Samiksha Choithani

Juhi Mishra

Every child needs full attention of a parent. While you are busy with the younger one, your elder child will experience a range of emotions, from excitement to jealousy or may be responsible and caring. In order to seek your attention, the elder child may show more tantrums or misbehave or refuse to eat. These emotions are short-lived but if not addressed well can have lasting impact on a child’s mind. Here are a few ways to make sure that your elder child does not feel neglected:<ul><li>Let them not feel left out: Take an extra care to ensure that the elder child never feels neglected (unintentionally though). Ask their suggestions for picking up clothes for newborn, choosing the toys for little one and more. Make sure you spend equal time with both the kids</li><li>Avoid giving excuses: Never make the younger one an excuse for not attending the elder child – “we can’t go to the park/playground as the baby is sleeping” “Keep quiet the baby will wake up” “After I attend the baby, I will listen to you” Instead tell him/her , “ We will play together when the baby wakes up, We will go to the park together May be giving a hope and the feeling of togetherness will help the child.</li><li>Pay more attention: Express extra care and love for elder one, increase your daily hugs and play some games or increase story time for the elder one.</li><li>Avoid comparing: This comes unintentionally but it can have a strategic impact on a child’s mind. Little things like who crawled first, child’s weight or who walked first can be taken as criticism by the elder one.</li></ul> Ensure both the children get equal attention and feel loved.

Every child needs full attention of a parent. So, pause and reflect on your parenting to make sure none of your children feel left out.

Managing sibling insecurity

Ravina Sewani

Palak Vyas

Fatherhood is a biological and an emotional sea of changes. Starting a few months before childbirth, testosterone levels lower as prolactin, vasopressin and other hormones increase rewiring a man’s brain to prepare him for fatherhood. Entire area of man’s brain grows and develops in response to hormonal changes in the first year of a child's life, which allows him to care for a newborn. There is an increased sensitivity to crying, a deeper capacity to bond emotionally and a greater responsiveness to another’s needs. Men and women can experience depression very differently. Symptoms which might indicate poor mental health of a father:<ol><li>Increased anger and conflict with others</li><li>Increased use of alcohol</li><li>Frustration or irritability</li><li>Violent behaviour</li><li>Significant weight gain or loss</li><li>Isolation from family and friends</li><li>Being easily stressed</li><li>Increase in complaints about physical problems, like headaches, digestion problems, fatigue</li><li>Problems with concentration or motivation</li><li>Loss of interest in work, hobbies and/or sex</li><li>Working constantly</li><li>Self doubt</li></ol> Some of the factors that can contribute to depression in new or soon-to-be fathers include:<ol><li>Personal history of depression</li><li>Family history of depression</li><li>Worries about being a parent</li><li>Feeling overwhelmed with expectations in your role at work and your role as a father</li><li>Financial problems</li><li>Lack of social and/or emotional support</li><li>Stress in relationship with family or spouse</li><li>Missing attention and/or sex from partner</li><li>Lack of sleep after the baby is born</li><li>Feeling excluded from the bond between mother and baby</li></ol> Diagnosis:Your mental healthcare professional will ask you to fill up a depression-screening questionnaire to confirm whether you have depression or not. Following are a few ways which you can follow to take care of your stress and emotions:<ol><li>Work on building stronger bond between you and your partner. Understand her needs and desires and talk about your own too. Feel free to express in front of your partner or family or friends.</li><li>Develop a support team from your family. Ask for help. Say YES when they offer.</li><li>Take time for yourself. Have some “me-time” either watching TV, going for a movie or taking a short break from work and spending time doing things you like.</li><li>Talk to other families who have experienced the same.</li><li>Spend time with your baby to develop your own confidence.</li></ol> Treatment:<ul><li>Talk Therapy: PPD is a severe form of clinical depression. Your psychiatrist might suggest you to see a counsellor who will ask you questions about your life. It is important that you answer them honestly. These sessions will help you gain a different and healthier perspective about things. Therapy is different and personalised for everyone but these are a few topics which you might touch in your sessions: your feelings, your beliefs, your behaviour, your life pre and post birth. There are 2 types of talk therapy:</li></ul><ol><li>Cognitive Behavioural Therapy: You and your counselor work together to identify, then change, thoughts and behaviors that are harmful to your mental health.</li><li>Interpersonal therapy: Your therapist helps you better understand how you behave in your relationships and how to work through any problems.</li></ol> <ul><li>Medication: Antidepressants are drugs designed to treat depression, including postpartum depression. They work on different chemicals in your brain.</li><li>Self-care: Get more sleep and exercise, eat healthy foods, do fun activities and relax. Doing these things can help to boost your mood.</li></ul>

A parent's mental health is of the top most priority when it comes to parenting. A healthy mental space leads to a happy and healthy bond between a parent and a child.

Postpartum Depression in Fathers

Dr Ajab Primuswala

Intolerance means the child is not able to share his/her space and get comfortable with other kids. You can try the following to improve the situation:<ul><li>Tell your child that you love them and just like you care for them, others will care for them too if they allow others in their space.</li><li>Keep a track of whether your child is being rude or abusive when their friends visit him/her or whether your child just walks away when friends visit. If your child is being rude or abusive, it is not acceptable. Tell them that being rude will have consequences.</li><li>But if they are just walking away, make your child greet and talk to their friend(s) and then walk away politely rather than walking away in an aggressive manner.</li><li>Intolerance may have psychological reasons as well. It may be because your child has trust issues due to a past experience or something else.</li><li>Observe their behaviour with everyone. Are they being intolerant of everyone or just of a single person? If it is everyone, you should get a clinical psychologist's help to tackle this behaviour. If it is just one person, the child might have had some bitter experience(s) with that particular person. Talk to your child to know the reason. If they don't give in, a psychologist can help you and your child.</li><li>The reason behind intolerance needs to be figured out at the earliest and a psychologist might be able to help you and your child in this matter.</li></ul>

Intolerance is not the same as possessiveness. It might have underlying reasons.

Child does not tolerate others

Nyctophobia is when a child fears nighttime or darkness, this is one of the common childhood fears that progresses till adolescence. Fear of darkness or sleeping alone at night usually develops between 3 to 6 years (36 to 72 months) of age. At this age some of the common fears are:<ul><li>Monsters</li><li>Ghosts</li><li>Strange noises</li></ul> Causes:<ul><li>Looking at the anxiety or fear of a parent/caregiver could develop a phobia in a child.</li><li>Over protection by parents can also lead to anxiety when left alone or without parents (with other family members).</li><li>Late night negative experience, like an accident while travelling or injury can lead to anxiety and panic during long term.</li></ul> Physical symptoms:<ul><li>Sweating</li><li>Increased rate of heart beat</li><li>Trembling</li><li>Discomfort in speaking</li><li>Tightness in the chest</li><li>Shortness of breath</li><li>Upset stomach</li><li>Numbness</li><li>Feeling dizzy or fainting</li><li>Nausea</li></ul> Psychological symptoms:<ul><li>Feeling out of touch with reality or detached from your body</li><li>Fear of fainting</li><li>Fear of losing control</li><li>Fear of dying</li></ul> Diagnosis:<ul><li>A mental health expert can diagnose phobia; keep a regular track of your child’s behaviour/health in particular situations and with objects.</li><li>Phobia diagnosis is based on diagnostic guidelines and a thorough clinical interview. If you feel that your child has a phobia, take him/her to a healthcare expert. Your child's doctor will either ask you or your child about the symptoms. The doctor might also take a medical, psychiatric, and family history.</li><li>Your child's doctor might also use the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).</li></ul> Treatment:<ul><li>Exposure therapy: This treatment exposes children to their fears repeatedly until the thing they fear, such as being in the dark, no longer triggers the feelings of anxiety or panic.</li><li>Cognitive Behavioural therapy (CBT): This type of therapy helps children identify their feelings of anxiety and replace them with more positive or realistic thoughts with the help of a therapist. With nyctophobia, your child may be presented with information to show that being in the dark doesn’t necessarily lead to negative consequences.</li><li>Modelling: In this method the child sees other person facing the situation without fear and panic.</li><li>Virtual reality (VR): It's a treatment where your child will be exposed to computer simulations of dark places. Getting the experience of a dark place in the virtual world can help your child get over his/her fear in a setting that feels safe.</li><li>Medicines like tranquillisers and antidepressants (prescribed by a doctor) can be helpful along with the above treatments.</li></ul>

Nyctophobia is when a child fears nighttime or darkness.

Nyctophobia - Symptoms, Causes, Diagnosis, Treatment

Children are active human beings. They want to walk, run, and climb anywhere and everywhere. Choosing the footwear which provides them with proper grip and balance is very important. <ul><li>Socks: Even when babies have not started walking, you can buy socks for them for protection from cold. Select socks made up of natural breathable fibres like wool and cotton. Never invest in 100% nylon material.</li><li>Soft and comfortable: The first shoes should be soft and comfortable; the baby should be able to feel his feet through the shoes.</li><li>Let it be lightweight and proper fit; not too tight but not that loose that it comes out while the child is walking.</li><li>Slippers of your child should properly fit at the toes so that they have a good grip.</li><li>Velcro fasteners are better than anything else because they are easy to wear and easy to remove.</li><li>Ensure the soles or bottoms of the shoes are not slippery. It should stay firm and hold the ground properly so that the child can maintain his/her balance.</li><li>Seams and edges should be soft.</li><li>Space near the toes should be wide enough so that the child can wiggle his/her toes easily.</li><li>Check the shoes after every 6 to 8 weeks for the right fit.</li><li>Make sure the shoes have proper padding on the heel backs, around the ankles and in the bottom inside.</li><li>Keep on checking babies’ toes regularly.</li></ul> Allow your child to walk barefoot wherever it is possible. They find perfect balance and grip by walking bare feet.

Footwear plays a major role in balance and grip of a child.

Guidelines to choose shoes for babies

Babies putting things in their mouths, otherwise known as mouthing, is not only normal, but also signals a growing interest in the world around them. In the first year, children explore their surroundings through their senses - seeing, touching, hearing, smelling, and tasting. The more they explore, the more they learn. But be careful about the following things:<ul><li>Keep the child away from choking hazardous things/toys. Provide them with bigger toys with smooth edges so that children do not swallow the toys.</li><li>Try and replace the items that are not safe in their hands either with some eatables or any other better option. Distraction is the key.</li><li>Constantly taking away things from their hands will only result into rebellious stubborn behaviour, rather gently distract them by giving suitable things and toys.</li></ul>

Mouthing or putting everything in mouth is very common. It signals growth so do not worry much.

Mouthing

Parents should be able to understand about half of a child's speech by the age of 2 years and about three quarters at 3 years. Identify these signs to understand language or speech delay issues among children:<ul><li>by 2 years: the child says only certain sounds or words repeatedly and can't use oral language to communicate more than his or her immediate needs</li><li>by 2 years: can't follow simple directions</li><li>by 2 years: has an unusual tone of voice</li></ul>Parental involvement plays a major role in treating delayed language/speech problems. Some of these steps can encourage speech development among children:<ul><li>Spend more time in communicating with your child, talk, sing, use gestures and encourage your child to repeat the sounds or gestures.</li><li>Read stories or show pictures to your child; try and name them while the child looks at them. You can then move on to rhymes, sing loud and clear with proper lip movements.</li><li>Talk about everything in routine situations – like when you use a refrigerator tell that I am opening a refrigerator to get fruits/vegetables – name them and show it to the little one.</li><li>Try to talk to your child throughout the day, Point out objects and ask questions.</li></ul>If required meet a speech therapist, a therapist can help the child to pronounce words and sounds by strengthening the muscles of mouth and face.

Delayed speech can be treated with the help of a speech therapist. There is nothing to worry about much as every child achieves milestones at different times.

Delayed Speech Problems among children

Acrophobia is the fear of heights that can cause anxiety and panic among children. Causes:<ul><li>Acrophobia is sometimes developed due to a traumatic experience in early years of a child’s life. Like falling from a great height, or closely watching someone from high place.</li><li>Acrophobia, can also develop without a known cause. In these cases, genetics or environmental factors may play a role.</li></ul> Physical symptoms:<ul><li>Increased sweating</li><li>Chest pain or tightness</li><li>Increased heartbeat</li><li>Nausea</li><li>Headache</li><li>Shaking and trembling</li><li>Feeling dizzy</li><li>Numbness</li><li>Shortness of breath</li><li>Upset stomach</li></ul> Psychological symptoms:<ul><li>Experiencing panic when the child sees high places</li><li>Child experiencing extreme fear of being trapped somewhere high up</li><li>Experiencing extreme anxiety and fear when the child has to climb stairs, look out a window, or drive along an overpass</li><li>Worrying excessively about encountering heights in the future</li></ul> Diagnosis:<ul><li>A mental health expert can diagnose phobia; keep a regular track of your child’s behaviour/health in particular situations and with objects.</li><li>Phobia diagnosis is based on diagnostic guidelines and a thorough clinical interview. If you feel that your child has a phobia, take him/her to a healthcare expert. Your child's doctor will either ask you or your child about the symptoms. The doctor might also take a medical, psychiatric, and family history.</li><li>Your child's doctor might also use the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).</li></ul> Treatment:<ul><li>Exposure therapy: In this type of therapy, your child will work with a therapist to slowly expose himself/herself to what (s)he is afraid of. For acrophobia, your child might start by looking at the pictures from the point of view of someone inside a tall building. The therapist might make your child watch video clips of people crossing tightropes, climbing, or crossing narrow bridges. Eventually, your child will progress and might go out onto a balcony or use a stepladder.</li><li>Cognitive behavioral therapy (CBT): In CBT, you child will work with a therapist to challenge and reframe negative thoughts about heights. This approach may still include a bit of exposure to heights, but this is generally only done within the safe setting of a therapy session.</li><li>Virtual reality (VR): It is a treatment where your child will be exposed to computer simulations of heights. Getting the experience of a heighted place in the virtual world can help your child get over his/her fear in a setting that feels safe.</li><li>Modelling: In this method, the child sees other person facing the situation without fear and panic.</li><li>Medicines like tranquillisers and antidepressants (prescribed by a doctor) can be helpful along with the above treatments.</li></ul>

Acrophobia is the fear of heights that can cause anxiety and panic among children.

Acrophobia - Symptoms, Causes, Diagnosis, Treatment

Nightmares/unpleasant (bad) dreams are common among preschoolers as this is the age when they start understanding about normal fears and their imagination is highly active. These unpleasant dreams disrupt child’s sleep and causes distress. Nightmares usually occur in the middle of the night or early morning. According to science, dreams are just a representation of what has been put in our brains. If the child is watching too many violent games or action thrillers or if (s)he has had a fight with friends/family members, (s)he can have bad dreams. Sometimes a verbal fight during the day with anybody can convert into violent dream. As a child, the unpleasant dream is mostly related to ghosts, witches or may be losing both or either of the parents. When they express this, be very sure and precise about how you are going to go ahead with this information and you should assess what kind of surrounding they are being a part of. When your child gets startled and wakes up from sleep:<ul><li>The first thing to do when they wake up startled because of a bad dream, is to give them a warm hug and tell them that you are always around them and so there is no need to worry. Ask them to openly express whatever they have gone through or felt in the dream. This is the basic thing which you can do to calm your child during and after their unpleasant dream.</li><li>Switch on some lights, dark rooms are scary for children. It can help them go back to sleep.</li></ul> There are three ways of knowing whether your child is having unpleasant dreams or not:<ol><li>The first is if the child wakes up in the middle of the night and starts screaming and is disturbed.</li><li>The second if the child suddenly starts clenching his teeth in sleep. The child is irritated, restless and may keep twisting and turning through the night.</li><li>The third thing can be that the child wakes up in the morning and expresses that (s)he has had a bad dream and gives you the details.</li></ol> In all the three cases just work the following things out:&nbsp;<ol><li>What's the child’s schedule and how the child is doing what the child is doing. Is there something which the child is viewing which is not so comfortable for the child?</li><li>Keep a continuous record of the things happening because children as young as 1 or 1.5 years start observing some cartoons on the television which have negative characters coming in, which might disturb them.&nbsp;Later on, they start seeing these cartoons as a part of their dreams and get scared. So you should keep a check on the kind of media they consume.</li><li>Another possibility could be, there might be something in the surrounding which is being talked about and they are not okay with it. May be as parents, you might be discussing something negative in front of them which they are reciprocating in their dreams.</li><li>One more concern could be, whether you are fighting in front of your children. Are you taking out your anger or rage in front of them? The child may start channelising your anger in their dreams. They may dream about ghosts or death and if they are expressing any such thing, you can analyse those expressions.</li></ol> Here are a few ways to avoid nightmares:<ul><li>Have a regular bed time schedule.</li><li>Try to give a sound and pleasant atmosphere to your child at home.</li><li>Snuggle your child while putting them to sleep, read good stories and talk about pleasant events.</li><li>Avoid scary movies, TV shows or threatening stories before bed time.</li><li>Also ensure that you not talking about any unpleasant event to other family members in presence of the child.</li></ul>

Nightmares/unpleasant (bad) dreams are common among preschoolers as this is the age when they start understanding about normal fears and their imagination is highly active.

swallowing parenting concerns

Parenting issues are a part of the everyday parenting journey. Following article(s) might help you with your concern(s).