newsletter Feb06

the 2nd newsletter, Feb 2007

The fears before giving birth

Awaited for impatiently like all unique events, feared with anxiety as all unknown events. Waiting to give birth is something full of contradictions: on one hand there is the joy of finally being able to embrace a child, on the other there are the doubts that inevitably arise when you get ready to face an event that you have never been through before. "What will happen?", "will I push correctly?", "will I know how to recognize the contractions?" and above all "will I be able to bear the pain?". There are many questions. Knowing about giving birth and the techniques that can assist you, can help you to reach a level of awareness and, therefore, confidence and calm that are necessary to cancel your fears. It is essential, however, to learn to accept one's fragility, one's state of mind, one's feelings. It is essential to learn how to listen to your inner self.

One of the most common fears for many future mothers is that they will not be able to physically deal with the moment of birth. When the event is approaching and the child has reached his full size, it can seem unbelievable that the baby can succeed in passing the hips, especially of the mother is minutely built or if she has been told that the baby is particularly "large". This is an unjustified worry because mother nature intervenes to resolve the problem and see that the measurements of the baby and the “adapt to suit the circumstances.” And just as unjustified is the fear that you will not recognize the labour pains: the cases of children who are born before the mother's arrival in hospital are rare indeed! The final labour phase is generally preceded by a preparatory phase, during which the future mother has contractions that can be quite painful and regular, but rather short: as a rule they don't last more than 20-30 seconds.

Only when the contractions occur at about 5-6 minutes apart, but above all when they increase in length (60-70 seconds) and intensity (they progressively become stronger) has the moment come to go to the hospital. Before then it would be inopportune: the preparatory phase can last, in the case of the first child, for even more than 24 hours.

Behind the anxieties of a future mother often hides the fear of the pain and the idea of not being able to bear it. The most important form of relief, also in this case is provided by nature, that has given women extraordinary instruments to bear the labour pains. During labour the maternal organism begins to produce large quantities of beta endorphins, that is endogenous morphine that has the same effect as opiates. In practice it is as if the body "anesthetizes" itself to bear the pain. Nevertheless if it is true that the mechanism works in all mothers, it is also true that the pain of the birth represents a totally personal experience, related to a variety of different factors, of a psychological and cultural nature. Behind the fear of physical pain, in fact, there are often other hidden fears and torments: the idea of losing one's status of being a pregnant woman and of "being physically separated" from the baby; the fear of not being able to cope with the role of a mother, the worry that the baby that is about to be born is not how you had imagined him during pregnancy; the shame of publicly experiencing such intimacy and pain. Acknowledging these fears, confronting them, talking to others about them, and re-dimensioning them is the only real solution to regaining your serenity and find realistic answers to your doubts. Answers that are nearly always found during the prenatal courses, where you learn about the birth, the relaxation and breathing techniques that help you to bear the pain and prepare for labour in a calm manner. The most important thing is to aim to achieve a psychological condition which will help you overcome the more intense moments more easily; don't dwell in advance on the event, have an open opinion, don't be influenced by stories of negative experiences. Giving birth is an entirely natural event that, in most cases, occurs in a totally natural and extraordinarily simple manner.

Amazement and worry. Joy and fear. Intense emotions and conflicting feelings that nearly always hit mothers and fathers when they hear the news that they are expecting...twins. On the other hand this is normal: become parents of twins is not a common experience and it requires without doubt great commitment and great sacrifice. The secret is to learn to get organized from the very start on order to face the commitment and discover that double the responsibility can also correspond to double the happiness.

Let's start with the nursing aspect. Needless to say that this will occupy a great deal of a new mother's time, reaching possible 12-14 feeds in just 24 hours. It is important in any case that the babies are breast fed at the same time, even if only one is actually feeding: it will help to synchronize their times and to simplify the organization of the day. The breasts must be alternated and if feeding times are particularly tiring, it is possible to use special U-shaped pillows, inserted under the arms to support both babies. If the babies are bottle fed it is essential that the bottle is offered in cycles, one after the other. It can be useful in this case to prepare some extra supplies of milk to keep in the fridge in order to face the next 24 hours. Also bathing and changing the nappies should be done separately, one after the other. If you have some help, it is best for someone else to look after one baby while you change the other. On the contrary, ma ke sure you place the second baby in a safe place where you can keep an eye on him. With regards to sleeping, it is recommended during the first dew weeks that the twins sleep in the same cot: they shared their mother's tummy for nine months, they will undoubtedly appreciate the reassuring presence of each other. After this short period, however, each one should have his own cot. Night-time rest is hardly ever a problem: the synchronization of feeding tends to also influence the sleep rhythms of babies which usually become more coordinated and regular as time passes.

Nevertheless, until the babies have adapted their own biological clock to that of the mother, there could be some alternate wakening. It is worth, therefore, adapting your own requirements to those of the babies, and try therefore to sleep when the babies sleep, even during the day. It is just as necessary that the partner actively helps, also feeding the babies at night. For a mother with twins the presence and the support of the persons around her is even more essential and indispensable.

As it is also vital to organize even the minor details of your daily commitments: ask for help in cleaning the house, reduce or delegate going shopping, don't prepare elaborate lunches and dinners, ask relatives and friends to limit their visits if this helps you handle things easier. In short, dedicate your energy to the babies who need so much of your time and commitment. The challenge is not impossible and to succeed also means experimenting your own abilities, increasing your own self-confidence, and feeling the undisputed protagonists of an extraordinary event. A final tip: before buying a stroller to take the children out in, assess the size of the doors, front doors and elevators and don't forget that all the safety regulations foreseen for travelling in cars must be respected: in the case of twins, the babies can be placed, one in the front and one in the back, remembering however to disengage the airbag of the passenger's side.

Discovery, novelty, growth. This is what playing is for a child of a few months old. There is nothing more serious and absorbing and there is nothing more important than the development of his movement and cognitive skills. Whilst playing, the child has the chance, whilst having fun, to discover the world that surrounds him, to experiment it, to make it his through his own emotions and his own inclinations. Mother and father can propose, stimulate and naturally participate. But in any case it must be the children who decide how to play, to establish times and procedures and overcome his limits on his own.

What adults can do is to help the child "to train" his own skills by exploiting his curiosity and his desire to play.

In the pram or cot, for instance, it has proved useful to hang a coloured toy a little above his eyes to stimulate him to follow its movements. Just as valid to stimulate his visual and auditory skills are musical toys with coloured little animals that move to the music: "immerging" the baby into a world of sounds means helping him to discover and to understand the environment that surrounds him. Without, nevertheless, exaggerating. Children of a few months old do not like loud and sudden noises: it is something to bear in mind when choosing his toys. Also the coloured gyms are particularly useful in this phase where it is essential that the child develops not only his visual and auditory skills, but also the coordination between sight and touch: as his gestures become more precise, the child learns that, with a bit of practice, he can touch the toys hanging above him and not simply admire them from far. The next step is the discovery that, in this world of soft, rough, cold, and warm things, he can also intervene. This is when the inevitable game of "throwing everything on the floor" begins. The child understands that his action causes one or more effects: as he throws something with his hands, the object falls on the ground, and when different things hit the floor they make different noises. It is therefore recommended during this phase to give him toys which offer him the possibility to understand that there is a connection between an action and the effect that it achieves. This is the case of the toys with levers and butt ons whose action are at the origin of music, noises and movements: the child will soon be attracted by the possibility of repeating the action and "causing" the extraordinary effect to happen on his own.

These first experiences are followed by new ones, just as gratifying and amazing. For a child it is impossible, for instance, not to applaud himself, triumphant, in front of the image of another baby reflected in the mirror who, like a puppet, repeats all his movements. And it is natural that his curiosity pushes him to look for that strange companion hidden behind a shiny and sparkling wall. Growing experiences where, nevertheless, the presence of his mother or father and their sharing his playtime is essential. Also from a psychological point of view. For children, for instance, what cannot be seen doesn't exist, and the old "cuckoo" game give him a comforting message: even when his mother disappears for a while, she always comes back. To help him to develop his motor skills you can try to put him on your knees and allow him to rock up and down. Or you can place some of his favourite toys on the play mat and leave him to try to point them out to you and t hen crawl to get hold of them. The important things is to give him the possibility to move on his own as this is the only way he will be able to experiment, to try, to fail, to try again and eventually learn.

Jealousy is the most painful of feelings. Adults are well aware of this, and so are children, for whom the idea of losing or sharing something they love is incomprehensible and intolerable. Children are jealous. Of their best friend, of their beloved toy and, above all, of their mother and father. Discussions and, even worse, scoldings are not helpful, especially when the jealousy is instigated by the arrival of a little brother. The parents will have to teach the first child that love can be shared without it losing in importance.

Fear, insecurity, anguish, anger: just like a person in love, a child often lives the birth of a little brother as a moment of deep distress. He becomes silent, complains of sudden discomforts, starts being obstinate.

There are even some who have regressive behavior such as wetting the bed, sucking their thumb, asking for the baby bottle and those who have apparent unintentional reactions which are even more extreme, such as skin rashes, nightmares or nervous tics. The reason, in all these cases, is simple: the security of a child is based on possession, in the certainty of being able to have, forever, and just for himself, his mother and father. A child is never "jealous of his little brother": he is jealous of his parents and the anger that he expresses towards the new arrival must not be read as a denial of the "rival" child. It is, more often, a request for reassurance that stems from the fear of being "forgotten" or "refused" by his mother and father. A request which must, as far as possible, be given a positive response. Without condemning the feelings of the child, without ridiculing them with irony or jokes, without pretending to put and end to the battle by appe aling to his "grown up" age: "You are grown up now. Now that your little brother is here you will have to help your mummy", "What, a young man like you!". The truth is that, at three four five years of age there are no "deputy-mothers" nor "young men": there are children to respect with their distress and "incurable" jealousy.

All that we can do for them is to help them to express, without shame, the anger and the distress they feel, speaking to them, giving them time and attention. And trying, naturally, to put some plans into action. As soon as the little brother arrives, for instance, give the first child a present telling him that it is a gift just for him from his parents and his new little brother. Make sure his father dedicates particular attention to him, but without dividing this duty in precise manner: if the mother is always with the small baby and the father with the first child he will think that, with the arrival of the baby his fears have come true...and he has lost forever the love of his mother. Let him take part in caring for the baby, ask him to help you change him or bathe him, encourage him to hold him in his arms and touch him. When you nurse the baby, keep the older child near you and cuddle him, explaining to him why you are looking after his little brothe r and reminding him, with stories and examples, how you also did the same with him.

The importance of breakfast

A quick coffee for mum and dad, a cake for the child, to eat in the car, during the journey to school. Common habits, often due to the difficultly in organizing breakfast and, in larger cities, to the long journeys. Wrong habits for adults and even worse for children. To do well at school children need a good dose of energy that only a proper Italian breakfast, confirms the most recent studies, is able to guarantee. Milk, bread, slices of toast and jam are the essential ingredients. Plus, naturally, the calm and the pleasure of starting the day all together around the table.

There are many advantages in a balanced breakfast: higher level of attention, of concentration, and a more active memory. The reason is simple. During the school hours the sugar in the blood of children is consumed more rapidly: if the child doesn't have a reserve, his scholastic performance will decline as the hours go by. But the damages are not limited to just this. By missing breakfast, the normal alternation between hunger-satisfaction is altered. The most immediate consequence is that it will lead to the need for a snack to calm the hunger, which will boost the calorie intake excessively, with possible problems of obesity: a risk that, according to recent research, in children who do not have breakfast is double in comparison to those that leave home in the morning on a full stomach.

Breakfast should therefore never be missed. But what should be on the table to assure the correct nourishment for a child which will also give him energy? Milk is at the top of the list: rich in calcium, proteins, sugars, minerals and vitamins, it is a complete food that is a must at all ages. Alternatively you can give him some yogurt that, like every milk by-product, is just as important: it has a high quantity of calcium, good quality proteins, vitamin B2 and vitamin A. Choose oven products rather than confectioneries, such as biscuits, cakes and toasted bread, prepared with simple ingredients such as eggs, milk and vegetable oils, and those richer in carbohydrates such as sugars and cereals, that give immediate energy. Jams and marmalades also give a good dose of energy. It is best nevertheless to distinguish them: jams to be defined as such must contain, by law, at least 35% pulp of one or more fruits, whilst in marmalade the minimum amount is 25%. But ter should be eaten in smaller quantities, as it has a high fat content. Highly recommended, especially during the winter, is a glass of orange juice to guarantee the child the minimum amount of Vitamin C.

It is preferable in any case that breakfast should be a calm event, sitting at the table and possibly together with mother and father. Even if this requires putting the alarm clock forward a little. Don't forget that it is difficult for a child to understand the reason for a rule if this is not respected by adults. It is necessary to "learn" in order to grow up properly. And, in order to learn, the parents must teach children and, above all, also give a good example, even if this involves making sacrifices. At times little things can really count: having breakfast together every morning is the right way to get the child used to an important morning ritual. A chance to rediscover, all together, the pleasure of sharing the start of a new day.

When its time for some medicine

"Just a spoonful of sugar and the medicine goes down..." In the real world things are not quite so easy. Not only because it is not easy to overcome the innate reluctance of children to swallow syrups and pills, but also because a neo-parent has to first deal with his own inexperience. Even the administration of medicine to a child is one of those things that one learns as one goes on. And often the solution is closer to hand than we imagine.

Under the age of two, for instance, the use of suppositories or micro-clysma are particularly effective, because they not only produce immediate effects they do not require particular collaboration from the child: simply place him on the changing mat and insert the medicine deep into his anus, squeezing his bottom for a few seconds to make sure he does not expel it. The most common form of administration at all ages nevertheless is oral medicine. There are some brightly coloured and tasty products on the market which can be a valid help to "make the pill go down". Syrups can be offered to the child with specific teaspoons, syringes without needled or special soothers. Simply take the child into your arms and approach the teaspoon or the syringe to the corner of his mouth, them slip the medicine between his tongue and his cheek. In the event, far from uncommon, that the child immediately spits out the medicine, just arm yourself with patience and...try again . Some times capsules and tablets can be opened or pulverized. It is important to follow, in these cases, the indications given by the paediatrician, but in general it is good to know that the powder can then be dissolved in a liquid or in his food. Be careful that the portions are not too big: it is necessary for the child to eat or drink everything. Also administration of medicine through the nose, often used in the case of infections of the respiratory tracts, requires particular attention. When, to get effective action, you have to resort to a spray, it is necessary to lie the baby down and, holding his head still, insert the nozzle into his nose, spraying the product first into one nostril and then into the other. It is important in this case to be quick and decisive: sudden jerks could move the nozzle and scratch the baby.

Another way of administering medicine, especially in the case of infection of the chest is using an aerosol. There is only one drawback: it needs the collaboration of the child. Something which is not always simple especially when he is absorbed in a cloud of steam with a strange mask over his face. To help things, it is essential that the apparatus is a good quality product and that it expels in just a few minutes the medicine in the phials.

You can try proposing it as a game to the child, involving dolls and teddies in the event. Some paediatricians advise administering it when the child is asleep, although, according to other experts, its action would in this case be less effective, because the aerosol needs deep breaths in order to be absorbed.

Particular attention should finally be given to the administration of drops in the case of otitis. Before beginning, warm the bottle with the palm of your hand to avoid the child being bothered by the sudden cold sensation. It is necessary to lie the child down, turning him on his side and, holding his head firmly and slightly backwards, squeeze the drops into the ear, and, if possible, keep the child still in the same position for one minute to prevent the medicine from oozing out. With regards to the eyes, it is necessary to remember to clean them with a sterile gauze soaked in some physiological solution before administering the drops.

There is a final indication that should be observed: before administering any medicine, always consult your child's paediatrician. Tips and remedies proposed by grandmothers, friends and neighbours are always welcome but when dealing with medicines and children, a do-it-yourself attitude is never the best guarantee for the child's wellbeing.