newsletter Feb06

the newsletter, June 2007

When the baby is late

Time is not always an accomplice for the desires of man. It passes so quickly when he would like it to stop, and it seems to be suspended, regardless of impatience, when it accompanies the endless wait for the most important events. Like the birth of a child: an immense joy that, in fact, requires a prolonged wait before one can enjoy it. A wait that, especially in the case of the first child, can turn out to be longer than expected for a mother and father. Long and weary. Due to the uncontrollable desire to embrace the baby but also the comprehensible fear of complications that could derive from the delay. Legitimate worries but, to be honest, more often than not unjustified. The problem is generally resolved using specific techniques, that vary according to the circumstances, but that guarantee, in any case, the safety and wellbeing of both the mother and child.

Let's start from a presupposition: an actual "delay" can only be called such after the 42nd week. A pregnancy in fact lasts for an average of 40 weeks but, in actual fact, the birth is considered to be on time if it occurs between the 38th and the 42nd week. After this term it is essential to resort to specific methods that allow the baby to be born without any problems and which avoid the risks of a lack of amniotic liquid or an aging of the placenta with consequent decrease in oxygen. This is when "artificial" methods are used to stimulate the birth. The most known is without doubt the "induced" birth, practiced if the placenta shows problems or is under developed, if the amniotic sack has broken or there is a decrease in liquid, but also if the mother suffers from pregnancy diabetes or the foetus is growing too much. Induction can be applied using three different methods that aim to solicit the expansion of the neck of the uterus and to favour the start of the contractions. The first technique is external induction, that consists in the administration of substances to the mother such as synthetic prostaglandins in the form of gel inserted into the vagina or the neck of the uterus. In most cases a couple of applications are sufficient and the method doesn't generally have side effects for the mother, who can freely move around during labour phase. It can happen nevertheless that prostaglandins on their own are not enough to start the birth. In this case the physician can decide to proceed with the second technique, that consists in directly administering a second substance called oxytocin into the veins, which is able to provoke longer, more intense and continuous contractions. If also this second expedient doesn't work, doctors usually resort to a third and final technique that breaks the amniotic sack but this can only be done when the uterus has dilated for at least four-five centimetres. Induced birth is not nevertheless the onl y method used for soliciting the birth of a baby. If the mother has already gone into labour but the contractions are too weak or she is excessively tired which both complicate a spontaneous birth, a "piloted" birth can be necessary. The procedure is very simple: the physician administers a first dose of oxytocin, then he modifies the quantity according to the reactions of the mother, monitored throughout the labour.

As for the other substances used to induce or provoke the birth, in fact, is up to the physician to assess the circumstances, taking into consideration the state of health and the conditions of the mother and the baby to make sure that there can be no side effects. Dangers are rare, to tell the truth, but constant control over the mother will serve to keep any possible problems at bay. And to give the mother and father the calm they need to face the longest wait of all.

Children and animals: the binomial is almost always a winner. Provided, naturally, that the relationship is handled appropriately. Growing up with a dog or a cat allows the child to have a special friend with whom to play, to develop his adaptation skills, his sense of responsibility and self-confidence. But the presence of an animal in the family also incurs constant care, limitations of freedom and certain expenses. When they start to cohabitate, it cannot be excluded that some problems could arise between the two "pups", mainly related to safety and the management of spaces, but also with regards to the need to educate them both towards a happy life together. Drawbacks which are usually easily overcome with a little patience and a few strategies.

To start with, considerable attention must be paid to hygiene. To avoid the child from catching illnesses or infections, it is essential to follow some simple rules, valid both for dogs and cats: meticulously follow the vaccination and anti-parasite course of injections, take the animal to the vet for periodic check-ups, even if he is not sick, make sure you clean the areas of the house that he accesses, plus his kennel and carrier systems.

With regards to the personal hygiene of the animal, it is important to know that the hair and skin of dogs and cats have natural protection that frequent washing can weaken. Try to avoid therefore washing the animals too often and, if in doubt, ask your vet for advice. Remember that when you are out for a walk the dog comes into contact with other animals and accesses dirty places: before letting him into the house, brush him well and check that his feet and ears are clean.

Another aspect to be considered is possible forms of jealousy, especially in the dog towards the child. The arrival of a baby can in fact be a serious cause of anxiety for a house pet and he often reacts by trying to mark his territory (for instance, peeing in the house) or, worse still, by refusing to accept the arrival of the new "guest". It is therefore recommended to approach the matter in stages and always under the supervision of the person whom the dog is used to obeying: the animal has to have the chance to calmly approach the child and sniff him "to get to know him" better and he must be rewarded every time he shows affectionate attitudes towards the child. The child must, in turn, be helped from the first few months to understand that an animal is not a toy but a living being that needs daily care and that he adores being cuddled and tugged at as long as he does not perceive them as a threat or intrusion of his territory. In order for the cohabita tion to be enjoyable therefore, we have to teach the child to approach dogs and cats confidently but taking the necessary precautions. As the months go by it will also be necessary to teach the child that a dog's tail is not just an "appendix": pulling or tugging it limits the dog's movements and his ability to communicate. A final tip: try to avoid leaving animals and children on their own. Pups get along well together but, at least during the first few months, they both need our control and our guidance.

Joy and serenity but also tiredness and anxiety. The first months of life with a child are articulated by conflicting feelings: children give incomparable emotions, they allow you to look forward, to imagine a happy future, but, inevitably they take up time, they consume energy, they change plans and habits. And, in this helter-skelter of states of mind there are also many doubts. "Perhaps I don't love him enough", some young mothers think when they are faced with their increasing desire to regain some space and moments of freedom, some time on their own or to spend with friends. It is a good idea, therefore, to eliminate all these misunderstandings: it is natural to worry about a child and his needs, as it is natural to feel the need to get a grip on your own life and space. It is natural, legitimate, even essential. Because if you repress your own desires and needs, this will only add the burden of dissatisfaction to the inevitable tiredness you feel, and the baby will be the one to suffer.

Maternal instinct is not a mechanism which is capable of destroying tiredness, nor the natural needs that a woman feels. You need to get some time back for yourself. Time for you, time to rest, time to dedicate to your thoughts. After months in which the needs of the baby – with feeds, nappy changes, bath times and night time awakenings – marked the hours of the day and night, it is right and possible to give yourself, without feeling guilty, two hours to go to the hairdresser, to go out with a friend, to take a walk, to read a book in the park. There is no anxiety that can justify your sacrifice. Take a look at your expectations, organize your appointments adjusting them to the needs of the baby. But above all learn to ask for help, to share with your doubts, your weaknesses, your feelings with others. Denial and self-censoring are the worst answers to a legitimate desire that takes nothing away from the primary need to assure love and affection to a child.

Share your state of mind with your partner, your desire to find some time and space for yourself. It is not easy for a man to understand your emotions if you don't try to explain to him clearly without any useless beating around the bush. Put yourself in his shoes: the image he sees is the intimate and symbiotic relationship that you have built up with the baby. And there is the risk that he will think you are happy and satisfied with this relationship. Involve him therefore in a new subdivision of duties and responsibilities, with the objective of giving yourself some moments of free time. A little time, but enough to regain your equilibrium, energy and serenity. You need it, but so does your child.

Gradualness, respect...and sense of timing. To say goodbye to nappies without "nostalgia" it is necessary to choose the right moment. The changeover to the potty represents one of the most tiring experiences throughout the natural growth phases of a child and, for this reason, it requires patience and respect with regards to the times and the needs of the child. Having to use an uncomfortable potty for his needs is nothing more for a child than a cultural rule imposed by adults, a convention that a child is not able to understand and that forces him to face a difficult conquest, something he only achieves after humiliating experiences and failures. Failures that the parents have to handle. Calmly, without reproaches and without the anxiety of wanting to accomplish the objective in a hasty manner.

It is therefore useless to try before the child is around 18 months old: until then practically no child has acquired the ability to control his stimuli. Recent research has even shown that the later you begin, the less time you will need to convince the child to abandon his nappy once and for all. But, also in this case, each child is unto his own. How to assess therefore is our child has reached the "right" age? First of all it is essential to check that the child shows good neuromuscular coordination. It most cases it is sufficient to observe his behaviour: if he is able to understand and to perform a simple order ("Put the book on the chair"), if he is able to climb up and down the staircase without leaning on the wall, if he understands that he needs to be changed because he feels wet, if he remains without wetting himself for at least two hours and remains dry at least during the night, then the moment to start using the potty has come.

Summer is inevitably the most suitable season to start. The child wears lighter clothing which makes any accidents easier to deal with. The holidays, and the time spent outside, provide excellent occasions to leave the child without a nappy, avoiding any problems to carpets and parquet. Wetting the ground represents a new experience through which the child has the possibility to associate the cause/stimulus with the wet effect that it leads to and he starts to understand that the "little puddle" around his feet entirely depends on him. Use therefore light and practical clothes, that can eventually be left wet for a few minutes in the case of an "accident". To make the changeover easier it is a good idea to show the child where the potty is, explaining to him how it works and teaching him to use it correctly. In the beginning it is fitting to stay with the child during his attempts, encouraging him when he is in difficulty and praising him for every small su ccess. If there are older brothers in the family, the emulative instinct can play a fundamental role: at around two years of age, the example of elders is something irresistible and who knows it this means the changeover times will be spontaneously shorter! Avoid making the child spend long periods of time sat on the potty or on the toilet and do not reproach or humiliate them: they must learn in a serene atmosphere, without transforming this experience into a tragedy. The child must be able to count on the confidence of the adults that surround him, because what is asked of him is not at all simple: he has to learn how to recognize his stimuli, to control them for the time needed to warn his parents and to be put on the potty. Failures are inevitable, but everyone must show a calm and serene reaction, showing understanding and encouragement. Because a child needs time to grow. And this time changes from child to child. But, in any case, this must never cause us to lose our respect and our patience.

His first lies

"I am not hungry because I have already eaten a pizza with the alien that is hidden in my closet"; "I didn't break that glass, it was my teddy Tobia". Common, inevitable, almost legitimate: sooner or later all children resort to telling "lies". To avoid a punishment, to show a need, to express a secret desire, or just...to play. But how should one react to these expedient, understandable, but also destined to become increasingly more articulated and refined as soon as a child grows up? And above all, how can you prevent "transitory" attitude from turning into a common and lasting behaviour? The solution is to concentrate – as children often do – on the magic binomial of examples and dialogue.

The first thing is not to consider lies as something which is necessarily negative, but rather a form of expression of a child, that can be characterized by different forms and phases. A child at preschool age is not capable of clearly distinguishing between imagination and reality: at three years of age a child can really be convinced that there is an alien in his closet. The French psychologist Jean Piaget considers this to be the development phase most characterized by "magic thoughts". At around four years of age a child finally begins to distinguish true from false, although in his lies there are still traces of that "magic thought".

The tendency is in fact for the child to deceive himself rather than others, denying an aspect of reality that he would like to change: a broken object, a dirtied tablecloth, a lively quarrel with a friend. It is also true, nevertheless, that these type of lies, particularly if they are frequent, can reveal states of discomfort and dissatisfaction that it would be opportune to investigate: the arrival of a little brother, the start of nursery school, the separation of parents are all, for instance, circumstances that children can live with uneasiness, who are then induced to use the most eccentric expedients to attract the attention of their mother and father. Also their first bad marks at school and the first negative experiences in relationships with school friends can sometimes lead a child to lie. The reason in these cases is that they are trying to compensate the strong feeling of inadequacy with the representation of a different image of themselves. A nother frequent lie in this period is the so-called innocence lie, the most classical: "It wasn't me", the use of which is destined nevertheless to decrease as soon as the child gains more conscience and learns to accept his errors as something that can be rectified. Lies therefore are a tool which a child initially uses to develop his imagination and thanks to which he discovers that his inner thoughts are only his and that others are not able to read them.

An extremely powerful and potentially dangerous tool, therefore. But if small lies as we have seen are normal, it is also true that one has to educate a child on the value of sincerity. And, the value of sincerity, is learned within the family. It would be important to try never to lie to a child, even when he asks embarrassing questions, striving rather to explain things to him – anything – in a manner he can understand. False answers and promises that never come true undermine the trust that the child has in his own parents and he in turn feels authorized to lie back. When children are around four-five years of age in fact, they are capable of distinguishing the truth from imagination, but they are not always able to recognize the difference between right and wrong. It is therefore important to create a climate in the family where sincerity is always rewarded, without nevertheless dramatizing or blaming the child when he tells a lie. It is neces sary, on the contrary, to explain to him that lies lead to a loss in trust, and that within a family it is essential to trust others. And that telling the truth involves no risks but, on the contrary, it means that others see you as a sincere person, confident and brave enough to know how to face the consequences of some small mistakes that may have been made but for which there is always a way of finding a remedy.

On holiday with dad

This is a chance for the child to discover the world with enthusiasm and thoughtlessness, for a father it is a chance to go back to looking at life through the eyes of a child. A holiday without mum can become a real party. Simply organize everything well, forget your anxieties and fears and try to have fun. And, naturally, help the child to get over his nostalgia for his mother.

Separated parents, mothers who cannot leave the city for work problems, holidays at different times: it is increasingly common to see fathers on holiday with their children. Happy fathers, who rediscover the pleasure of being with their children on the beach or in the mountains without the anguish of the general daily rush. Fathers who manage very well. Men who are increasingly less disorientated when they are faced with having to respond to their child's needs and increasingly more eager to discover the value of this type of opportunity. An opportunity to strengthen their relationship with their child, to feel part of his life, to represent for him a secure guide towards his conquest of independence. Which nevertheless does not mean that during the summer period you have to turn into a zealous teacher or, even worse, enjoy yourself at all costs in an attempt to recover, in a couple of days, the time that you have not had to spend with the child during the year. In ord er for the holiday to be truly special a father doesn't have to do much. He simply has to go back to being a child, to rediscover the pleasure of playing in the sand, walking along the seashore with his child, to climb a few hills and go for an ice cream. It is sufficient for him to try to leave all other thoughts at home and enjoy himself like only a father and child can. Without nevertheless forgetting that for a child to be separated from his mother, even briefly, is almost never a simple experience. The challenge is however not impossible. All it takes is to take into account all possible difficulties and be prepared to deal with them: allow the child to call his mother by phone when he wants to, encourage him to bring a t-shirt she gave him or a photo of them together or, you can even get him to write a diary or some thoughts for his mother that can turn out to be useful strategies to keep the comprehensible and inevitable nostalgia at bay.

Provided that, nevertheless, you can count on the complicity of the mother. And on her trust. Without her support things can be very difficult: never forget that a child perceives feelings and emotions in an extraordinary manner: the holiday will go well, without weeping when you leave and night-time awakenings full of nostalgia, only if the mother has been able to live the period before the departure without anguish and worries. "Will you be able to manage him?" "What will you give him to eat?" "Will the child miss me?"... There are so many doubts and they are all legitimate ones. But more than often they turn out to be unjustified: a man is perfectly capable of dealing with a child. If the sense of bringing up a child is more developed in a mother, this doesn't mean fact that a father is totally without. It is simply a fact that a man and a woman take care of a child differently. A different but complementary way that, for this reason, makes them both ess ential for the child when he is growing up. It will be the strong arms of a father which will give the child a more "masculine" and confident way of experiencing his holidays. It will be his confidence which allow him to face any possible drawbacks in a more "spartan" fashion. Perhaps the father will not notice the "sudden change" in the temperature of two or three degrees that would alert a mother. And perhaps there will be more exceptions than rules every day. But this is also why a holiday with dad is truly special.