This month I am taking a look at Phobias, Fears and Anxiety in Young Children and next month I will look at tips to help your children overcome their fears.
Anxiety disorders
Anxiety disorders are very common. One in four people will experience an anxiety disorder at some stage in their lives. We all feel anxious at times but some people are unable to control their anxiety it becomes so overwhelming that it affects their everyday activities making it difficult for them to cope.
Types of Anxiety disorders in children
There several types of anxiety disorders the most common in children are:
Generalised Anxiety disorder (GAD) - This is a feeling of being constantly anxious or worried.
Panic Disorder – An intense feeling of anxiety or panic attack which cannot be brought under control easily.
Social Phobia – when a child has a fear of failure, of being criticised or humiliated
Specific Phobias – being fearful of particular objects or situations.
Obsessive Compulsive Disorder (OCD) - this is caused by unwanted or intrusive thoughts and fears which cause anxiety. The anxiety are brought under control by carrying out certain rituals.
Common Fears of Toddlers
Toddlers love routines. Routines can often bring security and familiarity which help toddlers to feel safe or to help them deal with their fears. Knowing what is expected of you and what is coming next can help prevent childhood anxieties. This is often seen with a child who requests the same story every night or the same cup and plate to eat off.
Because young children do not have our understanding of the world as we do they may develop fears or become upset over things such being flushed away with the water going down the toilet or going down the plughole with the bathwater. This stems from their lack of understanding of size, space and time. If a child has a particular fear you may be able to avoid or change the situation for a short time and reintroduce them to it slowly over a longer period. Another idea is to make a fearful situation into one of fun. Place a small plastic ball in the toilet and watch it bounce around but not get flushed down. Have a shower with dad instead of a bath or bath in a large plastic bowl.
Around the age of 2-3 years toddlers are hyper sensitive to their emotions. This period can be quite frightening for them until they learn how to bring them under control. New thing or environment may seem very frightening, even if we see them as no risk at all.
They can also be fearful of other people’s powerful emotions and burst into tears when a parent shows anger or despair. In the heart of all toddlers is the desire to please those they love. Some toddlers are perfectionist by nature these children may feel angry at themselves when they have displeased or disappointed themselves or their parents. Talk to them gently and try to find out what has made them feel this way, reassure them that they are loved for who they are and not for what they do or do not do. Let them know it is alright to feel angry sometimes but also make sure they understand that when they are angry it is not alright to hurt themselves or others or to let anyone hurt them.
Common Fears of Young Children
Fear may be cause by a variety of events:
The most commonly cause of fear stem from the unknown – new or strange situations, and things we cannot understand or control. A child is constantly facing new and unfamiliar situations which to some children can be overwhelming and fearful.
Fear can also be a learned behaviour. A child may observe and respond to another person’s reaction – such as a parent who is fearful of dogs, spiders or heights.
Fear may have resulted from a frightening event where the child themselves personal experience something that terrified or harmed them such as an angry dog bitting them.
Then there is imaginary fear that can be caused by hearing scary stories or watching inappropriate TV programs. Children under the age of seven are unable to distinguish the difference between fiction, fantasy and reality and see all as reality. This is why all stories books and TV should be closely monitored for children under seven. Including graphic new stories on TV. Their vivid imagination and these images and impressions can also lead to nightmares. A child’s imaginations can also create their own fears such as monsters which can then lead to a fear of the dark. Parents can inadvertently exacerbate this situation by leaving a night light on which can reinforce their fears.
Abnormal fears
If you are concerned your child has problem with fear or has a phobia there are certain things you can look for.
Things to look for if you are concerned that your child’s fear has become a problem?
· Is this fear a reasonable reaction to a situation?
· Is the fear interfering with the child’s everyday life or that of the family?
Anxiety disorders are common, but the sooner you get help, the sooner you can help you child learn to control these conditions so that they do not control your child.
Next month I will look at tips to help your children overcome their fears.
This article was written by mothercraft nurse Sally Hall from Cradle 2 Kindy Parenting Solutions.
For more information on similar parenting topics you may like take a look at our e-books Publications on this link.
The psychological impact of your baby’s reflux on you and your family
I am a mother of two children who both suffered from reflux as babies and a psychologist who continues to see exhausted and distraught mothers of babies with reflux in my practise.
Having been through the incessant and nerve shattering screaming of the baby in pain, the broken and insufficient sleep for the entire family and the merry go round of searching for the right treatment, I can relate to this issue immensely. Fortunately, I can also relate to the relief and joy of finding the right treatment and support as well as finally seeing light at the end of the tunnel.
From the amount of friends, patients and family members I encounter who have struggled with a reflux baby; I can see how wide spread the problem is. When I had my first son Jake in 2005, reflux was not as commonly experienced or talked about in my circles as it was when I had my second son in 2008. In hindsight I can see that all the sleeping and feeding issues I had with Jake were very similar if not worse than those that I experienced with my second little one who was diagnosed with reflux by a paediatrician. At the time, particularly with being a new mum, I attributed those issues to my lack of experience, bad luck, just the type of baby I had etc. By about 8 months old many of the difficulties had eased (which I now assume was the reflux coming to an end) but we were left with a baby who woke up throughout the night every hour and two extremely frazzled parents. Fortunately we were able to get help and sorted out the sleep, but it was a very rocky period, especially for first time parents.
By the time I gave birth to my second baby, Brandon, many of my friends were experiencing reflux with their second babies. I had watched as my friends struggled with the sudden change of peaceful babies to screaming, unhappy, unsettled little people. I had also seen the transformation once reflux was diagnosed and treated. For the first 6 weeks Brandon was a ‘dream baby’ who slept and breast fed perfectly and then almost overnight he too transformed into the screaming baby who often could not be put down for hours on end, would not settle and was starting to be a problematic feeder. Being a second time mother and desperate not to repeat what I’d gone through with my first baby and with the knowledge I now had about reflux I decided to ‘get on top of it’ immediately. I contacted Cradle 2 Kindy and together with a great paediatrician and the right medication and monitoring of that medication as he grew, within a few weeks the reflux was greatly improved and eventually fully under control. By 8 months old Brandon was off the medication.
Those are the two very different experiences I had with what I strongly suspect were my two reflux babies and which are echoed time and again by my clients who are going through the same thing.
My advice from a psychological perspective would therefore be:
If you are struggling with your baby, read up, get advice and trust your instincts. If the problems seem to be more than the normal feeding and settling issues that parents struggle with from time to time with a new baby, get the appropriate help. The longer you wait, the more it depletes your resources as a parent.
Sleep deprivation is one of the biggest problems for parents. Exhaustion detrimentally affects moods – increased anxiety, weepiness, feeling agitated and touchy, oversensitivity, feelings of being overwhelmed, helpless and out of control are all common reactions to a chronic lack of sleep. The solution is not always easy, particularly for parents who do not have family around, single parents and parents with limited financial resources for extra help etc. This is the time to ask for and accept help from anyone who is prepared to give it. This is not the time to try to be superwoman! Get rest and breaks wherever possible. Sleep when the baby sleeps, prioritise rest over housework wherever possible, couples can take shifts with the baby to give each other decent breaks according to the baby’s schedule and so on.
Make yourself and your mental health a priority. ‘Happy mother happy baby’ is really a cliché that carries much truth. Do what is right for you, stop worrying about what others think and drop that mother guilt whenever it shows up. Constantly remind yourself that you are doing the best that you can and ‘this too shall pass’ can be a handy mantra to repeat to yourself. If baby won’t sleep or settle and you are at your wits end, putting baby in the stroller and going for a walk can be a great way to calm down and it may be easier to handle the crying. Pull out all your resources – exercise, meditation, yoga, ringing a friend, a massage, walking in nature; whatever you can do with the resources that you have to make life more manageable during a difficult time goes a long way to preserving your sanity.
Watch out for your relationship. Stress and sleep deprivation play havoc on even the best relationships. Try to remember that your partner is also going through a difficult time and reassure each other (or yourself when that is not possible) that this is about the situation and not about your relationship. In certain cases it may be about a relationship that was rocky to start off with and difficulties with your baby will cause extra stress. If that is the case try to get help in the form of counselling. Again, this may not be possible at the time with the demands of the baby and I would suggest getting the help as soon as possible and not just ignoring the problems in the relationship once life with baby get easier.
And last but not least, if you feel that you are not coping, do not hesitate to get professional help by seeing your GP, a psychologist or counsellor.
Michelle Fox is a registered psychologist currently practising in the Eastern Suburbs of Sydney. Her goal is to equip her clients with effective tools and techniques to enable clients to live their best life and to cope during difficult times.
When Karen Eriksen’s son began refusing almost all food at the age of
two, it would take five years and several specialists to establish what
the problem was.
My child lives on air alone. You think I am exaggerating, but not really. My seven-year-old boy, Finn, eats small quantities of dry white bread and chips (or potato balls) with tomato sauce. He also occasionally eats vanilla ice cream, pikelets or banana bread from a café. He drinks water, juice and sometimes strawberry milk. That’s about it
Finn doesn’t eat sausages, hamburgers, spaghetti bol or vegemite sandwiches. No meat, no fish, no sausages, no pasta, no rice, no grainy bread, no cheese, no yogurt, no butter, no jam or honey. He will come home from a mates’ birthday party and not have eaten a thing. He is of average height and thin, but not skinny. He is a worry, every day.
My friends ask how I deal with it, and I answer that I don’t any longer; that I have given up. But, naturally, that is not true. Periods of resignation alternate with my gathering my strength and dragging him to see another health professional. We have seen a lot of people over the years. And last year, we got a satisfactory diagnosis. But only after five years of worry and trying to make Finn eat.
Finn was a normal-sized baby, eight days overdue and breastfed until his first birthday. He was, however, a very unsettled and colicky child, but nothing that a dummy and over the counter medication couldn’t fix. Solids went well - the usual mashed up food, but also fish, risotto, yogurt. At about the age two, he started to decline food. When almost three his sister was born, a traumatic event that he is still coming to terms with. He continued to decline food – and more and more varieties of it.
The health-centre nurse said that he looks very healthy, and that he is over the 90th percentile in weight and height. I wasn’t surprised about the height, since I am over 180cm and he has tall Scandinavian genes in him. Our GP suggested that we see a dietician, the first of three we consulted to no avail. It wasn’t that Finn didn’t like the food; he never even took it into his mouth to try. Pushing him to take something into his mouth triggered heaving and sometimes vomiting.
By the time Finn was three, my husband lost patience, and suggested starving him out, with the notion “No child will starve himself to death.” Not true! The attempt to make Finn eat family meals or nothing at all had to be aborted after a few days. Finn was vomiting water, and he was still not eating.
We tried star charts, instant and medium-term rewards, punishments and encouraging Finn to earn himself some computer time by trying something new. Good advice arrived from everywhere. I offered Finn food that was similar to the types of food that he did eat, made food more interesting, involved Finn in the making the food, signed him up for cooking classes, made smoothies, put apple puree in pancakes, added wholemeal flour to banana bread.... All without success; Finn would not eat any of the food. Home-made food made him suspicious.
He also won’t take oral medicine or supplements. Thank God he doesn’t get sick a lot.
The paediatrician - twice consulted about the eating issue – said, after blood had been taken, that all Finn’s results were fine, a “miracle”, and, “even if they were not, what are we going to do about it, as he doesn’t take medicine.” This was not what I wanted to hear.
In kindergarten, Finn’s teacher voiced concern about his gross motor skills that might affect his fine motor, and therefore writing skills. An occupational therapist diagnosed him with ‘sensory integration dysfunction’, well known in the US, which basically means that his nerves are not very well connected to his brain. That made him clumsy, likely to fall over easily and could also, as the reading I did no the subject informed me, affect his eating. The occupational therapy fixed his motor skill problems, but not his eating.
Next was a visit to a speech therapist to see whether he had problems with his throat and swallowing. No problem there.
Our twice-yearly visit to the dentist revealed one hole after another; and the need for filling number four in a seven-year old that also already has a crown - his pirate tooth we call it. “Bad enamel,” the children’s dentist said. Finn also lost eight milk teeth while his classmates were still showing off their first missing tooth.
The third dietician managed to make Finn eat an almond. After ten weeks of consultations, she told us that she could save her time and I could save my money; there was nothing she could do to help him.
When we were on holiday, the problem turned into a nightmare. Foreign food looks and tastes different from things at home, most parents will know that. With a diet of chips, not a lot can go wrong you would think – but far from it. In America, the chips still have the potato skins on, in Germany, they put parsley and/or paprika on them - a major problem. On overseas holidays, Finn lives on vanilla ice cream. In Croatia one year, he developed hand foot and mouth disease. The hospital diagnosed it as tonsillitis, he didn’t eat for ten days and came home thin as a stick.
It isn’t as if Finn is not also completely frustrated by eating the same stuff day in and out. He gets desperate, but can’t make himself taking something new in his mouth. Uncountable times he has vomited across the table when we made him try a bit of fish or chicken.
Last year, my equally worried, mother who lives in Germany, had had it. We arrived in Germany for our annual holiday and he was whisked into hospital on day two to have a gastroscopy. No prior consultation necessary - my mum organised it with the chief gastro guy, we paid in cash, an hour later we were out of there with some pictures and a diagnosis. Finn’s oesophagus was inflamed; everything pointed to reflux. A paediatrician in Hamburg confirmed the diagnosis and prescribed some anti-acid medication. Back in Australia, we eventually got an appointment with the a gastro specialist for children. He looked at the stomach pictures, felt his stomach and said he didn’t even have to talk to me to diagnose the problem.
It’s quite simple: Finn has got reflux; he has had it all his life. The acid burns his stomach and throat, and his bowel is lazy and often completely full. His reflux also explains his abnormally bad teeth: the enamel is eaten by the acid. Why did nobody suspect that earlier? Couldn’t the specialist children’s dentist at least voice some concern? Finn never complained about pain. Still, I feel guilty.
At least now we have a diagnosis, and the anti-acid medication works. Previously, Finn didn’t get any deep sleep due to his reflux, and therefore was overtired and angry all the time. Fortunately, he is a changed child since taking the medicine. He is much happier, settled and pain-free. But that doesn’t make him eat.
A child who has been in pain when eating for his whole life will be deeply suspicious of food, even if not in pain any longer. We are now seeking a specialist to desensitise Finn and overcome his disgust of food in tiny steps. Finn’s future looks a lot brighter – but I still believe that he should have been diagnosed at two, not at seven year, and that if he has been, he would have avoided the psychological scarring.
Karen Eriksen
A note for Cradle 2 Kindy Parenting Solutions
Babies who are quite unsettled may be showing signs of reflux and should be treated immediately to avoid further complications. For more information on reflux or colic in babies and how to recognise the telltale signs please read Signs and Symptoms of Colic/Reflux Cradle to Kindy parenting coaches are specialized in recognising the symptoms of reflux and have practical tips to help you and your baby through this difficult time.
A lot of parents aim to stimulate their children early in order to promote good attention and learning abilities. This is a wonderful thing to do, but can sometimes lead to overstimulation of the child’s mind. Overstimulation can lead to moody behaviour, disobedience and difficulty in communication as they move toward kindergarten years. The one thing I tell new mothers is to feed your child’s mind, just as you would their appetite. You don’t want to over or under feed your baby and, as such, the same goes with their minds.
A healthy baby is going to have natural inquisitive behaviour about the world around them. Healthy learning development involves them being able to explore their environment, be it in their play pen or a secure room. They need lots of different shapes, colours, textures and (where parents can tolerate it!) sounds to explore. This should be done on a regular basis every day for a few hours and be supervised and structured by a parent or care-giver. If over-done, babies and toddlers can become disinterested in their surroundings because they literally have satiated their curiosity to soon. This is when you see them become moody and frustrated even at play time. It is therefore important that there is structured play time (several hours a day) with a person interacting with them to guide their learning vs. unstructured play time where a new toy, gadget, book or activity is introduced and the child interacts with it at their leisure to enjoy and work out its place in their world.
As children become older, parents tend to feel they need to engage them in lots of physical and mental activities. To some extent this is very good for them however, we can over do this. For example, if you think of yourself working 5 days a week and then engaging in extra-curricula activities of a night time after work, and hobbies or other social events on weekends, you would be exhausted because you have no time for yourself. In other words you have no time just to have ‘free play’. Children need unstructured play time and down time, just as adults do. This stimulates them to entertain themselves as well as to learn tolerance for not expecting structured learning or play throughout their childhood and later teenage years.
To summarise: to promote healthy learning behaviour and good attention in your babies and toddlers, consider doing the following on a day-to-day basis:
Have structured play time with your child where you read, engage in story telling with their toys, or simply provide basic puzzle solving games with blocks, shapes, colours and numbers. Do this for an hour or so every day.
Allow your child to continue unstructured play after the structured play time, or after they’ve have had a rest or a feed.
Try and change their play environment each week. For example, have them play in their room for a few days, then change their play environment to the living room for the next couple of days.
Always talk with your child during play. Even though they will not respond verbally, they will listen during play and retain phrases you say in relation to tasks you work on together.
Reward your children with lots of praise and cuddles each time they work out a puzzle or complete a game with you.
As your child gets older, remember to allow them to have ‘them’ time, where no activities or social events are planned for them during one or two days of the week. It is important they learn to engage their own intellect and accept that learning is not always externally regulated by parents and teachers.
Dr Andrew Campbell is a Child, Adolescent and Family Psychologist at the Brain and Mind Research Institute – Clinical Centre, located in Camperdown, Sydney.
Dr Campbell provides assessment and treatment for a wide a range of childhood behavioural development, mental health and learning disorders and accepts referrals from all GPs.
For bookings, please call (02) 9351-0672.
Medicare and Private Health Insurance rebates are available.
In today’s society children face many of life’s obstacles very early, even while at the breast. Some children react to breast milk. This invariably is attributed to what the mother is eating. There may be a lactose intolerance, cow’s or goat’s milk intolerance or a reaction to a certain type of food which their mother is eating and is passed through the breast milk to the child. Some of these children may grow out of their reaction other may be found intolerant or allergic to these foods. Food intolerances can also occur with bottle fed babies too such as a cow’s milk or soy intolerance. Some allergies and food intolerances are only picked up when a child starts solids.
Symptoms of an intolerance or allergy may begin in a baby with: vomiting, diarrhoea or loose smelly or mucusy stools, flatulence, irritable, excessive crying, black circles under the eyes, runny nose, wheezing, coughing, food refusal which may also indicate a reflux problem or it may appear as eczema, hives, itching, lethargic and in older children even aggressive or uncooperative behaviour.
For many years The National Health and Medical Research Council of Australia (NHMRC) followed the World Health Authorities recommendation of not starting solids before baby is 6 months. Unfortunately, it may be possible that this recommendation to delay the introduction of solids have done more harm than good.
Today, many Australian health professionals have revised their recommendation and have changing the age for starting solids to between four and six months. This is primarily due to the dramatic increase of all types of allergies, especially food related allergies, in children. Immunologists, doctors and dieticians specialising in allergies have suggested that delaying the introduction of solids may be interfering with the normal immune development reducing food tolerance and increasing allergies. Thus delaying the introduction of foods may actually be to the child’s determent. (see article: The Solids Controversy written by Karen Simmer PHD FRACP. Professor of Newborn Medicine, University of Western Australia).
Difference between Food Allergies and Intolerances
What is the difference between food allergies and intolerances? An allergy will give an immediate response as it is the immune system reaction to food proteins. An intolerance doesn’t involve the immune system but is triggered by food chemicals which irritates the nerve endings. These chemicals are found in groups of foods which accumulate in the body and eventually cause a reaction.
Food Allergies
Food allergies are often inherited and are associated with eczema, asthma and hay fever. Food allergies can range from mild to severe causing vomiting, cramps and diarrhoea, hives, swelling on the face, mouth, eyes. The most sever is a life threatening anaphylaxis attack which cause breathing difficulties due to the throat and tongue swelling or asthma.
Common children’s allergies are soy and cow’s milk, egg, sesame, wheat, seafood, peanut and other nuts. Many children grow out of their food allergies by five but peanut and seafood may continue through adulthood. Allergies but not intolerances can be diagnosed through a skin prick test.
Food Intolerances
Many foods have additives including colourings and preservatives but others have natural chemicals those low in chemicals are almost never a problem. Natural chemicals in foods help to enhance their flavour. Levels may either be high in unripe fruits and decrease with ripening or visa versa. MSG for example is found naturally in tomato, mushroom, silver beet, prune, plum and grape. Organically grown foods may have higher levels of natural preservatives and pesticides in their skin.
Foods moderate in natural chemicals:
The following foods are moderate in natural chemicals:
Fruits: pear, apple (golden, red delicious), mango, banana, papaya, rhubarb.
Vegetables: choko, potato, sweet potato, swede, leeks, celery, carrot, beetroot, marrow, pumpkin, parsnip, turnip, peas, snow peas, Chinese veg, asparagus.
Meats: chicken, eggs, fresh fish, veal, rabbit, lamb, beef.
All dairy foods other than mild and tasty cheeses.
Grains: rice, arrowroot, barley, rolled oats, sago, wheat, rye, buckwheat.
Foods high in chemicals:
Fruits: avocado, date, kiwi fruit, orange, pineapple, grape, plum prune, sultana.
Vegetables: cauliflower, eggplant, broccoli, mushroom, silver beet, tomato, broad bean.
Meats, fish and dairy: Tuna, salami, sausages, seasoned meat and chicken, tasty cheese.
Others: honey, jams, fruit or chocolate flavoured drinks, stocks and sauces.
Food intolerances are rarely serious. If you suspect your child has a food intolerance or allergy contact your family doctor of Paediatrician.
The good news is children often grow out of food intolerances and allergies.
The Royal Prince Alfred Hospital Allergy Unit, NSW has put out a recipe book called “Friendly Food’. It is a guide to avoiding allergies, additives and problem chemicals in foods and can be purchased through the allergy clinic or your local book store.
It is wise to consult a health professional or dietitian if there is a family history of food intolerance, allergies, eczema or asthma (particularly if you are a breastfeeding mother). Restricting a child’s diet unless under professional supervision is not recommend as essential nutrition may be lost. Most babies have grown out of their milk protein intolerances by 9 months and can once again tolerate cow, goat and soy based formulas. While older children usually grow out of food allergies around 3 years of age.
Not all children develop allergies or food intolerances but it is good to be aware and understanding towards those who have these challenges.
This article was written by mothercraft nurse Sally Hall from Cradle 2 Kindy Parenting Solutions. If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips. Down load an E-Book specifically related to your child's age group through Publications at Our Shop.
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Also known as perinatal anxiety and depression or antenatal and postnatal depression.
What Does it Actually Mean?
Women who experience a depressed mood during the perinatal period (ie pregnancy to one year post partum) for 2 weeks or more that is impacting on their life. The symptoms may include tearfulness, changes to sleep and eating patterns, feeling overwhelmed, anxious, angry, tired, hyperactive. Around 20% of women and 10% of their partners will experience perinatal anxiety and depression.
Difficulties Associated with Diagnosis
Perinatal mood disorders are multi-factorial with a biological, psychological and social basis. Hormones and chemicals play a role, as does the media, portraying motherhood as blissful and mother as beautiful. General life experiences (past or present) and stressful events (such as moving/renovation, financial concerns), and issues relating to the pregnancy and birth are also factors. Many mothers do not have realistic expectations of motherhood and the major bi0-psycho-social changes that occur. When the reality is exhausting, repetitive and isolating, the transition from independent to invisible can be a shock.
Many women do not want to admit they are not living up to societal or their personal expectations. Other women are not able to articulate their feelings. Women do not want to be judged as mad, bad or sad.
There is under-reporting by women and misdiagnosis by professionals. Referral pathways are difficult.
Getting Professional Help
Professional counselling is considered the most effective treatment. Antidepressant medication can be prescribed in conjunction with counselling, but should be carefully monitored. Professionals who can help include: PG, obstetrician, psychologist, psychiatrist, ECHC nurse, mothercraft nurse, midwife, supported play group.
There are differences in the nature, severity and duration of symptoms of perinatal mood disorders and professional help is recommended in order to diagnose and then identify the best approach to treatment.
General practitioners
General practitioners are generally the first step in seeking professional help. Some GP’s have an interest in PND and will identify and optimal treatment plan for you.
Furthermore, an increasing number of GP’s are registered with the Better Outcomes Project and can refer you to a social worker or psychologist trained in the psychological assessment and the treatment of PND. The Better Outcomes Project enables you to have a number of sessions with a rebate via Medicare.
Remember that your obstetrician or paediatrician can also assist you in seeking help if you let them know that you need help.
Social Workers / Psychologists /Psychiatrists
These professionals are skilled in psychological assessment and in a variety of treatment approaches and can be assessed in private practice or may be part of a medical/counselling practice. They will assess your individual/family needs and tailor a treatment plan to meet your needs.
Early Childhood Health Centres
A number of projects going on and much greater awareness within nursing community and Perinatal mood disorders.
Statistics from National Health & Medical Research Council show that 25% of adults are overweight or obese and 1 in 5 children are also overweight or obese. Both these figures are on the rise.
Obesity in childhood constitutes a risk factor for a range of health problems:
Diabetes
sleep apnoea
liver disease
psychological problems especially in girls
Health experts recommend children consume nutritious foods for proper growth and development.
Set up healthy habits from the start
Parents should offer fresh foods with fewer preservatives and low in additives and refined sugars. It is also important to watch the fat levels.
READ FOOD LABELS!!: Aim for Fat 10g/100grams, sugars 15g/100grams, high fibre, low salt (sodium)
It is important to find the balance of healthy eating and physical activity.
Some tips for mums and dads:
Enjoy a wide variety of foods – 5 serves vegetables, 2 serves fruit try and choose different colours for different vitamins & minerals
Never skip breakfast! Its true that children perform better at school if they have started the day with a healthy, high fibre breakfast such as weetbix, low fat milk, fruit and wholemeal or multi grain toast
Watch portion sizes – very important to serve food in the recommended quantities: ½ plate vegetables, ¼ plate Meat/Chicken/Fish, ¼ plate rice, pasta or potato. Choose smaller plates, bowls
Get children involved in healthy meal preparations and planning meals and healthy desserts. Get them to plan a ‘menu for the day’. They will love the challenge
Have set meal times and only allow healthy snacks such as fruits and vegetables
Try not to purchase unnecessary snacks bars, including nut bars and dried fruit/muesli bars, these often contain too many calories.
Limit snack foods, especially biscuits, chips, chocolates, lollies. Include fresh fruits and vegetables. Try making fruit kebabs, vegetables boats and healthy dips such as yoghurt, light cream cheese spread (philli light)
No juice, even freshly squeezed or “no added sugar” varieties should be offered. These contain a lot of natural sugars which can contribute to weight gain. Soft drinks are also considered a big “no, no” should not be offered unless on a special occasion. Low fat milk and water should be the only drinks offered.
Limit take-away to once/month. If you are a family relying on take away, choose healthy sandwich wraps, small kebabs (no hommus or cheese please!), have water as part of the meal deal and choose salad instead of fries. Avoid anything deep fried. Have fruit or yoghurt as your dessert.
Eat slowly; allow your hunger signal to turn off before too much food is consumed. Never force children to finish their meals if they are full. Kids will never starve themselves!
Dessert is not a mandatory part of the menu
Exercise; be actively involved in sports, swimming, tennis, soccer, football or dancing. Join a gym if you’re 13 years or older.
Kids lunchboxes
Recess:
2 pieces of fruit tip: fresh = better than tinned or dried fruit
e.g. 15 grapes and 2 plums or 1 apple and 1 nectarine
Rice crackers – limit to 6 or Sakata biscuits (packet) this is better than chips
Raisin toast – 1 slice
Mini fruit homemade muffin
Frozen low fat yoghurt
Lunch:
1 x Sandwich with wholemeal or wholegrain bread/wrap
With salad m/c/f or vegemite or light cream cheeselight sliced cheese/tomato/lettuce or light jam/margarine/labni (homemade with skim milk)
Add a favorite vegetable e.g carrot/cucumber/tomato/celery
Water or diet cordial
Try to avoid left overs and limit canteen treats to once/week or even once/fortnight. Don’t allow your children to purchase canteen food or to assume its a normal thing.
Ice blocks have 1 tablespoon of sugar per serve which would take 30 minutes of money to burn off, soft drinks and juices also have a significant amount of sugar
If you are frustrated the fruit and veg comes home, just offer it for afternoon tea instead of cake or biscuits.
This information has been brought to you by Hanan Saleh (APD,AN) Accredited Practising Dietitian Consultant Paediatric/Adult specialist in weight management
As seen on SBS TV series “Food Investigators”
Her website: www.thefooddoctor.com.au
Email: nutrition@thefooddoctor.com.au
To ensure you are getting enough dietary iron eat the wide variety of foods that are naturally high in iron. Iron from raw food is absorbed better by the body and therefore cause less constipation.
Here is a list of foods that are rich in iron:
Food
Iron Content (mg)
grams
Cereals, grains and nuts
Rice, brown
Pasta, wholemeal
Bread, wholemeal
Wheatgerm
Wheatbran
Branflakes
Cornflakes
Soya bean curd, tau hoo
Cashew nut
Pistachio
Walnut
Lotus seed
Almond
Sunflower seed
Watermelon seed
Soya bean, white
lentil
Gram, green
Gram, red
Humus
Tahina
1 bowl 200g
1 portion 100g
1 slice 30g
1 teaspoon 15g
1 tablespoon 15g
3/4 cup 30g
1 cup 30g
1 small square 85g
1/2 cup 65g
1/2 cup 65g
1/2 cup 50g
1/2 cup 15g
2 tablespoons 30g
1/2 cup 70g
1/2 cup 50g
1/2 cup 50g
1 cup 180g
1 cup 250g
1 cup 250g
3 tablespoons 50g
2 teaspoons 25g
10 halves 35g
10 90g
10 90g
1 packet 42g
1/2 cup 65g
10 85g
10 85g
One 155g
1.2
3.3
3.0
1.5
3.5
3.6
2.2
1.6
Vegetables
Kale, Chinese (kai lan)
Spinach (bayam pasir)
Kang kong
Chinese cabbage (bok choy)
Mustard leaves, chye sim
Seaweed, dried (hai tai)
Sea moss (fa chai)
1 cup 65g
1 cup 30g
1 cup 30g
1 cup 170g
1 cup 55g
1 sheet 15g
1 pinch 10g
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Some babies are born with flat spots on their heads. This is often due to the position they were in while in the uterus, other times it may be cause during the birth procedure or as in many cases it is the result of regularly sleeping with the head in the same position.
All babies are born with soft mouldable heads to allow for their passage through the birth canal. These soft malleable bones of the skull are not fused and often slide across one another, overlapping a little during birth. Once born, a newborn has very little head control causing the head to be floppy and roll to one side or the other. If your baby favours one position in particular, this may become a problem. After as little as four hours of sleeping there will be a tendency for the under side of the head to be a little flatter than the upper side. You may have see babies who have very round moon-shaped faces. These tend to be babies who have slept on their backs looking straight up. They often have quite obvious flat spots on the back of their heads.
There is no doubt that the incidence of SIDS has been lowered significantly since the introduction of Safe Sleeping Education. But evidence also suggests that we should make sure that the baby lies with his head turned to alternate sides during each sleep session. This practice should be started from birth.
As the baby develops and become more aware of his surroundings he may tend to turn his head to see bright objects, light, or the approach of his parents of a carer. Positioning the cot to make use of this voluntary turning of the head is a very good practice. Some people find it easier to sleep the baby at alternate ends of the cot.
Placing the baby on his tummy and alternating lying on his right and left sides when awake and supervised is also important. This practice should be started from birth otherwise baby may dislike being on his tummy for extended periods. This is often the case with babies 2 months or older. To help baby enjoy tummy time begin with short periods and keep extending the time until they are able to play happily for up to 60% of their wake time on their tummy. Baby massage, laying beside them on the play mat, lying while on your chest or across your knees, or after the bath on the change table, can be soothing for a baby and teach him that tummy time is pleasant and fun. Tummy time is also important for his brain development.
Mild flattening of the head often resolves itself once the baby is sitting up independently. Don’t be alarmed if you do not see results instantly, as the skull continues to grow and change shape until the age of 18 years. Aside from introducing good positioning techniques and plenty of tummy time, no intervention is required unless your baby has a severe misshapen head or you notice asymmetry in the face. This may include forehead bossing and/or ears or eyes not level with each other. In the more severe cases, a custom moulded helmet is designed to encourage the skull to grow in a more symmetrical manner. This form of intervention is effective on babies aged between 5 months and 18 months, the most common time to treat is between 6 and 12 months. The helmet is generally worn 23 hr/day for about 3 months.
If you have any doubt about the shape of your baby’s head, you can contact a paediatric physiotherapist and you can get further advice about handling and encouraging good development in your baby. There is also a brochure outlining the techniques to help in maintaining good head shape of your baby, available from your APA paediatric physiotherapist or through the National Office of the Australian Physiotherapy Association.
Alti Vogel, an Orthotist, has helped put this article together; she works at the Children’s Hospital assisting in the design and manufacture of helmets for babies with misshapen heads. (Information was also adapted from the Physiotherapy Association of Australia).
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Slip on a t-shirt, slop on some sunscreen and slap on a hat! We’re all urged to keep those sunlight rays away from our skin, but in our eagerness to prevent every possibility of skin cancer are we exposing our children to the other very harmful possibility of Vitamin D deficiency?
Vitamin D is a vitamin most well known for its major action of enhancing the body’s ability to absorb calcium from the diet. Vitamin D also has some other very important actions such as enhancing phosphorus absorption and playing a vital role in the immune system. Perhaps the importance of Vitamin D is best demonstrated by looking at the effects of Vitamin D deficiency. Without enough Vitamin D children are prone to develop rickets, a disease where young developing bones become soft and bendy, giving a bowed-leg, knocked-knee look and increasing the risk of fractures and breaks. Other serious symptoms of deficiency are grand mal seizures, fever, cough and vomiting then cardio-respiratory arrest.
During pregnancy Vitamin D is essential for foetal growth and bone mineralisation, and Vitamin D is stored up in the body to be used by the newborn after birth to protect against tetany, convulsions and heart failure. Because of this it is important for pregnant mothers to be aware of their own Vitamin D levels particularly in the last trimester of pregnancy when foetal bone growth is the greatest. After birth, a newborn’s stores of Vitamin D are used up in approximately the first 8 weeks of life. Newborns then obtain their Vitamin D from breast milk, although this too can be almost non-existent depending on mother’s own Vitamin D levels. Adding Cod Liver Oil to breast milk or a Vitamin D fortified formula is very important if this is the case.
The main source of Vitamin D is from sunlight. Sunlight levels vary greatly between different times of the day, seasons of the year, even between continents, and so it is hard to measure exactly how much sunlight exposure is needed. A good guide is at least ½ an hour of unhindered sunlight per day (no sunscreen!) to face, neck, shoulders and arms. In winter this will not be enough and so it is important to combine this with good dietary sources of Vitamin D. Those most at risk of developing Vitamin D deficiencies are dark-skinned people, vegetarians and vegans, veiled women, and breastfed infants of these groups of people.
Breastfeeding mothers should obtain 4000IU per day. In addition to enough sunlight (at least half an hour a day) good dietary sources of Vitamin D are egg yolks, butter from grass-fed cows, cheese, fermented foods, bone broths, fatty fish like salmon, mackerel and herring, and organ meats like liver. Vitamin D is much higher in animal products where the animal is grass-fed as opposed to grain-fed for the very obvious reason that sunlight is needed for the grass to grow!
Vitamin D also raises the need for Vitamins A and K, two other important fat-soluble vitamins for the immune system and nervous system development. If you are concerned about your own or your children’s Vitamin D levels it would be worth your while to go see a trusted medical practitioner or nutritionist.
ldren to finish their meals if they are full. Kids will never starve themselves!
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