Giving Time!

There is a political, social and economic chaos all around us. There is a political turmoil in Bangla Desh. On account of natural calamities, there is social distress in some parts in India. With wars and threats of war, there is an economic distress predicted globally.

We live in a climate where people live consuming and giving is less than natural or spontaneous. 

The flowers above practice giving nectar all the time. They remain open to bees, insects, and butterflies. The flowers give unconditionally and live to be used for others. 

Following the landslide in Wayanad, there is a new wave of giving among people. 

One form of giving is offering time to be with people who are grieving over their loss and bereavement.  

I came across reports and photos of volunteers, being with children who are in relief camps, to engage them in group activities to give them an experience of catharsis. 

I wish that there would be few volunteers attached to each relief camp to engage children daily, to give them an occasion to express themselves and to listen to their experiences! They need to feel cared for!

It is a time for giving! There are people in different situations of need and distress! 

Giving brings opportunities to receive. We grow by giving and receiving!

M.C.Mathew(text and photo)

When a Tailor bird does not sing!

 It is most uncommon for a Tailor bird not to sing its tune. That was what has happened during the last week with heavy rain disturbing its flight movements. 

I saw in the social media, a group of children in a relief camp, entertaining themselves with different performances. I noticed volunteers encouraging them to perform!

I watched their dull faces, feeble voices, and burdened body gestures. They related less and looked lost and disengaging. 

The shock and grief after having been displaced from their homes and some having lost members of their family, following the landslide in Wayanad, is the normal phase of transition. 

Most pre-school children process loss and grief in a temporal way, missing their toys, clothes, bed, pet, friends and those who took care of them. At three to five years, they miss what has been familiar and close to them, which formed part of their routine. So they would miss going to school, play outside their home and do the usual things they were used to. Their loss will be felt in an incremental way. It is in three to four weeks, the larger dimension of grief and loss would get expressed in their behaviour. 

What they would need are one or two companions with whom they can be in regular contacts and conversations, which would help them to feel connected and accepted. If they have lost a member of the family, the sense of loss would become an experience gradually. It is good to observe their sleep behaviour, social communication, feeding habit, play orientation, and mood in response to different situations. 

If they feel cared for by someone being available to engage in conversation, play, and narrating stories, they would feel insulated from fear overtaking them.

The fear of more loss afflicts some pre-school children! It is important to protect them from slipping into that abyss. 

The earlier they can go to a school the better. The earlier they can be in a home to restore their routine, the better.  While they are at a relief camp, a routine for the day, can be created with children of similar age clubbed into groups for group activities of interactive learning under the  supervision of a volunteer familiar with children or a trained teacher. I wish there would be a space for activities of children in the relief camps!

The tailor Bird would soon sing, once the days are sunny and bright!

These children too would gradually recover, although the sense of loss and grief can be a recurring experience for two or more years. 

M.C.Mathew(text and photo)

A turbulent beginning !

 A rose flower as it emerges from a bud, thrives on bright sunshine, moist soil and protection from Beatles who feed on the petals. 

An infant in the first six months after birth, thrives on a parenting environment of breast feeding, playful engagement, intimate body contact with the care giver and attending to the regular needs of the infant. An infant who grows up in such an environment, develops the attachment process and builds on that emotional bonding to move on to attain the developmental sequences of infancy. 

How does an infant learn the source of sound! It is because the baby hears sounds repeated and develops an orientation response to that sound with similar tone in the environment. Every mother while cuddling her baby would use sounds and voice to engage the infant to  establish facial contact. Why does an infant turn the head from side to side by about two to three months? It is because the baby gets oriented to human face associating with the voice. Why does the infant around three moths lift head or steady the head when carried! It is because an infant by about three months sees till about 2 meters, locates sound and associates sound and sight when they are constant and frequent. 

A mother holds the baby close to her and the baby feels warm, secure and comforted. An infant sleeps faster in mother's arms than when placed on a couch. The way the baby is fed on breast, changed when wet and carried when feeling cold or frightened by large sounds or bright light, gives the baby an emotional nearness to the care giver. It is a habit of most mothers to sing to the baby, carry the baby for short or long periods when awake, and use sound makers or visually engaging toys to give the first time experience with the toys. The secure feeling when the baby is wrapped up in warm clothes, is a comforting experience. Usually an infant by six months gets exposed to the father and other immediate family members and behaves in a familiar way when they engage the infant. 

All the above first time experiences will be lost for the few infants below six months, when displaced from their home following the landslide in Wayanad last week. I am yet to be sure if those few babies are bereft of mother, father or other immediate family members. 

An infant by six months is now in a new environment in a relief camp, without the familiar couch, physical space and comfort of the home. With parents and family in distress, the parenting response would be different from what an infant was used to. 

An infant usually expresses discomfort by crying, which cannot be easily consolable. Such babies cries till they, in exhaustion goes to sleep, but with interruptions without the regular sleep time of two to three hours after a feed. 

I wonder if the relief camp would have a quiet space, preferably a room where mothers can come to feed their infants! I wonder if the available care givers who were familiar with the baby alone attends to a baby in this transition time as too many unfamiliar care givers unsettle the emotional nearness, an infant needs to feel secure. 

For most infants, around six months of age, six to eight weeks will be a transition time to become familiar with new care givers. If mother is unavailable or breast feeding gets discontinued, to get the baby to be fed artificially will be another transition stress to the infant and the care givers. 

An infant is conditioned to experience stability of environment, which was what an infant had for nine months in the mother's womb and in the first few months of infancy.  

Now if the infant has been displaced of the home environment, following the landslide, what is needed is to create another stable environment to which the infant can get readjusted!

The photo of the rose flower above is a symbol- it is fragile, fragrant, and fresh. Its life as a flower is a short time. 

An infant too is similar in the first six months. Most of what is to follow during the next six months till the first birthday is a continuation of the experience of the first six months. 

Let this thought occupy the attention of all those who are involved in caring for infants around six months- a stable, constant, playful, comfortable environment to give continuity of emotional, physical and 

soil environment!

It is necessary to weigh such infants in transition every week, observe their bowel habits to know if they are adequately fed, and a keep diary of their sleep rhythm  to observe if there is a structure that is emerging for the day time and night time behaviour. An infant turns over from back to front by six months. So care to give safety of space for moving in the bed !

I wish a nurse or doctor familiar with infants will observe the infant's behaviour once every five days to look for anything unusual. When an infant is displaced, the immunisation schedule can get dislocated. This needs attention. If the infant is artificially fed, the strict protocol of sterilising the feeding vessels ought to be monitored. If formula feeds are used, the planning to give sufficient calories as the weight increases is another crucial factor!

A displacement from the warm and familiar environment for an infant of six months is a traumatic experience. Our efforts are for lessening the impact of that separation arising from displacement from the familiar environment and to restore semblance of stability and continuity! 

There might be other mothers who are still breast feeding their infant, who might offer to breast feed the infant, if the mother is not available. Whether this is suitable is a medical decision, to be taken jointly by the health care professionals and the family of the infant. 

An infant is in transition by six months as important developmental sequences follow on, between six months and the first birthday. 

The parents of the infant, if they are present, bear the brunt of displacement. They with their other upheavals are vulnerable to anxiety, insomnia, and anorexia. They need support and enablement to adjust amidst their loss and grief. 

If the mother is breast feeding, there might be a sudden reduction in the quantity of breast milk. That calls for attending to take care of the mother, monitoring her food intake, hydration, sleep and emotional state!

The professionals in the relief team would need support for their own wellness as they are listeners and providers in this stressful situation. A weekly debriefing and a break of one day every five days would be desirable.

A psychosocial team, attending to the needs of the professionals will be necessary to safeguard the wellness of the professionals, as the situation is highly stressful for every one in the relief camp.

M.C.Mathew(text and photo)

The Wounded Hills !

The birds spotted in our garden in isolated trees during a heavy rain , three days ago,  brought me close to the experience of children who were  displaced from  their home after the landslide in Wayanad, early this week. The birds who are normally in groups, now are alone, looking down cast and silent without bird calls. 

The news of children who have lost some members of their family or a parent or both parents in the landslide is trickling in. They are in different relief camps. A photo of a seven year old boy carrying his brother of 40 days in his arms, was  shocking to watch !

I felt moved and want to be involved in supporting these children and bereft families who lost their children. However it is too ambitious for me to do any practical help physically, as my age restrains me. 

But I thought of many professionals who would be involved in offering therapeutic help to children and adults and accompany them through their recovery journey. 

This blog which was inactive for a while, is a forum I want to use to share thoughts and experiences with children, who experienced post traumatic transition in their lives. Children being in different developmental stages of life till they become teenagers, it is often necessary to have an individualised protocol of promoting child development and healing!

I shall use this forum to share experiences and thoughts on different aspects related to loneliness, bereftness or grief, children of different ages experience. 

The silence in our garden,  which has regular bird calls during the day reminds me of the stress, that birds encounter during the incessant rains. 

Children, displaced from their home, school and their neighbourhood  have enough of stressful experiences. If they have suffered bereavement, it adds to the upheaval. 

I start this series carrying within me a sense of loss myself, because, it is only by being with children during their distressing time, one can be an enabler for their pathfinding!

I hope this forum can be a link with professionals,  who are involved as front line care givers, for promoting child development and healing!

M.C.Mathew(text and photo)

Parenting pathways-1

 Let me share an article 'The role of parenting in developing communication skills in infants and toddlers- an experience from a Child Development Centre', which I sent to the Developmental Paediatrics Unit at CMC Vellore, for a conference, which was arranged in April, 2023 at Vellore.

I have updated the article, giving some more information on the child development initiatives that ASHIRVAD, Developmental Paediatrics Department at MOSC and the department of Physical Medicine and Rehabilitation of the Bangalore Baptist Hospital, jointly sponsored during the last four years. 

In fact, at the fortieth year of ASHIRVARD, an initiative for Child Development, started in 1983, fostering development of its services in Chennai, Nagpur, Vellore, Pondicherry, Bangalore and Kolenchery, the following narration of the events and experiences of the last four years highlight some of the aspirations we pursued. 

During my morning walk recently, I noticed tender cashew nuts covered with red ants in the cashew tree inner garden. I felt awful. The red ants suck the sap from the pulp of a tender nut, which would have become a full cashew nut in few months. If not sprayed with insecticides, these nuts would have considerably reduced the pulp inside, sometimes leaving them as a shell without any pulp! 

The cashew nuts have to survive this vulnerability!

1 The changed infant nurturing practice

It was while walking back to our cottage after sighting the cashew nuts covered with ants, some thoughts about the vulnerability of an infant in the  changing circumstances, in which they grow up now, dawned on me. For most part of my childhood and later years, till the technology revolution invaded the homes from the nineteen eighties, with the use of the colour TV, computer, internet, later the Mobile phone, iPads, etc, parenting was an interactive process between infants and parents.  The parenting process of a new born was at the centre of a family’s daily rhythm. Now infants and toddlers have to adapt to the priorities parents choose for themselves. Now in the words of Dr Susan George, while referring to the technology invasion in our home capturing the pre-school children, wrote: 'Their bodies are with us but their mids are sold'!

I remember how parents used to sing to their children, tell stories, read stories from picture books,  play with them with balls made of paper or coconut palm leaves, go to a nearby stream to play in the water, play in the sand, make clay models, etc,. Even when I was training to be a paediatrician in the seventies, it was common for parents to give reasonable attention to promote communicative habits in infants and toddlers by engaging them in play.

Just as the red ants invade and harm the tender cashew nuts, the overuse of mobile phones, TV, internet and iPads distract and impair the normal development of language, communication and social skills of  pre-school children! The machine interface has replaced the normal physiological human interface between infants or toddlers and their parents. 

2. A challenge to  Infant’s processing skills

The auditory system of an infant is conditioned to recognise human voice from few weeks  after birth. The visual cortical system enables an infant to recognise the mother's face by about three months and develop a reciprocal smile with a familiar person by four to six months. The human voice, facial appearance, the feel of the person who often carries the infant, his or her odour, the touch and strokes on the face and hands or rituals during bath time, feeding time or while or changing the napkins create a sense of familiarity and curiosity in an infant. 

An infant, who babbles or makes jargons sounds in the latter half of the first year, as early imitations of regular sounds heard at home, goes on to express variety of sounds, syllables and words before the first birthday. An infant wants to communicate and reciprocate as he or she grows up in an environment of words, gestures, actions, pictures, singing, etc. Being in such an environment increases the communication instinct of an infant. 

Now about seventy percent of pre-school children, who come to the Child Development Centre, where I work now, are brought by their parents, for not having shown the proficiency of language development expected at two or three years. The history of many infants is that,  from the time of starting the weaning food at six months,  they were introduced to the visual screen of TV or Mobile phone, where they watched advertisements, cartoons or other entertainments for four to six hours during the day. Some of them slept late and developed fragmented sleep due to the over-activation of their visual and auditory systems. Since most mothers, if they work outside home, return to work after six months of the maternity leave, the breast feeding got discontinued and a third person would have taken charge of the infant care. This further hampers the development of attachment behaviour between the infant and parents, required as a foundation for developing normal language and communication process.   

The eco-system of the human interface is replaced by the machine interface, which might be  a factor for the current explosive numbers of toddlers brought to Child Development Centres for delay in their language, social skills and behaviour.  Is this a consequence of making the TV or Mobile phone as the 'Third parent' !

3. A change in co-parenting

The machine interface is an invader that displaces infants and toddlers from being attentive to human voices, their faces and interactive communication. Adding to this, if the infant is left without the usual rituals of being sung to (not listening to music from the phone), played with, taken for social contacts with adults and children, or engaged in play at home with toys and household articles, then the delay in the interactive and communication process would get compounded.

The mind set of some parents currently from what I come across, is that the Internet, Mobile phones, cartoons, etc  are good for pre-school children as they would help to develop proficiency in language early. What toddlers do is repeat the machine language in the way they heard in the cartoons, without knowing the meaning or context. They parrot a language which is too early for the brain to process for its semantics, pragmatics and prosody. The colourful screen, animations, movements, stereotypical body movements of the cartoon figures with no semblance to normal human body or appearance or behaviour, freeze an infant or a toddler to a fixation of sight and sound which occupy their mind, displacing the human interactive process they needed to develop for normal communicative intent and content. 

The American Paediatric Association suggested that children below four years watch mobile phones or the TV only when one adult accompanies a child, in order to explain to the toddler what is going on in the screen, that too less than half an hour in a day. It is not ideal to let  children below six months to watch TV programmes on a regular basis. Often infants and toddlers jointly watch the adult TV programmes with their parents, which add to the complicity of the causal pathways for the delay in acquiring the language and social skills.  

4. Adverse influences on child development

We seem to have created an iatrogenic developmental delay of language, communication and social behaviour in infants and toddlers by overexposing them to the visual screen! 

Another dis-service professionals do to the parents is to announce this, as an Autistic Spectrum Disorder, without carefully studying the causal pathway for this developmental delay. Only a few pre-school children might have an unknown cause for the developmental delay. Most of the toddlers were already vulnerable due to hereditary factors, antenatal events or perinatal risk factors, which initiated  their developmental delay. This got compounded by lack of human interface, which if present would have naturally enhanced the neuro-plasticity for some recovery from the developmental delay. 

I feel disturbed by large number of pre-school children showing low values of vitamin D, Iron, Zinc and high levels of IgE, ASO titre, and cholesterol in blood. The premature closure of the coronal sutures observed in seventy percent of pre-school children with communication dysfunction who visit us alarms me. Is it linked to low levels of vitamin D from early infancy! A few publications appeared on this topic from this department.  I have some clarity now from the evidences gathering from 2002, that the Cortical Electrical Dysfunction identifiable in the EEG of about thirty five percent of pre-school children with language and communication disorder or sleep dysfunction might be factor in the causal pathway for  their developmental delay. 

During a pre-school health survey of 540 children in a school we noticed that less than five percent were left handed unlike the normal distribution of ten percent or more of left handedness. This raised the suspicion of enforced change of handedness at home or school. In the pool of pre-school children we welcome with language and communication disorders, about twenty five percent of children had a prominence of their left thumb and great toe, while they use the right hand as the dominant hand or are ambidextrous. In such children a high percentage used the left leg to kick a ball. 

We are now developing a criteria to distinguish between natural left handedness and acquired left handedness due to cerebral insult. The interference with the lateralisation of dominance and its impact  on evolution of language and communication dysfunction that arises out of it is now in an advanced stage of a study in our department. We are shocked how there is consistently low pulse oximetry readings at night in children, who have obstructed nostrils with or without snoring, which have gone unnoticed for a while in many pre-school children. 

Most families do not follow a sound sleep hygiene practices leading to fragmented sleep caused by sleep latency disorder, sleep interruptions and disturbed sleep-wake rhythm. From the time I was involved in setting up a sleep monitoring room with EEG tracing in 2004 for children in the Hall of Residence, at the Developmental Paediatrics Unit at CMC Vellore,  I have pursued the role of sleep dysfunction in behaviour and communication dysfunction since then.  The three studies published from this department on sleep and the benefit of using Melatonin to overcome the sleep related disorders, carry the message of the value of monitoring the sleep behaviour of children at home. We rely on the videos parents take to help us understand the sleep ignition process, sleep duration and sleep related disorders

Let me quote one of the articles to indicate the thought process that evolved in responding to the sleep related challenges in pre-school children. 

International Journal of Contemporary Pediatrics

Thampy M et al. Int J Contemp Pediatr. 2023 Apr;10(4):546-553

http://www.ijpediatrics.com

pISSN 2349-3283 | eISSN 2349-3291

DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20230735

Original Research Article

Megha Thampy1, M. C. Mathew2, Anna Mathew3*, Liya Grace Kurian4, John Michael Raj5

The role of melatonin in regulating sleep wake disorders in children attending the developmental pediatrics outpatient service of a tertiary care hospital in South India

2Department of Developmental Pediatrics and Child Neurology, 3Department of Pharmacology, 4Department of Developmental Pediatrics, 5Department of Biostatistics, 1MOSC Medical College, Kolenchery, Kerala, India

Received: 20 February 2023 Revised: 15 March 2023 Accepted: 16 March 2023

*Correspondence:

Dr. Anna Mathew,
E-mail: mosc.research@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: We have observed that 75% of children with neurodevelopmental challenges visiting the Developmental Pediatrics department of this institution have sleep wake disorders. Disturbed sleep has a negative effect on learning and behavior. In this study we assessed the effectiveness of melatonin in improving sleep wake disorders in children with developmental compromise from this south Indian state.

Methods: Children with developmental challenges having sleep wake disorders confirmed by the pediatric insomnia severity index PISI, who were prescribed a daily dose of 3mg of melatonin participated in this prospective, observational, longitudinal study if the parents gave written informed consent. Parents were educated in the practice of sleep hygiene. The sleep disturbance scale for children (SDSC) was used to assess the overall pattern of sleep and six common disorders before and three weeks after starting melatonin.

Results: Based on the PISI scores, 13, 58 and 20 children had mild, moderate and severe insomnia respectively. Melatonin improved sleep latency, increased duration of sleep, decreased night awakenings, crying spells, dreams and daytime drowsiness. There was a significant improvement in the sleep pattern as indicated by better scores in the total SDSC score as well the scores for the six sleep disorders (p<0.001).

Conclusions: Melatonin has a significant role to play in regulating duration and quality of sleep and improving sleep pattern in developmentally challenged children with sleep-wake disorders.

Keywords: Melatonin, Sleep disorders, Neuro-developmental challenge, Sleep-wake rhythm disorders 

5. A fall out of the COVID time restrictions

It is the COVID season which brought this to its current serious situation. All were advised to keep 'social distancing'. But what was needed was to practice ‘physical distancing’ and engage in creative ways of sustaining social communication. The on-line schooling legitimised the prolonged use of the visual screen at home.  The inadequate social vigilance by the professionals, added to the woes of parents struggling to find a way forward to engage their pre-school children, when social restrictions prevailed for over two years.    

The post-COVID season calls for urgent corrective measures and emergency action plan to help toddlers and preschool children, who are currently struggling to catch up in their language, communication and social skills! The therapy centres, offer occupational therapy, speech therapy and behaviour therapy to pre-school children. But more action is needed to offer parenting education to restore communicative and interactive practices at home.

6. Towards restoring healthy parenting practices 

Let me share six exercises of the last two years in the Child Development Centre where I work, which arose out the need to engage parents and professionals to promote a communicative and interactive environment at home and at the pre-schools. 

The first exercise was to invite parents of pre-school children to have a weekly online interaction on co-parenting and define the content of the nurturing behaviour to promote play based engagement with children at home. This involved each parent taking turns to be with their child during a meal time, bath time, play time, bed time, outing time, etc. It was one way of restoring the routines and rituals associated with infant and toddler care, which got dislocated during the COVID season. Some parents who brought feedback gave indications of how they were able to find an alternative way to media over exposure, by introducing new experiences through play. 

The publication below, released in 2021 by ASHIRVAD at the time of the tenth Anniversary of the Developmental Paediatrics Unit at MOOSC Medical College,  is a guide to parents to observe and record the developmental sequences of children in ten domains, and for parents to be keen observers of the developmental path, their children take. This was a step towards making parents primary developmental champions of their pre-school children. There are video links provided in this booklet, which help parents to follow the steps involved in taking, weight, height, mid arm circumference, and observe skills of hearing, and vision. 

The second exercise was to popularise the idea of creating a Child’s Corner and play at home. A child’s corner is a place at home to locate the collection of toys, books, art and craft materials and other visual aids which would engage pre-school children. The Child Development Centre uploaded  videos in the u-tube to propose a design for a child’s corner at home and illustrated how this can make children gravitate towards play and interaction. The traction towards the visual screen could be partially altered when children have an area at home, which reminded them of what they can do with their toys. We have had parents bringing back encouraging reports of how the child’s corner gave an interactive space for parents and children to explore new activities. The link to the videos:

         https://youtub.be/kqdTnSWBvco  and https://youtu.be/1eONrsUbwkA .

The third exercise that we got involved was to create videos of nursery rhymes and action songs, sung by the professionals in the Child Development Centre and upload them in the u-tube. They were sung and acted in a way, that parents watching them would get introduced to the way rhymes and action songs can be used to engage pre-school children to initiate them to sing along and follow the actions. Most young parents we were in touch, got used to screening the rhymes to the pre-school children, while they sang along and joined in  the actions.  The videos we created helped some parents to return to live singing without the video, which captured the attention of children and promoted better interaction. The link to the videos:

 https://www.youtube.com/watch?v=1fMNug5ncyM

            https://youtu.be/1Y2j_e6kZ88                            https://youtu.be/0xG1jJpBi5E

The fourth exercise was to invite all parents who came to the Child Development Centre  to visit the Family Life Centre, which is a room of exhibits of toys, books, papercraft for children  and posters displaying the different stages of child development from infancy to adolescence. This exposure to the canvas of child development was introduced to the parents for them to pause and reflect on what changes they can bring in their parenting style of pre-school children.

Parents were drawn by what they saw and heard from the professional accompanying them to arouse interest in revising the parenting practices. The child development process is often nebulous in the minds of parents. The visual images help parents to develop a perspective to promote child development practices  by proactive steps in parenting.  

The fifth exercise was to create a manual for parents, Accompany your child, a plan for monitoring the developmentally challenged child (1-5 years), which in its 70 pages of parent friendly presentation, give charts describing the developmental domains.  

Parents can observe and record the developmental process of their pre-school child every two months. This manual is being used by some parents for self-monitoring the development of their pre-school child. They carry this with them when they come to visit us and show their recording of the developmental process of their pre-school child in different domains. 

The sixth experience was getting some professionals to meet online weekly for two years, to discuss the issues of child development and clinical pathways to support developmentally challenged children. The physical Medicine and Rehabilitation department of the Bangalore Baptist Hospital under the leadership of Dr Vinita Varghese created the Zoom platform for this during the COVID season. This provided a forum for peer reviewing some of the activities we were promoting to augment the parent-involved and home-based child development plan. 

7. The way Forward 

All Child Development Centres have two cardinal functions. One is to be a resource centre engaged in paving the way for the developmental journey of a child through an individualised action plan. The second is to enable parents to pursue sound parenting practices to make homes formative and educative for child development.  

What pre-school children have lost in the recent years is the normal communicative environment at home. They were denied regular school experience during two academic years due to the COVID restrictions. Now is the time to restore to pre-school children, their regular communicative environment both at home and in the pre-schools. 

Parents and professionals are to be partners in this journey!

M.C.Mathew (text and photo)

A note: All the percentages of different co-morbidities referred to in this article is based on the unpublished data from the department of the Developmental Paediatrics, MOSC Medical College, Kolanchery, Kerala, India. They are preliminary findings of the studies currently going on.  

Acknowledgments: The professionals at the MOSC Child Development Centre, Miriam, Liya, Shalini, Femy and Femine for creating the videos. Shalini composed Accompany your child; Dr Anna Mathew edited it and ASHIRVAD published it. Dr Vinita Varghese of the Baptist Hospital co-ordinated the weekly online professional forum. 

A pathfinding journey!

This news bulletin published on 14th September 2021, when we stepped into the tenth year of the child development services for children, I felt that the call to 'Build to Belong', the logo of the department, came upon us even more clearly. 

You can get an online PDF version of this bulletin by writing to childdevelopment@moscmm.org  

In about six weeks children in some classes would return to school after a gap of 18 months of the Corona pandemic season. 

Lok out for reflections on the following topics in the coming days!

1. Children's transition

2. Teacher's dilemma

3. Parent's concerns

4. School administrator's situation

5. Health provider's thoughts

In this unprecedented situation, there are more questions than answers. I hope we can explore them based on the information available to us. 

All movements to plan for children returning to school would be conditional to how the pandemic fades away or surfaces in waves!

M.C.Mathew(text and photo)

.

 

A Meal time!

One of the difficult times for parents is to get a two year old child to get to sit in one place and feed himself or herself. Most parents resort to make them watch TV or mobile phone while been forced to eat. They eat with no awareness of the texture, flavour, odour and consistency of food. They eat unaware of the movements of lips, tongue, throat and all the movements associated with swallowing. Eating becomes a passive activity just as watching the TV.

A better way to get a toddler to start into a good way of eating food is by helping a child to be at the family table form about a year when a child is able to sit unsupported. It is the sight, colour, flavour and the seeing others eat which forms the first impression for. toddler to want to taste all that are served on the table. All children seek for food when they are hungry. Reserve offering food while at table along with others. Even when a snack has to be offered it is best done with a child sitting on a high chair at the dining table. The high chair, table, meal time rituals and patience to introduce food to a child would make a child want to be at the table to share a meal. There might be exceptions with soem children on account of tier special situations developmentally.

The habit of having the family meal with TV or audio on ought to be replaced with conversations which children can enjoy. Often what children are happy to hear are about things that happen in and around the house. I am of the opinion that conversation pertaining to the adult's world ought to take place elsewhere and not at the family table. Some parents woeful even read s tory at the end of a meal to close the family meal with good thoughts fo ra child to stay with. 

The food fads which children develop are directly relational to the proclamations that adult make about the food he or she likes or avoids. The conversation about the taste of rtes food or anything physical about the food is a bad introduction or example to children. It is not just the taste which determines the quality of food; so why talk about taste and complain about what is less or more in the cooked food, which is an ungraceful way of making the one who cooked food feel disappointed or hurt. 

Children observe and pick up habits adults practice. A table is apace to honour each other and not to criticise anyone or make others as the agenda of conversation. 

A child told me that he does not like ice cream because his father did not eat ice cream. Le tis remember that meal times are habit forming; meal time conversations influence the thought process of children; and meal time can be an endearing time between members of the family. 

Food times are relational times and are most formative for children in the early years of their lives. 

Let su make it that way.

The Sunbird in the photos above find nectar! Children too would come to the table to find their food, if the memory of the meal times is refreshing and enjoyable!

M.C.Mathew(text and photo)