Help! Our baby's premature!

I am very fortunate: my babies were all born about their due date and normal, as were my grandchildren, but what would have happened had they been premature?

A premature baby, known as a premmie here in Australia, is by less than 37 weeks gestation, but with modern medicine and technology, many babies born much earlier than this survive and go on to live happy and productive lives.  They can spend many weeks in Neonatal Intensive Care Units (NICUs) and Special Care Nurseries (SCNs) on a rollercoaster ride of progress and crisis before being discharged to their parents' care.  Some, unfortunately, do not survive, but are remembered by their families for their struggle to live.

All this means that being the parent of a premature baby can be very stressful and a time of turbulent emotions, often a mix of:

• relief that the baby was born alive;
• fear for the baby's life and fear about lasting damage as a result of the prematurity;
• guilt that something a parent had done might have brought on the prematurity;
• anger and frustration that the pregnancy didn't last the whole 9 months and result in a normal delivery with a healthy baby;
• feeling helpless inadequate as a parent surrounded by humidicribs, tubes, masks and people who seem to know a lot;
• feeling disconnected from the tiny baby lying in a plastic box;
• exhaustion and all the hormonal changes normally associated with giving birth.

Parents generally want to spend as much time as possible with the new baby, and this may be complicated by the need to care for older siblings, work responsibilities and the utter exhaustion that comes from spending long periods indoors in the NICU or SCN. 

Grandparents and friends can play an important part in helping with childcare and housekeeping tasks at home, caring for pets, preparing meals and offering time out for the parents by perhaps maintaining a hospital vigil while the parents can have a meal, go for a walk or do something escapist.

In hospitals with NICUs and SCNs, staff are generally used to working in these situations and are very aware of different responses parents have to the situation and are usually happy to give information and encouragement.  It is important that parents ask questions and talk about things they don't understand or that are worrying them.  And if necessary, to keep asking until they do understand.

Social workers, hospital chaplains and other professionals are also available to support parents during this difficult time, as are other parents going through the same process. There are also support groups, both online and in person to give information, support and empathy during this difficult period.  Life's Little Treasures Foundation has even developed apps to enable you to track your baby's progress and to understand the terms used in NICUs.

LINKS:
Life's Little Treasures
Rogan Family Care Agency services are available to help with child care needs for siblings of children in NICUs/SCNs and for on-going child care arrangements.

Protecting our children, Part 2: What you can do.

I wrote last week about child abuse, how to recognise it and what to do if you become aware of children that need help.  This week I want to look at ways you can help children to reduce their risk of abuse.  You may remember that the vast majority of abuse of children happens within the home despite the relentless media campaign about the predators 'out there'.   No one likes to think that their family is one where the mistreatment of children occurs, but while some forms of abuse, especially physical abuse, are more common in disadvantaged families, like other forms of family violence, child abuse occurs across all sectors of society.

So what can you do within your home to protect your children?

• ensure that adults in the family have healthy ways of relieving stress: exercise, relaxation, hobbies, nurturing relationships rather than excess alcohol and watching violent and/or pornographic movies;
• encourage children that there is nothing so bad that it can't be talked about, and the only secrets that need to be kept are fun ones(eg about birthday surprises), not those that worry children and parents need to keep lines of communication open;
• teach children that their bodies are their own private space and that they should say 'NO, Don't do that!' if anyone touches them in a way that they don't like;
• encourage children to be aware of their own network of adults they can trust to talk about things that are worrying them;
• encourage your children to be assertive and resilient young people in all the ways we have discussed in previous posts.

This is not to say that it is children's responsibility to protect themselves, it isn't.  It is always the responsibility of adults to protect children, but adults don't necessarily know what is going on if  children have been sworn to secrecy or are ashamed of what has happened to them.  SO if a child's behaviour or personality seems to change, it is always worth exploring what is going on for them in such ways as 'you seem much more angry/quieter than usual lately...Has something changed or is something worrying you?'

If the child or young person reveals that abuse has been going occurring, what are you going to do?

• Don't panic, and don't dismiss what the child says.
• Thank and reassure the child that they have done the right thing in telling you, that you will take the steps necessary to protect them and that the abuse was not their fault.
• If the abuse is of a sexual nature, and the person the child names lives in the same house as the child, you need to ensure that there is no way the child has contact until you notify either the Department of Human Services or the police.
• Seek professional advice from the Department of Human Services, or contact one of the many family support and counselling agencies.

Links:

http://www.dhs.vic.gov.au/for-individuals/children,-families-and-young-people/child-protection

Victoria Police: Telephone  000 for cases of immediate life threatening risk to children

Department of Human Services: Office Hours: Ring appropriate regional office.

          After hours and weekend: 13 12 78

Family support agencies

Australian Childhood Foundation


 

Protecting our children Part 1

In SusanSays this week and next week I'm considering the subject of child abuse, difficult to think and read about, but as parents, nannies and those concerned with the well-being of children, it is important that we are informed.

The abuse of children is defined as an act by a parent or caregiver "which endangers a child or young person's physical or emotional health or development. Child abuse can be a single incident, but usually takes place over time.
In Victoria, under the Children Youth and Families Act 2005 a child or young person is a person under eighteen years of age." Such an act may take the form of physical, emotional or sexual abuse, or of neglect, or a combination of these.

There has been much recent publicity about the abuse of children by priests and brothers in the Catholic Church, but it is important and shocking to remember that most abuse of children takes place in family homes.  Both men and women are responsible for physical and emotional abuse and neglect, more often against boys, but nearly all cases of sexual abuse are by men, mainly against girls, and these men can be fathers, older brothers, uncles, step fathers even grandfathers.

Recognising abuse sounds easy, but it can be difficult in all except the most obvious cases of physical injury and neglect.  It is often a case of putting together signs of injury, behavioural clues, and explanations given by children and by their parents or caregivers.  Despite recent pleas from the AMA for smacking to be outlawed, it is still legal for parents to smack a child in Australia, but the question is, when does a smack become physical abuse?   With emotional abuse, it is a matter of how and when it happens, and how much is too much?  Is it neglect not to take a child to the doctor when it runs a temperature?

There are guidelines for recognising signs of abuse, which as people who care about children, we should know, because they form the basis for us to respond by reporting our concerns to those who can act to assess exactly what is happening and act to protect children from harm.  As members of the public, this is our responsibility, and all that is needed is that we have a genuine concern for the well-being of a child.  Teachers, doctors, nurses and police are "mandated" (required) to report their concerns.

The effects of abuse are serious, and the longer the abuse continues, the longer and more serious the effects are likely to be:

• physical injuries, occasionally resulting in death or lasting disabilities
• trauma
• emotional injuries resulting in difficulties forming attachments and relating to others, passivity or anger and aggression, behavioural changes
• self destructive behaviours 
• alcohol and drug abuse
• offending against the law

The abuse of children is serious and the Victorian Government's Department of Human Services has a team of workers who respond to concerns from the community (parents, teachers, doctors, neighbours, you and me), assessing the seriousness of concerns and where necessary, intervening to stop the abuse.  This intervention may involve putting the family in touch with services that can help the parents and children to manage better (Child FIRST), regular supervision from the Department or where necessary, the removal of abused children from the family home for varying lengths of time.  In cases of physical and sexual abuse, police may also lay criminal charges against the perpetrators as these are criminal offences.

Link:
http://www.dhs.vic.gov.au/for-individuals/children,-families-and-young-people/child-protection

Victoria Police: Telephone  000 for cases of immediate life threatening risk to children
DHS: Office Hours: Ring appropriate regional office.
          Afterhours and weekend: 13 12 78

It's not simply make believe!

I have noticed recently a trend to giving toddlers and young children explanations for various phenomena that they observe, presumably in the hope of building their knowledge of the world and how it works.  While part of me sees this as a useful idea, part of me also rebels at:

1. the need to have a factual explanation for everything
2. introducing concepts and words that are really beyond a child's need to know.

I guess that I'm old fashioned but I think that pushing a rational explanation for everything does take away some of the 'magic' of childhood.  And that is precisely why it is done...magic doesn't exist, so using it as an explanation is misleading a child and creating ideas that will have to be unlearnt in the future.  In this view, cultural icons like the tooth fairy, Father Christmas/Santa Claus, and any religious belief need to be discarded. I can't help thinking that this rather undervalues the ability of children to grow and mature in their understandings and imposes a rather grey and colourless world on children.

I don't disregard the wonder of science, the magnitude of worlds without and within, the advances of knowledge that have helped revolutionise the world in health, communications and every field of endeavour.  I read a while ago that Albert Einstein, the great physicist, was a great believer in imagination, intuition and creativity as an aid to scientific thinking, which prompts me to think that children in time need to grow in knowledge and understanding of their world, but they also need to keep alive their imaginations.

Children have great imaginations. They can laugh and play growly bears or snapping crocodiles from an early age, also learning quickly to express a pretend fear of such creatures.  I watched a short video of a little chap, probably less than 2, bursting into giggles when he put his finger into the top of his water bottle.  I don't know what was funny about putting his finger into the water bottle, but he did...almost a pre-verbal imagination! They can dress up and be superheroes saving the world, monkeys swinging through the branches, doctors and nurses curing their dolls, old ladies having a cup of tea, experimenting with different roles and a wide variety of fields of activity.

I saw a blog post recently introducing science to a child of maybe 3.  He was having fun with water play and found if he put enough stones in his beaker of water that the water would eventually overflow.  The parent was pleased to be able to give him the name of displacement of water for this phenomenon.  I though it might have been more useful for him to observe his experiment with different conditions: different sized beaker, bigger stones or sand etc and then to simply share his observations and wonder, but perhaps I would just have missed a learning opportunity!

I have a friend who is doing research with medical notes from the Nineteenth Century.  She says they are full of detailed descriptions of people's tongues and physical appearance from which various diagnoses were drawn.  These may not have been accurate diagnoses by today's standards with all sorts of machines to help, but what impresses her is the closeness of the observations.  That is the starting point for science, from these observations and active imagination, improved machinery come modern medical advances.  As Professor Julius Sumner Miller used to say on TV back in the seventies, the question becomes "why is it so?" and the imagination is let loose to develop theories that stand up to testing in all sorts of conditions.

So let's keep childhood a time for creativity, wonder, experimenting, and observing and let our children gradually grow into a formal understanding of the world alongside having an active imagination.