Saturday, May 31, 2014

It's a mad, mad, mad, mad world--especially for children

One of the biggest threats to the health of young children and the success of our society largely goes undetected—mental illness.  Mental illness has a cumulative effect on our populations with many parents going untreated for their mental illness and either passing it along to their children genetically and/or environmentally.  As more violent crimes and school shooting are being carried out by children/teens suffering from mental illness, we are just now beginning to pay closer attention.  The statistics are staggering and provide a universal calling for a change in the way we look at and treat mental illness across the globe. “Overall, 350 million people worldwide suffer from depression. More than half aren't getting the help they need, and that the problem is growing worse…The World Health Organization (WHO) estimates that the five developed countries with the highest rates of any kind of diagnosed mental health problems (including substance abuse) are Colombia, France, the Ukraine, New Zealand and the United States, according to a 2009 report” (Niller, 2012).  Wow.  If 350 million people are suffering from depression or mental illness, how many children are at risk of developing mental illnesses or disorders of their own?

My ex-boyfriend suffered from addictions, mental illness and Narcissistic Personality Disorder.  Mental illness had wreaked havoc on his family since he was a small child, and in adulthood, he was required by family and society to take a look at his own.  In an effort to help him win his battle, we often had many discussions about his childhood.  His mother was wrongly diagnosed schizophrenic when she was actually suffering from M.S.  She was institutionalized when my ex was a toddler severely disrupting their bonding and secure attachment.  His father struggled to deal with the circumstances of being a single parent with two young boys, and often resorted to alcoholism and anger to mask his grief and sadness over the loss of his living wife.  As a result, my ex and his brother were often left to fend for themselves begging for food and other needs from close relatives and neighbors.  His brother seemed to model himself more after his father resorting to violence and abuse to deal with his emotions; he went into the military.  My ex took another approach and dissociated from himself, which can be considered one of the beginning stages of Narcissistic Personality Disorder (NPD).  According to WebMD:
“The exact cause of narcissistic personality disorder is not known. However, many mental health professionals believe it results from a combination of factors that may include biological vulnerabilities, social interactions with early caregivers, and psychological factors that involve temperament and the ability to manage stresses. Some researchers believe that narcissistic personality disorder may be more likely to develop when children experience parenting styles that are excessively pampering, or when parents have a need for their children to be talented or special in order to maintain their own self-esteem. On the other end of the spectrum, narcissistic personality disorder might develop as the result of neglect or abuse and trauma inflicted by parents or other authority figures during childhood. The disorder usually is evident by adolescence or early adulthood when personality traits have become consolidated.”

My ex used to say that the only time he felt special was when the extended family gathered together and they would ask him to sing and dance for them.  The result was that he became a highly successful musician with over 15 top 10 hits.  However, he also had created a life that mirrored his own childhood.  He suffered greatly from depression and addictions attending over a dozen different rehab facilities and 5 psychiatric hospitals.  He abandoned his own children and unconsciously contributed to the same cycle of destruction for another generation.  He could not sustain close relationships and lacked self-esteem, empathy or a moral compass. Even with all his success, he suffered greatly on a daily basis.  Children don't have the capacity to understand the motivations of adult behavior and the result of the inevitable neglect or abuse resulting from a parent's mental illness often leaves the child with internalized (often hard-wired) feelings of shame, guilt, and loss of self-esteem that will effect the rest of their lives.  I often wonder that if proper acknowledgment, understanding, and treatment were more accessible, how many lives would be saved from internal ruin.

As a result, I’ve been very interested in what I could do as an early childcare professional to help children avoid these outcomes in the future.  From our studies we know that the mental health of a parent can be a stressor that causes problems for their children biosocially, cognitively, and psychosocially.  Even those parents who are diagnosed with lesser forms of depression leave that imprint on their children who often carry those characteristics into adulthood without ever knowing why.  To be able to intervene in a family’s welfare in a meaningful way means that childcare professionals must use their observation skills, listen intently, and establish trust with the parents in order to encourage them to seek professional mental help in order to avoid undesirable and unintended outcomes for their children.  We must find ways to lift the taboos around this subject and talk about it openly as it doesn’t just effect one child or one family, but it’s effect both long and short-term leave a devastating mark on the overall health of our society as a whole.

References:

Eric Niller, 2012



Saturday, May 17, 2014

Mama Makes the Best Milkshakes: Breastfeeding

Although I'm not a mother, breastfeeding has been on my mind lately due to a close friend who's struggling to get the hang of it.  I've been trying to keep her spirits up by joking and laughing with her about my friend's mother's (from the last entry) advice on the subject.  She says, "Breastfeeding is best when you can get another woman to do it!"  Her children often tease her about passing them off to the other women in a hippie commune in the 70's.  Many women enjoy breastfeeding, however many also struggle with the process.  "Doctors worldwide recommend exclusive breastfeeding...Breast milk should remain in the diet for a year or more, according to the World Wide Health Organization" (Berger, (2012), 153).  But what about the mother's who struggle?  What are their options?

We know that breast milk is a magical concoction of balanced nutrition, including fats, nutrients, and micronutrients promoting optimal brain/body development, as well as antibodies to help fight infection and disease; but, did you know it can also help deter school drop-outs and teen pregnancy (Berger, (2012), p. 152)?  Why would anyone not breastfeed when it creates so many benefits for the infant, the mother, and the family.  There are several reasons, in fact.  One particular reason is for pre-term deliveries; often at this stage of pregnancy, the mother's milk has not come in yet limiting her ability to nurse her infant.  Luckily, solutions to this issue are taking cues from past when wet-nurses were commonly employed, or other eager lactating women in the community kindly shared their own breast milk. Today, doctors are even known to prescribe beast milk from local milk banks--a place where woman can safely donate and receive breast milk.  If you are interested in learning more about this type of service, please visit www.milkbank.org  , Mothers' Milk Bank located in Austin, Texas.  I was very happy to see the services and opportunities they provide, and in the future, I will certainly recommend that new mothers talk with their physician and look into this wonderful option before they give up on breastfeeding altogether.

Another issue preventing breastfeeding, in my mind, would be that of an HIV-positive mother. However, it seems that breast milk is so powerful that "In some African nations, HIV-positive women are encouraged to breastfeed because their infants' risk of catching HIV from their mothers is lower than the risk of dying from infections, diarrhea, or malnutrition as a result of bottle feeding" (Cohen, 2007; Kuhn et al., 2009) (Berger, (2012), p. 152).  In fact, according to Unicef, "In West and Central Africa, exclusive breastfeeding could save hundreds of thousands of the three million children under five who die annually"("Promoting and Protecting Breastfeeding", Unicef).  The article goes on to say that while breastfeeding is a cultural tradition in the region, the problem is that only about "20 percent of infants under six months are exclusively breastfeed...rates remain among the lowest in the world" ("Promoting and Protecting Breastfeeding", Unicef).  The solution seems to only be accessible through long-term, wide-spread promotion of health care practices and support groups within these communities; once again, education is "the key to this life-saving practice"("Promoting and Protecting Breastfeeding", Unicef).

References:
Berger, K. S. (2012). The developing person through childhood (6th ed.). New York, NY: Worth Publishers.

Mothers' Milk Bank, http://www.milkbank.org/milk-banking/milk-for-your-baby/

Unicef, "Promoting and Protecting Breastfeeding",
http://www.unicef.org/wcaro/english/4501_5055.html

Saturday, May 10, 2014

To C-section or not to C-section...That is the question in Chile

I have never given nor witnessed a birth although I have had many discussions with women who have.  One of my favorite birthing stories comes from a friend’s mother; she’s an American woman who gave birth to five children while living in Chile in the 1970’s.  Her birthing and child-rearing stories have often been humorously discussed at family gatherings because of their intensity.  While living in a rural area of Chile, she described going into labor pains and waking her husband in the middle of the night.  He was so shocked by the news that he ran out of the house naked to get help from the neighbor.  By the time he returned, she was holding their son in the sheets of the bed; she had managed to give birth alone to a healthy baby boy with the aid of a small hand mirror—that’s right, no drugs, no doctors, no nurses or midwives, just a hand mirror.  During subsequent childbirths, she labored so quickly that her older children were called to assist in the birthing process.  As they tell the stories now as adults, it’s often accompanied with grimacing facial expressions, but I’ve often wondered if participating so closely in the birthing process had, in fact, bonded these siblings in a very special way.  I’ve also wondered if this type of home-birthing practice was common in Chile both then and today. 

As I began to research birthing practices in Chile, what I discovered was quite the opposite.  An article published in The Lancet entitled, “Health sector reform and the rise of caesarian births in Chile”, states “National statistics suggest that Chile has outstripped Brazil in having the highest reported caesarean section rate in the world” (Murray & Pradenas, (1997).  Wow.  How and why did this happen? It seems the biggest contributing factors are the restructuring of the heath care system financing by creating a private health insurance system separate from the national health fund as well as the risks doctors are facing with malpractice suits.  As more privatization of heath insurance occurred, as well as changes to the national health fund, more C-sections are being performed as a result.  Another hint toward this reasoning comes from a “Chilean forum in English for Gringos, Expatriates, and Travelers to Exchange Ideas and Information about Chile, South America” at AllChile.net,where one woman describes the risks and consequences facing doctors in the country. Kel writes that one, “should also know that in Chile, when a doc has a bad outcome, he can be taken to court. The result may not be just an award of money to the Plaintiff but the judge can send the doc to Jail. As a result many private docs require patients to sign away the right to sue for a bad outcome. Who can blame them for not wanting to go to jail? Its also a powerful incentive to practice on the conservative side.”  C-sections are also easier to schedule and complete leaving doctors with more time to include more patients in their practice.  This seems to be a cautionary tale.  As the article points out, “Privatisation and the opening up of choice in maternity care seem to have resulted in more surgical intervention at birth. As many countries plan changes in their health care financing, the experience of Chile should stand as a timely reminder that, whether intended or not, shifts in funding have the potential for enormous impact on health care practices and behaviours”  (Murray & Pradenas, (1997).

As modern women around the world continue to debate the pros and cons between natural and surgically assisted child births, I realize there are many choices to consider each one weighted with family values, culture, and education.  However I also wonder about the women who don’t get a choice.  Was my friend just lucky?


References:
Susan F MurrayFanny Serani Pradenas The LancetVolume 349, Issue 9044, Page 64, 4 January 1997
doi:10.1016/S0140-6736(05)62208-8
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)62208-8/fulltext  

Kel » Sat Feb 28, 2009 12:56 pm
http://www.allchile.net/chileforum/topic1183.html