the newsletter, April 2006

Are you ready to leave your job?

 
To continue working or to take maternity leave? On reaching the seventh month, working mothers are called upon to take an important decision. Up to some years ago, in fact, the law obliged pregnant women to stop work two months before the birth and to remain at home for the following three months. But Law n. 53 of March 2000 introduced an important option: the 5 month leave period still remains, but the future mother now has the possibility to keep on working until the 8th month of pregnancy, so she only uses one month before the birth and has 4 months leave after. This is an important possibility which can, nevertheless, be a difficult decision to take.

 
It is necessary to bear in mind that in order to continue working for an extra month, it is necessary to get a doctor's certificate that confirms a good state of health. Nevertheless a certificate of this kind says a lot, but not everything. One can be in good health, but objectively tired from the pregnancy. A feeling of tiredness which is not only physical. The body and the mind of a woman during pregnancy respond to complex stimuli. As the weeks go by, an extraordinary natural mechanism beings that somehow focuses its attention on the imminent birth. The need for greater calm is felt, the need to find more time for oneself, the need for “solitude”, concentration, and intimacy.

 
Here, then, a doctor's certificate says a lot but, as you can see, not everything. It says that a woman is well, this is true, but it doesn't say how much she needs to rest, or her need for reflection, for serenity. Before, therefore, you decide to continue working until the eighth month, stop a moment to "listen to your inner-self" and ask yourself some questions. The anxiety of wanting to spend as much time as possible with the baby after the birth, the fear of having to interrupt too soon a relationship and way of life that has only just begun, can reach the point where it hides fatigue and the natural need to get ready for the birth in the best possible way. Don't be afraid to recognise your limits and your needs. To do so means to protect, today and in the future, both your baby and yourself. The birth and the care of a newborn baby require energies that the body and mind cannot "search" for in the weeks that precede the birth. Weeks when there is a need for rest, for reflection, for serenity to prepare for the birth and to devote yourself only to your baby.

 
Don't allow yourself therefore to be rushed into taking a decision. Think objectively about the risks of remaining "too long" on your own with your child. If nevertheless the desire to dedicate yourself completely to the baby is that strong, if the desire to live hour by hour and for as long as possible his first months remains a prevailing matter, remember that in many cases there is also the opportunity to stay home for longer than the foreseen five months by making a request to the leave of absence Institute. There is no reason to think that today's decision will preclude the opportunity of being with your baby tomorrow. The main point is that all the decisions, those of today as those of tomorrow must be taken consciously and freely. Because only a conscious and free decision gives a baby the joy of a happy and satisfied mother.

 

What it is necessary to know about vaccinations

 
Trivalent, hexavalent, compulsory vaccinations, recommended vaccinations. Difficult for a new mother to unravel the numerous indications of physicians, magazines and acquaintances. Difficult, above all, to be certain of what the correct choice is when the information appears to be, all so often, complicated or confused. Let's try therefore to make things clear, remembering nevertheless that in order to protect the health of babies it is essential in any case to trust, always and exclusively, the suggestions given by your paediatrician.

 
It is a good idea to start by making a clear distinction between compulsory vaccinations and recommended vaccinations. Both make reference to the "vaccination calendar", periodically updated according to the indications given by the Ministry of Health. The current calendar, which is the National Vaccination Programme 2005–2007, foresees that small children should be administered, in different periods, with the following compulsory vaccinations:

 
• At the 3°, 5° and 12° month:
anti-diphtheria
anti-tetanus
anti-polio
anti-hepatitis B

 
Vaccination that is made at birth if the mother is positive for the hepatitis B test
The recommended vaccinations, therefore optional, foreseen by the calendar are:

 
• At 3°, 5° and 12° month:
anti – whooping cough
Hib (invasive infections from Haemophilus Influenzae B)

 
From last year it is possible to combine the two aforesaid vaccines in just one vaccination, called "hexavalent", which can be given together with the 4 compulsory vaccinations.

 
• From the 3° and 36° month (according to the type of vaccine and the health programmes):

 
• Meningococco C (anti - meningitis).
•At the 12° month: MMG (Measles, Mumps, German Measles)–trivalent.
• Between the 13° and the 24° month (according to the health programme):
anti-chicken pox.

 
Boosters should be done from 5 to 13 years of age for the hexavalent types (or, singly, for all the compulsory vaccinations plus the anti-whooping cough and the Hib if administered), from 5 to 15 years of age for the MMG vaccine and from 11 and 15 years of age for the anti-chicken pox.

 
It is important to remember that the vaccines must only be administered when the child is in a good state of health. Before a vaccination, whether compulsory or not, it is essential for the child to get a check up by your local doctor to check that it is ok to proceed with the optional vaccines. The vaccines stimulate the organism to actively produce an immunitary response and they make it capable of resisting infections. It is through the use of vaccinations that, for instance, every year in the world, no less than three million deaths are avoided of children under 5, and at least 400.000 cases of polio, an illness which will soon be totally eliminated all over the world, just as in the case of smallpox. Observing all the vaccination appointments means therefore to safeguard the health of children. This doesn't mean, nevertheless, that in some cases some vaccinations may not be recommended by the paediatrician looking after a child. The reasons lie, in any case, in the professional conscience of whoever knows that every child is different from another and that every individual reacts to pharmacological treatments differently, according to his personnel clinical history and growth. It is therefore a good idea to meticulously trust the indications that an experienced and trustworthy physician considers most opportune for the health of every single child. The suggestions made by mothers, friends and acquaintances are always well accepted. But when the health of a child is at stake, it is better to be certain to choose the correct solution for them.

Back into shape, quickly but without anxiety

 
It is no good denying it. There is a sign of cellulite, the muscular tone is not really what it was before the pregnancy and the extra kilos... have not disappeared by magic, even though months have passed since the birth. But, it is not necessary to dramatise. You should, on the contrary, "understand" your body: it faced a difficult test as only a pregnancy can be and, if you are breast feeding, you still have a lot to ask of it. If in the nine months the weight increase was limited (10-12 kilos) the time needed to get back into shape will be brief. If on the other hand the weight gain was higher you will need a bit more patience and time but the results, never fear, will equally arrive. Simply try not to turn the target into an absolute priority and commit yourself to the constant small sacrifices that you will definitely be able to face.

 
During breast feeding a severe diet is certainly inopportune. It is essential on the other hand to vary your diet with foods rich in proteins such as eggs, meat, fish, milk, cheeses. Bread, pasta and rice must also never go amiss as they are the main source of complex carbohydrates. Fruit and vegetables are also essential for their Vitamin C and A content. Water or fruit juices, herbal teas should all be drank liberally in order to reintegrate the liquids lost during nursing. Limit the consumption of sweets, alcoholic drinks, preserved meats and molluscs.

 
Only at the end of nursing, if the increase in weight during the pregnancy was excessive, it will be possible to start a proper diet. Also in this second phase, nevertheless, the keywords are patience and consistency: the diet programs that make you lose weight quickly never give lasting results as what is easily lost is just as easily regained. The loss of one kilo a month is enough to guarantee you regain your figure. Just as self-defeating are the "do it yourself" diets: following the tempting suggestions of your friends or the seductive proposal of the diet of the moment is, in any case, not recommended. Losing weight, in fact, must be programmed with the help of a physician and over long periods, foreseeing that it will take you about a year to regain your normal weight. It is the only way to begin a healthy food style that is easy to follow, that doesn't impose frustrating limitations, that corrects little by little your bad habits and that, ab ove all, will guarantee you a, "truly" effective result.

 
With the help of some small sacrifices, this is obvious. Start by keeping away from temptations. Don't go shopping when you are hungry: you would risk filling the shopping basket with appetizing but high-calorie goodies. Limit your purchases of biscuits, chocolate and sweetened drinks. But, above all never miss meals: momentary fasting is totally self-defeating because it alters the metabolism and stimulates you to eat more. Just the opposite of what you are trying to achieve. Do not eliminate from your diet pasta or bread, or fats. There is no one food, not even the most caloric, that is solely responsible for the extra kilos. Being overweight is the result of bad eating habits, excesses that concern types of foods. It is enough if you learn to reduce the amounts. And, naturally, to adopt an active life style, that foresees some time spent on consistent physical activity. Further to helping you burn the accumulated fat, physical activity also contributes i n fact to invigorating the muscles and to improving one's mood. Half an hour's medium effort exercise is enough to burn between 120 and 150 calories a day. And if the time at your disposal doesn't help you, it is not necessary to go to a gym to do it: a brisk 15 minute walk with the pram or the stroller and five minutes walking up and down stairs are all targets that all mothers can reach.


The love between brothers must be cultivated

 
Affection, jealousy, competition, emulation, complicity: no relationship is as rich in ambivalent and conflicting feelings as that among brothers and sisters. One moment they fight together against the others and a moment later they are envious and detest each other. Love, just like respect, between children are not at all feelings to be taken for granted. After all a brother is not chosen, we find him as he is. And with him, so often very different from us, we have to share affections, spaces and experiences. Growing up with a brother, learning to love him, requires time but, above all it requires the understanding and the commitment of parents who have to show their children, that "to become" brothers doesn't mean having to give up on a part of their love, or their own spaces, but, rather, to be able to have someone close with whom to share joys and difficulties.

 
At the basis of the obstacles that brothers generally encounter when dealing in the accomplishment of a mutual affection there is generally envy, jealousy and competition. Even if they manage to understand that it can be useful to have an ally, brothers never give up fighting to obtain from their mother and father something more than the other or, in any case, to be sure not to have anything less, from both an emotional and material point of view. And, a jealousy in this sense, is not only limited to the younger brothers. Just think about it: "my little brother receives more attention", but also, "my older brother has more freedom", "my big sister is better at school and is praised more often". The reasons for competing are indeed many, in both cases. Then there is also the fact that the smallest brothers often tend to "take advantage" of their position of being able to get "more" than the elders and that the latter often feels privileged by his age and the fact he can do something that the younger child cannot do. To teach children mutual respect is therefore the first step to take. In the awareness, above all for parents, that children are not all alike.

 
Every child has a different point of view on things, that must be respected, in any case. To ignore him or, even worse, to privilege a child or to show preference for his behavior compared to that of another child is one of the most frequent errors that one risks making. "Your brother was better at school", "he is more obedient than you", "she was good, you aren't". Comparisons and judgments have direct consequences that accentuate grudges towards the better brother, the good, more obedient brother, who becomes unbearable to the eyes of his "rival". Grudges that do not disappear during childhood, and that, also endanger the self-respect of the "less" capable child, perpetually convinced that he is not as good as his "perfect" brother.

 
Children must be treated differently only in relation to their age and their needs. But to make "differences" doesn't mean to make "preferences". And neither does it mean giving children roles that "allow them" to assume a privileged position. "Try to understand him he's only small", "You are grown up now. Now that your little brother is on the way you will have to help mummy": how many times have we heard sentences like this? But, once the little brother has arrived, the older child soon discovers that he doesn't want to be grown up at all and that the child is not his, he is not a toy, that he cannot do what he wants with him. And that is when the jealousy often starts. "A grown up boy like you!", is the most common answer from grandparents and relations. The fact is that a child is never a "deputy-mother" and never a "little man". He is simply a child to be respected in his suffering this "incurable" jealousy. All that we can do for children is to help t hem express, without shame, their anger and suffering, and take time to talk to them about it, to give them attention. To all of them equally. And to leave them to discover on their own, as weeks go by, that their mother and father love them as they have always loved them. Only without jealousy the younger children will see their older brother as a "master" of experience, a "bulldozer" for his own difficulties, whilst the older child will feel the desire to protect him and to support him. Only without comparisons they will both learn to count on their own qualities, to increase their own level of self-confidence, to respect and to accept others for what they are. Starting with their own brother.

Happiness is..."sucking his thumb"

 
Before falling asleep, when his mother is about to go out, after the umpteenth scolding. Sucking his thumb represents for a child one of the most relaxing and reassuring actions. To get the child to stop, above all when the "bad habit" has been prolonged in time, is without doubt an arduous task. Most often, in fact, behind the impelling need to suck there are unexpressed needs and uneasiness. And it is only by understanding their needs that we can help children to live without that calming thumb in their mouth.

 
Sucking is relaxing, reassuring, gratifying. From the first few months a child not only searches for his mother's breast for nourishment, but also to receive comfort and consolation. And the thumb is nothing more than a substitute for the maternal breast: it allows the child "to relive" the special bond with his mother and to feel calm and relaxed again as if he was sucking from her breast. Not by chance the desire to suck is whetted when stressful conditions arrive: before falling asleep, in moments of tension or sadness or, more generically, when a separation intervenes, even momentary, from the person of reference. In all these occasions sucking the thumb releases the tension, it is an antidote for their fear and loneliness, it makes a child feel safe and protected. It is in short a true expedient to regain happiness. This habit usually disappears spontaneously within three years of age. It is not rare nevertheless to find children who tend to continue t his habit for even longer: to help them to stop little by little, is without doubt more simple that trying to force them to stop this bad habit in one go. A habit that, after all, if prolonged, will cause deformation of the mouth, of the jaw and the dental arch. And not only. School, social activities and initial friendships will force the child to meet up with children of his own age and, on these occasions, this childish habit can become a reason for the others to tease and distance the child.

 
In general, the frequency, intensity and persistence in time are the factors that better determine the seriousness of the problem. Nevertheless, whatever the entity of the uneasiness, it is best to consider that a wrong approach in facing the matter could turn out to be totally self-defeating. Prohibitions, punishments, difficult tests to be overcome, exhortations to stop with constrictive methods or humiliating sentences like "get your hands out of you mouth!", "stop putting your fingers in your mouth like a baby" only emphasise the problem and cause a sense of dissatisfaction and impotence which is much more harmful than the consequences from sucking the thumb. A child who sucks his thumb doesn't need adults to "judge" his behavior. He needs his mother and father to understand him, to congratulate him when he is able to give up his need for consolation and that help him to overcome the problem, allowing him to see, with their presence, that the comfort and the calm brought by the attention of his parents are more effective than a finger in his mouth.

 
Explain to the child calmly that sucking his thumb can ruin his teeth. Try offering him some "reassuring alternatives", such as a lullaby or a game before falling asleep. Try to keep him busy during the day with games and exercise that keep his hands busy. Avoid, in any case, intervening when the child is going through periods of change, due for instance to the birth of a little brother or the start of school. On these occasions it will be essential to accept his need to suck and to postpone the attempts to dissuade him from the "bad habit" until the satisfaction of his "need for consolation" becomes less impelling. This is what a child needs. Two parents that know how to calmly evaluate the situation, that know how to admit their own responsibilities. To be truly capable of being close to their child, to give him all the security he needs. To stop sucking his thumb, today. To face life and grow up, tomorrow.

When school becomes difficult

 
Tired and lazy children, excessively lively children, children lacking in enthusiasm. Difficult children. Difficult as the growth and learning process is difficult. Not always a child that appears lazy, or disheartened "is like that". Not always an extremely restless child is a "spoilt" child. And, not always, a hostile attitude towards school stems from a simple desire of a child student to get out of school work and his duties. For some children this refusal is sometimes an indication of a pathological uneasiness that has not yet emerged. A problem which is more than often resolvable if faced with commitment at the right time.

 
It happens, more often than one would imagine, that the causes which lead to the anomalous behavior in children are nothing to do with education and a will to work hard. Dyslexia (difficulty in reading), dysgraphia (difficulty in writing), arithmetic difficulties, are just some of the troubles at the base of unusual reactions, of attitudes that are only too often liquidated as superficial evidence of the growth of a child. School is for children the first occasion for comparison and experimentation. Experimentation, in some cases, of failure and the embarrassment that it brings. The letters of the alphabet that look like scribbles or the numbers, incomprehensible signs, turn the initial childish curiosity to learn, into an endless nightmare that show the child, even before the parents, the difficulties that are related to school work. It doesn't take long for a child with learning difficulties to start feeling inadequate, which in turn leads to disintere st, aggressiveness, lack of concentration and attention. As, it doesn't take long for the discouragement to turn a personal and surmountable delay into a chronic learning disturbance.

 
To avoid underestimating the attitudes of children is, therefore, the first step to make. Children are almost never capable of explaining the reasons for their behaviour. They aren't capable when the causes are "banal", therefore they aren't when the matter refers to an association of a learning difficulty with an emotional reaction. It is up to the parents to understand what is hiding behind their uneasiness. It is very important to pick up on the right signs of uneasiness that children communicate to us. "I was like that", "in the end nature resolves everything", are easy sentences but not particularly useful when it comes to resolving the problems of a child. Sentences to be avoided. As also to be avoided are attitudes that can turn out to be extremely compromising for a successful learning process, which is already difficult in itself. To underestimate, for instance, school and the value of learning: "we can leave anyway, even if he misses school..." do es nothing more than move an already disinterested child's attention towards the specific "evolutionary duty". As equally it is not much good overpowering the child with the enormous responsibility of having to satisfy the expectations of his mother and father and to contribute, even unconsciously, to increasing his feelings of inadequacy and frustration.

 
There is not a problem that is resolved without first accepting its existence. There is no help that can be offered to a child without having first recognised his personal limits. To bring up a child it is necessary to feel love, a sense of responsibility and, also, much humility. Parents are asked for nothing more. If not to observe their child, to talk to him, to leave him to express his problems and his feelings, to understand him, to encourage him and to also congratulate him even for the smallest of successes. And to prepare, with courage and the full awareness of a need, a "global" intervention that also involves the school and the experts in the field. Ask for the collaboration of teachers, tell them of your doubts, discuss their points of view. And remember, and remind those who take of children that "mulish" or "stupid" children don't exist, simply children with difficulties. Children that must be encouraged and sustained more than the others, that must be helped to find resources and energies to face, together with the others, their journey towards the future.