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Archive for October, 2009

Is Thimerosal a money-saving tactic?

Saturday, October 31st, 2009 by:

Thimerosal, a mercury-based preservative, is used to prevent contamination in multi-dose vials of vaccines. Since multi-dose vials are much cheaper than single-dose vials, the seasonal and H1N1 flu vaccines are almost always multi-dose (a few single-dose H1N1 flu vaccinations may be available in November but with up to eight-hour line-ups for vaccinations are administrators really going to deal with requests for single-dose vials?)

Are multi-dose vials really necessary? Would you pay $5 or even $20 a shot for single-dose to make sure the shot was thimerosal-free?

To circumcise or not to circumcise

Tuesday, October 27th, 2009 by:

I didn’t take the decision to have my sons circumcised lightly. Before my first son was born I read countless studies and articles on the pros and cons of circumcision. Most dramatic for me was the drastic reduction in sexually transmitted infections (especially HIV) in circumcised males. In the end, I decided to have my son circumcised, but I am not in the Canadian majority.

Based largely on the death of one infant from post-circumcision hemorrhage, the Canadian Paediatric Society (CPS) has strengthened its stand against neonatal circumcision. The CPS recommends that circumcision of newborns should not be routinely performed. As a result, all provincial health insurance plans have removed non-therapeutic male neonatal circumcision from the schedule of covered procedures due to a “lack of health benefit.”

The result is often a somewhat shady cash transaction that has resulted in a huge reduction of neonatal circumcisions. In 1994 neonatal circumcision was performed on about 20 percent of Canadian male neonates. By 2005, this number declined to 9.2 percent. Circumcision rates are on the rise in many other countries due to the potentially live-saving health benefits of reduced infections and possibly even cancer rates.

Canadian doctors argue that Canada has condoms and good hygiene which counteracts and circumcision benefits seen largely in third world countries. Do you agree?

Teaching your child to be gentle with siblings

Thursday, October 22nd, 2009 by:

One issue moms often talk to me about is how strongly they react when their older child hurts, or is rough with, the baby. This is really common, especially if the older child is under five. Young kids are often rough with their little siblings–sometimes it is intended and behavioral, and sometimes it’s just because they get really excited and can’t control those big feelings.

Either way, it can make your protective instincts take over and your response can be more intense than you meant it to be.

Safety is important and older siblings must learn to be gentle with baby siblings, but sometimes “blowing up” can lead to more of the very behaviors that made you upset in the first place. They can add to any feelings the older child may have of feeling less important or less loved than the baby. This is not rational, young kids don’t reflect on their behaviors, they just focus on how they feel.

Here are some things you can do:

1. Remember to try and stay neutral, which is very hard, I know. You can be serious and firm, but if you “fly off the handle,” it won’t help.

2. Sit down with your older child every day for some connecting play with her alone. She may even want you to baby her and give her the same kind of attention the baby gets. This is fine and she will not regress permanently. In fact, it can be tremendously helpful and strengthening for your older child.

Pull out baby pictures, her favorite toys or little outfits she wore when she was younger and tell her lots of stories about when she was a baby. This alone may decrease her negative feelings or behaviors regarding the baby.

3. Talk to your older child in a calm moment about the importance of being careful and gentle with the baby and let her know that there will be consequences if she chooses to be rough.

What I like to suggest is an interruption. It’s not a traditional time-out, instead, she is asked to go somewhere else to think for a few minutes and can come back when she is ready to comply. You don’t have to lecture or discuss it when the interruption is over, just welcome her back and repeat the routine until the behavior stops. If you are calm and consistent, it will work.

4. Help your older child make good choices by offering alternate ways to interact with the baby and let her know when you notice her trying to be appropriate. Remember too, that the baby is not made of glass. Babies are pretty tough and, within reason, being squeezed and picked up by siblings is part of living in a family.

Jennifer Kolari is a child and parent therapist, and found of Connected Parenting. For more information you can contact Jennifer at info@connectedparenting.com or visit www.connectedparenting.com.

The flu shot’s available–should I get it?

Wednesday, October 14th, 2009 by:

It’s a question I’ve been pondering a lot lately. And to be honest, I still haven’t decided. I’ve never gotten the flu shot, or given one to my children before–why should H1N1 be any different?

For one, H1N1 preys on children and young adults–most severe forms of the flu target the sick and elderly. Since April 2009, 76 children have died of H1N1 (including 19 last week). Sure, 36,000 people die of the flu each year, but 76 children in just six months of non-flu season is abnormally high.

I’m also thinking of getting pregnant again, which makes me question whether I should get the shot. The immune system is compromised during pregnancy, putting the expecting population more at risk. During the first four months of the outbreak, 100 pregnant Americans were hospitalized and 28 died. The further along the pregnancy, the higher the risks to mom and baby. In the third trimester the fetus pushes against the thoracic cage, decreasing lung capacity and increasing respiratory risk.

Since the H1N1 vaccination is available starting this week, why take the risk? Shouldn’t I just get the shot? To help weigh my options I made a pro/con list:

Against: The multi-dose vial contains thimerosal (a form of mercury), used as a preservative to prevent contamination.

For: A can of tuna contains more mercury than the H1N1 shot.

Against: Has the H1N1 vaccination really been tested sufficiently?

For: Experts say yes. In fact, even more so because it has already been widely used during the Southern Hemisphere’s flu season. During China’s flu season just four of the first 39,000 people to receive the vaccination experienced muscle cramps and headaches as side effects.

Against: Canadian shots contain adjuvants, which increase the potency–and the uncertainty–of vaccination safety.

For: American shots are adjuvant-free and pregnant Canadians can get adjuvant-free shots.

Against: My kids and I may be exposed to flus other than H1N1 and get sick anyways.

For: At least we’ll be H1N1 safe.

My decision? I remain undecided but am leaning more heavily towards getting the H1N1 vaccination.

Cold water hand washing is just fine

Tuesday, October 13th, 2009 by:

My two-year-old Bode is ultra independent. He wants to do everything himself–including washing his hands. If I’m supervising, we use warm water. But for those times when Bode climbs up and turns on the tap himself I don’t even want to get into hot water. I’ve asked him to limit his use to the cold tap so he won’t “burn himself.” And he actually listens to me.

Bode loves soap and can often spend a few minutes washing his hands. But I’ve always wondered is the cool water is enough to kill germs? Turns out it is.

A study by the Journal of Occupational and Environmental Medicine found that water temperature had no effect on bacteria reduction. When it comes to removing germs, it’s soap and water that’s important–not temperature.

Independence, safety and results–just perfect.

When in-laws feel more like out-laws

Monday, October 12th, 2009 by:

I promised I would deal with really difficult in-laws, so here we go. This one is not easy. Having a tense relationship with your in-laws can be stressful and can cause major friction between you and your spouse. One of my dear friends refers to her in-laws as her “out-laws” (sometimes all you can do is try to find the humour in a bad situation). The truth is, some grandparents just do not know the first thing about boundaries and they have no idea when to say something–and more importantly, when not to. If you have a good relationship with your in-laws, consider yourself blessed. If you don’t…take a breath and read on.

First, really go inward and make sure you’re honestly evaluating your role in the situation. Own any behavior you think may be contributing to the situation and do your best to change it. You don’t even have to tell anyone else, you just need to be honest with yourself.

Next, talk to your partner about your feelings, but remember that no matter how unreasonable your in-laws are being, they are still his parents and criticisms about them can be hard for him to hear. This can lead to fights where both of you sling “yeah, but your parents do this and your mother does that’s” at each other. Make sure to acknowledge his feelings, then let him know that you must be a team on this and that together you need to establish boundaries with your in-laws.

Now it’s time to talk to your in-laws. It’s important this is experienced as a communication, not an attack. I teach parents a technique called mirroring, which works beautifully on kids, but here’s a secret – it works equally well on husbands, parents, and in-laws! Try saying something like, “You have raised a family and have more experience than I do. I also know how much you love your grandchildren. But we are parents now, and we need to figure out how to be the best mother and father we can be, our own way,” which will firmly remind them that this is the way you and your husband do things.

If your in-laws persist and it gets ugly, try to be strong, but stay neutral. As soon as you get defensive or start yelling, they will not reflect on their own behavior and will instead become obsessed with yours. Make your point calmly and concisely, then move on. Don’t get sucked back into the argument. Let them know that you have made your point and heard theirs, but you are moving on. Feelings might be a little hurt for a while, but you will have set an important boundary.

If the relationship becomes unbearable, agree with your spouse to be present for portions of visits, then be busy doing something else. It is important not to cut them off completely–that is hard on the relationship with your spouse and may deprive the kids from valuable grandparent time. You have to make some appearances and be there for important events, but can agree with your spouse to be absent from others.

Remember to take the higher ground–if they are really that difficult, there is probably nothing you can do to change them or to help them gain any insight into their own behavior. In other words, it probably has much more to do with them than you. This will help you to not take it so personally and to treasure the positive supportive relationships you do have in your life.

Jennifer Kolari is a child and parent therapist, and found of Connected Parenting. For more information you can contact Jennifer at info@connectedparenting.com or visit www.connectedparenting.com.

Getting along with your baby’s grandparents

Monday, October 5th, 2009 by:

It’s hard enough to navigate the challenges you face with your partner after a new baby, but other relationships can get shaken up as well. Suddenly, getting along with your parents or in-laws can become tricky. My mother is a wonderful mom and a fantastic grandmother, but I do remember a time, just after my first child was born, when she elbowed me out of the way at the change table.

I remember thinking, “Did that just happen?”

I don’t even think she realized it–as my mother, she was used to taking care of me, and taking care of my baby seemed the thing to do. It was hard for her to see me as the mother in this situation and it was an adjustment for her to pull back and support me rather than take over. We had many a blanket war. I would take it off, sure my son would overheat, and she would put it back, certain he would freeze. It took a while for each of us to find our roles and our places.

It can be even more challenging when this battle is playing out with in-laws. Small issues can crop up, such as your baby’s features being attributed exclusively to your partner’s side of the family (as if he was born by immaculate conception), as can bigger issues, like criticizing your parenting or undermining all the work you did to get your child to sleep through the night. This can cause friction between you and your partner too, forcing you to take sides and align with each other or your parents.

The best way to handle these challenges is to remember that most of us work it out and find ways to see the good outweighing the bad. (I’ll deal with problem in-laws in a future blog post–I promise). Grandparents offer a lifetime of wisdom and have already raised their kids to adulthood. If you and your partner disagree on what they have to say, stay neutral–getting mad only escalates things. Listen and reflect back their advice, then make your point. If you’re confident, you will send the message that you hear them, but you and you partner will be making your own choices.

Treasure your baby’s grandparents; the magic, perspective, and history they can bring to your children are incredible gifts. No one can make your child feel as special as a grandparent. You may not always want to hear what grandparents have to say, but their wisdom can be priceless. When it isn’t, find the humour in it. At times, the best thing you can do is shake your head and laugh.

Jennifer Kolari is a child and parent therapist, and founder of Connected Parenting. For more information you can contact jennifer at info@connectedparenting.com or visit www.connectedparenting.com.