Moms – HTV https://htv.com.pk Mon, 10 Aug 2020 09:21:21 +0000 en-US hourly 1 War Talk – How Our Children Are Keeping Up https://htv.com.pk/moms/war-talk Mon, 21 Oct 2019 10:05:00 +0000 https://htv.com.pk/?p=54795

On August 5th, the Indian government revoked the special status given to Indian-Occupied Kashmir. Following the move, it shut down all telecommunication and internet in the region, putting the state under a literal lockdown with thousands of additional Indian troops sent to the valley. Since the lockdown in Indian-held Kashmir began, children in Pakistan are […]

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On August 5th, the Indian government revoked the special status given to Indian-Occupied Kashmir. Following the move, it shut down all telecommunication and internet in the region, putting the state under a literal lockdown with thousands of additional Indian troops sent to the valley.

Since the lockdown in Indian-held Kashmir began, children in Pakistan are exposed to violent images on television and newspapers. And in some cities, graphics posters have been installed on streets. This has led to many children asking ‘why are people being tortured and killed?’

Experts believe that children who have exposure to indirect war are likely to suffer from various mental health problems, because violent images coming from conflict zones leave their mark on children’s brains.

Ayesha Mehboob, a mother of three, says that to stay informed her husband watches news at 9pm during their dinner time. This routine has started bothering her, as their 11-year-old daughter Amna now asks why Kashmiris are being killed, while their son Hashir wants to join the army to fight for those suffering.

How Exposure to Indirect Violence Affects Children

Karachi-based psychiatrist Dr Nazila Bano Khalid says that children who indirectly witness war suffer from anxiety. This is because they develop empathy quickly and feel vulnerable that war might start in their country too.

“Violent images on television and newspapers can cause aggression among children, for instance, they think [about] how they can help those facing violence in their homeland,” she elaborates.

Dr Khalid explains that our children, especially those living in Karachi are already prone to mental health issues owing to the volatile situation in the metropolis. “Just as they leave their house, parents start praying for their safety,” she says, adding that since parents feel insecure, children also feel the same, and this sense of insecurity can cause various problems. “We cannot tell our children to become indifferent.”

Related: AIDS In Children – Problems, Prevention And Prognosis

Psychologist and mental health counselor, Yumna Usmani, also says that psychological effects of indirect war on the children can be intense because their brain is still developing.

“Children cannot comprehend the causes of the war or understand the triggers and foresee the consequences. Violent images make a child go through unanticipated and abrupt losses and disruptions in their lives, which leads to depression and anxiety. They are unable to understand what might trigger or lead to a full-blown war, henceforth, [they] develop anxiety over everything.”

Usmani says violence on TV may induce aggression in children. It also either desensitizes them to violence and normalizes it or makes them anxious and super sensitive to violence, she adds.

How Can We Help Our Children?

Dr Kahlid says there is a need to guide children on what they can do in their individual capacity. “It’s a pity that most games that children play on their mobile phones or play stations involve shootings,” says Dr Khalid.

Exposure to such games either makes children feel scared or aggressive. Therefore, Dr Khalid says, parents and teachers should help children have a positive attitude towards life.  “We need to instill confidence in our children and tell them that an eye for an eye is not a solution to the problem,” she says.

Dr Khalid also mentions that caregivers and guardians should take steps to make children more productive rather than aggressive. “For instance, schools should organize debate competitions focusing on positive attitude ad gratitude,” she adds.

On the other hand, Usmani suggests schools should make mental health counselling and character education a part of their curriculum. “If mental health counselling is made a regular part of the school, children will learn healthier expressions of emotions, will be mindful of their expressions, and learn how to channelize anger,” she elaborates.

Related: How Abusing Screen Time Is Affecting Our Eyes

However, we cannot deny that we live in a volatile state. As a result, Dr Khalid advises we should also arm our children with the right information. “This means telling them about all emergency numbers in their area and teaching them basic first aid methods,” she adds.

The international organization Red Cross believes that every child aged between five and 11 should be taught basic first aid to help them stay safe and save lives in emergency situations. More importantly, first aid knowledge helps boost a child’s confidence.

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Why Mothers Are Finding It Difficult To Breastfeed Their Infants in Pakistan https://htv.com.pk/moms/breastfeed-infants-in-pakistan Wed, 10 Jul 2019 05:43:03 +0000 https://htv.com.pk/?p=45235

As per the National Nutrition Survey 2018 key findings published last month, there has been a steady increase in the proportion of children receiving breast milk during the first hour after birth between 2011 and 2018. However, the trend for exclusive breastfeeding is not linear. From 50% in 2001, it decreased to 37.7% in 2011 […]

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As per the National Nutrition Survey 2018 key findings published last month, there has been a steady increase in the proportion of children receiving breast milk during the first hour after birth between 2011 and 2018.

However, the trend for exclusive breastfeeding is not linear. From 50% in 2001, it decreased to 37.7% in 2011 and then again to 28% in 2018, bringing Pakistan close to the World Health Assembly target of 50%.

So why exactly has there been a decrease in women exclusively breastfeeding their infants?

Pediatrician at Margalla General Hospital Dr Nazia Abbasi says breastfeeding practices in Pakistan are decreasing every year due to multiple factors.

These factors include the fact that earlier only women who belonged to upper-class households used to avoid breastfeeding because they think it has an impact on their body shape among other things. But now women from the middle-class work full-time and don’t have the facility of daycare centers at their workplaces.

Shazia Luqman who works at a university in Islamabad gave birth to twins twice and never had complaints of less milk production. But she couldn’t take her kids to her workplace as it lacked the facility of a daycare center.

“At work I used to feel uncomfortable as I always felt the need to breastfeed as I had access milk production but had no choice but to wait. I couldn’t afford to quit my job,” she shares.

On the other hand, lower middle-class women complain about low milk production because of malnourishment.

Exclusive breastfeeding

According to the survey, the proportion of children who are exclusively breastfed for the first six months of life is highest in Khyber-Pakhtunkhwa (60.7%) and KP-NMD (59.0%), and lowest in Azad Jammu and Kashmir (42.1%) and Balochistan 43.9%.

Prevalence of the practice of continued breastfeeding is highest at one year of age at 68.4% and thereafter decreases to 56.5% at two years of age. Relative to the rates in 2011 this represents a decrease from 77.3% and an increase from 54.3%, respectively.

Dr Abbasi says children who are not breastfed for six months after their birth are more likely to suffer from various respiratory infections, such as, pneumonia and diarrhea. “Mothers must breastfeed exclusively for the first six months and continue it for at least the first year of the child’s life,” advises Dr Abbasi.

However, in urban areas a lot of women cannot breastfeed because there are no daycare centers at their workplaces, informs Dr Abbasi. On the other hand, most offices and organizations don’t allow children at work. “There is no replacement for mother’s milk and formula milk can never be a good substitute to it,” she says.

Related: Breastfeeding Tips For New Moms

It is also important to note that only a small segment of the society can in fact afford formula milk. Dr Abbasi explains that a lot of children are also malnourished because most people turn to lose milk as formula milk is a financial burden, and the former can affect the child’s physical growth and cause various infectious diseases.

Medical officer at the pediatrician department at the Mayo Hospital, Dr Imran Shah says that after six months the child can be fed comfort food. This may include khichri, semolina, kheer and banana. Hence, in case the child can’t be breastfed exclusively, he/she should be fed comfort food.

Moreover, lack of awareness also leads to a decrease in mothers breastfeeding their infants. For instance, a lot of women believe they cannot breastfeed their children if they have Hepatitis or TB.

However, Dr Shah clarifies that women who have AIDs are not allowed to breastfeed. Women who have TB and Hepatitis can breastfeed their children.

He also pointed out that the infant should be breastfed in the first hour of its birth as the mother’s milk has colostrum, which has antibodies and it boosts the strength to fight against diseases.

Most importantly, breastfeeding also strengthens the bond between the mother and the child, he elaborates. “It is also a natural contraceptive and reduces the chances of breast cancer in mothers,” mentions Dr Shah.

How to promote breastfeeding?

Dr Shah says there are things that can be done on governmental level like organizing lectures by medical field officers who talk about the importance of breastfeeding.

“When lady health workers visit houses and talk about these issues, women don’t pay attention to it thinking they are women of their [own] areas, hence they think how can they teach us.”

On the other hand, as the employment rate of women has increased, offices should be encouraged to set up a separate nursing room for mothers, recommends Dr Shah.

Related: When Does Breastfeeding Stop Hurting?

Dr Abbasi also says that companies need to revise their policies. “In Pakistan most women don’t get paid leaves and are required to forgo income in order to breastfeed,” she says. “In a country like Pakistan, breastfeeding should not be viewed as a personal choice as almost all women do understand how important breastfeeding is for the health of their children,” she adds.

There is a need to recognize the social and economic realities that curtail options for women who want to breastfeed their kids.

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Signs That Your Child Is Being Bullied At School https://htv.com.pk/moms/bullying-in-school Mon, 01 Jul 2019 09:54:42 +0000 https://htv.com.pk/?p=45164

Bullying can take many forms and is not limited to physical force. It can take place in the cyber and physical spheres and includes actions that can physically harm, emotionally hurt, intimidate or manipulate a person into doing what they don’t want to. A 2017 report stated that bullying in Pakistan is rapidly growing and […]

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Bullying can take many forms and is not limited to physical force. It can take place in the cyber and physical spheres and includes actions that can physically harm, emotionally hurt, intimidate or manipulate a person into doing what they don’t want to. A 2017 report stated that bullying in Pakistan is rapidly growing and it currently place 22 out of 25 countries for the highest rate of cyber-bullying.

Bullying in school is often ignored and the signs are sometimes difficult to pick up on. Furthermore, children are less likely to approach a problem head-on or complain about it. There are certain signs that you can however, pick up on that could potentially mean that your child is being bullied.

Unexplained headaches, stomach aches or other complaints

Waking up with any ailment that doesn’t have an explanation- and seems to happen frequently maybe a red flag. It isn’t that your child is making up illnesses but keep in mind that anxiety manifests itself in many ways- anxiety could be a legitimate cause of a stomach ache in children, they just don’t know how to explain it.

Read: 5 Ways You Can Prepare Your Child To Go Back To School

Reluctance in going to school

Where a once happy child was super eager to go to school, he/she is now reluctant or not as excited for school- it may be time to ask questions. Ask teachers if he is acting differently, check for other behaviors that are unlike him and may be due to bullying in school.

Answers to questions don’t add up or if he/she avoids answering certain things

If your child is giving you answers that don’t add up or answers simple questions like ‘did you have fun in school today?’ with vagueness or disinterest, it may be a sign of concern. Although, many children do not tend to answer questions and it does not indicate bullying. Lack of coherence and connectivity in stories is more of a red flag.

Lack of interest in social activities/ lesser friends

All of a sudden your child is not going to birthday parties, or is not interested in play dates. He/she may not want to attend extra-curricular activities and seems to have lesser friends than before. If they’re spending more time on cyber-activities or at home instead of playing, then it may be tell-tale sign on bullying.

Fear- seems more attached to family members

Usually children will turn to family members for comfort and acceptance. If your child seems more attached (more than normal) to you/ or other family members, it may be coming from a place of fear. Requests previously uncommon like ‘I want mom to drop me all the way to class’ or ‘can you stay throughout my football session’- could be a sign of worry.

Bullying is something that requires early intervention and a collaboration between the school and the parents to effectively manage. If you feel that your child is being bullied, do not hesitate to ask the class teachers to keep a more vigilant eye on your child and his behavior.

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How To Take Care Of Your Infant In This Heat https://htv.com.pk/moms/infant-in-the-heat Wed, 26 Jun 2019 13:22:53 +0000 https://htv.com.pk/?p=45123

Adults prepare themselves accordingly as the summer season approaches Pakistan. The moisturizing, planning to stay indoors more and drinking as much liquid as possible. However, infants are dependent on their parents or caregivers. The heat can sometimes be too unbearable for their tiny bodies. Just last month, eight children reportedly died at the District Headquarters […]

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Adults prepare themselves accordingly as the summer season approaches Pakistan. The moisturizing, planning to stay indoors more and drinking as much liquid as possible. However, infants are dependent on their parents or caregivers. The heat can sometimes be too unbearable for their tiny bodies.

Just last month, eight children reportedly died at the District Headquarters Hospital Sahiwal due to a malfunctioning air-conditioning. Though later the Punjab Health Department released a statement dissolving the doctors and the hospital of any responsibility, we cannot rule out the fact that infants need proper care in the heat.

They are prone to various health problems and those who are already ill need extra care.

Pakistan Pediatric Association General Secretary, Consultant Pediatrician and Dow Medical College Professor Dr Muhammad Khalid Shafi says hospitals are constructed keeping in view the installation of air-conditioning systems.

Unfortunately, at some facilities in the country there is a poor ventilation system. If ACs stop working even for hardly an hour one cannot stand the suffocation. “Poor ventilation can have serious consequences,” he warns.

On the other hand, people at home must have a good ventilation system as well. The summer season gravely effect infants, if they are not properly taken care of, because they don’t have a strong immune system, says Dr Shafi.

Moreover, a body’s strength to fight illnesses reduces in extreme weather conditions, he adds.

Signs to watch out for

Germs and bacteria thrive in the summer season. Therefore, the little ones are prone to dehydration, sunburns or several other heat-related health problems.

Dr Imran Shah, a medical officer in the pediatric department at the Mayo Hospital, says that extreme heat and cold can both be dangerous for infants. But during summer, “children under the age of six months should be exclusively breastfed. Mother’s milk has 80% water and hence, it protects a child against water shortage in his/her body,” he says.

Dr Shafi also advocates for breastfeeding infants frequently during the day than feeding them water.

Related: Breastfeeding Tips For New Moms

However, if visible symptoms are not present then look out for other signs. For instance, when heat affects infants, they become restless and stop drinking milk properly, says Dr Shafi.

Making use of nature

A lot of parents who visit the Mayo Hospital come from villages and hence, are concerned about not being able to provide proper cooling to their infants as they don’t have electricity and air-conditioners.

Dr Shah mentions that in such a situation the doctors advise parents to ensure their children rest under a shade of a tree. “It’s good to keep them in the shade to avoid sunburns and other health issues,” says Dr Shah, adding that infants should also be given showers at least three to four times a day.

Bathing children frequently also protects them from getting prickly heat, which is the most common skin problem in children during summer. It normally clears up on its own after some time but in case it gets worse a professional help from a doctor must be sought.

Tips to avoid your child from getting a heat stroke

Dr Shah explains when a child has water deficiency in the body, his/her fontanelle reduces, skin and tongue dry up and urine turns dark yellow. Since parents are responsible for a child’s health they should avoid going out from 11am to 5pm, so that infants do not have much sun exposure.

Related: Common Challenges Faced By New Moms

Moreover, parents in Pakistan have a general practice of wrapping their infant but Dr Zain Yusuf Ally, pediatrician at the Ziauddin Hospital, says that parents should avoid doing that. “Infants should be dressed in thin and loose clothing,” he suggests.

Talking about feeding water to over six months old child, Dr Yusuf advises boiling water first to prevent any diseases. “Patients often say they use filter water but I always tell them it won’t help. So, the best thing is to boil water for 15 to 20 minutes.”

Moreover, there is also a need to keep the house clean as a lot of children suffer from diarrhea and vomiting. “If we don’t keep the environment clean, there are chances that cholera spreads,” he mentions.

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Cut With Caution: The Truth Behind Episiotomies https://htv.com.pk/moms/truth-behind-episiotomies Mon, 25 Mar 2019 12:40:39 +0000 https://htv.com.pk/?p=43593

All around the world, the majority of childbirths occur through normal vaginal delivery. The expectant couple and clinicians both agree that this “natural” route should be undertaken when there are no health hazards to either the mother or baby. It should, however, be noted that even a normal vaginal delivery may get complicated if labor […]

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All around the world, the majority of childbirths occur through normal vaginal delivery. The expectant couple and clinicians both agree that this “natural” route should be undertaken when there are no health hazards to either the mother or baby.

It should, however, be noted that even a normal vaginal delivery may get complicated if labor gets obstructed due to the size or positioning of the baby. In such cases an episiotomy is performed which is a surgical cut made at the opening of the vagina, to enlarge the opening and facilitate the passage of the baby without rupturing the vaginal tissues. The rationale remains that a surgical cut is easier to stitch and takes lesser time to heal compared to an uneven tear in the tissues.

Episiotomies may help in many of these cases but should be considered as a separate surgical procedure, with its own set of indications, techniques, and complications.

Approximately half of all stillbirths and a quarter of neonatal deaths result from complications during labor and childbirth. Episiotomies may help in many of these cases but should be considered as a separate surgical procedure, with its own set of indications, techniques, and complications. By no means should it be considered as a standard part of the vaginal delivery procedure, because there are many vaginal deliveries which go smoothly without the need for an episiotomy.

Research shows that the burden of maternal and perinatal deaths is disproportionately higher in low-and-middle-income countries compared to high-income countries. This may be the reason why obstetricians in many developing countries remain cautious during childbirth and perform routine episiotomies in an effort to facilitate the passage of the baby. Clinical judgment of the obstetrician varies from one to another, but in some settings, episiotomies are performed without any justification. The obstetrician may be well intentioned but does not realize that these unnecessary stitches will cause the mother pain and discomfort long after the procedure.

Research shows that the burden of maternal and perinatal deaths is disproportionately higher in low-and-middle-income countries compared to high-income countries.

A study conducted on women who underwent episiotomies revealed that they took much longer to return to routine activities. Some women even complained about aesthetic deformities and how it affected their sex life.  All the women in the study claimed they would have been better prepared for these changes if they had been informed about these post-episiotomy complications in the beginning.

During their pregnancy, women trust their obstetrician with their own lives as well as their unborn baby’s life. The obstetrician is the focal source of information and the decision maker in most cases. Therefore, to bring around a change in the culture of routine episiotomies, the obstetrician plays the most important role.

At the local level, all clinical staff including midwives, nurses, and doctors involved in obstetric practice should be educated about current clinical guidelines along with the rationale behind them.

A study conducted on healthcare professionals in South America, the Middle East, South-East Asia showed that a lot of clinical staff was unaware of the current clinical guidelines related to episiotomies. Based on their own experiences, they felt the episiotomy made the delivery easier for the staff and safer for the mother and baby. In Cambodia, a clinical practice had a financial motive behind performing episiotomies as they felt they could charge the patient more in this way.

The only way of reversing this culture of unnecessary episiotomies is through education of both the expectant couples as well as the clinical team.

At the local level, all clinical staff including midwives, nurses, and doctors involved in obstetric practice should be educated about current clinical guidelines along with the rationale behind them.

At the federal level, healthcare policies should give the episiotomies the same consideration as any other surgical procedure, which includes making it mandatory for informed consent to be taken before performing the procedure.

Through informed consent, patients will be educated about the advantages and disadvantages of the episiotomy and the mother can choose to accept or refuse the procedure as per her own judgment.

Globally, patient empowerment is rapidly gaining popularity and taking consent before episiotomies is another way in which decision making can be shared between the patient and doctor. This not only increases the accountability of the doctor but also ensures the patient is aware of their own clinical status and can contribute to their own well being.

References :

WHO recommendation on episiotomy policy — February 2018

https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/care-during-childbirth/care-during-labour-2nd-stage/who-recommendation-episiotomy-policy-0

Image Source: sheknows.com

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