Arti Anand, psychologist Sir Ganga Ram Hospital says, “Summer camps provide an opportunity to children to engage their minds in creative and active pursuits away from the indoctrination of TV. They learn new things which makes them confident” Normally, children believe summer vacation is for watching and re-watching runs and re-runs of their favourite shows and to fiddle with their cool videogames. “Normally children stay indoor these days. By enrolling in an active sport like horse riding or skating they get the much-needed reprieve from TV and the necessary exercise”, says she.

Namita, spokesperson for Alpine school says, “The whole philosophy behind summer camps is to keep children busy by engaging them in creative pursuits without encumbering them with the burden of studies.”

Shopping for summer camps

Many playschools in conjunction with various hobby classes spring summer camps in these months to cash on the trend. They may be a viable option as they are in the neighbourhood, still if you are deciding on summer camp, it is advisable to talk to your children and explore their areas of interests.

• Activity—the kind of activity in the camp should be in sync with the interest of the child. Gitanjali Dogra, manager with Amadeus school Gurgaon, says, “Amadeus school offers sporty activities like horse riding and skating, and have facilities of swimming pool for children and parents alike.”
• Counsellor—As goes with any group-based activity a moderator or counsellor is assigned to a group. The group should be large enough to foster interaction and small enough to be monitored. Ideally, seven to eight members in a group suffice.
• Duration—Summer vacations are meant for unwinding and relaxing. A camp engaging children for a duration longer than three-four hours and more than four weeks thwarts the purpose and begins to double up as day-care.
• Transport—You got to find about the pick-up and drop facilities. Alpine school offers free transport on their bus route, informs Namita.
• Meals—Will the children get some refreshments at the camp or will they need to carry their own?
• Amount of activities—Any camp that boasts of doing too many activities will not do justice to even one.
• Cost— Summer camps come at a tag of Rs. 500 per week to Rs. 1500 per week.
• Flexibility—Will the programme allow you to enroll for a week or two or you have to enroll for a month?

Before scouting for summer camps it is a good idea to have a heart-to-heart talk with children on what they wish to do. After all, children should be interested in the array of activities that are on offer in the summer camp to make most of it.

Burdensome education

A new school year is here! Lugging heavy bags to school have become an integral part of school life.

Check that bag
Children between the ages of 6 and 14 are typically in their formative ages. At this stage the body's vital organs are not fully developed and are therefore more vulnerable to injury. The heavy book load that children are subjected to carry lead to physical stress and poor posture, which may have repercussions on spine health.

Dr S. P. Mandal, senior consultant, department of orthopaedics, Sir Gangaram Hospital reveals the health hazards of lugging heavy backpack. He expresses, “Heavy backpacks affect your child's health in many ways. The pressure of the belt in the bag presses the vital structure of shoulder and neck, due to which in the long term can cause muscle fatigue and neurovascular embarrassment.”

“Ideally for a ten-year-old child the weight of school bag should not exceed beyond two to three kilos”, advises he.

Tips to load-off

• Encourage your children to check their timetable carefully to minimize the load to be carried.
• Your child's school should provide lockers as a storage space to lighten the load.
• Help your child to avoid countless bulky books, which make your child's load too heavy.
• Keep a set of textbooks, which can be shared by groups of students.
• Provision of safe drinking water and hygienic food in the school canteen instead of allowing them to carry these from home.
• Also encourage your child's teachers to plan ahead and inform students when texts are not required for lessons so that they are not carrying unnecessary loads.

Some schools like Excelsior American School, Gurgaon believe in the philosophy of going ‘bag-less’. Parents need to help the school in this effort and Shalini Nambiar, Director of Excelsior American School, Gurgaon, gives some advice in this regard— “Check that backpack on a regular basis. They are typically full of unnecessary items. ... I think if you went through the backpacks, you could shed 10 pounds just like that.”

“Isn't school a place to study and home a place for parents to spend quality time? I often have parents insisting on homework but one needs to give this keeping the age of the child in mind. Homework should be re-enforcement of what is being done in school and if it is well planned then children don’t need to carry loads of books back home,” she adds.

When kids learn to lie

Parenting is akin to enrolling yourself in a school. Everyday springs new surprises and has lessons to offer, wise parents keep learning and moving on. Often, parents feel shocked when they learn that their otherwise honest and truthful child has begun to experiment with lies. While some lies are innocuous and are products of overactive imagination, there are some, which are spoken intentionally. Now, there is a good and bad news attached to it—the good news is that the child has become grown up enough to tamper with facts to wriggle out of awkward situations like an adult to save his skin and the bad news is that he has learned to lie.

Agreed, these lies are not big and are usually in response to the questions that children prefer to avoid, yet lying is not good.

Why kids lie?
Lying is a symptom and it calls for parental affection and concern. My friend's eight-year-old, daughter Sagarika complained of unexplained aches and pains in her leg just before the Kathak class. The pains would last only for an hour. Her mother insisted on taking her to the class and sat through out the session. She found that Sagarika was not able to dance like the older girls in her class and felt de-motivated for this reason. When she joined the class meant for girls of her age group, she became the star dancer and her pains vanished. ‘Now, in fact, she looks forward to her Kathak class’, says the beaming mother.

Sometimes what we call lying is just a figment of imagination. Kids live in make-believe world and their thoughts correspond accordingly.

Many a time unknowingly parents introduce their children to the web of lies. What do we expect our children to learn when we ask our spouse, friend or staff to answer a phone call for us and concoct an excuse for us. The impressionable minds of children are quick to learn that adults tamper with facts, and so can they.
Often, parents tend to attach strings to their love towards the child. Sometimes this can coerce your child to tamper with truth because s/he wants to conform to the standards set by parents.

If you find that your child experiments with lies make them understand that lies erode trust. Have faith in your children and try to get to the root of lying; you might find a fear lurking there.
As kids grow they become more independent and want to exert that too. Often lying becomes an escape route to wriggle out. Try to see them the reason behind your questions and they are likely to conform to your expectations. Have faith, your kids are going to get out of this habit.

Raising children with healthy body image

Weight has always been a tricky subject. With new entrants--young girls who are obsessed with their reed thin frame, the weight imbroglio has taken a dangerous turn. Media has a role in it because it continuously beams unrealistic body images. Girls as young as four have deciphered their body image and there is absolute clarity on the subject. Thin is what they want and will strive to be, and thin has a name now—it is size zero, the size Paris Hilton is and closer home Kareena Kapoor has reduced herself to.

No denying the fact that obesity invites several health complications and there is a greater likelihood for obese children to grow in obese adults, yet this degree of fanaticism with weight scares parents and has reasons to do so. Size zero has been linked to anorexia nervosa and bulimia, which involves extreme steps like starvation and throwing up after having food to lose weight.

Repercussions

• If a growing body is starved of calories, it leads to frequent attacks of giddiness and hypogly-caemia (a sinking feeling due to low blood sugar level).
• These children become more prone to infection, as their immunity takes a nosedive. We have seen a rise in cases of tuberculosis in young adults even in well-to-do families.
• Fewer calories create a hormonal imbalance and cases of irregular periods are common among teenage girls. They appear tense and frequently complain of headaches.
• Among boys, inadequate calorie intake may result in delayed growth pattern. The body becomes more prone to hypocalcaemia (low level of calcium in the blood) thus becoming vulnerable to fractures.
  ‘Parents have a sensitive task before them. They have to maintain a very delicate balance between promoting a healthy weight and placing too much importance on body weight’, says Evelyn Tribole in her book Intuitive Eating anti-diet and self-help book.

Ten tips to instill a healthy body image

1. Educate your child about the genetic differences in body types and the nature of prejudice.
2. Avoid placing judgments upon people who do not meet your standards for beauty. Refrain from giving critical comments like, "You"ll look more beautiful if you lose some pounds," or "Don't eat so much. It will make you fat."
3. Discuss with your child the dangers of trying to alter body shape through dieting. Emphasize the value of choosing the right kinds of food and moderate exercise for stamina and cardiovascular fitness.
4. Avoid labeling foods as "good" or "bad" and "low-fat" or "fattening".
5. Be a good role model in regard to sensible eating, sensible exercising and self-acceptance.
6. Help your child develop appreciation for others - especially women - for who they are and what they do and not for what they look like or how they dress up.
7. Do not limit your child's calorie intake unless a physician has instructed you to do so. Children need a variety of foods including fats, protein and carbohydrates for their growth and body maintenance.
8. Allow your child to be active and to enjoy what they do and feel. Encourage them to exercise for their health rather than their weight.
9. Give them a lesson in metabolism. It is a known fact that our metabolism slows down when we cut down our intake of calories.
10. Promote your child's self-esteem and self-respect in every aspect of their being, including intellectual, athletic and social endeavors.

With your support, your child will overcome her fixation with body image. This is the time when children should feel secure in the growth of their body and that’s the way to be.

Holi Hai!!

The festival of colours is round the corner. The official welcome of spring, a time of new beginnings and blossoms can also become a time, when you scurry to your paediatrician's office with your kid in tow. Kids go wild while playing Holi. Read ahead to learn safe ways to celebrate Holi and have more fun minus the inconvenience and pains. This sounds a better way of celebrating Holi.

What meets eye
During Holi eye injuries are on rise, a majority of them result from balloons hitting an eye. .

Eye traumas arising out of Holi include –

• Direct injury- when a water-filled balloon hits an eye, it causes maximum damage and it could result in vision loss of the affected eye.
• Abrasion and problems due to chemical toxicity- Usually sand and mica, glass, talc and starch are mixed in colour. It damages eye, may result in impairment of the eyesight. If the coloured water splashes in eyes it can damage the ocular surface and cause temporary visual disability, discomfort and complications that pose a great danger to the vision.

Toxic colours
Colours appear innocent but they are not. Colours can harbour acids, powdered glass and asbestos, silica, oxides, copper sulphate and mercury sulphite to name a few. The speckled shine in colours comes from silica and mica - substances that can cause skin irritations and even damage your vision.

Play safe

• Dress your child in full-sleeve shirts and trousers, preferably denims.
• Smear her with oil all over including hair.
• If she agrees, make her wear dental caps to protect her teeth from staining.
• Sunglasses can keep her eyes safe.
• Buy natural colours and refrain from using colours with toxic chemicals.

After-effects
If your child feels nauseous after playing with colours, take him/her to the doctor immediately. Aloe Vera gel and Calamine lotion are good skin soothers post the celebrations. If coloured water splashes in the eyes of your child wash with lukewarm water. Watch out for the clarity of the vision, in case the child complains that the clarity of the vision is affected take her/ his to an eye-specialist immediately.

Winning formula for exams

Exams exasperate. Now, that they are almost there, students are cramming their textbooks with feverish pitch. Nevertheless, many times children fear that they are not able to retain what they have studied and their mind is as blank as a blackboard. The stress levels soar high during the exam time and parents need to learn PQRST model to help their child with revisions so that the fears of children could be put to rest.
Imperial College London has suggested PQRST, which is a good revision technique that can be used
Preview - skim the material to get an overall preview
Questions - formulate questions that highlight what you aim to derive from your reading
Read Actively - make appropriate notes of key ideas
Summarize - identify the main points using lists, key words, flow diagrams, etc. and connect them with knowledge from other sources
Test - test yourself by reciting and reviewing the summaries immediately after learning the material and again at later intervals

A good way for effective retention is to take breaks while studying.

Strategy inside the exam hall
Writing exams is an art and like all other arts it needs to be mastered. After all, this is the place which judges your academic accomplishments in a time of three hours. Naturally, stress and exam hall go together. Take help from tips mentioned below to score better in the exams--

Map your time. This is the primary rule of writing an exam. Read the questions carefully and allot time to writing answers to these. While solving numerical questions if you are getting stuck, it is a good idea to move on and return to the question later. Always strive to have 15 minutes in hand so that you can revise the answers before handing your answer-sheet.

Avoid irrelevance. This is not going to fetch you any mark and your will waste your time.

Write in a legible handwriting and avoid grammatical and spelling errors. It becomes difficult for examiner to give marks if s/he can't read what you have written. Spelling errors and grammatical mistakes are a big put off.

Underline important points. Leave a line between paragraphs and between the answers. They may sound common sense, nevertheless are overlooked in the hurry to complete the answers.

Start your answers with crisp definitions, and give relevant diagrams wherever necessary.

Tips for parents

1. Exam time is stressful for children. However, with the support of parents children can beat stress.
   Be affectionate with the child but your over-attention is going to make him/ her uncomfortable.
2. Spend some light moments with your child. It could be sitting at the dinner table and sharing some jokes with the family.
3. Forget about an exam as soon as your child has appeared for it, ruminating over it is not going to help you or your child. Inculcate the same in your child.
4. Do not set down rules for your child; let the child follow his or her routine while studying
5. Encourage your child to take adequate breaks.
6. See that the child gets eight hours of shut-eye.
7. Nutritious food is essential for your child but steer clear of foods that are high in fat and sugar.
8. Fresh fruits and vegetables are the best bet.
9. It is however recommended that in extreme cases of stress, insomnia and tearfulness expert consultation should be sought.
   

Finally, children remember external pressures around exams can be huge. It can be hard to deal with, especially with family and people you respect, but you need to remember that it's your life and your exam, with you in control. Also try to put the last exam out of your mind and look ahead to the next one - you can't go back and change things.

Day-care dilemmas

There is no place like home. But for mothers who work day-care is inevitable and so is the dilemma. When it comes to children we hate to compromise, yet many of us are ignorant of the facts, one should look for while deciding on a day-care.

Checklist

1. Go by the word of mouth. While deciding on a day-care, go for one, which is highly recommended. Seek the opinion of other mums.
2. Find out adult to child ratio. Experts say that crèche should have a realistic child-staff ratio. That is one adult to four two-year-olds or six three-year-olds. Avoid crèche that is run by ayahs, maids rather than mothers and facilitators.
3. Is it clean? Look for a day-care that is clean and comfortable. This means toilet flushes should be in working conditions, clean toilets and mattresses to loll around the daytime. Staff should be aware of hand washing practices.
4. Are children punished? Corporal punishment is a big no. So is a crèche that ostracises children by making them wear badges for an unacceptable behaviour. A day-care that reprimands children for accidental leakages is to be avoided.
5. Safety. Safety is of paramount concern. Have a close look at the driver who ferries children in the van. If the school employs a teenaged driver then reject the day-care immediately. Does a maid accompany children in the school van? Do they keep tissue papers to wipe nose of children and water with plastic cups in the van. Do they have child-proof switchboards? Is the toilet seat low for toddlers?
6. Could you visit anytime? An open door policy for parents is what you want. Does the place seem clean whenever you walk in? Large imposing gates are intimidating and a day-care that does not allow you easy access to your child is not a good idea, after all.
7. Activities. A day-care should endeavour to have a healthy mix of activities. Children should have a routine to follow for all their activities, which should offer age-appropriate stimulation.
8. Open space. A day-care that offers open space like a jungle gym or a park is preferable to one that does not have this kind of space. Young children need open areas to expend their energy.
9. Number of children. Smaller the size of daycare better it is. Also it is not a great idea to mix children of different age groups, as they have different requirements.
10. First aid knowledge. The staff should be trained enough to handle emergency situations. Children as well the staff should follow the vaccination chart religiously.

If you feel that your baby is not accepting day-care, there has to be some inherent problem with the day-care, or your child is not ready to accept separation from the mother. To make transition easier start looking for better options—like a crèche at work, working from home, flexi-timings, so that you are able to spend more time with your baby.

BEAT BULLYING

What bullying does?

In our growing years we all have faced bullying, either we were bullied or we did the bullying. All said and done, bullying is a universal phenomenon. Though years later, you may recover from the aftereffects, while you are undergoing it does make life difficult and miserable for the victim. Without doubt, it erodes confidence of the victim and when s/he decides to retaliate, the price may be steep sometimes stained with blood, as we witnessed recently in Gurgaon. Everyday in our schools, families and neighbourhoods children are tormented, teased and bullied for their looks, accents, intelligence and backgrounds--to name a few. No doubts, bullying is a big menace and we need to do someting to curb this.

Bullying takes many forms: it isn't all physical violence, it is also verbal and social abuse. Passing a nasty remark, a snigger, calling names come under the purview of bullying. Bullying erodes the confidence of the vicim and often stems from low levels of self confidence of the bully.

Bullying can't be brushed away, rather it needs active parental intervention as well support of school to curb this menace. Spending quality as well quantity time with children is mandatory to curb bullying. Listen to what they have to say because in our hurry we often forget to hear what kids need to share, and if you get a whiff of the fact that your child is bullied, do not ignore it, rather complain and take action. Let us all join our hands to beat bullying and not bullies.

Health Web Sites

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