newsletter Feb06

the 2nd newsletter, Jun 2007

A few tips to fight the swelling

Heavy legs, swollen feet, marked ankles. Especially in summer, expecting mothers are have to deal with one of the most common "disturbances" during pregnancy. There are many causes at the origin of this discomfort, and they are basically related: the progesterone and estrogens, the hormones typically seen during pregnancy, encourage a higher level of water retention in the tissues, whilst the uterus increases in volume, and puts greater pressure on the blood vessels making the blood circulation more difficult from the legs towards the heart. The problem tends to increase in the summer months because the higher temperatures contribute to dilating the blood vases, causing a greater influx of blood, with a consequent stagnation in the subcutaneous tissues. Like most of the slight disturbances typical of pregnancy, the swelling of the lower limbs is also therefore due to the hormonal changes and the overload in work that the organism is subjected to. But don't worry. These are problems that will disappear naturally after the birth, and to give oneself a "lighter" pregnancy there are a few tips which could help.

It is recommended to keep the legs moisturised and toned. You can use a good moisturizing cream (particularly those which contain vegetable extracts and hyaluronic acid) applied morning and night, preferably after a shower, massaging the legs from the ankles upwards with light circular movements. The moisturizing cream should however be combined with an elasticising and firming cream, which contains elastin, collagen and phyto-extracts, ideal for stimulating the micro circulation, protecting the capillaries and maintaining the tissues supple. Creams and supplements which contain blueberry extracts are excellent as they help to protect and to strengthen the walls of the vessels and encourage better blood circulation. After consulting your doctor and making sure there are no side effects, you can also try draining or lymphatic massages – or for those who want a "cool" effect you can try cold leg wraps or sponging: the sudden change in temperature forces the capillaries to tighten, which encourages better circulation.

Cosmetic and aesthetical treatments, though pleasant and relaxing, are not nevertheless enough to guarantee light legs and toned legs. In order for the creams and massages to be truly effective it will be in fact be necessary to integrate them with a correct life style. A few but precious rules therefore, to keep in shape. First of all you have to drink at least one and a half litres of water a day, eat fruit and vegetables and reduce the intake of foods rich in fat, spices and salt. These substances in fact tend to stagnate in the bowel and to "clog" the vessels, preventing good circulation. Those whose job obliges them to remain seated for long periods will have to remember to change their position often and to avoid crossing their legs. It is essential to get some exercise: a brisk walk for an hour, during the cooler hours, can turn out to be very helpful. Whilst mothers on holiday at the seaside will have to be careful not to exaggerate under the sun, they must not forget to exploit the benefits of walks in the water: this gives the legs a natural and refreshing massage which encourages the micro circulation. In the evening, to help the circulation whilst you are asleep, it is useful to raise the feet slightly, resting them on a pillow. To conclude, avoid wearing tight clothing which can compress the legs and stomach and hinder the circulation; choose wide trousers in natural materials such as linen or cotton.

If, despite these precautions, the problem is particularly annoying or persistent, don't hesitate to consult your gynaecologist. A specific visit will make sure there are no serious pathologies such as gestosis, and help to plan a personalised programme to fight the swelling and help the future mother to live a "lighter" pregnancy.

When the skin turns yellow

It is very common among children born on time and very common on those born early. In most cases the problem disappears within a few days without any consequence. But, due to its "visual impact" it continues to frighten new parents. We are talking about jaundice, a term that indicates the yellow coloration of the skin and the white of the eye that which occurs when there is an excessive accumulation of bilirubin in the blood.

Bilirubin is a yellow-greenish substance that is produced by the degradation of the haemoglobin, a protein found in red blood cells whose function is to carry oxygen to all the organs in the body. Newborn babies are subject to jaundice because, in their organism, a sudden and massive degradation of red blood cells occurs.

When the baby is in the womb, the foetus receives oxygen only through the umbilical cord: the level of oxygenation is very low, therefore the organism is forced to "to work harder" to produce a high quantity of red cells that are used to carry oxygen through the body. A higher number of red cells "capture" a greater quantity of oxygen, assuring therefore a sufficient supply. Immediately after the birth, the child's lungs start to work at full pace and the intake of oxygen is higher. It is no longer necessary therefore for so many red cells to be present: these cells, unused, are therefore progressively destroyed, forming the bilirubin that give the skin and "white" of the eye, the particular yellowish colour.

Jaundice appears around three-four days after the birth. In the cases of some babies, the yellowish coloration disappears very quickly, whilst in other cases, it can remain for a week or ten days.

It is not possible to know before the birth if the child will suffer from jaundice or for how long it will last. Particular conditions exist however that favour its appearance. It has been noticed, for example, that jaundice often appears in children who are born early and in children born underweight. The phenomenon is also often seen in children who are breast fed: physicians call it "breast milk jaundice" and is caused by the fact that the takes in maternal hormones with the milk, that encourages the appearance of jaundice.

There are no risks related to jaundice, if it lasts only a few days and if, apart from the yellow complexion, the baby shows no other physical condition, he is well, he eats with an appetite and sleeps without problems. If, however, the yellowish coloration remains for many days and shows no sign of decreasing, it is necessary to have his blood tested to assess the concentration of bilirubin. If this is over 20 mgs per decilitre of blood, it is recommended to try to lower the level of bilirubin to avoid risks to the baby's health. Today an effective and harmless method is used: phototherapy. It consists in exposing the baby to special ultraviolet lamps: bilirubin, in fact, is sensitive to blue spectrum light and in its presence it is degraded into a non-toxic form. It is important, therefore, to remember that ultraviolet rays are present in natural light. This means that also children that show a physiological and not pathological form of jaundice, can be h elped to regain a healthy complexion, without resorting to medical care, but by constantly confiding in the "power" of a simple walk in sunlight.

The child is no longer a newborn baby. And his mother has decided to go back to work. It is the moment to dedicate the necessary time and attention to the choice of the childcare facility where your child will spend part of the day in a delicate moment such as his first separation from the family. Before visiting a childcare facility, make an appointment so you can view all the environments calmly and talk to the staff outside school hours, without interfering with the children's activities or naptime.

The first requisite to check is hygiene, so it is important to inspect the bathrooms. They must be clean and new, tidy and without any water on the floor (the children can slip) or leaking taps. There must be changing mats which are in good condition, nappies and cleansers to change the smaller children. If possible, it is a good idea to inspect the canteen kitchens (there is generally an internal canteen at nurseries), to make sure they are clean and are fitted with all the appropriate equipment to prepare the various foods. The daily menu must be exhibited and take into consideration the nutritional requirements of a child.

A lot of attention must be dedicated to the interiors, they must be large to allow the children to move around freely and they should have large windows, for good natural lighting. It is a good idea to ask if the children will be divided into age groups, so that each group receives the attention and encouragement which is correct for this learning phase.

The play areas must be clean, but not excessively neat and tidy. There should be a "pleasant disorder", that gives the place a familiar and friendly atmosphere. The noise should only come from the children's voices, possibly not amplified by echoes or resonances. There should be no noise from the road or cars.

The furniture must be child-size: coloured, low (adults should get the impression that they are in a doll's house) with rounded corners and well fixed to the floor. The sockets should all be covered by the special protection devices. There must be a lot of toys, clean and in good condition, in non-toxic materials and without detachable parts. They have to be simple, so that a child can manipulate them as he pleases.

It is also important to appraise the number of the educators: the ideal number is one every six children. The staff should also be trained and updated during periodic meetings. You can get information about this at the Director's Office. There should also not be too many replacements: a child tends to grow fond of a person, therefore he has to be able to count on the presence of the same educator for as long as possible.

A good nursery has a daily programme which is displayed also to parents, that lists the games and the activities that the children do day after day and that are essential for their psycho-physical development. To conclude, the presence of a garden is also important, possibly not near a busy road and equipped with safe small toys, to encourage the children to play outside when the weather is good.

The premise is essential. The sucking instinct is present in children even before the birth. Often in fact the foetus can be seen already sucking his finger in the prenatal scans, and it is this instinct that pushes him, from the first hours of life, to suckle his mother's breasts. For the baby therefore sucking is a natural action that brings feelings of gratification, reassurance and protection. The success of the soother is based on this concept. In fact the desire increases when the child is very tired or in difficult moments, such as bed time when he has to leave his mother and father.

For the same reasons, however, eliminating the soother can be a most problematic phase, that must be faced respecting the times of the child and arming yourself with a great deal of patience. It is important to choose the right period and avoid delicate moments such as the arrival of a little brother, a change of house or a period of particular stress for the mother and father. The summer holidays can be a good chance as you spend more time with the children, on the condition however that the child knows the environment and feels at ease. The main point is to proceed step by step. You can start, for instance, by trying to remove the soother for a few hours a day. And before you try to remove it at night, it is best to try during his naps in the afternoon. In some cases it can be useful to try "to replace" it every now and again with a different object, capable of reminiscing the bond with the mother: a garment that for instance has the perfume of his mother, a "special " teddy, a warm and soft cover. With the older children it is possible to establish agreements: rewarding them when they do without the soother and setting longer periods as time goes by.

In any case it is important to avoid scold the child or making him feel guilty if he insists on wanting his soother. And it is essential to put aside drastic and sudden solutions. Making the soother disappear all of a sudden can work, but there is a risk of provoking in the child a sense of helplessness and insecurity which is much more harmful than the momentary habit of his soother. It is essential to remember that it will be necessary to try a few times before reaching the final result: if you realize that the child is not ready to face this separation, take a break and try again after a few months. Always with a smile on your face. Always remembering that every child is different and that the growth phases are never identical.

In water without fear

What can ruin a holiday at the seaside with children? Almost nothing. Unless your child "discovers" this year that he is afraid of the water. But why this year, if in the past everything has gone smoothly? Because between three and five years of age, children face a critical period of their growth phase. They are no longer small "reckless" kids, who jump into even potentially risky situations, without realizing it. But at the same time they don't have the awareness of their own abilities and the necessary motor coordination to calmly face situations that they now perceive as potentially dangerous.

Consequently it can happen that children of three or four years of age refuse to enter the water when it gets deeper and they remain clutched to their parent's neck.

How should you react in this case? Above all, it is not necessary to consider this phase as real problem: many children who are afraid of the water today, will tomorrow become excellent swimmers. Some "tips" on what to do can however help the child to gain confidence. During the first few days, it is a good idea, for instance, to allow the child to get to know the beach, to explore it, to learn to move around at ease on the seashore. Once he has "regained" a little confidence with the waves and splashing water, it will be the child who will search for new contact with the water. In any case it is essential to avoid any sudden "baptising", such as dipping the child into deep waters. Even if he is wearing arm bands or a life belt, the child could get scared to the point where he no longer wants to even go near the shore. It is equally wrong to spur him on continuously, making mock of him or, even worse, comparing him to the other, maybe older and more reckless children.

If the child feels he has lost the support and the trust of his parents he will face the problem with greater lack of confidence.

The most effective method is to show him with actions that there is no need to be afraid of the water. What can you do? You can enter the water slowly, smiling, whilst the child waits on the shore. Avoid sentences like: "See? There is nothing to be afraid of". At four or five years of age, it is completely normal for a child to use arm bands and a life belt. So he should be allowed to use them, if they make him feel safer. If, however, one day he decides to try to float without these objects, it is important to hold back our fears and let him try. Often a child finds it difficult to get confidence in the water because unconsciously he feels his parents are worried.

There are, on the contrary, parents who have to deal with the exact opposite problem, that is with a reckless child, who doesn't think twice about plunging into the deep water, without arm bands and without knowing how to swim well. Scolding him can be self-defeating because it can push him to challenge his parents. It is better to try to make him reason, explaining the risks of a such reckless behaviour. Nevertheless, it is essential to remember that such "brave" children must be supervised with greater attention as they can get into dangerous situations, especially on days when the sea is very rough.

At the table in summer

In summer many parents have to deal with a decrease in the appetite of their children. Behind a "I don't want any" there is not only the desire to get up from the table and start running around as soon as possible, but also the natural response of the organism to the external conditions: when it is hot, in fact, both children and adults need less calories to maintain the right body temperature. More than just insisting that our child eats it is therefore important to understand what he wants to eat and to try to come up with some simple menus which are well balanced and "great for summer".

The first rule is to make sure the child is drinking enough: at least one litre of liquids a day.

Obviously as much water as he wants, never too cold to avoid congestions and it should be integrated with fruit juices and other non-fizzy drinks which give him vitamins and mineral salts. Milk is also great: rich in minerals, proteins, fats and sugars, drunk cold it is an ideal snack, but it can also be used to prepare some great recipes "to drink" (smoothies, yogurt, puddings). With regards to the foods you take to the table, first of all there must be lots of seasonal fruit and vegetables: easy and quick to prepare and low in fat. A useful idea to fight his lack of appetite is to make the meals quick and pleasant and change his traditional eating habits, allowing him to eat little and often.

The main point is to pay attention to every snack, imagining that you have to make a jig-saw out of all the nourishing principles which he needs: a glass of milk with a slice of bread and jam for breakfast, fruit, a piece of cheese or some diced cooked ham at mid morning, a packet of crackers after his swim in the sea, a large ice cream (better if it is fruit flavoured) as a snack. This way we will not only guarantee that our child gets all the vitamins and mineral salts he needs to face the heat, but also as parents we can take a break from the pots and stoves. Without however forgetting that mealtimes also represent an important moment in which the family can get together and chat, and that if the snacks are a good solution during the day, at least once a day it is necessary for everyone to sit together around a table. The evening, when it is cooler and the child has a day's playing and adventures behind him, is the most suitable moment to complete his di et with proteins and carbohydrates, always privileging one course which is light, such as salads with pasta or rice, grilled meat with roast potatoes and tomatoes and, even a couple of times a week, a delicious pizza.

To conclude let's remember to avoid where possible pre-packed snacks and fast foods. They are quick and attractive alternatives, but disastrous from a nourishment point of view, as they are the main cause of the increase in child obesity today. And if, especially at the beginning, the child turns up his nose when you give him fruit instead of a snack, we can always try to convince him by explaining that, if he chooses the fruit, he won't have to wait long to go for a swim.