Advice Column - Parenting Hub

Advice from the experts

Treat Headaches Safely During And After Pregnancy

Being a new mother can be an exciting time for many women. Taking care of a new child can be one of the most wonderful experiences. But this time can also be extremely stressful when headaches occur. A recent study published in the journal Headache showed there are many safe methods to treat these headaches and migraines when women are breast-feeding. A list of commonly used migraine medications was agreed upon by the 6 researchers, who treat migraine and other headaches on a regular basis. Each medication was researched by an author utilizing widely accepted data sources, such as the American Academy of Pediatrics publication “The Transfer of Drugs and Other Chemicals Into Human Milk”. Dr. Elliot Shevel, South Africa’s migraine research pioneer, said the study found there are many reliable medications for women who are worried it will affect their babies through breast milk. This comprehensive study revealed there are many commonly used migraine medications that may be compatible with breast-feeding based on expert recommendations. “Ibuprofen, diclofenac, and eletriptan are among acute medications with low levels in breast milk. They are therefore safe to use,” says Shevel. What does not work? Aspirin did, however, cause some concern. Due to an association with Reye’s syndrome; sedation or apnea is problematic with opioids. Finally, preventive medications not recommended include zonisamide, atenolol, and tizanidine. Headaches during pregnancy Most headaches seen in women are primary headache disorders (migraine, tension-type headache), complications or conditions associated with pregnancy can present with a secondary headache. Headaches are very common symptoms in idiopathic intracranial hypertension, eclampsia, and reversible cerebral vascular syndrome. Migraines may begin or worsen during pregnancy, but pregnancy tends to reduce migraine frequency and severity. Although it is desirable to avoid medications for headaches during pregnancy, treatment should be considered when headaches are severe and cause significant disability. “We always promote treating headaches and migraines without the use of drugs. This is the safest method we can employ,” says Shevel to treat these headaches and migraines when women are breast-feeding. Being aware of possible treatments for migraine and headaches during pregnancy is essential. To find out more about how migraines affect your child, call 0861 678 911 or visit www.theheadacheclinic.net

April 3, 2015

Cathay Pacific’s Top Tips For Travelling With Children

As families prepare to board their flights for local and international holidays during the Easter period, Cathay Pacific offers some advice and helpful tips when travelling with children. “Travelling with a small child on a long haul flight may seem like a daunting experience, but if time is spent preparing yourself and your family ahead of your departure, the journey can be less stressful and more manageable for parents,” says Rakesh Raicar, Country Manager, Cathay Pacific, Southern Africa and Indian Ocean. “Time spent with family is precious, and every second counts when the family is together. No one wants their holiday time restricted due to careless planning or an oversight that could have been avoided. Plan an overseas trip well in advance, and don’t avoid preparations for the time you’ll spend on the ground before your flight, and for the flight itself.” First and foremost, remember that from June 2015, the South African authorities require any adults travelling with minor children to present an unabridged birth certificate for each child, in addition to their passport and other standard travel documents. Keep all your travel documents in one place for easy access. Make sure that you are familiar with the latest hand luggage restrictions at South African airports: Carry-on bag and 1 slim-line laptop bag per economy class passenger No bag should exceed these dimensions: 56cm x 36cm x 23cm Weight limit per bag: 7kg. Hand luggage which exceeds the dimensions mentioned above will have to be checked-in. This could delay you so make sure you abide by the new regulations to avoid a frustrating travel experience. Please note that a woman’s handbag and man’s satchel are exempt from the regulations. Little people love feeling like grownups, so let them pack their own bag (with your supervision) to take on the plane. The bag could hold a few of their favourite toys, as well as a change of clothing, freeing up some space in your own carry-on bag. Try to check in online 48 hours prior to your departure, as this will save you time when you arrive at the airport and will allow you more time to get your children prepared to board the plane. Make sure you pack enough food and snacks to keep your children fed between meal times on the flight. However, Cathay Pacific flights carry a wide range of baby food that is suitable for all ages, so you don’t need to bring a full set of meals for your little one when travelling. You can also order a special meal for your little one 24 hours before your flight with Cathay Pacific. Pack and label any medication that your child requires, and take along a mild analgesic to treat fevers in an emergency. Other basic medical supplies you should take with you include plasters, an antihistamine ointment to treat stings or bites, and a thermometer. If your child has a serious allergy, travel with a card that specifies the allergy in the language of your destination, what they are allergic to and how serious the allergy is. While babies under two years old share a seat with their parents, you can book a bassinet in advance. These are comfortable for babies up to the age of six months, keeping them strapped in safely while they – and you – get some sleep on an overnight flight. If you’re travelling with a toddler, remember that you can keep your pram with you until you board the plane, then ground staff will take it from you to load in the hold. This means that you can still push your little person around the airport between check-in and boarding, saving you from carrying them (or chasing them) around the terminal. If your little one needs to take a break and run around the terminal while you’re waiting to connect to your next flight, write your phone number on their arm so that you can be reached if they slip out of your sight. Some duty free shops may sell a device that clips onto their shoe, leaving a remote tracker in your hands. You can then sound an alarm if you lose track of your child, making it easy to find them. Check with your airline if you can take your regular car seat onto the plane, to add to your child’s in-flight comfort. Cathay Pacific welcomes forward-facing car seats that have a well-defined shell structure and a single three-point harness on many of its flights. This is great news if you’re going to need a car seat when you reach your destination, as you won’t have to hire one from your car-hire company. Take a pack of wet-wipes with you whenever you travel, even if you don’t have children in nappies – they’re great for cleaning up spills, wiping sticky hands and sweaty brows, whether you’re on a plane or out sightseeing. Zip-lock bags are also a great secret for keeping mobile phones safe from rain, for re-packing snacks on day-trips out, and for storing travel-size quantities of toiletry necessities like cotton buds and hair bands. Cathay Pacific has a children’s channel as part of their in-flight entertainment, but there is also a wide variety of tablet computer applications available for children of all ages. While unlimited screen-time is never advised, it’s ok to bend the rules on long-haul flights a little, to keep little ones entertained.

April 1, 2015

Understanding Temperament

Temperament is defined as an individual’s behavioural style and characteristic way of responding. Therefore, it is how the child, adolescent or adult usually acts and consists of a variety of traits. Parents all over the world will have noticed that, if they have several children, each child is “different”. The differences are usually attributed to the child’s temperament (which some people also refer to as their “personality”). Researchers have paid particular attention to babies where they have noticed that some infants are born with certain characteristics, for instance, some babies are more active and constantly move their little bodies, whilst others are tranquil and yet others explore their environment at great length. In addition, some babies respond warmly to people whilst others fret and fuss. In essence, the suggestion is that individuals are born with a certain temperament which stays relatively the same throughout their lives. Psychiatrists, Stella Thomas and Alexander Chess, believe that there are three basic clusters of temperament namely “easy”, “difficult” and “slow to warm up”. An “easy” baby is generally in a positive mood, establishes regular routines and adapts easily to new experiences. A “difficult” baby has a predisposition to react negatively and cries frequently. Routines that are supposed to be consistent are irregular and the “difficult” baby usually accepts new experiences gradually. A “slow-to-warm up” baby has a low activity level and can be somewhat negative. Low intensity of mood is also common and their ability to adapt is lowered. Various dimensions make up these three basic clusters of temperament namely: Activity level (the degree of energy and/or movement for example, the difference between a child who is constantly on the go, fidgets and squirms in comparison to the child who is able to sit for long periods of time without complaining). Approach or Withdrawal (how new people are approached and situations are managed for example, whether a child is eager to try new things and make new friends or is there a tendency for the child to be cautions and taking their time to warm up to new people). Adaptability to change (the ease to which the child tolerates changes to routines, in other words is the child flexible with the ability to “go with the flow” and is not bothered by changes to his/her routines in comparison to the child who thrives on routine and who would be likely to get distressed when there are changes to his/her routines). Predominant quality of mood (the degree to which the child’s moods and general disposition are either positive or negative, namely are they optimists or pessimists. The child with the positive mood is likely to laugh and smile more readily and easily than the child with the negative mood who is more is likely to cry, whine and complain). Distractibility/Attention Span/Persistence (the degree to which a child can be distracted, for example, is the child easily distracted by many things in his/her environment or is the child able to focus. Persistence implies whether a child perseveres with a task or has a tendency to give up easily). Rhythmicity (the regularity of eating, sleeping etc., therefore does the child have a biological rhythm that is regular and predictable or not). Sensitivity to stimuli (the degree to which a child is sensitive or not. For example is the child sensitive to noise, bright lights, clothing labels and so forth or is he/she able to easily ignore external stimuli). Intensity (the degree to which mood is expressed when happy, unhappy etc. Some children display their emotions without hesitation in other words everybody will know that the child is sad or happy and they will have no difficulty crying in-front of the whole class whilst other children are thoughtful and mild and tend to keep their feelings “inside”). Thomas and Chess further believe that temperament is a stable characteristic of newborns that comes to be shaped and modified by the child’s later experiences in later life. Why is important to take cognisance of children’s temperament? When you take your child to a child psychologist they will probably ask you ‘how your child is like’, in other words what their temperament is. This has a variety of implications for play therapy and parental guidance. The child psychologist will usually work with what suits the individual child and help him or her with the coping resources which will be the most effective for his/her temperament. The child psychologist also works with the parents’ temperament in order to facilitate discipline difficulties etc. Thus, a child who for example falls in the category of expressing their emotions intensely like crying hysterically over something perceived to be relatively small will have different needs to the child who is anxious when meeting new people. How parents and other caregivers react to the aforementioned scenarios will also have implications for the child. In addition, being cognisant of a child’s temperament is also very important when they have to undergo an educational or developmental assessment by a psychologist. Children for example, who are naturally busy (the level of activity) and are very curious (distractibility/attention span) are sometimes diagnosed as having a disorder such as ADD/ADHD when in fact those characteristics are merely part of their temperament. If parents are aware of their child’s temperament they can provide activities that work with their child’s temperament which they will enjoy. A child can also be disciplined in ways that “fit” his/her nature. It is also important for teachers and other caregivers to understand a child’s temperament so that their learning is facilitated by what suits them. Temperament affects all aspects of a child’s life such as how they learn, how they play and how they interact with others and should never be overlooked. Sandton Psychology Centre offers numerous psychological services for children. All assessments are covered including school readiness, educational and developmental evaluations. A career assessment was especially designed for adolescents and adults by the Centre’s Counselling Psychologist, Deane Sutic. Play therapy/child counselling is also offered by our

March 31, 2015

School Holidays Don’t Have To Be A Complete Circus!

School’s out and without their usual after-school play dates, sports and activities, how are your kids going to beat the boredom and stay active? Easy, Virgin Active is introducing circus themed activities these Easter holidays. This fun holiday programme will ensure your child is both mentally and physically stimulated. The philosophy behind the successful Club-V and Club-V Max facilities at Virgin Active Health Clubs is that active minds and active bodies translate into happy children. “For Club-V we’ve created a 3-hour programme designed for children ages 3 – 7. We’ll keep them busy with awesome activities, from creative arts, crafts and colouring in activities, to games to get your kids moving and having buckets of fun,” says Catherine Coupar, National Junior Member Manager of Virgin Active. “For Club-V Max (children ages 3 – 13), kids can look forward to 4 hours of fun that balances mental and physical stimulation.” Why it’s important to get kids to move more Although screen time and technology is an essential part of being a kid in 2015 and beyond an important part of having a well rounded lifestyle is to take some ‘time out’ from sitting at a screen and get active and moving. It’s vital to interact with others, play and exercise … here’s why: Helps to develop strong muscles and bones Controls their weight Lowers their chances of developing type 2 diabetes and other chronic diseases Helps them sleep better Gives them more confidence and a better outlook on life Makes them more mentally alert and improves their likelihood of being academically motivated and successful. ‘Being at the Circus’ activities will be held daily from April 7 to 10 but, in addition to this, Virgin Active is hosting a special family class on 11 April. It’s the ideal way for moms, dads and kids to spend time together … whether it is an exercise class such as KAOS, TwentyFour Family or a fun Twisty Tales activity, there’s nothing better than getting active as a family. Booking for the ‘circus’ holiday camp experience is essential and on a first come, first served basis, so if you are Virgin Active members, sign your kids up at Club-V or Club-V Max, or chat to a Club-V team member for more information. Club-V and Club-V Max Virgin Active offers two ‘kids’ clubs: Club-V (6 weeks-7 years) and Club V-Max (6 weeks-13 years) which are dedicated indoor play and activity areas, essentially a ‘mini-club within a club’. The aim is to take a holistic look at keeping children aged up to 13, entertained and active through creative, fun, interactive programmes designed specifically for different stages of their development. The staff are fully trained in early childhood development and have paediatric first aid training. Check your local club for details on www. virginactive.co.za

March 31, 2015

Adolescence And Suicide

Suicide is a devastating tragedy which is a grim reality in most parts of the world. If you suspect that your adolescent is at risk get assistance from a mental health care worker as soon as possible. There are a variety of risk factors regarding the adolescent and suicide which can include some of the following: Specific characteristics of the adolescent: (for example, hyperactivity, impulsivity, ‘difficult’ temperament, and other psychiatric difficulties, such as depression) Peer relationships:(for example, if they are rejected by their peers or belong to a group of “bad company” or have poor interpersonal skills) Functioning at school: (for example, not achieving at school and failing) Cultural/Community and Societal influences: (for example, poverty, discrimination, unemployment, societal acceptance of aggression, easy access to guns and alcohol in the community, societal acceptance of violence, and exposure to violence in the community or via the media etc.) Victimisation, shame and humiliation: (for example, bullying which in this technological age takes on an additional form with the advent of the social media and easy distribution of photos etc. South Africa has unique facets that can exacerbate the problem, for example the high rate of “corrective rape” of lesbian young woman and perpetrators getting away with the crime.) Very high expectations/pressure to perform: (These high expectations can be self- imposed or they can emanate from other sources such as from within the family etc.) Poor problem solving skills and difficulty communicating their feelings. What are some of the warning signs? Depressed mood Talks about committing suicide Previous attempt at committing suicide Family dysfunction such as significant problems with a parent/s Withdrawal behaviour (withdraws from family and friends) Difficulties dealing with sexual orientation (a high percentage of this minority group have been found amongst suicide rates in adolescents) Substance Abuse (alcohol and/or drug abuse) Giving away belongings that had special meaning for them Preoccupation with violence and gory themes in TV shows, movies, internet sites etc. Having a family member or relative who committed suicide Family violence or abuse Engaging in anti-social behaviour (cruelty to animals, fire-setting, running away from home; being jailed) Isolated from family and peer group/social isolation Poor self-esteem.

March 30, 2015

The Effects Of Trauma On Children

Unfortunately, trauma is an all too common occurrence in South Africa. Trauma has many different guises and can encompass anything from criminal occurrences (such as muggings, hi-jackings, smash and grabs, house robberies etc.), natural disasters (floods, etc.) or any other unexpected event (such as witnessing or experiencing abuse, being involved in a motor vehicle accident, divorce of parents, having a family member that is ill, etc.). In addition, some children can also experience a secondary traumatization when their school peers for example, undergo a traumatic experience and re-tell the event. If parents are concerned that their child has undergone a trauma they need to be aware of some of the possible signs and symptoms of trauma: Anxiety, manifested by excessive worries and fears especially about the safety of significant others and themselves; Mood changes, such as irritability and whining; Behavioural changes, such as decreased levels of concentration and attention, withdrawal, aggression and over-activity which can adversely affect school performance; Somatic complaints, such as headaches and stomach aches etc.; Increased talk and awareness regarding death and dying; Sensitivity or a startled response to various sounds and noises; Talking about the traumatic event repeatedly as well as recreating the event via play; Regression in younger children, such as ‘wanting to be a baby’ and not performing age appropriate tasks that they were completing before such as eating by themselves, sleeping in their own beds etc. Adverse impact on issues of trust, security and safety; Symptoms of depression, such as lack of interest in usual activities and changes in sleep or appetite and withdrawal; Anger, as well as hateful statements; and Avoidance of people, places, or situations that remind them of the traumatic event. Not all children will experience trauma in the exact same way as well as manifest all the above symptoms as not all circumstances are the same for every child. In addition, children have different personalities and temperaments which affects the way they experience a traumatic event (for example, an anxious child may react differently to a laid back child if they were to experience the same trauma). Moreover, trauma can be subjective in that what is traumatic for one child may not be perceived in the same way by another child, or indeed an adult). If you are concerned about your child with regard to a trauma consult with a child psychologist who will determine the best course of action, such as play therapy or parental guidance to help you assist your child.

March 27, 2015

ADHD And The Foods We Eat

ADHD: The most common childhood disease ADHD is the most commonly diagnosed childhood disease and is said to affect approximately 10% of the South African population. It could be present from birth (often not recognised) or early childhood and usually persists into adulthood. It is often undiagnosed in adult, which is an unfortunate oversight, since appropriate treatment helps control symptoms and improves quality of life. The term ADHD denotes Attention Deficit Disorder with &/or without hyperactivity & has been used to describe both ADD and ADHD as well as all aspects of the condition more accurately. ADHD is a chronic condition of the brain that makes it hard for those affected to control their behaviour. According to the American National Institute of Mental Health, two to three times more boys than girls are affected by the disorder and the reason for this is uncertain. Problems generally associated with ADHD include inattention, hyperactivity and impulsive behaviour. This can affects nearly all aspects of life. How can I tell if my child has ADHD? Most specialists believe that a child shouldn’t receive a diagnosis of ADHD unless the core symptoms of ADHD appear early in life and create significant problems at home and at school on an ongoing basis. Ideally ADHD should be assessed and diagnosed by a multi-disciplinary team. As there is no proven diagnostic test for ADHD at this time, a clinical diagnosis is usually made by a paediatrician based on specific criteria. It is a process that involves several steps and it requires information on behaviour. Information is required form parents, teachers, carers, health professionals for an official diagnosis to be made. In most children with ADHD, a diagnosis are made from the age of 5 – 7 years (formative school-going age), although some of the symptoms could be present from birth. These symptoms must significantly affect a child’s ability to function in at least two areas of life – typically at school and at home. It is important that the symptoms, be present for a period of more than six months in all situations. This helps ensure that the problem isn’t with only a particular teacher or with their parents. Most children with ADHD don’t have all the signs and symptoms of the disorder, and they may be different in boys and girls. Boys are often more likely to be hyperactive and girls tend to be inattentive. In addition, girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly. Boys also tend to be less compliant with teachers and other adults, so their behaviour is often more conspicuous. What causes ADHD? Parents often blame themselves when a child has been diagnosed with ADHD. However, the cause of ADHD is at present still unknown. Experts are investigating a number of genetic and environmental causative factors – some of these theories have led to dead ends, some to exciting new avenues: Altered brain function & anatomy: There is an imbalance of certain neurotransmitters or poor nerve communication and transport in certain parts of the brain. Genetics (70-80% of cases): There is great deal of evidence that ADHD runs in families and if one person in a family is diagnosed with ADHD there is a 25-35% probability that another family member also has ADHD. Exposure to toxins such as cigarettes and alcohol during pregnancy, high levels of lead in the bodies of children. Brain injury: only small percentage of children with ADHD has been found to have suffered from traumatic brain injury. There is no clear answer! What we do know is that ADHD is a condition of the brain, likely caused by unknown factors which influence nerve communication and transport in certain parts of the brain, which has a strong genetic basis. Common misconceptions: Food additives and sugar has long been controversial. Some research suggests that artificial colourings and preservatives may be associated with hyperactivity in children. But an association is not the same as a proven “cause-effect” relationship. There is no proof that food additives cause ADHD. Poor parenting, family problems, excessive TV watching, poor teachers and schools, food allergies or excessive sugar intake are not thought to cause ADHD. These environmental factors may contribute and worsen ADHD symptoms though but are not the cause. How is ADHD treated? Optimal treatment is still a matter of debate and every family wants to determine what treatments will be the most effective. It is thought that lifestyle can either reduce or strongly exaggerate symptoms of ADHD. Clinical experience has shown that the most effective treatment for ADHD is a combination of: Medication, when necessary Dietary intervention The correct supplementation of vitamins and minerals Exercise Therapy and counselling to learn coping skills and adaptive behaviours Medication There is a wide range of medications available, the most common being Ritalin, Dexedrine, Adderall, Concerta. Medication does not cure ADHD. The role of medication is to control the symptoms when taken and works effectively in 70% of ADHD cases. Each medication has its negatives. The most likely side-effects include reduced appetite, corresponding weight loss, headaches, nervousness, irritability, tummy aches, nausea & vomiting, sleep disturbances. It is found that 30% of cases don’t respond or do not tolerate prescribed medication for ADHD. In these cases there is no other option then to opt for dietary treatment. Diet and ADHD Each child requires an individual approach. Helping a child with ADHD is like trying to solve a jigsaw puzzle. Puzzle pieces might include low iron status, poor diet, essential fatty acid deficiencies, magnesium deficiency, zinc deficiency, sensitivity to food stuffs such as artificial colourants, flavourants and preservatives. Remember each child is a unique puzzle with different puzzle pieces. It is therefore essential to consult a dietitian specialising in the field. Diet in itself does not cause ADHD but can worsen the symptoms. Diet modification however does play a major role in the management of ADHD and the associated symptoms. When dietary changes are made the results could

March 26, 2015

The Mommy Blues

Mutual regulation refers to a communication system that allows a mother to read emotional signals from her baby and meet his or her needs, as well as allowing the baby to read his/her mother’s response. So what happens when this system breaks down? Post Natal Depression (PND), otherwise known as Postpartum Depression, is a condition that affects between 10% and 15% of mothers. It has many similar characteristics with depression, and if help for this form of depression is not sought, it may have an impact on the way the mother interacts with her baby, as well as the child’s future cognitive and emotional development. One of the biggest problems with PND in mothers is that they are less sensitive to the needs of their babies, as well as being less engaged with them. Things like interpreting a baby’s cry and responding to it is one of the aspects that can be affected, such as being able to tell the difference between the hungry, sleepy or nappy-change cry. Symptoms of PND (according to the Royal College of Psychiatrists)include: Depression Irritability Chronic fatigue Changes in appetite An inability to enjoy anything Loss of interest in sex Guilty thoughts Anxiety Unsociability Hopelessness Thoughts of suicide Effects of PND also include feelings of guilt, the idea that you may not love or feel close to your baby, or that he or she doesn’t love you back, and resentment towards the baby. It is important for women to understand that these symptoms are normal, and are a result of hormonal and emotional difficulties and are not an indication of good or bad parenting. There are various suggestions as to how this can be treated or even prevented. Techniques to help depressed mothers include: Listening to music Visual imagery Aerobic exercise or yoga Meditation or massage therapy Talking to a professional Advice to new mothers: Don’t take on too much too fast. Learn to ask for help. Find someone to talk to Seek antenatal advice Sources: A Child’s World and The Royal College of Psychiatrists

March 25, 2015

A New Fact On Migraines And Participating In Sport

Claims that participating in sporting activities is detrimental for migraine patients are untrue – a new study found that participating in sporting activities actually has health benefits for migraine patients. The study, recently published in the Sports Neurology Journal ascertains that under Neurological supervision sporting activities can be safely integrated into the lives of migraine patients. This is the first time empirical research has been done to review known risks involved with participating in sporting activities by migraine patients. “It was a study that sampled patients with; epilepsy, migraines, and multiple sclerosis”, says Dr. Elliot Shevel a South African migraine research pioneer and the medical director of The Headache Clinic. Shevel confirmed that as long as there is proper supervision in place for migraine patients, playing sport is not harmful. Dr. Elliot Shevel says that migraine patients are often discouraged from participating in sports based on theoretical detrimental effects, when in actual fact they can and should be encouraged to participate in sports provided that the exercise does not trigger the pain. Where exposure to prolonged sun triggers the pain indoor sports should be pursued. With schools re-opening and sporting activities being part of the academic experience, children that suffer with migraine should take the time with parents and teachers to work out which sporting activities suit them best.

March 24, 2015

Values, Discipline & Respectful Communication

Every child, just like every adult has a set of values, a hierarchy of things that are from most to least important to them. With children under 10, their highest value will usually have something to do with play, although this will differ from child to child. For example, one may like playing with dinosaurs and another with dolls and another may like playing ball games. Once they reach the 10-20 age range their values will normally shift to be around socialising, and again specific to each individual child. Every one of us, regardless of our age is inspired to do things linked to our highest values. These are the things that we don’t need to be motivated from outside to do – that we just do without being reminded, they are the things that we enjoy, that give us energy, that we do with enthusiasm. We also feel heard, understood and loved when someone else acknowledges our values, and we feel hurt, misunderstood and unloved when our values are challenged. Most of what parents call disciplining their children is trying to get the kids to live within their values, not understanding that a child has their own set of values that do not necessarily match those of the parent. Every person has a set of values that are fingerprint specific to them, so your child’s values, even if similar to yours, will never be exactly the same. Now, I’m not talking about values as in social idealisms, like honesty or trust or dependability. I’m talking about things that are genuinely important to you in your life as it currently stands. So, a mother may have her children as her highest priority, followed by her career and then socialising. The father may have finances, then spirituality and then knowledge as his priorities. And each child will have their own list of things that are important to them. If we understand and respect each other’s values, instead of trying to force our own onto the other members of the family, then we open up a new level of communication and respect where discipline can be completely redefined. We will never need to bribe or punish a child to do or not do something if they can see how doing or not doing it is helping them to fulfil their highest values. For example, my daughter has dinosaurs as her highest value. She is intrinsically inspired to learn about, read about and play with dinosaurs. So if I want her to come and bath (I have a higher value on cleanliness than she does) then instead of fighting with her and insisting that bathing is good for her because I say it is (imposing my values into her) I simply say, “Hey Kai, I heard a rumour that there are some glow in the dark dinosaurs getting up to no good in the tub, just waiting for you to come and play with them”. You can spend an hour of shouting and bribing and insisting that a child get in the bath when they don’t want to, or you can appeal to their values and have them actually enjoy doing what you want them to do. It is worth finding out what your children’s values are, as you will need to communicate differently with every child as every child is a unique individual with a unique set of values. Respect their values, link what’s important to you to what’s important to them and you have respectful communication rather than discipline.

March 19, 2015

Your Guide To Making Blended Families Work

Do you fear that you’ve become the evil step-monster? It’s so easy to feel like that, especially with blended families becoming the societal norm. Telling a child what to do, especially when they are not your own, can be tricky business. Yes, children are the gifts that keep giving, but let’s not joke: they can also be crafty little critters and can sometimes put serious strain on a marriage. When two families come together, things don’t often run smoothly. Between children resisting change, the parents trying to accommodate different personalities and rotating between two different households at any given time, things can become extremely rough. Some things you may consider when trying to blend families: Planning for your blended family: Everything needs planning – absolutely everything. When you and your partner decide to merge your two families, keep in mind that things don’t always go smoothly. Respect is earned, not demanded. Step-sibling relationships can be particularly sticky, especially when alliances are formed. Plan for bonding sessions and make your new family get to know each other. Lay foundations and set boundaries: Children do best when routine is not disrupted. To this end, one should strive to keep life as normal as possible, and this is done by laying foundations and setting boundaries. Remember that too much change at once can unsettle children. Find ways that all of you can maintain your routines. Don’t allow ultimatums or manipulation to happen, as this is a dangerous foundation to lay. Conversely, don’t be too harsh – after all, the “you’re not my real mom” argument is infamous for a reason. Also try to limit expectations – you shouldn’t expect to fall in love with other children instantly (and vice versa). These things take time. Keep all parents involved at all times: So as not to “step on anyone’s toes” you should strive to maintain a good relationship with your ex, and encourage your new partner to do the same. Ex spouses respect being kept in the loop when it comes to their children, and the kids benefit when there is no animosity between the various parents. In some cases, this can certainly be a very difficult thing to maintain, but civility is free. Court battles, on the other hand, are not. According to helpguide.org, the following should be observed: Listen respectfully to one another Address conflict positively Establish an open and non-judgmental atmosphere Do things together – games, sports, activities Show affection to one another comfortably If you are struggling to keep the family together, it may be a good idea to consult with a professional and get some advice on a way forward. It’s not always easy to keep everyone happy, and sometimes you just need a bit of assistance. If a child is expressing particularly excessive anger towards a parent or step parent, if favouring starts to happen and alliances get formed, or members of the family openly avoid each other, seek advice from a psychologist dealing with family matters.

March 13, 2015

Tips For Choosing A Family Car

Buying a car when you are young, single and have just started working is very different to when you are trying to buy a car for a family. Your needs as a new couple are not the same as they are when you start having children, suddenly safety is more important than speed, space is more important that style. It can be confusing trying to choose a family car because you aren’t always sure what you need to look for. We have a few tips that can make the hunt for a new family car easier. Check the safety features. Safety becomes of utmost importance when you are transporting your children. Make sure you check if there are safety belts on all the seats, that the back seat is safe for a car chair. Size does count. Whether you decide to only have one child or a rugby team, children take up space. Take this into account when you are looking at cars. If possible take your pram with to see how easily you can get it into the boot and how much space it takes up. Consider things like going on holidays, lifting friends, additional sports bags and how many car chairs you will need to have at one time. A car may say 5 seats but with car chairs in it suddenly becomes a 4 seater. Sometimes the 7th seat is in the boot taking away boot space. Is it a wanted car? While we don’t want to have to think about being hijacked, it should be a consideration. Try to steer clear of cars that are high on the hijacking list, it may mean you don’t have the coolest car in the parking lot but it will be worth it. Consider your needs. How many children do you want? Will you have two car chairs at the same time? Do you go away in your car a lot? Do you need to transport bicycles? These things will all play a part in the size and type of car you buy. Take it for a test drive. If you are going to be the primary driver, test drive it, parks it, make sure you are comfortable driving it especially if it is on the bigger size. Buying a family car can feel like an overwhelming decision but it really doesn’t have to be. Do not rush into the decision, take your time, consider all your needs and requirements and do not settle for anything less than that, no matter how hard the salesman may try to convince you otherwise.

March 12, 2015

Nobody Warned Me

Charming perceptions of motherhood in the magazines, Mothers comforting their babies, it seems so precious, suggesting that graceful feeling that we all long for so dearly. Yes, this could be true, but what wrecks us up most in life, is the picture in our head of what it’s supposed to be. We dismiss the belief that there is such a thing called reality. When I was pregnant with Jamie, I was offered all the advice a pregnant woman could ever ask for. I Read all the books, and the expectations of having this baby was sounding positively promising. However, it took me by surprise. The emotions came in fast and heavy, the idea that I would not be good enough; what if the baby didn’t love me? What If I didn’t know what do to make him comfortable? What about my life? My husband? My friends? With the pregnancy being unplanned, I was aware that having a baby would be my biggest life changing event yet. I was forced to grow up and prepare myself for the challenges of Motherhood. My Mother had revealed stories of Motherhood from her experiences, and prepared me for as much as she could. I was oblivious. Once he was born, the realization had set in – no one can prepare you for this journey. It is an experience in itself, Filled with love, happiness, sadness, and tough lessons. But nobody warned me. I wish I had taken it all in. So here it is. Fun and serious, personal lessons learnt from the progress of raising my son of 3 ½ years old. When you are pregnant, everyone will be kind and want to be a part of your life. Not all of them stay. You will lose friends, but the great news is you will also gain new ones. Moms befriend other moms very easily. You will cry when leaving the hospital and arriving (probably the entire drive) home with your new baby for the first time. If I knew why, I would divulge that information, but to this day, I cannot give reasons as to why I broke down in an ugly cry. (Hormones got the better of me, OKAY?) Breastfeeding is draining, and there will be many times you will feel like sending up the white flag. If you don’t have to, don’t. I wish I didn’t have to give up. But if you do, IT IS OKAY. Moms, don’t forget to be a wife. Dads, don’t forget to be a husband. This is important Make time for yourself. Take up the offer from ‘Aunty’ or ‘Granny’ to babysit. Have that nap. Sleep does wonders for the soul. Introduce routines from the start. It is heaven sent (well, once you have perfected it, and yes, I’m still getting there) Put the kids in their own beds every night, or you will regret it. (I am still struggling to get Jamie to sleep in his own bed) Boys will try and pee on you almost each time you attempt a nappy change. Get your armor or hold the nappy closed until you have everything ready. There will be more than one form of projectile, and you won’t care if it’s all over you. They will become extremely irritable and start drooling the river of Egypt, you will get excited at the realization that your baby is teething and start making pancakes. But this does not mean he/ she has teeth, yet, it could take a couple of months to push through and this may cause them to be ill. In my case, 7 months and a ton of high fevers for the first one to appear. They will become ill, and there will be copious amounts of TLC needed in this time. They will start blowing bubbles with their food, and soon, feeding your baby is like utilizing a blender without the lid. They will want to pull themselves up on every piece of furniture, becoming fearless, making you realize there are nerves you didn’t know existed. But to some extent, learn to trust them. This is also the chapter that most people avoid offering to baby sit. You might also lose some lingering baby weight. Yay! Your house will never (ever) look the same again. Bye-bye OCD! They will start listening and repeating everything you say, and you will learn to speak another language. Silence is golden, unless you have kids, then it’s just suspicious. You will finish watching the Disney Pixar Movie after they have fallen asleep, even though you have seen it for the 6th time that day. Terrible twos have got nothing on Cheeky threes! You should never come between a 3 year old and his Smarties. If your child says old mac Donald has a Lion-spider on his farm, then old mac Donald has a Lion-spider on his farm. Okay? They will make use of reverse psychology. Be .very .careful You will learn strengths you never knew you had. (For example, running faster than the speed of light, or incredible reflexes by saving a vase from breaking from the other side of the room) You will know when it is the right time to grow your family. Don’t rush. Spend time with your child and make it count. When making the decision to expand as a family, make sure your 1st child is just as ready as you are. I’m glad I did. Take it all in, every minute of it. Watch them grow, Hear instead of Listen, Guide instead of show, laugh with them, allow them to mess, don’t be afraid, join in on the fun, encourage their imagination and enjoy the adventures of their magical little world, always kiss them goodnight, and tuck them in tight. MOST importantly, remember, it is an everlasting love, whole heartedly, they will love you unconditionally and you will always be their favourite person, someone that they will forever depend on. Even on those days you will feel you have failed as a Mother.

March 12, 2015

Crying Through The Ages

Newborn The newborn baby is typically much calmer and cries less than you would expect. Many parents are surprised that their baby does not scream at birth but rather makes quieter sounds and has a period of relative calm. Your hormones released in the birth process and the natural birth process itself results in a calm alert baby on the day he is born. Even after the initial 24 hours, the new baby is only really likely to cry when hungry, which once the milk comes in can be as often as two hourly or may be spread out to closer to four hours. It is important in the early days to feed your newborn on cue as this will not only settle him but also encourages your milk supply. The other time newborns cry is when being changed and bathed. Both changing and bathing result in feeling the cold air and new touch sensations, which can be disconcerting for the new baby. If a newborn (0-2 week old) cries a lot, it is important to have him checked by a doctor or clinic sister as this is typically a period of relative calm, which we call the honeymoon period. Most babies do not cry extensively during the early days. 2 weeks -3 Months At around the two week mark, many babies become unsettled and begin to fuss more than during the honeymoon period. This is completely normal and in fact the ‘crying curve’ is well documented. This curve shows that babies begin to cry seemingly without reason at around 2 weeks old and by 12 weeks old this crying has almost entirely abated. This unexplained early baby crying peaks at about 6 weeks of age. Traditionally called colic, we now know that in fact this crying has nothing to do with the digestive system and remedies for tummy ailments make as much difference as sugar water. (St. James) Even if your baby tucks his legs up or kicks and screams for an extended period of time, you can rest assured that almost every crying baby of this age is healthy and normal. Colic is caused by over stimulation. Being alive in our busy sensory world can be overwhelming for many babies and this coupled with too little sleep will result in crying as your baby responds to the sensory input of the world and the little bubbles in his tummy with crying. The best ways to avert colic is to swaddle your baby and settle to him to sleep after only an hour of awake time. If your little one is very unsettled, do not worry about spoiling him at this age. Under four months of age babies do not have long term memory and so will not be ‘spoilt’ by being rocked or lulled to sleep. 4-6 Months The four to six month old is much less susceptible to overstimulation and therefore is more settled. But just as you think you are getting the hang of this parenting thing, you will find your baby become a little less predictable. Instead of remaining settled for a good three to four hours between feeds, many babies of this age begin to fuss and wake more frequently at night too. This relates to their new and growing nutritional needs. At this age you can choose to respond to the increased demand for nutrition with increasing the number and frequency or quantity of milk offered or you may choose to introduce solids. The latest research indicates the introduction of solids is safe and good for babies anytime between 4 and 6 months of age. Your 4-6 month old may still become crotchety if overtired or over stimulated. Watch your baby’s awake times (Baby Sense 2010) 6-12 Months The older baby is a bundle of fun and laughs and will not spend much time crying. There are a few reasons that typically raise their heads: Illness – many babies get their first colds and illnesses at this age and an irritable baby with a fever is not much fun. Separation anxiety – as your baby develops object permanence and realizes he is separate from you, he will become increasingly irritable whenever you are out of site. A transition object or security blanket will help him to feel a little more secure. Nappy change time – all 8 month olds resist having their nappy changed and become very irritable. This is typical and is no reason to be concerned. Simply put the back position for nappy changes is way to passive and our little one will get very irate when placed on his back. Teething – typically your baby’s first tooth will emerge during this stage and you may have a day or two of irritability. Toddlers Your toddler has an opinion and mind of his own and generally this will impact on his mood. There are three main reasons for crying and tantrums A toddler may throw an almighty tantrum if he is overtired – we tend to overestimate our toddler’s ability to stay awake and be stimulated. The reality is that toddlers need at least one day sleep and an early bedtime. In addition, toddlers can only socialize for a limited period before becoming over stimulated and crying or throwing a tantrum. If your toddler feels misunderstood, you will have a tantrum on your hands. Toddlers understand more than you would believe and can process cognitively what they want to say or do. The problem is that it will be some time before your toddler can express himself adequately. When he feels like you do not understand him a tantrum may ensue. Some toddlers throw tantrums and cry simply to get their way. Again this is normal and is part of developing independence and autonomy. Finally, it is vital to realize that all babies are different. Some settled little ones cry very little and take each stage in their stride, while a sensitive baby cries for almost no reason and is

March 12, 2015

Tips For When Your Tween Wants To Go Out With A Group Of Friends

As children get older, the milestones don’t stop, they just get different and pull at their parents heart strings a lot more. As your children approach their teenage years they start getting more independent, they start wanting to do things on their own, be their own people. This is very difficult sometimes for parents to deal with. Allowing your child to venture out without you means you are relinquishing control, which is hard for most parents. Despite this being hard for the parents, this is a vital milestone for children to reach. Obviously in today’s world you can’t simply send them off without a care in the world. There do need to be some guidelines, rules and expectations for both you and your child. Whether it be a trip to the movies, skating rink or just a milkshake at a restaurant, keep these guidelines in mind before agreeing to let your child go. Find out who is going. Don’t assume your child will be going with their usual friends. Find out exactly who is going to be there, if there are names you don’t recognise ask who they are and where they are from. Find out exactly where they plan to go. A trip to the movies may include a stop for a coke before or a pizza afterwards. They need to supply times and places of where they are going. If for some reason they need to drive from once place to another, find out who will be driving them, offer to help out if it hasn’t been sorted out yet. Keep phone communication open. Most children have phones today, they are a privilege not a right and your child needs to understand that they have to keep in contact with you. When you send a message, they must respond and they must let you know if plans change, even if it is something as simple as changing from one restaurant to another. If possible get the number of another one of the children who are going with. Make sure they have enough money. It is fairly easy to gauge how much money they will need for their outing but make sure they either have some additional cash or at least access to it. Have an emergency plan. This may sound like an overreaction but it doesn’t need to be something that makes them feel insecure. It can be simply a plan if they get separated from their group or they are unable to contact you. Make sure they have your contact details written down somewhere safe and they know that they know where to go if they feel unsafe. Set the boundaries with your child. Let them know before they leave what behaviour is acceptable or unacceptable and they need to know the consequences. Let go. As hard as it may as their parent, it is important that you show your child that you trust them enough to let them do something like this on their own. You have equipped them with the skills they need to be able to handle themselves in a situation like this. Allow them to use those skills. Allowing children their freedom is probably harder to come to terms with than the lack of sleep in those early weeks. It is an emotional roller coaster ride for both the parents and the children but if you both know where the boundaries are and what you expect from each other it can be a positive experience for everyone.

March 11, 2015

The Oppositional Defiant Child

Child psychologists at Johannesburg’s Sandton Psychology Centre are often consulted by worried parents who are concerned about their child’s disruptive behaviour. Sometimes, what emerges is a pattern of non-compliant conduct which is stressful for the entire family. Not all unruly children fit the profile of the oppositional defiant child, and the symptoms must be viewed with caution. As is the case with many psychological disorders one has to rule out other aspects or syndromes is order to make a proper diagnosis. Once the correct diagnosis is made child psychologists will assist with psychotherapy (in the form of play therapy) and behaviour management. Other treatment for Oppositional Defiant Disorder may also include specialized parent training, family therapy, structured group therapy, and school- and home- based contingency management programs. The DSM-1V lists the essential features of Oppositional Defiant Disorder as a “recurrent pattern of negativistic, defiant, disobedient, and hostile behaviour toward authority figures” that persists for at least 6 months and is characterised by at least four of the following behaviours: Loses temper often and for no good reason Argumentative with adults Defies or point blank refuses to comply with what adults have requested Does things deliberately in order to annoy and irritate others Does not take responsibility and blames other’s for their own mistakes or wrongdoing Is easily irritated and annoyed by others – everybody bugs him/her Demonstrates anger and is filled with resentment Is often spiteful and vindictive The Oppositional Defiant Child is not a happy child. In addition to the aforementioned traits they also struggle with social interaction and are often depressed and exhibit low self-esteem. Furthermore, they tend to not do well at school academically as they have a short attention span and a general lack of motivation. These children also have frequent mood swings and low frustration tolerance.

March 9, 2015

Changing Our Minds

My husband and I recently set out for a long drive around the city, while our neighbourhood’s lights were out, when we found ourselves in an interesting conversation. I have recently seen the ugly side of generations before me, how they cannot understand when you go against the norm and follow your heart and ambitions, which lead me to realize that we’re responsible for rewiring our minds for the well-being of our children. We both grew up in fairly traditional and religious households, though you wouldn’t say so. He’s family is Anglican and mine is Christian, his father is a warden at the church and my grandparents are missionaries, who head their own church. They were ever-so proud when they would call me in front of their friends, asking where Jesus lived and I would happily say, “In my heart!” Until my teen years, I listened to every word they preached, absorbed it, shared it and followed it. My husband was much the same – only, he was always causing a racket at church – but you could bet your bottom dollar that every Sunday, The Botha’s would be there, all 3 kids in tow. Fast forward years later, where we said our “I-Do’s” which saw me walking down the aisle to an upbeat pop song by an underground boy band, saying vows which included zombies, helicopters and our exit strategies, in case of an apocalypse. Our wedding cake was traditional white, but topped by robots and slayed zombies with swords sticking out of them. It may sound trashy, but it was an extravagant affair and something that I hold very dear to me. To top it off, after exchanging rings, we exchanged swords too. It’s hard to picture that the little boy and girl who grew up in a very traditional family, would have anything but a white dress, suit and tie sort of wedding, isn’t it? In my heart of hearts, I believe that having the religious background gave me the foundation to open my mind and question, probably more than my family would wish. Knowing that I always had my faith to turn to, I knew that I was able to explore and dig deep into the adventures that tradition has taught us to stay clear of. My family’s expectations for me were clear – they wanted me to matriculate, study and become a teacher, doctor or lawyer. My dreams, which I followed, was to get married young, start a family and focus on my family life. My family couldn’t understand, when I turned down a studying opportunity which included a bursary and for weeks after I faced the disappointing eyes of my elders and felt as if I had failed them. Last weekend, a little girl ran up to my son to play and when we left, my husband whispered to him, “that could’ve been your first girlfriend.” Something shook my insides and we both got onto the topic about how our minds have been trained by previous generations that little boys will have GIRL-friends – tradition. He agreed how wrong and limiting a simple phrase can be, considering if we continued to say things like him having girlfriends, that somewhere along the line he may discover that he isn’t interested in girls but would rather pursue a relationship with a boy. He might mistake our light-hearted joke as an expectation from us and suddenly feel pressure be uncomfortable about telling us about his newfound relationship. Nothing breaks my heart like the thought of my son not being comfortable with his parents. I want to be those parents, where my child doesn’t feel the need to lie, because he knows that we will support him no matter what may happen – I had that sort of mom. I cringe at my sub-conscious who for a long while, had to take a double-take when I saw a mixed-race couple. I have nothing against it and in the last year, I have gained friends and follow several families who are considered mixed-race. To be very honest, I never even considered them to be mixed-race or didn’t think that it was a point worthy of consideration. The only reason it was brought to my attention was that they were debating what to put on the school forms under “racial group.” Wait, what? We’re STILL asking that question? Do you realize that South Africa is one of the very few (if not, only) countries that allows for that sort of categorization? In most countries, they are only allowed to ask what language you speak, so that they know how to address you. As a mom, I can imagine how challenging it is to tick “coloured” when you, personally, do not identify with such a small, limiting box. Truth is, I have seen how my son plays with children from every racial group. He sees no colour, gender or income-group. He only sees a friend. It is so beautiful to witness the innocence in children, and that’s when I realized that it’s my responsibility to cling onto that, to stop it from seizing to exist like the hope that I have for so many generations before me. There is no need for the anger and hatred that we so desperately hold on to, we are all people and equal. We have different experiences but share the same hopes and ambitions for our children. My goal is to bring up my child(ren) not pointing out the gay couple, walking in the shopping mall – I want him to see the loving couple that stands before him, let him admire a balanced, strong relationship and one day wish for a love so real. We are responsible for moulding our children and that means that we may have to spend time moulding ourselves, rewiring our brains into believing that in this day and age, moms can be the breadwinners while dad’s play dress-up at home, families come in all shapes and sizes and

March 8, 2015

Bipolar Disorder- Growing Up, Pregnancy & Motherhood

It has taken me a long time to write this post. It is something so deeply personal, but I can’t tell you how good it feels to let it all out. This is my clean slate… my fresh start to 2015. Sometimes the baggage gets too heavy to carry in your mind. Up until a few years ago, most of my thoughts consisted out of wanting my life to end. There was no real reason – I just didn’t, and sometimes still don’t, want to be here any more. It has taken me years to understand my disorder. I know I will never be cured, but after years of juggling medication, therapy and building a support base I know I can manage it. I am no healthcare professional, I believe there are as many ways people develop to cope (or not cope) as there are people suffering with depression and Bipolar. I am simply telling my story. What is Bipolar Disorder? Bipolar disorder is a mental illness marked by extreme shifts in mood ranging from a manic to a depressive state. Bipolar disorder is also called bipolar disease or manic depression. Symptoms are caused by a defect in the brain’s regulation of mood. The major symptoms are lack of interest in activities you used to enjoy, lack of motivation, sleeping problems (either Insomnia or oversleeping), feelings of hopelessness, a lack of energy and social withdrawal. At other times, high or manic moods can bring confidence, a feeling of invincibility, high energy levels and optimism, as well impulsive reactions and decisions. All of these feelings are usually to the extreme and anything can trigger it. On paper these symptoms can be confusing – not everyone who has sleeping problems or has trouble getting excited about their job has a mental disorder. Everyone feels hopeless from time to time and sometimes things happen that can cause a period of depression (losing your job, death of a loved one, a break-up, etc.) – that’s life… When you are Bipolar or depressed you feel like that for weeks and months on end for no concrete or apparent reason. A state of depression becomes clinical when it is no longer manageable to yourself, or others, or where there is a significant disablement on daily life. Bipolar disorder can have a significant impact on someone’s life, but it’s important to know that people who live with it can lead productive, creative lives. I grew up in a stable, loving home with a supportive family who gave me the world and more. There was absolutely no reason for me to be depressed or unhappy. As a child I was always a bit different, I never felt like I fitted in and I found it extremely hard to make friends. I felt like an unwelcome tourist in a place called earth, as dramatic as that sounds. I had a rough start at school. I am not sure why, but my Grade 1 teacher hated me. She targeted me as the child she would use to make an example of. I remember her telling me that I wasn’t as pretty as I thought I was, I remember her making me stand up in class and asking me really hard math questions – when I did not know the answer or could not answer fast enough she would call me names like ‘dumb’ and ‘stupid’. To this day I have a massive mental block towards maths. When we were colouring in I got into so much trouble for colouring in different directions and writing my name in the corner of the picture – when I tried to explain that it was the way my mom (an artist) did it I was hit with a ruler over my knuckles and told that I was no artist. All this special attention I was getting made the other kids reluctant to be friends with me and I was teased for being ‘dumb’. That pretty much set the tone for the rest of my school life. It is true what they say, a teacher can make or break you. A significant event in my life that triggered the first onslaught of depression was when my mom told me that my dad was not my biological father and that my biological father had died in an accident before I was born. It shook me more than I realized, even though it had no reason to. I can honestly say that my stepdad never treated me any different to his own daughters, I never felt like I was loved any less and to me he was and always will be my real dad and hero. The shit hit the fan when I found out that the accident my dad died of was actually suicide, and that his family wanted nothing to do with me or my mom and left her to struggle as a single mother for years before my stepdad came along. I think this was where I noticed that there was something wrong with me.. I had lost faith in humanity. I know my mom did not tell me the whole story to protect me, but I could not help but feel a little bit betrayed. More than ever I felt like I did not belong, I was angry and depressed. I had so many questions about my biological father, but could not bring myself to ask my mom about it for fear of hurting her or bringing up painful memories. I started making up stories, I created a whole new fantasy life for myself… I made up stories of who he was and later on struggled to distinguish between my lies and reality. Soon I wasn’t just lying to myself, I started lying to my friends and parents about little things. The lying and depression did not go unnoticed and I was eventually sent to a psychologist – his feedback to my parents was that I was selfish and manipulative, and other than that

March 6, 2015

Do You Take Your Day Out On Your Kids?

As the year gets going, life tends to get busier and busier. Most parents I speak to are overwhelmed with work and social functions as well as helping kids to settle in at new schools or getting their extra murals sorted out. Our lives tend to be so busy anyway, that this added pressure can get a bit much and we need to be careful that our kids are not bearing the brunt of this. Do you ever find that you make it through a tough day at the office only to come home and lash out at your kids for the smallest mistake? Or that you are churning internally about some unresolved emotional issue and snap at your children when they interrupt your train of thought? We tend to lash out at the people closest to us – in our homes we feel free to vent, to “be ourselves”, to let go of the pent up stuff that we didn’t express with the people who really got our backs up. If you are carrying around unresolved negative emotions you are likely to take this out on your kids (and/or your partner) at some point. It’s not that you mean to hurt them, but you do. It is really worth taking some small gaps in your day to assess your own emotional state, particularly before arriving home. This may be as simple as sitting in your car for 5 minutes after arriving and just doing some deep breathing and letting go of your day before greeting your family. Or if you have deeper issues that you are battling with, find a coach or councilor or even a good friend that you can chat to so that you have a constructive outlet for your negative emotional baggage, and particularly if you find that you are not able to address issues with the actual people concerned. And, of course, keep in mind that we are all human, and we all crack sometimes. If you’ve snapped at your child after a long and difficult day, start by forgiving yourself and then apologise to your child and let them know that it wasn’t their fault. Our kids can learn a lot from our mistakes about how to handle life, relationships and bad days!

March 5, 2015

Type 2 Diabetes in the Youth

Dr Kuben Pilay is a paediatric endocrinologist in private practice at Westville Hospital, Durban. In the last 20-30 years there have been changes in the world of diabetes. Firstly, there has been a rapid increase in the number of people with diabetes. It is recognized that more adults are developing type 2 diabetes across the world. It has also become clear that the number of children who are developing diabetes is increasing. Twenty years ago, there was a clear distinction between the types of diabetes. Type 1 diabetes developed early in life, affected people required insulin from diagnosis, they were usually thin and often had ketones when diagnosed. Type 2 diabetes occurred after 45 years of age, usually in overweight/obese adults, people were usually asymptomatic and they could be treated with life style change, weight control and tablets. In the last 20 years, the types of diabetes in child, adolescents and young adults have changed. Now, we can recognize more types of diabetes in these young people. While the majority of young people in South Africa still have type 1 diabetes, we now recognize that they may also get type 2 diabetes, neonatal diabetes (in children younger than 6 months), cystic-fibrosis related diabetes and range of rare types of diabetes. It is also becoming more difficult to determine what type of diabetes children have. Youth with type 1 diabetes are more often overweight and those who may have type 2 diabetes may be unwell with ketones and are occasionally not very overweight. Many affected youth now have features of both type 1 and type 2 diabetes. This inability to differentiate the types of diabetes has created ‘new terminology including ‘type 1.5 diabetes’, ‘double diabetes’ and ‘even triple diabetes’. The increase in type 2 diabetes in both youth and adults is closely associated with the increase in the rates of obesity around the world. Increasing weight is a huge risk factor for the development of type 2 diabetes at all ages. The main reason for the increase in obesity is a change in life styles to increased intake of (often high carbohydrate and high fat) foods and decreased physical activity. Only in rare circumstances is obesity due to hormonal disorders or medical conditions. Certain other features increase the chances of a young person having type 2 diabetes including: Family history of diabetes Females Certain ethnic groups e.g youth from African and Asian ethnicities (also Hispanic, American Indian and Pacific island ethnicities) The onset of puberty is often a time when youth are diagnosed with type 2 diabetes as the hormonal changes that occur with puberty increases insulin resistance. People of all ages often have no symptoms of type 2 diabetes. When they do occur, symptoms develop slowly and may include: Unexplained weight loss Increased hunger or thirst Dry mouth Increased urination (including at night) Tiredness and lethargy Blurred vision Slow healing of sores or cuts The diagnosis of diabetes is made by checking blood glucose values. In recent years, and HbA1c has been used for making a diagnosis of diabetes. Unfortunately, in youth, this is a less reliable way of making the diagnosis (particularly in obese children and adolescents). In certain countries where children have type 2 more commonly than type 1, screening for diabetes in carried out in schools! While the treatment options for type 2 diabetes are well known, less is known about how to treat this condition in children and adolescents. The safety and effectiveness of medications have not been tested in this group of people. As more youth with type diabetes are cared for around the world, it have become more obvious that this is a more aggressive form of diabetes than type 2 diabetes in adults. Complications appear more rapidly and therapy needs to be more aggressive than in adults. The additional changes in growth, puberty and the emotional changes of puberty increases the challenge of having type 2 diabetes at a young age. These changes and the emergence of type 2 diabetes in youth means that these young people need medical attention from practitioners that have the necessary knowledge and skills to give them appropriate care.

March 4, 2015

ADD And ADHD In Adolescence

Adolescence is the period in a child’s life which is filled with much turmoil and changes. Not only are there physical changes (including hormonal) but an emotional shift where the youngster has to grapple with several of the following: Acquiring a feeling of identity (self-identity such as “who am I”; social identity such as “which group/s do I belong” and certainty about his/her own values and ideals “where am I going with my life”). In establishing an identity for themselves, the adolescent phase is characterised by experimentation and rebelliousness, which leads to conflict with parents mostly about authority and decision-making. Being acknowledged by peers as well as being accepted by them (fitting in). Concerns and worries about school, exams and careers after school. Foray into romantic relationships with accompanying insecurities etc. During a youngster’s development from childhood to adolescence it becomes common for the symptom pattern of ADD/ADHD to change, most notably by a decrease in hyperactivity. Nevertheless, difficulties with attention and impulsivity remain. It was thought that ADHD tends to “burn out” by the time children reach adolescence and rarely continues into adulthood, however research suggests that this is not the case. Other difficulties that can appear for an adolescent suffering from ADD/ADHD over and above the usual teen concerns are: Adolescents with ADHD often feel “different” from others and they may become socially isolated, especially if they are impulsive and act before they think without due consideration for the feelings of others. They may also still carry the remnants of a lowered self-esteem developed in childhood as a consequence of ADHD. Remember that children and adolescents that have been diagnosed with ADD/ADHD would have experienced the gamut of difficulties on an academic, social and personal front. Low self-esteem may lead to a teenager refusing medication, avoiding educational or other activities and be more vulnerable to peer pressure in order to fit in. They may also lack motivation as they could have internalised that they are not as competent as their peers. Difficulties with focusing, organizing and long-term planning usually pose a difficulty for the ADHD adolescent as the workload at school increases and becomes more complex. As a result adolescents may have difficulty completing tasks, taking good notes, being able to prioritize important tasks and apply adequate study methods for tests and examinations. Adolescents with ADD/ADHD are to some extent more likely to experiment with undesirable behaviours at an earlier age because of their impulsivity and not considering the consequences of their actions. Usually teenagers tend to develop new strengths that help them with decision making, consequently, their ability to think long term, resist instant gratification and regulate their own behaviour does improve. The teenagers with ADHD, however, are simply likely to lag behind in these areas. Therefore, teenagers with ADHD have much more of a harder time regulating their impulses, even when they know their behaviour is destructive. As such, impulsiveness can potentially lead to substance abuse, aggressive acting out, unprotected sex, promiscuity, reckless driving or any other high-risk activity. Like all teenagers, the need for acceptance and to “fit in” is substantial. Some teenagers with ADHD will be more at risk of becoming the “class clown” or becoming the “most rebellious” or the “outrageous” one to get some attention and acknowledgement from their peers. On the whole, ADD/ADHD is a complex disorder and usually there are accompanying conditions such as depression, learning difficulties, anger and anxiety which can affect adolescents with ADD/ADHD in widely contrasting ways. Sandton Psychology Centre has psychologists that work with adolescent difficulties and issues. It may become necessary for a parent to seek professional assistance for their teenager during this period. Adolescents will likely benefit from psychological intervention that will teach them how to deal with impulsive behaviour, difficulty with remaining focused and/or organisational skills, long-term planning and low self-esteem which are all aspects related to ADHD

March 2, 2015

The Importance Of Career Assessment

Psychological career assessment and vocational guidance are often a last resort for many individuals at a critical career cross-roads in their lives. Often the choice of a particular career path is considered an innate or “given” factor for many people and, consequently, something which they shouldn’t have to think about especially hard. This assumed attitude of “I should already know” can stand to cause a great deal of anxiety for an individual, especially if they are uncertain of their career path, their aptitudes or their personal employment preferences. The importance of career assessment and vocational guidance cannot be overstated and, considering recent data, it seems that although assessment and guidance are not the norm, they really should be. A survey from the University of the Western Cape (UWC), conducted across the 1990’s revealed that there is a direct correlation between career guidance services and job satisfaction. Of the individuals surveyed, the study found that approximately two thirds of the students surveyed were dissatisfied with career guidance services they received. The study also indicated that a very similar number of students experienced problems with their career choices after their time at tertiary education. It seems then that, once an individual works through a career assessment and guidance process, they tend to find a career which is satisfying to them. Given the prohibitive expense of a university degree, coupled with the amount of time it takes to complete, one might suggest that the choice of educational field, institution and career path might be better served by a thorough and rigorous assessment of the individual followed by supportive, pro-active guidance rather than taking a shot in the dark and simply hoping for the best. This strategy, it seems only works in around 40% of cases. But when should one engage in the process of vocational assessment and guidance and, what should one expect from this process? A vocational assessment battery can be performed at almost any time, from early adulthood through to late career. With this said, the Sandton Psychology Centre works with school-aged learners choosing subject fields for the first time (approx. 16 years and typically in grade 10), through matriculants choosing a field of study at a tertiary institution and finally to working adults experiencing a career-crossroads or need to re-examine their career choices in later life. In any career assessment one should expect a range of assessments which test an individual’s ability or interest in a certain area. For example, an interest evaluation such as the Self-Directed Search (SDS) helps an individual to isolate specific areas or fields of interest which have a special significance for them. It also allows for the ranking of these interests so that the individual can see which are the most important and which are least important to them. The simple exercise of noting these preferences can serve to greatly reduce the anxiety of career choice. Although the career assessment process should not, strictly speaking, be prescriptive, a great deal can be gained from the confirmation that individual “X” has a strong preference for art, social affairs and writing. It is highly likely that X, was already aware of this preference but the psychometric confirmation of this can go a long way to helping them recognize their dominant traits and preferences. This, in turn, raises the question of what should a career evaluation consist of? Although many methods exist and many more are currently being developed, a general rule of thumb specifies interest surveys such as the SDS, Jackson Vocational Interest Survey, or Values Scales; as well as some personality assessment tool such as the 16 Personality Factor Questionnaire or Myers-Briggs Type Indicator. When combined these results can paint a very useful picture of preference and personality type. This is incredibly useful in ascertaining the degree of “fit” an individual may have for a particular occupation. For example, “John” shows a clear preference for outdoors work and a love of animals. His personality traits indicate that his is an extrovert who prefers giving instructions to receiving them. From this it is clear that John’s career path does not lie in a highly structured, hierarchical office environment; working as a game ranger might be a closer fit for this particular individual. Each career assessment case is unique in this regard and it is only through a systematic process such as this that a skilled psychologist can assist an individual to recognize that their specific set of abilities, knowledge and personality traits may work well in one area or another. Career assessments are not prescriptive either, that is, one should not expect to take an assessment and to be told, “Go and work in accounting.” Again, with each individual being so unique and specialized by their abilities and experiences, the assessment only serves to point a useful, general direction forward, eliminating potentially poor career options and preferencing “best fit” choices for the individual. However, it remains up to the individual to chose their own path. With an ongoing, therapeutic understanding of this process and its development, working closely with a psychologist can greatly enhance an individual’s ability to mount the typical obstacles of working life as well as to assist the individual in creating a meaningful understanding of their career and the path it is on. Ongoing vocational guidance is essential to this process and is especially useful in the creation of enduring and thoroughgoing life and work choices.

February 27, 2015

Imaginary Friends In Childhood

It is a common idea that children with imaginary friends have issues for which they are compensating, and while this may be the case, it is not the sole reason your child will develop a friendship with an invented chum. Research shows that girls are more likely than boys to have imaginary friends, or at the very least just to acknowledge them, while boys are more likely to impersonate fantasy characters. Children who have imaginary friends can distinguish fantasy from reality, so there’s no reason to worry when your child exhibits signs that he or she has a made-up companion. They are more likely to engage in pretend-play than children without companions, and they play more happily and more imaginatively. Studies also show they are more fluent with language, watch less television and show more excitement, persistence and curiosity. In one study in particular, children with imaginary friends showed a keener ability to do theory-of-mind tasks than children who did not. These children also showed a greater emotional understanding three years later. Having imaginary friends is common in early development, and approximately 1/3 of children have them. The relationship the child has to his or her imaginary companion is like a normal peer relationship which is characterised by reciprocity, unlike children who nurture or take care of other objects like stuffed toys or dolls. Imaginary friends also provide wish fulfilment functions, such as when a child has an absent parent and compensates for this, or the desire for a sibling which is then role-played through imagination. They are also a safe way for a child to express his or her fears or support themselves in difficult situations, such as standing up to a bully. Self-esteem is increased through imaginary friends, as is creativity. The only time an imaginary friend should cause alarm is if your child’s developmental age has surpassed this stage. An imaginary friend at the age of seven or eight may represent a bigger problem. If the friend is a character that concerns you, such as one who is modelled after something negative, consulting a professional for guidance and advice is the best option. But keep in mind that imaginary friends are perfectly healthy, and are even considered a positive step in development of your child’s emotional and psychosocial development, as well as his or her cognitive functioning. Sources: A Child’s World, 12th Edition.

February 25, 2015

The Big Issue With Self Esteem

What is all the fuss about and what can parents do to improve their children’s self-esteem? In recent years self-esteem has become a bit of a buzz word. Parents, teachers, occupational therapists, psychologists and social workers (to name a few) have all become reasonably obsessed with the concept, and near panic proportions are reached if a parent is told that their child has (gasp) POOR self-esteem! For many parents, the very thought that their child might have poor self-esteem is met with horror, severe guilt and is coupled with dire thoughts about the child’s future and whether or not he or she will ever be a success. But what is self-esteem exactly, and why is it so important? More importantly, what can parents do to ensure that children develop a healthy self-esteem? Put very simply, self-esteem is the way in which a person thinks and feels about him or herself. An individual with good self-esteem perceives herself as acceptable, competent and accomplished. A person with poor self-esteem feels unacceptable and doubts his or her ability to confront and solve problems in a masterful manner. The reason there is a big fuss about self-esteem is that it does appear linked to important things such as physical and mental health and satisfaction in life. Many studies have shown that poor self-esteem is linked to such things as low academic performance, depression, anxiety, sexual risk behaviour, drug and alcohol abuse…to name a few. It is therefore reasonably understandable that parents feel a sense of concern over the quality of their children’s self-esteem. The big question then, is WHAT CAN PARENTS DO to enhance the self-esteem of their children? The following article will answer this question, starting from the moment that an individual first becomes a parent, giving simple hints and suggestions for dealing with infants and older children alike. Infancy: The importance of a good attachment A child’s most significant relationship is usually (although not necessarily) with it’s parents. It is within the safety of this primary relationship that children start developing thoughts and feelings about themselves that are mirrored to them through the eyes of their parents. The bond between a parent and child is traditionally referred to as the ‘attachment’ between the child and it’s primary caregiver. The quality of this attachment can range on a continuum from very good, to very poor and starts developing from the moment that a child is born. Importantly, a good attachment is one of the primary foundations upon which one’s self-esteem is based. Although there is no rule book for establishing a positive attachment with one’s infant, there are a few things that parents can do to make a good attachment more likely. There are also red flags to look out for that might prevent a parent from establishing a good attachment with one’s child. Most significantly, it is critical that parents are RESPONSIVE and focussed on the needs of the child. Infants are completely dependent on their parents for protection and nourishment and are unable to meet any of their needs independently. A responsive parent is one who is reasonably in tune with their infant. As such, they are able to react quickly and accurately to the needs of the child. These needs could be physical or emotional and may include food, a clean nappy, comfort, warmth or sleep. As the child gets older and more interactive, this responsive style starts to include the child’s increasingly complex emotional experiences. It becomes important for a parent to accurately respond to both positive emotions, such as smiling back or laughing when the child smiles; or negative emotions, such as soothing a frustrated or upset infant. Red flags for parents to be aware of are any issues that prevent a parent from being able to respond to the needs of their child. These could include: post natal depression, marital conflict, alcohol or drug abuse, mental illness such as depression or anxiety, or burnout from severe work stress. Parents are advised to seek timely help from a professional if they are unable to cope with these issues on their own or with the help and support of family and friends. Consistent praise and encouragement: How it relates to self-esteem As children grow older and start talking, praise and encouragement become incredibly important for children and are a vital ingredient in promoting a healthy self-esteem. Positive feedback can relate to behaviours, but can also relate to specific aspects of a child’s character (for example, “You were so kind when you helped that little boy who fell”; “You laugh so easily, I love your sense of humour”) as well to the relationship between you and your child (“you’re my special boy”; “I love you”). In these ways, positive feedback can help a child to understand that they are loved and cherished, for specific qualities that are noticed and appreciated. Solve problems WITH your child rather than FOR them As children continue developing, their abilities become more complex and more is expected of them by society. As individuals, our ability to confront and solve problems determines much of our experience of success or failure. Children who consistently rely on parents to solve their problems for them are unlikely to feel the sense of accomplishment and pride that comes from solving their own problems. In addition, as children develop into adults, over-reliance on parents for problem solving will lead to unhealthy levels of dependence. In order to foster independence and a positive self-esteem, it is important that parents allow or assist children to solve their own problems. Problem solving refers to a variety of different situations and often involves a great deal of patience from parents. For example, it might take your child ten agonizing minutes to figure out how to use a new toy or to find the place where the puzzle piece fits in. Although you might be able to do it for your child in seconds, it is more important that you allow your child to explore

February 23, 2015

The Un-Motivated Teenager

An unmotivated teenager can be frustrating for parents and other authority figures such as teachers. In addition, the teenagers themselves are likely to suffer adverse effects and consequences due to this state of being. It has been said in jest that teens are very motivated but only at doing what they want to do. Nevertheless, when it is your teenager that is un-motivated and seemingly not interested in anything it can become an extremely distressing and stressful time for the entire family. The de-motivated and un-motivated teen commonly emerges in the academic arena first, or at least this is where the most stress emanates. This is because school and school-related activities such as studying for tests, completing homework and assignments takes up the majority of the teenagers time. However, other areas where one can see an un-motivated teen are social activities, sport and home/family commitments. Sometimes, the terms un-motivated and underachiever are used interchangeably and creates much confusion. However, there can be a clear distinction between the two which is measurable. When one looks at underachievers one has to determine the gap between their actual ability and their results at school. Their actual ability is easily measured by IQ and scholastic testing. This is an important aspect to look at as there are many facets to the discrepancy. It sometimes happens that people like parents and teachers assume that a youngster is very bright, but upon examination discover that they have very high verbal abilities, however this is not matched by their non-verbal abilities resulting in lower grades in various subjects. The true underachiever, is when a youngster is measured to be gifted or have high cognitive abilities as measured by an Intellectual test but this is doesn’t translate to their academic achievements at school. Why do some teenagers have no motivation? The reasons for an unmotivated teenager vary and include some of the following: Low self-esteem; A teen’s peer group has no ambitions and the group may promulgate an attitude that it is “un-cool” to care about school marks and achieve good grades; Does not care about the consequences of their lack of motivation; Has psychological difficulties such as depression and anxiety or other worries; Does not respect authority and not being motivated is a way to rebel; Is under too much pressure from parents and teachers to achieve; Parents want their teen to achieve their ambitions and not what the teen is interested in; Parents are too strict or too lax with expectations; Pre-occupation with family problems; What to do if you are concerned about your teen’s lack of motivation? If you are concerned about your teenager’s grades it will be prudent to have an educational assessment if your teen has not previously undergone an assessment. A full assessment will determine your teen’s learning style as well as any strengths and vulnerabilities and what can reasonably be expected from them academically. In addition, a good educational assessment will also look at a teenager’s emotional well-being to evaluate whether there are any emotional difficulties that are hampering their progress or motivation. A career assessment may be necessary if the teen does not know what he /she is going to do with their future, as they may feel “lost” and therefore un-motivated to reach their academic goals. Psychotherapy and counselling may be beneficial in terms of helping adolescents with their motivation. In addition, study skills and addressing learning styles will be beneficial in helping youngsters. (Learning styles are determined by educational assessments).

February 20, 2015

Teenager Self-Harm & Cutting

Self-harm, self-mutilation or self-injury behaviour all mean an action that is deliberate on the part of the adolescent to hurt or injure themselves. Self-harming behaviour is usually not an attempt from the adolescent to commit suicide, however does suggest that the teenager is struggling with underlying emotional issues. Depression and suicidal ideation, should however, never be discounted as for some teenagers this is a real concern. Teenagers who engage in this behaviour may partake in other risky behaviours such as alcohol and drug use. One particular phenomena related to self-harming behaviour is that is can become contagious in that it is common for teenagers to ‘copy’ or try fit in with their peers. It thus becomes ‘cool’ or trendy and self-harming behaviour can occur more prolifically when others in the peer group start engaging in this type of behaviour. There is not one particular reason why teenagers self-harm. It generally suggests emotional turmoil brought about by several factors such as the following: Inability to deal with emotional difficulties, such as relationship difficulties or problems within the family (such as not getting on with siblings, parent/s, step-parents etc.); Feelings of distress, anger, frustration, guilt Feelings of having ‘no control’ over their lives; Poor self-esteem and feelings of worthlessness; Clinical disorders such as depression, anxiety or obsessive compulsive disorder; Inability to deal with stress; Feelings of pressure (academics, sports or from peers); Inability to express feelings in a healthy way; Loneliness and feelings of isolation; Wanting the attention of people who can help them; Spending with time with individuals who self-harm; and History of abuse or of having experienced a traumatic event. Self-injury can become addictive and progressively serious. Teenagers who self-harm have difficulty asking for help. It is therefore important for caregivers and teachers to look out for this behaviour and seek the help of a psychologist.

February 17, 2015

Depression And Anxiety During And After Pregnancy

Pregnancy is generally assumed to be a wonderful time in the life of a family, a time of abundance and anticipated joy. For some women however, pregnancy can be an extremely stressful time, with many women experiencing feelings of both depression and anxiety. It is well known that pregnant women need to take care of their bodies in order to foster the growth of a health baby. However, it is equally important for pregnant women to take care of their emotional well-being, as untreated depression and anxiety during and after pregnancy can have long term consequences for the whole family. This article addresses some of the important issues with regards to pregnancy and depression and anxiety, and offers some advice on how best to cope with depression and anxiety during pregnancy. Are there different forms of depression during pregnancy? Depression is a common problem amongst women, and is most common in women age 18 to 44. This is the time when many women fall pregnant and so it stands to reason that pregnancy and depression can often overlap. Depression can therefore take on several different forms during and after pregnancy. Some women will be depressed prior to falling pregnant and this will continue into their pregnancy and even after the birth of their child. Some women will only become depressed during pregnancy and this can continue once the baby is born (becoming what is classified as postnatal or postpartum depression). In fact, research has established that women who are depressed whilst they are pregnant are more likely to experience postnatal depression, making it important that women who are depressed during pregnancy seek help before their baby is born. Some women will be emotionally well during their pregnancy, but will suffer with postnatal depression after the birth of their baby. Postnatal depression does not necessarily occur immediately and can start up to eight weeks after the birth of a child. It is important to bear in mind that all forms of depression are treatable, and that there are many different forms of treatment available to pregnant women who are depressed. Depression during pregnancy can often go hand in hand with anxiety. This is not surprising, as the many changes that occur during pregnancy can be very stressful for many women. During the first trimester, many women become anxious that they will miscarry, or that something else will go wrong at this early stage of pregnancy. During the third trimester, many women can become anxious about the birth of their child, worrying about the birthing process itself as well as the enormous impact that having a baby will have on them and their relationships. Many first time mothers become anxious during pregnancy as they worry ability to take care of an infant. Research has also shown that it is common for women to become anxious before being discharged from hospital once the baby has been born. These are all normal concerns and should not be seen as abnormal or wrong. However, if these anxieties become too extreme, or they are coupled with feelings of depression, then it is important that they are addressed and treated during pregnancy, as women who are extremely anxious during pregnancy are also more likely to experience postnatal depression. Why does depression often go undiagnosed and untreated during pregnancy? During pregnancy women experience many physical changes which differ depending on the stage of pregnancy. It is not uncommon for pregnant women to feel extremely tired, especially during the first and third trimesters. It is also very normal for pregnant women to have a change in appetite, ranging for example from nausea and lack of appetite in the first trimester, to increased appetite in the second and third trimesters. In addition, many women who are pregnant experience changes in libido. These are all normal aspects of pregnancy and are certainly no cause for concern. However, these changes are also hallmarks of depression. For this reason, depression can often go undiagnosed during pregnancy as both women themselves, and doctors, do not recognise these physical changes as depression. Unfortunately, up depression in pregnant women is misdiagnosed up to 50% of the time. This does not mean that all pregnant women should become overly concerned with becoming depressed or worry that the physical changes that they experience during pregnancy could be depression. Whilst up to 70% of women will experience some feelings of depression during pregnancy, it is estimated that only between 5 and 10% of women will experience clinical depression during pregnancy. In addition, approximately 13% of women who give birth will experience some degree of postnatal depression. This means that most pregnant women will not encounter problems with depression at any stage of their pregnancy. However, it is important for the small proportion of women who become depressed during pregnancy to seek help. Importantly, pregnancy is generally a time when women have regular contact with health care providers, meaning that there are numerous opportunities to access treatment for depression and anxiety during pregnancy. How will I know if I am depressed? Two important signs of depression are feeling down, depressed or hopeless and feeling little interest or pleasure in things that were previously enjoyable. We can’t all be happy all of the time, but if these feelings persist for most of the day over a period of about two weeks, then it is likely that your doctor would need to consider the possibility that you are clinically depressed. Many pregnant women feel too ashamed or embarrassed to mention these feelings to their doctors or to their friends or family. Women often feel an enormous amount of pressure to maintain a ‘happy face’ as they believe that pregnancy is supposed to be a time of joy, not sadness. However, it is extremely important for depression during pregnancy to be treated as there may be long term effects of depression on the baby as well as on the relationship between the mother and the baby. Importantly, depression during pregnancy is also

February 13, 2015

Getting Back Into A Routine

The holidays have come to an end. No more getting up at half past eight. No more getting done when you feel like it. No more just taking it easy (as if parents could ever take it easy). You are almost back to the daily grind and now you have start worrying about getting up on time, making lunch and all the other routines associated with normal day to day to day life. We all have our little sanity savers to make life easier and I thought I would share some tips and tricks I have learnt and adopted in the morning for school. Our morning routine Most important is be up before the kids are so that I have time to have a bath and to get breakfast and lunch ready. I usually decide the previous day as to what breakfast and school lunch will be. This allows me to buy what I need and prevents deciding in the morning based on the contents of your fridge. We have a dedicated set of lunch containers for their lunches and ensure these are washed the night before and left ready to be packed. Breakfasts usually consist of oats (energy packed low GI food) every second day, mixed with either cranberries, grated apple, cinnamon or honey. Other days include foods such as scrambled eggs, bacon and toast, home-made crumpets (I have a great recipe that can be mixed and cooked within 15 minutes), French toast with syrup and on rare occasions cereals (Milo, Coco Pops, etc.) Once done with breakfast and packing lunches, I wake the kids (if not up already). Once they are up, it’s straight to the bathroom for them for a quick wash and to dress. They then have breakfast. TV can be a big distraction in the morning in getting the kids done, so my kids are only allowed to watch TV once they ready for school and finished breakfast. With regard to clothing, let them pick out an outfit the night before. We also have a shelf within their reach with a few choices so they can choose their own clothing. School uniforms simplify this process immensely. School bags are packed the night before and left waiting at the front door. Non co-operative kids? This is where the secret box of Milo cereal or Coco Pops comes in handy. It’s a pleasant treat for our kids to have something (or rather anything) with chocolate on it. But they can only have it if they help getting ready for school. Promising to do a special activity with them in the afternoon is also a good motivator. A visit to the park after school is a good motivator to send a completely lethargic kid scurrying to find that lost shoe. Sometimes all kids need is a hug and a few extra minutes to wake up. If they are very crabby in the morning, I usually leave them in bed for a few extra minutes while I get something else done and come back for them. That’s why part of my strategy is to make sure that I am done before the kids so that I can spend a little extra time with them if need be and not trying to do everything at the same time whilst running out the door. My advice to find the correct routines Each family is different as is each child. So decide on a routine that best suits you. Importantly stick to the routine once you decide on it (e.g. in my case I do not give in to the no TV before breakfast rule). Do allow a certain amount of flexibility in the routine for those non-cooperative days, but not so much that the routine changes every day. If that is the case then you need to relook at your routine. If you have a nanny or domestic helper, make sure that they know what their duties are in the morning as well. It does not help when you of you are trying to do the same thing or even redoing what one person has already done. What works best for us is to share the tasks so that one parent is not under pressure all the time. For example, one parent does school lunches and breakfast whilst the other parent washes and dresses the kids. Routines can have a downside in that children’s lives are so regimented that they don’t get to make choices, do their own thing, play, have fun and just relax. Your routine should be designed to ensure all of this happens whilst having the key features of being well planned, regular and predictable. And don’t forget that everyone enjoys an occasional change of routine to break monotony. My apologies if this post is lacking some humour but unfortunately getting done in the morning is no laughing matter……

February 12, 2015

PG 13

It’s a busy, busy world. There is too much to do and not enough time to do half of it. It’s getting harder and harder to monitor exactly what our children are filling their time with. Some of it is harmless enough, but a great deal of what’s airing on TV these days is, for lack of a better word, poisonous. Let’s begin with how much television or game time your child is allowed each day. The best thing to do is minimise this time and supplement it with outdoor activity. Allow between one and two hours of TV a day, and not longer than that in one sitting period. Do not allow television during meal times, or right before lights out. Try reading a story instead, and give their minds imagery that requires imagination rather than that which could disturb their precious minds. Next, monitor what they are watching and playing therein. Before you buy a DVD, watch it. Play a game before you give it to your child. There is a very good reason that the Film and Publications Board gives ratings to movies – because some can be extremely harmful to young, imaginative minds that are not used to the violence that we adults have sadly become desensitised, even accustomed to. Wrestling shows are not appropriate for young boys because their playfulness and desire to imitate can often turn into tears on the playground. Blood, gore and foul language also have no place in the lives of children when it comes to entertainment. When it comes to super heroes and fantastic myth, explain to your children that they are fantasy and not reality, and can therefore not be imitated without painful consequences. Video games are a big consideration people need to keep when dealing with monitoring their child’s activities, as these affect some very fundamental parts of your child’s mind. Because game simulation is becoming more and more lifelike, children are finding themselves rapt with these fast-paced and aggressive worlds they go into. As a result, the lines between fantasy and reality begin to blur and violence and aggression, as well as addiction, begins to grow. This is not to say do not allow your children enjoy the thrill of entertainment, it simply means think twice before allowing your 7 year old to steal cars in Grand Theft auto or attempt to save the world from aliens that rip intestines out (it’s true, a lot of the games these days feature such graphics) and because we don’t monitor what they are, we are left unaware of the threats they pose to our children’s mental well-being. Make sure you know what entertainment your child fills his or her time with, and decide whether you deem them healthy or age-appropriate. Trust your instincts here – if you don’t like it, chances are it’s not healthy.

February 11, 2015

Childbirth Education Can Save Lives

Knowledge is the key to a safe, successful pregnancy, birth and parenting experience. At the very least childbirth education will improve your birth experience, and at best it can save your life. Of the million plus women who become pregnant in South Africa each year, those who receive antenatal care and quality childbirth education are the most likely to experience a healthy pregnancy and birth. Ideally all pregnant parents would attend childbirth education classes, which cover all aspects of pregnancy and birth as well as how to care for the newborn baby. However only about 5% of expectant parents do. There are some good online courses available. However, attending classes – which are usually held in the evenings or over a weekend – are more recommended; the interaction with the childbirth educator and other pregnant couples in the class is invaluable. Often lifelong friendships are formed. Typically childbirth education classes will cover: Pregnancy – physical and emotional changes Birth options Labour – breathing, water, massage, relaxation, visualisation Pain relief options Birth plan Breastfeeding Care of the new born baby Postnatal depression To help find the right childbirth educator for you and your partner ask the following: What are her qualifications? Ideally your childbirth educator is a qualified midwife and has completed a post-graduate diploma in Childbirth Education. Is she a member of the Childbirth Educator Professional Forum? Is she a mother? Which birthing methods are covered in the course and which are emphasised? What are her ideals of labour and do they match yours? Can partners attend? Ideally dad will be involved in some or all of the classes too! Are practical techniques taught e.g. breathing and positions for labour, massage, relaxation and visualisation? There is a list of qualified childbirth educators in the Expectant Mothers Guide or online on www.expectantmothersguide.co.za.

February 11, 2015

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viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

Cookie	Duration	Description
_ga	2 years	This cookie is installed by Google Analytics. The cookie is used to calculate visitor, session, campaign data and keep track of site usage for the site's analytics report. The cookies store information anonymously and assign a randomly generated number to identify unique visitors.
_gid	1 day	This cookie is installed by Google Analytics. The cookie is used to store information of how visitors use a website and helps in creating an analytics report of how the website is doing. The data collected including the number visitors, the source where they have come from, and the pages visted in an anonymous form.

Cookie	Duration	Description
_gat_gtag_UA_18530557_4	1 minute	No description
pron_ip	session	No description
pvc_visits[0]	1 day	This cookie is created by post-views-counter. This cookie is used to count the number of visits to a post. It also helps in preventing repeat views of a post by a visitor.
tk_ai	session	Gathers information for WordPress by themselves, first party analytics tool about how WP services are used. A collection of internal metrics for user activity, used to improve user experience.