Calling all parents again

Dear parents,

I am back again after a long break. Did I sleep too long? Sorry for that.

Just to pick up the strings where we left them, I have re-posted my first letter again. New mothers and fathers can go through it too.

Is your baby now 3 months old now? Then this letter is for you!

The  newborn has now grown into a 'smiley face' 3month old infant. 

He is now learning to turn over, hold his head up, look around, search his mother’s face, cry when hungry or uncomfortable, and then smile meaningfully. He looks at dangling colourful toys, tries to reach out and finally grasps it at around 4 months.

Now he can laugh aloud with pleasure! Infants at this age also begin to explore their own bodies and a sense of self emerges. How does that happen? Let's try to explain with an example. The little infant wiggles his hands in-front of his face and also touches a dangling toy. Each time he can see his fingers moving and realizes they are fully under his control, he realizes that they are his own. Those hands will touch the toy whenever he wants it to. On the other-hand, when he cries, most often he sees the known smiling face (mom’s face), but not ALWAYS. So that is not his self. In this way slowly the 'self' versus 'non-self' concept evolves in the little one's brain.

Four-month-old infants seem to be "hatching" socially, as he starts taking more interest in the outer world. During feeding, infants no longer focus exclusively on the mother but become distracted.

In another few months he can sit up and crawl. He notices small objects, tries to pick them with a ‘pincer’ grasp with 2 fingers and put it in his mouth. By now, he is making a lot of sounds and trying to communicate with those around. He loves to play with whatever is around by holding, dropping, poking and mouthing whatever he can lay his hands on.

 His attachment for his parents becomes intense and the preference is also very clear by 4- 5 months. The primary emotions of anger, joy, interest, fear, disgust, and surprise appear in appropriate contexts as distinct facial expressions by 4-6 months.

As he progresses along the development ladder, he is always banking on new stimulation and responses. Each new endeavor is backed by a cause and effect analysis in the little brain. So, an enriched environment ensures growth while stressful experiences can impede proper blooming. As a parent we need to pick up the little one’s cues and respond appropriately and consistently. Every cue from the baby is like a service at the tennis court, the vigilant player/parent timely returns every single serve/cue.#serve and return technique.

Babies develop attachment right from birth to the primary care-giver, most often the mother. Her touch, her smell, her voice and her face evokes a special response in the newborn baby and he responds by looking into her eyes as she feeds him, or by calming down when held and caressed by her. This attachment increases as the baby grows and the love and care is reciprocated by the parents. This reciprocation generates stability in the baby. Parents who are emotionally available, sensitive, perceptive, and effective at meeting the needs of their infant throughout the early months of life are likely to have securely attached infants. Parents who are affectionate and responsive to the child’s physical and emotional needs, who provide adequate stimulation, carry a positive attitude, and give adequate emotional support see their babies grow into stable and sociable individuals. Children’s secure attachment to caregivers also is associated at a later age with more effective coping with stress and better performance at school.

During these early months, just as the baby is developing an attachment, the parents are also getting to understand their baby and his needs. It is a two way bonding, each strengthening the other. By 3 months of age, the child and parents achieve a synchronized reciprocation through vocal and affective exchanges. A happy, smiling interactive parent evokes smiling, cooing, and playfulness in the infant. This is the seed laid down for effective social reciprocation in later life. Good attachment with parents provides a secure base, which allows infants to explore their world with confidence.

This little infant has begun to bloom and is just learning to explore her immediate environment. Her tiny grip on your finger, her winning smile, and her squeals will win your heart. What does this little angel want from you? Your active presence and your milk. So, go ahead with breast feeding on the baby’s demand and play with her, enjoy her company. She now has a definite bonding with you and enjoys every smile, every caress every glance you give her. The more active stimulation she gets in the form of handling, caressing, feeding, smiling, laughing and singing, the more responsive she will be. And it is so much fun to see her do something new almost every other day!

The baby, by now can express his basic emotions, as we have discussed earlier. He also seeks reciprocation of his expressions.  The infant makes face-to-face behavioral expressions, which reveal his ability to share emotional states, the first step in the development of communication. If the parent does not respond, he tries to draw her attention and engage her and cries angrily if he fails to evoke the required attention. If this lack of response perpetuates, infants gradually make lesser efforts to re-engage. Rather than anger, they show sadness and a loss of energy when the parents continue to be unavailable. This is often seen in infants of depressed parents or abandoned infants.

Now a busy mother might repent that she is unable to be with her baby as much as she wants to. No fear dear, babies will accept separation provided it is predictable and Baby realizes that Mom will be back. It is consistent availability that matters, not necessarily constant availability. Little babies are unable to handle unpredictable circumstances and get frustrated. It is the quality time that she demands. So please remember the golden rule to be Consistent, Responsive, Predictable and Comforting (CRPC). Your lively, animated presence will spark the expressions in the little one and help her develop newer skills.

For most parents, this is a very happy and rewarding period of parenting. Don’t you agree?

Enjoy nurturing God’s special gift for you....and if, in the process, you have any questions for me, mail me at udbhaas@gmail.com
I will be back for the baby turning 7 months.
Bye for now,
Dr N Chatterjee
Paediatrician, Udbhaas

#child development  #parenting tips  #serve and return

Calling all Parents

An Open Letter for all Parents

Dear Parents,
It is such a pleasure to see you all so happy with your children. As I close my eyes I see children of all ages, from newborns to teenagers, clinging to their parents, sometimes happy & merry, sometimes sad and crying, some healthy, some sick, some content and pleasant, some irritable and cranky. But one thing is common in all the parents-- their eagerness to help their children. Every parent has numerous questions to ask pertaining to better child care. As a paediatrician I have been responding to these questions for long many years. But now when I look back I feel, much has remained unspoken and unexplained. So in this open letter I will try to address the parental queries that I can recollect.
Newborn -2 months
Let’s start with the young mother with her newborn baby, who is ready to give all for her baby but just doesn’t know what is best. Dear Mom, don’t waste time, start breast feeding as soon as possible and feed her as frequently as she wants, holding her close. The best gift you can give her is your milk and your lap. This will provide not only nutrition and warmth, but also sense of security and gratification.

As the baby grows in your lap, look into her eyes, smile at her and talk with her. Very soon she will start to recognise you and reciprocate with her own cues. This is the beginning of social interaction. Whenever the little baby cries to express any need, respond immediately. This pacifies the baby and gives her a sense of control over her environment. She learns the meaning and impact of her own cry. This is her first exposure to the cause and effect phenomenon.
We must remember that the newborn baby can see, hear and feel too, just like us adults; they are not inert! They can also express their feelings and needs with their cry, their gestures and body movement. It is for us to honour their senses and pay attention to their cues...and the mother is the best at it. Strong or flickering lights, loud noise, harsh touch, hot or cold temperature...all these irritate a baby, whereas he/she is soothed by soft music, soft light and soft, warm touch. This is why the little one is so peaceful and comfortable when mama holds him in her arms, humming a lullaby.
Even a newborn can see and they preferentially focus on human faces. So you will notice that in a few days the baby is looking at your face as you feed him. Look back with a wide, warm smile. Here, we must remember, during the first six weeks of life the baby is much like a demanding, grumpy old man, either feeding, sleeping or showing discontent. He will need frequent feeds and a lot of sleep but doesn’t seem to pay heed to your smiles. Don’t lose heart, your efforts aren’t lost. He feels the comfort of your lap and warmth of your smile and is developing an attachment, though still unable to express happiness.

• Come 6 weeks and he will start showing responses. As you look into his eyes, he will stare back and gradually a smile will appear anytime between now and 2 months. This ‘social smile’ implies that he is beginning to understand human behaviour and can win your attention with his smile. This is the beginning of his communication skills. Your consistent and animated response will boost his confidence and self control. He will learn that his feelings are important and he can affect his environment.

A lot of things you see the baby do during these early days may seem unnatural and problematic. He may want to feed almost every few minutes, he may pass watery stool with yellowish granules upto 8-10 times a day, or, not pass stool at all for a week, there may be peeling of skin all over, big blue patches on his back, a baby girl may have bloody discharge from her vagina, there may be a blister on the upper lip or maybe a tooth or two...these are all normal variants. Do not panic, but consult your doctor to make sure.
Enjoy nurturing God’s special gift for you....and if, in the process, you have any questions for me, mail me at udbhaas@gmail.com
I will be back for the baby turning 3 months.
Bye for now,
Dr N Chatterjee
Paediatrician, Udbhaas

#child development #parenting #serve and return

To The Blessed Parent

Being a parent is a blessing, an honour, a privilege; also an enormous responsibility, an extreme commitment. This is a new role you have to take up as you hold that little bundle of joy in your arms. A role for which you can seek all the advice your family, friends, books and above all, Mr Know-all, the internet can give you to equip yourself, or you can simply depend on your intuition, emotion and gut feelings. Either way, it works out fine if the basics are clear. You have a precious gift, love him, nurture him, support him but do not try to possess him or live his life for him. You are that very fortunate gardener with an unique baby plant, that will grow up with your care. You will witness the blooming of an unique flower with the colour, shape and fragrance she is ordained to have. You just make sure she happily blooms to the fullest, emanating love and joy. As a parent you facilitate the growth of the child at every stage, you set the goal and pave the road to the goal, you hold the torch light so he can see, you cheer, you warn, you support all along. But all the while you remember ‘he is growing, I am not making him grow.’

Parenthood does call for a lot of mental preparation. Firstly, one must be ready to feel a surge of unconditional love, which she may have never felt before. This love surpasses the self, knows no bounds, is spontaneous. Yes, it spurts out like a fountain head, but the big thing is to contain it in the heart, cherish and nurture it as the child grows, never attaching conditions to this purest love. A mother’s love never wanes, no matter what. How a child behaves or how he appears or what he achieves can have no effect on the parent’s love. Being a parent means hardships, deprivations & sacrifice, but that magical love makes it all acceptable with no resentment.

This parental love, though unconditional, generally never goes unrewarded. The little one gives back a million times with his first gaze into your eyes, his tiny grasp, his heavenly smile and all his hugs and kisses, all expressing his love and affection. For any parent, this is the best rejuvenating gift.

Parenthood also means a huge responsibility. You are gifted with a ball of play-doh and you dream to make a flawless doll out of it. Suddenly you discover it’s a magical play-doh that changes shape and colour on its own, that sometimes stings and sometimes slips out of your hands. “Can I do it? Am I on the right track? How do I handle this?” are constant worries plaguing you. So how can we prepare ourselves for this mammoth responsibility? A few simple rules can help a lot. Firstly, try to figure out what you intend to do for your child. Our intention should be to guide and support him to i) attain the best to his ability ii) to imbibe the values we honour iii) to lead a happy, purposeful life with happiness and content. For this we ourselves first need to adopt a consistent, stable life style with definite principles, values and goal. The child’s nature will evolve automatically according to the ambience he is in. You will just need to give the right guidance at the right time and in the right manner.

We have to remember that bringing up a child is not fulfilling your own dream. It is his/her own life to be framed in his/her own way, which depends on his/her genes, nature, environment and your rearing. So don’t feel shattered if the doll you make is not your dream doll. It is your doll anyway, so love it as it is, make sure it does not break. Remember each doll is unique and beautiful in its own way. As one grows up, he is confronted with criticism from every corner. Let there be someone there beside every child, who will just love without judging. That is the greatest gift a parent can give a child.

Before discussing parenting, we, as parents need to be clear about a few things.

•              What is the goal of human life to us?
•         What do we want to see our child achieve?
•         What are our expectations?

Goal of Life

The goal of life varies from person to person widely. Some want to be rich, some want to lead, some want a relaxed easy-flowing life, few strive for higher goals…. But at the end we all want peace of mind, we want to be happy. As a child we all talked about becoming a doctor or lawyer or football player or a businessman or maybe a truck driver or fashion model or astronaut or a scientist. We all tried to pursue our dreams, some made it, some didn’t. But in the process we hardly ever stopped to ponder whether we got peace of mind or joy or happiness or content. One day we realized, we had become something, but those magic words, ‘peace’, ‘joy’,’ content’, ‘happiness’, were still far away, because we forgot to reach for them. So, why don’t we, as parents set the goal such that our children strive towards peace and happiness, through whichever route he goes, no matter what he wants to become? Can our parenting lead him in that direction? It can.

What I want to see my child achieve

Well, we need to be very cautious with these two words: ‘want’ and ‘achieve’.

When we say ‘achieve’, we automatically think of the end point and too much emphasis on the end point can take our focus away from the means, which is far more important. Getting good marks in an exam is important, but learning the subject is more important. If the child is taught to aim at good marks, without a focus on sincere learning and honest attempt, the result may be disastrous. Let not parental demand take the child’s attention off the means of attaining the goal.

Expectations?

As a parent, if you think you ‘want’ something out of your child, please sit back and think again, why? Is it to fulfill some of your dreams, your expectations? Then you have to beware. Your child has a life of his own, for him to live his way, you are there only to help and guide him. He is NOT your second chance live life over again. His nature and your nurturing will bring out the person that he is. Then, won’t a parent have any expectations? Of course he/ she will, but we have to learn to accept it if they don’t match with the child’s dreams and aspirations. The parent can live the life, be a role model, slowly steer the child in the direction she thinks right, then leave it to the child to follow spontaneously.

Dear parents, I request you to think over these few issues we have raised, it may help find your own solution to many a problem you come across in parenting your precious one.

Amidst All (Sabar Majhare)

Today we talk a lot about ‘inclusion’ and ‘mainstreaming’ of children who are ‘differently-abled’. What exactly do we mean by these terms? Neuro-science and society has determined certain levels of ability, both physical and mental, for adequate functioning in our social structure. Any deficit or aberration, according to the laid down norms are considered as a disability, or to put it more softly, different ability. We also mention that every person is born with equal social rights, so every child, whatever his/her level of ability, should be included in the mainstream, with everybody else. So as parents, as teachers, as social reformers, we tend to focus on ‘inclusion’ and ‘main-streaming’.

What I fail to understand is why does it require an extra mention? Every child, whatever his/her level of ability, is a mother’s child, and to that mother all her children, including the ‘different’ one are equally dear. This is natural, instinctive inclusion. The same is expected at a social level too. But no, first we ostracize and reject the unfortunate, then to soothe the ugly sore, we prescribe balms like ‘inclusion’. The problem lies with us, the able, functional community, who fail to realize that the differently abled are as much part of this society as we are, as much the children of Mother Earth as any of us. Unless we broaden our vision and begin to see our heart reach out to touch the million hearts around us, we will not feel the joy of including.

Here comes in the notion of ‘connecting’. We all can start to connect with each other, if we can feel that Oneness prevailing among us all. This fundamental concept of ‘amidst all’ or ‘SabarMajhare’ as we say in Bangla, is today’s theme, which our little ones from Udbhaas will present before you. They will highlight on various differences we project, like traditions, creeds, nations, language, appearances, abilities, but ultimately we are united, we are One. I do hope, their imperfect presentation will convey a message to you all, which will be good food for thought.

Working closely with these children, I have felt, many a times that they realize and express high thoughts in their very simple and straight-forward ways, which we, with all our complications, fail to fathom. Love, sharing, trust, faith come so easily to them. The big reason is they are not judgmental. They see white for white and black for black, oblivious of any grey zone cluttered with ‘ifs and buts’. As we grow up to become intellectual adults, as our grey cells mature, we cultivate this very grey zone which shrouds our concept of Oneness.

Friends, look at these children on stage, some with major problems, some who have overcome their difficulties and some who have no problem at all. They are happily mixing and supporting each other in presenting their performance. The beautiful flowers are all strung together into a marvellous garland, we don’t see the string which binds them, but It is very much there, The Omnipresent is there among them all, “Sabar Majhare”. We need to acknowledge this Supreme Existence, which will enable us to connect with all and realize that nobody, no matter how different he may be, is an outsider. We all belong.

The Struggle to Bloom

A little baby boy was born preterm with a birth weight less than 2 kg in October 2011 in a remote village in Purulia. He did not cry at birth. He was kept in the Newborn care unit at Purulia for almost 2 weeks and then discharged. When we saw him in October 2012 , he was found to be undernourished weighing barely 5 kilos, with gross hypotonia and developmental delay. The child at around 1 year of age, was unable to turn over or sit with support. 

Since then the child has been brought to our development clinic regularly, a herculean task for the parents residing at a remote corner of the district, about 100 km from our centre. With treatment and regular therapy sessions (Physiotherapy, occupational therapy, special education sessions), his nutritional status and muscle tone improved, gradually the child learnt to sit up and stand, to play effectively and communicate. 

 Presently, at 4 years of age, he can walk with little support, use both his hands, though there is a slight stiffness in his right limbs. He has good cognitive development and communication skills.

 

This happy little boy, Sudipto, has a very energetic and receptive mother who has helped him achieve so far.

Recently we gave Sudipto and his mother another exposure which has stimulated them a lot. He was given colours and paper and assisted to create art with his fingers. With a little guidance he did wonders and here is his creation...

 

SUDIPTO'S  ART WORK

Adding colour to life

Litttle did we know how enlightening and rejuvenating colours 

could be to the little developmentally challenged children from 

remote villages in Purulia.

 Their disability coupled with environmental deprivation and poverty had deprived them of most enjoyments of childhood. Life was stagnated in a stale, grey pool of futility.

UDBHAAS came up with a new scheme to test the creative abilities in these challenged children, some  spastic, some with mental retardation, others  autistic. Our special educator sat with them with paper, crayons and paint and with a little motivation and support their artwork flourished! Instantaneously their eyes lit up, they simply loved the effect of colours on the canvass. As colourful pictures evolved, heavenly smiles of contentment appeared on the little faces, speaking tons of their enjoyment and sense of achievement. The ability to create something colourful was such a gratification for the kids and their parents. And for us, retrieving the hidden talents was a revelation! It was the magic moment when we could all shout  out ‘WE CAN DO IT!’

An Open Letter for Parents

Dear Parents,

It is such a pleasure to see you all so happy with your children. As I close my eyes I see children of all ages, from newborns to teenagers, clinging to their parents, sometimes happy & merry, sometimes sad and crying, some healthy, some sick, some content and pleasant, some irritable and cranky. But one thing is common in all the parents-- their eagerness to help their children. Every parent has numerous questions to ask pertaining to better child care. As a paediatrician I have been responding to these questions for long many years. But now when I look back I feel, much has remained unspoken and unexplained. So in this open letter I will try to address the parental queries that I can recollect.

Newborn -2 months

Let’s start with the young mother with her newborn baby, who is ready to give all for her baby but just doesn’t know what is best. Dear Mom, don’t waste time, start breast feeding as soon as possible and feed her as frequently as she wants, holding her close. The best gift you can give her is your milk and your lap. This will provide not only nutrition and warmth, but also sense of security and gratification.

As the baby grows in your lap, look into her eyes, smile at her and talk with her. Very soon she will start to recognise you and reciprocate with her own cues. This is the beginning of social interaction. Whenever the little baby cries to express any need, respond immediately. This pacifies the baby and gives her a sense of control over her environment. She learns the meaning and impact of her own cry. This is her first exposure to the cause and effect phenomenon.

We must remember that the newborn baby can see, hear and feel too, just like us adults; they are not inert! They can also express their feelings and needs with their cry, their gestures and body movement. It is for us to honour their senses and pay attention to their cues...and the mother is the best at it. Strong or flickering lights, loud noise, harsh touch, hot or cold temperature...all these irritate a baby, whereas he/she is soothed by soft music, soft light and soft, warm touch. This is why the little one is so peaceful and comfortable when mama holds him in her arms, humming a lullaby.

Even a newborn can see and they preferentially focus on human faces. So you will notice that in a few days the baby is looking at your face as you feed him. Look back with a wide, warm smile. Here, we must remember, during the first six weeks of life the baby is much like a demanding, grumpy old man, either feeding, sleeping or showing discontent. He will need frequent feeds and a lot of sleep but doesn’t seem to pay heed to your smiles. Don’t lose heart, your efforts aren’t lost. He feels the comfort of your lap and warmth of your smile and is developing an attachment, though still unable to express happiness.

·         Come 6 weeks and he will start showing responses. As you look into his eyes, he will stare back and gradually a smile will appear anytime between now and 2 months. This ‘social smile’ implies that he is beginning to understand human behaviour and can win your attention with his smile. This is the beginning of his communication skills. Your consistent and animated response will boost his confidence and self control. He will learn that his feelings are important and he can affect his environment.

A lot of things you see the baby do during these early days may seem unnatural and problematic. He may want to feed almost every few minutes, he may pass watery stool with yellowish granules upto 8-10 times a day, or, not pass stool at all for a week, there may be peeling of skin all over, big blue patches on his back, a baby girl may have bloody discharge from her vagina, there may be a blister on the upper lip or maybe a tooth or two...these are all normal variants. Do not panic, but consult your doctor to make sure.

Enjoy nurturing God’s special gift for you....and if, in the process, you have any questions for me, mail me at udbhaas@gmail.com

I will be back for the baby turning 3 months.