Samiksha Choithani

Dr Ajab Primuswala

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.

Child experiencing unpleasant dreams

It is a very common human stratum that we always have rivalry with our siblings. This happens in every family. But with certain families, it becomes very strong and gets difficult to handle. Sibling rivalry can be as simple as- siblings who are not ready to share things or can be extreme like - physical or verbal abuse and cooking up stories so that the other one gets the scolding or punishment. Common factors of sibling rivalry are: <ul><li>Age difference: It is very common to have sibling rivalry when the age difference is very less. So it's both ways , they like each other’s company, want to play together and still can’t play as they have the same levels of maturity and same kind of issues. If one of the siblings is quite older than the other, there’s less communication, their schedules are different and so in short when interaction is less, there are less issues and their maturity and understanding is also different. The elder one can handle things maturely. When there is a non-violent sibling rivalry between your kids, you can avoid them by saying, “This issue is between the two of you so please take care of it on your own, I am sure you both will resolve it beautifully.” You can escape this scene by making them responsible and showing your trust in their skills to resolve issues among them.</li></ul> <ul><li>Gender of your children: Well, It is observed that children of same gender have more common issues to fight with each other. Though they can grow as close siblings in later stage but in the initial years, it can get difficult to resolve their sibling rivalry because there is direct competition and comparison between them. On the other hand, a brother and a sister of the same age generally get along well. It is important to note that when it comes to sibling rivalry, there is no guarantee as to whether the siblings will fight or not. It depends on individual bonding between siblings.</li></ul> <ul><li>As a parent, if you are paying more attention towards one and neglecting the other or if one or both of the children has this feeling then this can brew into a sibling rivalry. You have to verbalise and assure them that you love and care equally for both of them in the same manner but depending on their individual needs your priorities might change. You should be aware and should keep in mind to take care of all your children’s needs and requirements one by one.</li></ul> Talking about the solutions: <ul><li>The first thing you can do while your kids are fighting over something is walk away, when it is not so serious or dangerous. Tell them: “It’s your matter, you handle”. In case if it gets severe and is happening frequently, you can ask them to maintain a diary about the issues. Decide the day to read the diary and solve it out.</li></ul> <ul><li>If you ask them to write it down, they are going to avoid such stories or situations where they will require you to come and solve it.</li></ul> <ul><li>This is a strong perspective where you are not avoiding them, instead giving them importance and proving a point that you have many other things that need to be taken care of.</li></ul> <ul><li>Sibling rivalry can be very dangerous if it continues till the later stages of life. Siblings can be either the most supportive or the most opposing depending on the kind of bonding they have had over the years. We, as parents, at times give rise to sibling rivalry by comparing our children with each other. So the key to not develop sibling rivalry is to stop comparing. Tell them whatever you want to, without giving each other’s examples. This can be more productive and progressive way of dealing with sibling rivalry.</li></ul>

Sibling rivalry is an age-old problem and get can be addressed easily if done at the right time.

Sibling rivalry

Ravina Sewani

Treatment for animal bites depends on the type of animal that has bitten your child. Your child's healthcare provider will determine specific treatment for an animal bite. Treatment may include the below: For bites from a household pet that is immunised and in good health:<ul><li>Wash the wound with soap and water from a tap for at least 5 minutes. Don’t scrub the wound as this may bruise the tissue. Apply an antiseptic lotion or cream.</li><li>Watch for signs of infection. These signs include fever, increased redness or pain, swelling, or fluid leaking, or red streaks from the bite. Call your child's healthcare provider right away if you notice any of these.</li></ul> For deeper bites from any animal, or for any bite from an unknown animal:<ul><li>If the bite or scratch is bleeding, apply pressure to it with a clean bandage or towel to stop the bleeding.</li><li>Wash the wound with soap and water from a tap for at least 5 minutes. Don’t scrub the wound as this may bruise the tissue.</li><li>Dry the wound, apply antibiotic ointment, and cover it with a sterile dressing. Don’t use tape to close the wound as it can trap harmful bacteria in the wound.</li><li>Call your child's healthcare provider to decide if more treatment is needed. This may include antibiotics, a tetanus booster, rabies vaccine, or repair of the wound with stitches.</li></ul> Get medical care if:<ul><li>the wound is on the face, neck, hand, foot, or near a joint</li><li>the wound won't stop bleeding after 10 minutes of applying pressure</li><li>the wound appears to be deep, large, or severe</li><li>the attacking animal was stray or wild or behaving strangely</li><li>if there is a broken bone, nerve damage, or serious injury.</li><li>If your child has diabetes or a condition that weakens his/her immune system.&nbsp;</li><li>your child’s last tetanus vaccine was more than 5 years ago.</li><li>the bite or scratch has pus coming out from it, or becomes red, hot, swollen, or increasingly painful</li></ul> Keep in mind:<ul><li>If the animal was unknown, try finding the animal if possible. This is necessary to capture the animal and watch it rabies. Contact the nearest animal control office in your area to capture the animal. If the animal cannot be found or is a high-risk species (raccoon, skunk, or bat), your child may need a series of rabies shots.</li><li>Call your child's healthcare provider for any flu-like symptoms after an animal bite. These symptoms may include fever, headache, ill feeling, loss of appetite, or swollen glands.</li><li>‘Cat scratch disease’ is a bacterial infection that develops from a cat scratch (usually from a kitten) even if the scratch site doesn't look infected. So it is crucial to report to your child’s healthcare provider if a cat has bitten your child.</li></ul> Prevention:<ul><li>Teach your children to stay away from stray animals, and not to tease or provoke any animals, even if it’s family pets.</li><li>Make sure your pet is properly immunised and licensed.</li><li>Never leave your child alone with a pet.</li><li>Stay away from animals that are sick.</li><li>Keep your pets on a leash when in public.</li><li>Do not disturb animals when they are eating or sleeping.</li></ul> In case of a Snake bite: Other than basic procedures carried out during animal bite treatment, snake bites specifically require treatment with antivenom. Prevention of snake bites:<ul><li>Avoid tall grassy areas.</li><li>Wear protective shoes/boots.</li><li>Keep storage areas clear of rodents.</li><li>Remove rubbish and woodpiles from around the home.</li></ul>

Treatment for animal bites depends on the type of animal that has bitten your child.

Animal Bites in children

Authoritative parenting style; the parents are nurturing, responsive, and supportive, yet set firm limits for their children. They attempt to control children's behaviour by explaining rules, discussing, and reasoning. They listen to a child's viewpoint but don't always accept it. Children raised with this style tend to be friendly, energetic, cheerful, self-reliant, self-controlled, curious, cooperative and achievement-oriented. This parenting style generally produces the best outcomes in children. CharacteristicsParents in this style have high expectations, but also know the importance of open communication and provide the support their kids need to be successful. They offer consistent discipline, considering the situation. They also are role models of the behaviour they expect from their children. <ol><li>Responsive and demanding –&nbsp;Parents in this style have high expectations, but also know the importance of open communication. Parents support their kids to manage their behaviours. This approach is the most effective parenting style leading to the healthiest outcomes for children and thus the lowest difficulties scores.</li><li>Independent and self-reliant -&nbsp;Parents encourage children to be independent and develop their own identities, but at the same time, they also provide rules for their children. Due to the guidance children receive, the children tend to follow them consistently.</li><li>Higher academic performance -&nbsp;Parents support their children. Whether it's weekly homework or a particular project, they make themselves available and provide all the necessary tools for their children's success in school. They're present at school events and meetings. Their expectations for home and in school are consistent but reasonable and age-appropriate.</li><li>Open-minded -&nbsp;These parents are adaptable and willing to provide explanations. They help their children understand the reasoning behind specific rules. This type of openness and discussion helps their child develop good communication and social skills. They may also become more flexible and open-minded with others.</li><li>Reasonable emotional control and regulation -&nbsp;These parents show good emotional understanding and control. Their children also learn to manage their emotions and learn to understand others. Hence, it helps them to build healthy self-esteem and self-confidence.</li></ol> Effects on ChildrenThe authoritative parenting style takes a more balanced approach. Parents are neither bosses nor best buddies, but guides and mentors. Below are the impacts of authoritative parenting on a child: <ul><li>They learn to think&nbsp;independently and are very self-confident.</li><li>They can manage&nbsp;aggressive behaviour&nbsp;outside the home.</li><li>Children are also&nbsp;happy, capable and successful.</li><li>Achieve higher&nbsp;academic success.</li><li>Have&nbsp;better mental health&nbsp;— less depression, anxiety, suicide attempts, alcohol, and drug use.</li><li>Develop&nbsp;good social skills.</li><li>Exhibit&nbsp;less violent&nbsp;tendencies.</li><li>Children are&nbsp;well-adjusted and goal-oriented.</li></ul> Pros of Authoritarian ParentingWhen it comes to authoritative parenting, it's pretty much all good news! Parents communicate in confident, friendly and peaceful ways, and do not set goals based on the child's desires, but rather, based on past performances and achievements. Responsibility -&nbsp;Children who are raised by authoritative parents understand the responsibilities for the choices they make, which empowers them to make the right decisions.Respect -&nbsp;Children whose parents show them respect by allowing them individual freedoms are more likely to respect others. They often thrive in social settings and get along well in social life.Flexibility –&nbsp;Raising children using this style allows for more flexibility with age. As your child grows older, their needs and desires change. Thus, the child will grow with a better personality, which is more comfortable for the authoritative parent to deal with.Leadership -&nbsp;Because of their ability to make their own decisions, these children have the kind of confidence and savvy that allows them to take on leadership roles. Cons of Authoritarian ParentingOften in life, finding a balance between two alternatives is the best solution to a problem, and that's certainly the case here. But that doesn't mean that everything will be smooth sailing as long as you practice authoritative parenting. Rebellion -&nbsp;As they grow, kids go through typical phases of rebellion, anger and apathy. These phases may be incredibly tricky for authoritative parents, who naturally have high expectations of their children, and have tried hard to raise their kids the best way possible. Here, patience is the key to success.Low Self-Esteem –&nbsp;Some children may feel that their world is being controlled and they don't have the freedom to exercise their judgments and actions.Difficulty to Adapt -&nbsp;An authoritative parent tends to try to be the best parent possible at all stages of childhood, which can add more stress to parenthood. Hence there will be an issue in adapting and creating rules in different stages for child growth and development.

There isn’t a single formula for raising children well. After all, parenting isn’t an exact science. There’s definitely a bit of an art to good parenting. Authoritative parents carefully define limits for children, are good role models and praise children for their efforts.

Authoritative Parenting

Most small cuts aren't a danger to children. But larger cuts often need immediate medical treatment.For minor bleeding from a small cut or scrape:<ul><li>Rinse the wound thoroughly with water to clean out dirt and debris.</li><li>Wash the wound with a mild soap and rinse well.</li><li>Cover the wound with a sterile adhesive bandage.</li><li>If the bandage gets wet, remove it and apply a new one.</li><li>Check the wound daily.</li><li>Call your doctor if the wound is red, swollen, tender, warm, or draining pus.</li></ul> For bleeding from a large or deep cut:<ul><li>Rinse off the wound with water. Do not use alcohol, or similar agents to clean the wound. They will cause pain and irritation and will not clean the wound any better than clean water.</li><li>Wash your hands so they are clean before you help your child. Preventing the wound from getting infected is your first priority. Place a piece of sterile gauze or a clean cloth over the wound.</li><li>Using the palm of your hand on the gauze or cloth, apply steady, direct pressure to the wound for 5 minutes.&nbsp;</li><li>If blood soaks through the gauze, do not remove it. Apply another gauze pad on top and continue applying pressure.</li><li>You can use an antibiotic ointment to protect against infection and help keep the bandage from sticking to the wound.</li><li>Once a cut or scrape has formed a scab, you can leave it open to the air.</li></ul> Call your doctor for all large or cuts if:<ul><li>You can't stop the bleeding after 5 minutes of pressure</li><li>Something else stuck in the wound</li><li>The wound is on the child's face or neck</li><li>The cut is more than half an inch long or is deep — large or deep wounds can result in nerve or tendon damage.</li><li>Fever</li></ul>

Most small cuts aren't a danger to children. But larger cuts often need immediate medical treatment.

Cuts and Scrapes in children

Children break their bones either by falling or while playing a sport. Sometimes, an unfortunate accident is also the reason behind fracture. Fractures are of two types: displaced and non-displaced.Non-displaced fracture is when the broken parts of bone are lined up correctly. This type of fracture is harder to identify.Displaced fracture is when the broken parts of bone are not lined up. Symptoms of bone fracture:<ul><li>Pain</li><li>Bruising</li><li>Swelling</li><li>Snapping noise</li><li>Numbness: This could be a sign of nerve damage near a break. A change in the colour of his skin could mean the same thing.</li><li>Can't straighten the injured area</li><li>Can't move a limb like normal</li></ul> Diagnosis: A fracture is diagnosed by doctors via X-rays. An X-ray can show where the break is and its type. Treatment:Treatment includes the use of cast, splint, or brace. These keep the broken bone from moving while it heals. Even the displaced broken bones often will heal straight over time. For the displaced bones, they are sometimes put back in place before the cast, splint, or brace is put on. This is done through a procedure called a ‘reduction’. This is also called "setting the bone." There are two types of reductions:<ul><li>Closed reduction: This is done without any incision or cut. The doctor gives a medicine to the child to ease the pain and then moves the bones back into the right position. No incision (cut) is needed.</li><li>Open reduction: This surgery is done for a more complicated injury. The surgeon makes a cut and moves the bones into the right position. Before this procedure, the doctor will usually give anaesthesia to your child. Surgical plates, screws, or wires might keep the bones in place.</li></ul>New bone formation may take several weeks to months after a break, but full healing can take much longer time. While waiting for medical help:<ul><li>Make sure your child is lying down. Then put pressure on the area with a sterile gauze pad or a clean cloth. Don't try to push the bone back into place. Don't wash it.</li><li>If you can't see the bone, don't move the limb. Try to cut away or remove clothing around the injured area, but do it gently so you don't cause any extra pain.</li><li>Wrap ice or a cold compress in a cloth and put it on the skin near the injured area. Don't do this in babies and toddlers because cold temperature can hurt their skin.</li><li>Don't give any food, drink, or medicine to your child in case (s)he needs surgery.</li></ul> Things to keep in mind post treatment:<ul><li>Make sure that your child eats a healthy diet that includes plenty of calcium and vitamin D.</li><li>Teach your child to take good care of the cast or splint.</li><li>Help your child to follow the health care provider's directions for rest and/or doing any exercises.</li></ul>

Children break their bones either by falling or while playing a sport.

Fracture in children

Palak Vyas

Juhi Mishra

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

Sleep talking is common among children. Sleep talking can be due to:<ul><li>Uneven sleep cycle</li><li>Excitement</li><li>Worry</li><li>Guilt</li><li>Physical illness</li><li>Hereditary</li></ul> Sleep talking among children is not a major cause of concern, however it is important to treat it. Here is how you can reduce or eliminate it:<ul><li>Make bed time free from stress, talk to your child about things that are affecting their behaviour. Communication can help them relieve stress and sleep without worries.</li><li>Regular exercises can also help the child sleep well without disruptions.</li><li>No sugar or caffeine at night.</li><li>Maintain a healthy sleep cycle.</li><li>Don’t wake your child while he/she is sleep talking. They will follow instructions while sleeping and you can calm them gently and guide them to go back to sleep. Waking them will make it harder to go back to sleep.</li></ul>

Sleep talking is common among children. It is not as serious as sleep walking habit and it can be resolved easily.

Resolving sleep talking problems

Before asking them to stop shouting, identify from where they learned it. Usually, children learn such behaviour from home itself or from their surroundings. If as a parent, you are yelling at your child, the first thing you need to do is stop shouting at your child. Child models your behaviour. What they see, they learn. If you have screamed at your child for a certain thing, they learn that screaming at people gets the task done. Once they learn to yell, it's difficult for them to unlearn. Steps you can take to stop your child from yelling: <ul><li>Face to face communication: Whenever you talk to your child, look them in the eye and calmly convey your message. Do not make faces. Stop staring and glaring at them. Always, go near to your child or call them near and then talk calmly. Do not show a frustrated or angry face or use abusive language.</li><li>Use a timetable to avoid conflict: When the time table is pre-decided there are fewer chances of conflict and anger and frustration. Gradually, the child develops the habit of accepting the time frames for particular activities and follows it. Stay flexible and understanding if your child fails to follow the timetable once in a while.</li><li>Walk out of the argument: In instances where the child is yelling, tell them, “It is not right to shout and yell at others. Let’s calm down and then talk”. Don’t sound stubborn but be firm.</li><li>Set an example: Yes! We know the situation is frustrating and triggering for you, but this is your test. Maintain your calm and composure during the argument. This may seem difficult but with practice, you will learn it too.</li></ul> In cases of toddler’s yelling there are few points that need to be considered:<ul><li>Toddlers scream just to check their ability to scream and experiment. It might be a fun thing for them.</li><li>Sometimes they yell to grab attention or to have a toy. In short, they yell to show the power and make you believe that you either fulfil their wish or they will shout and get it. In such cases, if you do what they ask just to escape their shouting, you are making a huge mistake. Be firm and calmly tell them whatever they do, you would only listen to them when they lower your voice.</li><li>At times they might be really uncomfortable in some situations so always make it a point to first ask them the issue and then respond accordingly.</li></ul>

travelling concerns parenting concerns

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