CHILDREN'S DEVELOPMENT STAGES/HEALTH

What are some of the developmental milestones my child should reach by one month of age?

In the very beginning, it may seem that your baby does nothing but eat, sleep, cry, and fill his diapers. By the end of the first month, he’ll be much more alert and responsive. Gradually he’ll begin moving his body more smoothly and with much greater coordination—especially in getting his hand to his mouth. You’ll realize that he listens when you speak, watches you as you hold him, and occasionally moves his own body to respond to you or attract your attention.

Here are some other milestones to look for.

Movement Milestones

• Makes jerky, quivering arm thrusts
• Brings hands within range of eyes and mouth
• Moves head from side to side while lying on stomach
• Head flops backward if unsupported
• Keeps hands in tight fists
• Strong reflex movements

Visual and Hearing Milestones

• Focuses 8 to 12 inches (20.3 to 30.4 cm) away
• Eyes wander and occasionally cross
• Prefers black-and-white or high-contrast patterns
• Prefers the human face to all other patterns
• Hearing is fully mature
• Recognizes some sounds
• May turn toward familiar sounds and voices

Smell and Touch Milestones

• Prefers sweet smells
• Avoids bitter or acidic smells
• Recognizes the scent of his own mother’s breastmilk
• Prefers soft to coarse sensations
• Dislikes rough or abrupt handling

Developmental Health Watch

If, during the second, third, or fourth weeks of your baby’s life, she shows any of the following signs of developmental delay, notify your pediatrician.

• Sucks poorly and feeds slowly
• Doesn’t blink when shown a bright light
• Doesn’t focus and follow a nearby object moving side to side
• Rarely moves arms and legs; seems stiff
• Seems excessively loose in the limbs, or floppy
• Lower jaw trembles constantly, even when not crying or excited
• Doesn’t respond to loud sounds
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What are some of the developmental milestones my child should reach by three months of age?

By the time your baby is three months of age, she will have made a dramatic transformation from a totally dependent newborn to an active and responsive infant. She’ll lose many of her newborn reflexes while acquiring more voluntary control of her body. You’ll find her spending hours inspecting her hands and watching their movements.

Here are some other milestones to look for.

Movement Milestones

• Raises head and chest when lying on stomach
• Supports upper body with arms when lying on stomach
• Stretches legs out and kicks when lying on stomach or back
• Opens and shuts hands
• Pushes down on legs when feet are placed on a firm surface
• Brings hand to mouth
• Takes swipes at dangling objects with hands
• Grasps and shakes hand toys

Visual and Hearing Milestones

• Watches faces intently
• Follows moving objects
• Recognizes familiar objects and people at a distance
• Starts using hands and eyes in coordination
• Smiles at the sound of your voice
• Begins to babble
• Begins to imitate some sounds
• Turns head toward direction of sound

Social and Emotional Milestones

• Begins to develop a social smile
• Enjoys playing with other people and may cry when playing stops
• Becomes more communicative and expressive with face and body
• Imitates some movements and facial expressions

Developmental Health Watch

Although each baby develops in her own individual way and at her own rate, failure to reach certain milestones may signal medical or developmental problems requiring special attention. If you notice any of the following warning signs in your infant at this age, discuss them with your pediatrician.

• Doesn’t seem to respond to loud sounds
• Doesn’t notice her hands by two months
• Doesn’t smile at the sound of your voice by two months
• Doesn’t follow moving objects with her eyes by two to three months
• Doesn’t grasp and hold objects by three months
• Doesn’t smile at people by three months
• Cannot support her head well at three months
• Doesn’t reach for and grasp toys by three to four months
• Doesn’t babble by three to four months
• Doesn’t bring objects to her mouth by four months
• Begins babbling, but doesn’t try to imitate any of your sounds by four months
• Doesn’t push down with her legs when her feet are placed on a firm surface by four months
• Has trouble moving one or both eyes in all directions
• Crosses her eyes most of the time (Occasional crossing of the eyes is normal in these first months.)
• Doesn’t pay attention to new faces, or seems very frightened by new faces or surroundings
• Still has the tonic neck reflex at four to five months

What are some of the developmental milestones my child should reach by seven months of age?

From age four to seven months, the most important changes take place within your child. This is the period when he’ll learn to coordinate his emerging perceptive abilities (the use of senses like vision, touch, and hearing) and his increasing motor abilities to develop skills like grasping, rolling over, sitting up, and possibly even crawling.

Here are some other milestones to look for.

Movement Milestones

• Rolls both ways (front to back, back to front)
• Sits with, and then without, support of her hands
• Supports her whole weight on her legs
• Reaches with one hand
• Transfers object from hand to hand
• Uses raking grasp (not pincer)

Visual Milestones

• Develops full color vision
• Distance vision matures
• Ability to track moving objects improves

Language Milestones

• Responds to own name
• Begins to respond to “no”
• Distinguishes emotions by tone of voice
• Responds to sound by making sounds
• Uses voice to express joy and displeasure
• Babbles chains of consonants

Cognitive Milestones

• Finds partially hidden object
• Explores with hands and mouth
• Struggles to get objects that are out of reach

Social and Emotional Milestones

• Enjoys social play
• Interested in mirror images
• Responds to other people’s expressions of emotion and appears joyful often

Developmental Health Watch

Because each baby develops in his own particular manner, it’s impossible to tell exactly when or how your child will perfect a given skill. The developmental milestones listed in this book will give you a general idea of the changes you can expect, but don’t be alarmed if your own baby’s development takes a slightly different course. Alert your pediatrician, however, if your baby displays any of the following signs of possible developmental delay for this age range.

• Seems very stiff, with tight muscles
• Seems very floppy, like a rag doll
• Head still flops back when body is pulled up to a sitting position
• Reaches with one hand only
• Refuses to cuddle
• Shows no affection for the person who cares for him
• Doesn’t seem to enjoy being around people
• One or both eyes consistently turn in or out
• Persistent tearing, eye drainage, or sensitivity to light
• Does not respond to sounds around him
• Has difficulty getting objects to his mouth
• Does not turn his head to locate sounds by four months
• Doesn’t roll over in either direction (front to back or back to front) by five months
• Seems inconsolable at night after five months
• Doesn’t smile spontaneously by five months
• Cannot sit with help by six months
• Does not laugh or make squealing sounds by six months
• Does not actively reach for objects by six to seven months
• Doesn’t follow objects with both eyes at near (1 foot) [30 cm] and far (6 feet) [180 cm] ranges by seven months
• Does not bear some weight on legs by seven months
• Does not try to attract attention through actions by seven months
• Does not babble by eight months
• Shows no interest in games of peekaboo by eight months

What are some of the developmental milestones my child should reach by twelve months of age?

From eight to twelve months of age, your baby will become increasingly mobile, a development that will thrill and challenge both of you. Being able to move from place to place will give your child a delicious sense of power and control—her first real taste of physical independence.

Here are some other milestones to look for.

Movement Milestones

• Gets to sitting position without assistance
• Crawls forward on belly by pulling with arms and pushing with legs
• Assumes hands-and-knees position
• Creeps on hands and knees supporting trunk on hands and knees
• Gets from sitting to crawling or prone (lying on stomach) position
• Pulls self up to stand
• Walks holding on to furniture
• Stands momentarily without support
• May walk two or three steps without support

Milestones In Hand and Finger Skills

• Uses pincer grasp
• Bangs two cubes together
• Puts objects into container
• Takes objects out of container
• Lets objects go voluntarily
• Pokes with index finger
• Tries to imitate scribbling

Language Milestones

• Pays increasing attention to speech
• Responds to simple verbal requests
• Responds to “no”
• Uses simple gestures, such as shaking head for “no”
• Babbles with inflection
• Says “dada” and “mama”
• Uses exclamations, such as “oh-oh!”
• Tries to imitate words

Cognitive Milestones

• Explores objects in many different ways (shaking, banging, throwing, dropping)
• Finds hidden objects easily
• Looks at correct picture when the image is named
• Imitates gestures
• Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)

Social and Emotional Milestones

• Shy or anxious with strangers
• Cries when mother or father leaves
• Enjoys imitating people in play
• Shows specific preferences for certain people and toys
• Tests parental responses to his actions during feedings (What do you do when he refuses a food?)
• Tests parental responses to his behavior (What do you do if he cries after you leave the room?)
• May be fearful in some situations
• Prefers mother and/or regular caregiver over all others
• Repeats sounds or gestures for attention
• Finger-feeds himself
• Extends arm or leg to help when being dressed

Developmental Health Watch

Each baby develops in his own manner, so it’s impossible to tell exactly when your child will perfect a given skill. Although the developmental milestones listed in this book will give you a general idea of the changes you can expect as your child gets older, don’t be alarmed if his development takes a slightly different course. Alert your pediatrician if your baby displays any of the following signs of possible developmental delay in the eight-to twelve-month age range.

• Does not crawl
• Drags one side of body while crawling (for over one month)
• Cannot stand when supported
• Does not search for objects that are hidden while he watches
• Says no single words (“mama” or “dada”)
• Does not learn to use gestures, such as waving or shaking head
• Does not point to objects or pictures

What are some of the developmental milestones my child should reach by two years of age?

Your baby enters her second year and becomes a toddler, crawling vigorously, starting to walk, even talking a little. Exploring the boundaries established by your rules and her own physical and developmental limits will occupy much of her time for the next few years.

Here are some other milestones to look for.

Movement milestones

• Walks alone
• Pulls toys behind her while walking
• Carries large toy or several toys while walking
• Begins to run
• Stands on tiptoe
• Kicks a ball
• Climbs onto and down from furniture unassisted
• Walks up and down stairs holding on to support

Milestones in hand and finger skills

• Scribbles spontaneously
• Turns over container to pour out contents
• Builds tower of four blocks or more
• Might use one hand more frequently than the other

Language milestones

• Points to object or picture when it’s named for him
• Recognizes names of familiar people, objects, and body parts
• Says several single words (by fifteen to eighteen months)
• Uses simple phrases (by eighteen to twenty-four months)
• Uses two- to four-word sentences
• Follows simple instructions
• Repeats words overheard in conversation

Cognitive milestones

• Finds objects even when hidden under two or three covers
• Begins to sort by shapes and colors
• Begins make-believe play

Social and emotional milestones

• Imitates behavior of others, especially adults and older children
• Increasingly aware of herself as separate from others
• Increasingly enthusiastic about company of other children
• Demonstrates increasing independence
• Begins to show defiant behavior
• Increasing episodes of separation anxiety toward midyear, then they fade

Developmental health watch

Because each child develops at his own particular pace, it’s impossible to tell exactly when yours will perfect a given skill. The developmental milestones will give you a general idea of the changes you can expect as your child gets older, but don’t be alarmed if he takes a slightly different course. Alert your pediatrician, however, if he displays any of the following signs of possible developmental delay for this age range.

• Cannot walk by eighteen months
• Fails to develop a mature heel-toe walking pattern after several months of walking, or walks exclusively on his toes
• Does not speak at least fifteen words by eighteen months
• Does not use two-word sentences by age two
• Does not seem to know the function of common household objects (brush, telephone, bell, fork, spoon) by fifteen months
• Does not imitate actions or words by the end of this period
• Does not follow simple instructions by age two
• Cannot push a wheeled toy by age two

  What are some of the developmental milestones my child should reach by three to four years of age?

  With your child’s third birthday, the “terrible twos” are officially over and the “magic years” of three and four begin—a time when your child’s world will be dominated by fantasy and vivid imagination. During the next two years, he’ll mature in many areas.

  Here are some milestones to look for.

  Movement milestones

  • Hops and stands on one foot up to five seconds
  • Goes upstairs and downstairs without support
  • Kicks ball forward
  • Throws ball overhand
  • Catches bounced ball most of the time
  • Moves forward and backward with agility

  Milestones in hand and finger skills

  • Copies square shapes
  • Draws a person with two to four body parts
  • Uses scissors
  • Draws circles and squares
  • Begins to copy some capital letters

  Language milestones

  • Understands the concepts of “same” and “different”
  • Has mastered some basic rules of grammar
  • Speaks in sentences of five to six words
  • Speaks clearly enough for strangers to understand
  • Tells stories

  Cognitive milestones

  • Correctly names some colors
  • Understands the concept of counting and may know a few numbers
  • Approaches problems from a single point of view
  • Begins to have a clearer sense of time
  • Follows three-part commands
  • Recalls parts of a story
  • Understands the concept of same/different
  • Engages in fantasy play

  Social and emotional milestones

  • Interested in new experiences
  • Cooperates with other children
  • Plays “Mom” or “Dad”
  • Increasingly inventive in fantasy play
  • Dresses and undresses
  • Negotiates solutions to conflicts
  • More independent
  • Imagines that many unfamiliar images may be “monsters”
  • Views self as a whole person involving body, mind, and feelings
  • Often cannot distinguish between fantasy and reality

  Developmental health watch

  Because each child develops in his own particular manner, it’s impossible to tell exactly when or how he’ll perfect a given skill. The developmental milestones listed here will give you a general idea of the changes you can expect as your child gets older, but don’t be alarmed if his development takes a slightly different course. Alert your pediatrician, however, if your child displays any of the following signs of possible developmental delay for this age range.

  • Cannot throw a ball overhand
  • Cannot jump in place
  • Cannot ride a tricycle
  • Cannot grasp a crayon between thumb and fingers
  • Has difficulty scribbling
  • Cannot stack four blocks
  • Still clings or cries whenever his parents leave him
  • Shows no interest in interactive games
  • Ignores other children
  • Doesn’t respond to people outside the family
  • Doesn’t engage in fantasy play
  • Resists dressing, sleeping, using the toilet
  • Lashes out without any self-control when angry or upset
  • Cannot copy a circle
  • Doesn’t use sentences of more than three words
  • Doesn’t use “me” and “you” appropriately

  What are some of the developmental milestones my child should reach by four to five years of age?

  Before you know it, the somewhat calm child of three becomes a dynamo of energy, drive, bossiness, belligerence, and generally out-of-bounds behavior. You may be reminded of the earlier trials and tribulations you went through when he was two. Also obvious during this time is the tremendous spurt of imaginative ideas that spring from children’s minds and mouths. All of this behavior and thinking will help your youngster build a secure foundation as he emerges into the world of kindergarten.
  Here are some other milestones to look for.

  Movement milestones

• Stands on one foot for ten seconds or longer
• Hops, somersaults
• Swings, climbs
• May be able to skip

Milestones in hand and finger skills

• Copies triangle and other geometric patterns
• Draws person with body
• Prints some letters
• Dresses and undresses without assistance
• Uses fork, spoon, and (sometimes) a table knife
• Usually cares for own toilet needs

Language milestones

• Recalls part of a story
• Speaks sentences of more than five words
• Uses future tense
• Tells longer stories
• Says name and address

Cognitive milestones

• Can count ten or more objects
• Correctly names at least four colors
• Better understands the concept of time
• Knows about things used every day in the home (money, food, appliances)

Social and emotional milestones

• Wants to please friends
• Wants to be like her friends
• More likely to agree to rules
• Likes to sing, dance, and act
• Shows more independence and may even visit a next-door neighbor by herself
• Aware of sexuality
• Able to distinguish fantasy from reality
• Sometimes demanding, sometimes eagerly cooperative

Developmental health watch

Because each child develops in her own particular manner, it’s impossible to predict exactly when or how your own preschooler will perfect a given skill. The developmental milestones listed here will give you a general idea of the changes you can expect as your child gets older, but don’t be alarmed if her development takes a slightly different course. Alert your pediatrician, however, if your child displays any of the following signs of possible developmental delay for this age range.

• Exhibits extremely fearful or timid behavior
• Exhibits extremely aggressive behavior
• Is unable to separate from parents without major protest
• Is easily distracted and unable to concentrate on any single activity for more than five minutes
• Shows little interest in playing with other children
• Refuses to respond to people in general, or responds only superficially
• Rarely uses fantasy or imitation in play
• Seems unhappy or sad much of the time
• Doesn’t engage in a variety of activities
• Avoids or seems aloof with other children and adults
• Doesn’t express a wide range of emotions
• Has trouble eating, sleeping, or using the toilet
• Can’t differentiate between fantasy and reality
• Seems unusually passive
• Cannot understand two-part commands using prepositions (“Put the cup on the table”; “Get the ball under the couch.”)
• Can’t correctly give her first and last name
• Doesn’t use plurals or past tense properly when speaking
• Doesn’t talk about her daily activities and experiences
• Cannot build a tower of six to eight blocks
• Seems uncomfortable holding a crayon
• Has trouble taking off her clothing
• Cannot brush her teeth efficiently
• Cannot wash and dry her hands

  What's the best way to get a child to stop sucking his thumb or using a pacifier?

  As a first step in dealing with your child's sucking habits, ignore them! Most often, they will stop on their own. Harsh words, teasing, or punishment may upset your child and is not an effective way to get rid of habits. Instead, try the following:
• Praise and reward your child when he does not suck his thumb or use the pacifier. Star charts, daily rewards, and gentle reminders, especially during the day, are also very helpful.
• If your child uses sucking to relieve boredom, keep his hands busy or distract him with things he finds fun.
• If you see changes in the roof of your child's mouth (palate) or in the way the teeth are lining up, talk to your pediatrician or pediatric dentist. There are devices that can be put in the mouth that make it uncomfortable to suck on a finger or thumb.

No matter what method you try, be sure to explain them to your child. If they make your child afraid or tense, stop them at once.

The good news is that most children stop their sucking habits before they get very far in school. This is because of peer pressure. While your child might still use sucking as a way of going to sleep or calming down when upset, this is usually done in private and is not harmful. Putting too much pressure on your child to stop may cause more harm than good. Be assured your child will eventually stop the habit on his own.

MIDDLE CHILDHOOD 5- 10 YEARS

How can we help our children choose the right friends?

Between the ages of 5 and 12, making friends is one of the most important missions of middle childhood - a social skill that will endure throughout their lives. Developmentally, school-age children are ready to form more complex relationships. They become increasingly able to communicate both their feelings and their ideas, and they can better understand concepts of time- - past, present, and future. At this age they are no longer so bound to the family or so concerned mostly about themselves but begin relying on peers for companionship, spending more time with friends than they did during the preschool years. Day by day they share with one another the pleasures and frustrations of childhood.

Choosing friends

A number of factors can come into play as your youngster selects his friends. If he fools good about himself, and if he has been loved and respected within the family, he is more likely to make good choices of friends. If you and your spouse relate to each other well, and if your child has caring and supportive relationships with his brothers and sisters, he will have seen and experienced positive examples of how people can relate, and he will carry these impressions over into his own friendships, including the friends he chooses. On the other hand, if those family experiences have not been supportive and confidence-boosting, he is likely to seek out peers who have similar types of troubles.

Take some time to help your child understand why he chooses the friends he does. This is an opportunity to discuss his own values, feelings, and behaviors.

Healthy friendships

A healthy friendship is one in which both children are on an equal footing. Neither child should dominate the other to make all the decisions on what activities to pursue. They should share and make an effort to please each other. They should also be capable of problem-solving on their own: If one boy wants to play with a particular toy that belongs to his buddy, they will probably work out a time schedule so that each can have a turn. Or they might devise alternative activities that they can do together.

Language skills are essential for building and solidifying a good friendship. During middle childhood, friends learn to communicate clearly with one another, sharing secrets, stories, feelings, and jokes. Children with language or speech problems often have difficulty making friends, frequently using inappropriate words and missing out on subtle messages and cues - verbal as well as nonverbal - from their peers.

A "best" friend

In middle childhood some youngsters concentrate their social activity on a single best friend. In these relationships children usually match themselves with someone with whom they feel completely compatible, someone who is capable of meeting their needs for companionship, approval, and security.

These can be wonderful friendships, the kind that seem as though they will last a lifetime - sometimes they actually do. Even though parents often worry that exclusive friendships can be confining and stifling, and that their child has too much invested in this single relationship, most experts disagree. Sharing experiences, thoughts, and feelings with one special pal can often be more satisfying than spending time with a large group, as long as these two friends are having a positive influence on each other and are not excluding themselves from a broad range of experiences.

Negative peer influences

Dealing with negative peer influences is a challenge, but there are solutions. Some parents may demand that their own youngster stop spending time with this "bad influence," but this may not be the best strategy. In most cases a better strategy is to reinforce positive friendships with other children whose behavior and values meet with your approval. Encourage your youngster to invite these children over to your house to play. Arrange activities that are somewhat structured, mutually enjoyable, and time-limited, such as bowling, bicycling, or watching a sporting event.

At the same time, do not hesitate to express your displeasure over the less desirable playmates. Speak calmly and rationally when you explain why you would prefer that your child not spend time with them. Let him know the consequences if he ends up adopting the unacceptable behavior that you have seen in these other children, while still not absolutely forbidding him to play with them. This approach will teach your youngster to think more logically and assume responsibility of his actions, and show that you trust his growing capacity to make the right decisions

How can we help our children handle the stresses of everyday life?

In middle childhood, pressures may come from a number of sources-from within the child herself, as well as from parents, teachers, peers and the larger society in which the child lives. Pressure can take many forms that challenge children and to which they must respond and, often, adapt. Whether these are events of lasting consequence like the divorce of their parents, or merely a minor hassle like losing their homework, these demands or stresses are a part of children's daily existence.

Children welcome some events and are able to adapt to them with relative ease. They perceive other events as threats to their own or the family's daily routines or general sense of well-being, and these stresses are more troublesome. Most stress faced by children is in the middle, neither welcomed nor seriously harmful, but rather a part of accomplishing the tasks of childhood and learning about themselves.

Youngsters may also worry about making friends, succeeding in school, combating peer pressure or overcoming a physical impairment. Whatever its form, if stress is too intense or long-lasting, it can sometimes take a toll on children. Clusters of stressful events seem to predispose children to illness. Major events, especially those that forever change a child's family, like the death of a parent, can have lasting effects on children's psychological health and well-being. Minor daily stresses can also have consequences. They can contribute to loss of sleep or appetite. Children may become angry or irritable or their school grades may suffer. Their behavior and their willingness to cooperate may change.

How different children cope with stress

Children's temperaments vary and thus they are quite different in their ability to cope with stress and daily hassles. Some are easygoing by nature and adjust easily to events and new situations. Others are thrown off balance by changes in their lives. All children improve in their ability to handle stress if they previously have succeeded in managing challenges and if they feel they have the ability and the emotional support of family and friends. Children who have a clear sense of personal competence, and who feel loved and supported, generally do well.

Certainly, a child's age and development will help determine how stressful a given situation may be. Changing teachers at midyear may be a major event for a child in the first grade and merely an annoyance for a sixth-grader. Being short may be a minor issue for a 5- or 6-year-old boy but a source of daily embarrassment for an adolescent. How a child perceives and responds to stress depends in part on development, in part on experience, and in part on a child's individual temperament.

Ironically, many parents believe that their school-age children are unaware of the stresses around them and are somehow immune to them. After all, their children not only have all their basic needs met, but perhaps they also have a roomful of toys, friends to share them with, plenty of playtime, and a full schedule of extracurricular activities.

Yet children are very sensitive to the changes around them, especially to the feelings and reactions of their parents, even if those feelings are not communicated directly in words. If a parent loses a job, children will have to adjust to their family's financial crisis; they must deal not only with the obvious family budgetary changes but also with the changes in their parents' emotional states. Children may have to cope with a bully on the playground, a move to a new neighborhood, a parent's serious illness or the disappointment of a poor sports performance. They might feel a constant, nagging pressure to dress the "right" way, or to achieve the high grades that can put them on the fast track toward the "right" college.

Stress and today's middle-years child

Some psychologists believe that today's middle-years youngsters actually are faced with more stress than the children of previous generations were and have fewer social supports available. The change in family structure from the large, supportive, extended families (including both parents, aunts, uncles and grandparents) of previous generations, to the present high incidence of divorced families, single-parent families and stepfamilies has drastically altered the experience of childhood. Millions of youngsters must adjust to such changes.

Even in intact and stable families, the growing number of households with two working parents often forces children to spend more time in after-school programs or at home alone. For some children this loss of time with their parents is quite stressful. So, too, is the responsibility for caring for themselves and the family home and sometimes for overseeing a younger sibling after school.

Many children and their families are stressed by the multiple activities that fill children's "free time.'' Overscheduled children with inadequate "down time'' can become exhausted.

Today's children are also being raised in an era in which they are exposed to violence and peer pressure about sexual activity and drug use and are warned to be cautious about kidnapping, sexual abuse and other crimes. This sense that they are living in an unsafe world is a constant source of stress for some children. In short, today's youngsters are regularly confronted with challenges to their coping skills and often are expected to grow up too fast.

Good and bad stress

Not all stress is bad. Moderate amounts of pressure imposed by a teacher or a coach, for example, can motivate a child to keep her grades up in school or to participate more fully in athletic activities. Successfully managing stressful situations or events enhances a child's ability to cope in the future.

When the stress is continuous or particularly intense, it takes a toll on both the psyche and the body. Sudden stressful events will accelerate your child's breathing and heartbeat, constrict her blood vessels, increase her blood pressure and muscle tension and perhaps cause stomach upset and headaches. As stress persists, she might be more susceptible to illness and experience fatigue, nightmares, teeth-grinding, insomnia, tantrums, depression and school failure.

My child is shy and does not make friends easily. Should I be worried?

Although childhood shyness is commonplace, it concerns many parents, especially those who place great value on sociability. Some children become shy because of harsh life experiences, but most are born that way. For some middle-years children, social situations and interactions can be terrifying. When they come in contact with new children, they rarely feel at ease. Typically, they are unwilling or unable to make the first move, preferring to abandon a potential friendship rather than reach out to the unfamiliar. A few of these timid children may be emotionally distressed, but they are in the minority. In fact, some children are just naturally withdrawn and slow to warm up in new situations.

Severe shyness

In some cases, shyness can be disabling. Extremely shy children often do not adapt as well as most of their peers in the classroom and on the playground. The longer this pattern exists, the more difficult it is for children to change. Shyness can increasingly lead to purposeful avoidance of social settings and withdrawal, and ultimately create an inability to function effectively as a social adult. If your child's shyness becomes debilitating, it may be caused by an anxiety disorder or a temperament pattern; then an evaluation by a child mental-health professional would be helpful.

Time to adjust

Most shy children, however, do well in relationships and in social settings once they are past an initial period of adjustment. Children who have difficulty establishing and maintaining relationships even after the ice-breaking period merit more concern and attention. Eventually, many (and perhaps most) children who are shy learn to conquer their tendency. They function in ways that are not obviously timid or reticent, although inside they may still feel shy. Parents can gently guide or direct their children into social situations in which they can learn to successfully interact.

Rejected children

Most children want to be liked, yet some are slow in learning how to make friends. Others may long for companionship but might be excluded from one group or another, perhaps picked on because of the way they dress, poor personal hygiene, obesity, or even a speech impediment. Youngsters are often rejected by peers if they exhibit disruptive or aggressive behavior. Still other children may hover on the fringes of one clique or another but never really get noticed. These neglected children spend most of their time alone.

Rejected youngsters are overtly disliked by their peers and are constantly made to feel unwelcome. They often tend to be aggressive or disruptive and very sensitive to teasing. They may be bullies and rule-violators, or they may be so unsure of themselves that they invite the rejection of others. They might also be rejected because of their impulsive and disruptive behavior. Some of them may have attention deficits or hyperactivity.

Neglected children

Neglected children, on the other hand, are not overtly rejected and teased but are often just ignored, forgotten, not invited to parties, and are the last ones picked for a team. These youngsters may be perceived as loners but might be passive and detest their isolation. Others may actually prefer to be alone. This latter group might be respected and admired by others but simply feel more comfortable in solitary pursuits or in spending time with parents, siblings other adults, or even pets. They may also lack the social skills and self-confidence necessary for them to enter social arenas, often because of limited social experiences. Or they may be more shy, quiet and reserved than most of their peers.

How parents can help

Successful peer interactions require a variety of skills and special ways of interacting. Parents should look for these skills in their children and help develop and model them.

• Coping with failure and frustration
• Coping with success
• Coping with change and transitions
• Coping with rejection and teasing
• Managing anger
• Using humor
• Forgiving
• Apologizing
• Refusing to accept a dare
• Thinking up fun things to do
• Expressing affection
• Avoiding dangerous situations
• Defending himself
• Comforting someone
• Sharing
• Making requests
• Self-disclosure
• Giving a compliment
• Expressing appreciation
• Coping with loss
• Sticking up for a friend
• Doing favors
• Asking for help
• Helping others
• Keeping secrets

  What are the signs of low self-esteem?

  To help you determine if your child has low self-esteem, watch for the following signals. They could be everyday responses to how your child relates to the world around him, or they might occur only occasionally in specific situations. When they become a repeated pattern of behavior, you need to become sensitive to the existence of a problem.
• Your child avoids a task or challenge without even trying. This often signals a fear of failure or a sense of helplessness.
• He quits soon after beginning a game or a task, giving up at the first sign of frustration.
• He cheats or lies when he believes he's going to lose a game or do poorly.
• He shows signs of regression, acting babylike or very silly. These types of behavior invite teasing and name-calling from other youngsters, thus adding insult to injury.
• He becomes controlling, bossy, or inflexible as ways of hiding feelings of inadequacy, frustration, or powerlessness.
• He makes excuses ("The teacher is dumb") or downplays the importance of events ("I don't really like that game anyway"), uses this kind of rationalizing to place blame on others or external forces.
• His grades in school have declined, or he has lost interest in usual activities.
• He withdraws socially, losing or having less contact with friends.
• He experiences changing moods, exhibiting sadness, crying, angry outbursts, frustration, or quietness.
• He makes self-critical comments, such as "I never do anything right," "Nobody likes me," "I'm ugly," "It's my fault," or "Everyone is smarter than I am."
• He has difficulty accepting either praise or criticism.
• He becomes overly concerned or sensitive about other people's opinions of him.
• He seems to be strongly affected by negative peer influence, adopting attitudes and behaviors like a disdain for school, cutting classes, acting disrespectfully, shoplifting, or experimenting with tobacco, alcohol, or drugs.
• He is either overly helpful or never helpful at home
  .
  ADOLASCENC

  My teenager is starting to drive. How can I help keep her safe on the road?

  Traffic crashes are the leading cause of death for teens and young adults. More than 5,500 young people die every year in car crashes and thousands more are injured. Parents can play an important role in reducing these numbers and keeping their teens alive. Before you let your teen drive, set specific rules that must be followed.
  I, _______________________________ , will drive carefully and cautiously and will be courteous to other drivers, bicyclists, and pedestrians at all times.
  I promise that I will obey all the rules of the road.
• Always wear a seat belt and make all my passengers buckle up.
• Obey all traffic lights, stop signs, other street signs, and road markings.
• Stay within the speed limit and drive safely.
• Never use the car to race or to try to impress others.
• Never give rides to hitchhikers.

I promise that I will make sure I can stay focused on driving.

• Drive with both hands on the wheel.
• Never eat, drink, or use a cell phone while I drive.
• Drive only when I am alert and in emotional control.
• Call my parents for a ride home if I am impaired in any way that interferes with my ability to drive safely.

I promise that I will respect laws about drugs and alcohol.

• Drive only when I am alcohol and drug free.
• Never allow any alcohol or illegal drugs in the car.
• Be a passenger only with drivers who are alcohol and drug free.

I promise that I will be a responsible driver.

• Drive only when I have permission to use the car and I will not let anyone else drive the car unless I have permission.
• Drive someone else's car only if I have parental permission.
• Pay for all traffic citations or parking tickets.
• Complete my family responsibilities and maintain good grades at school as listed here: ____________________________________________________
• Contribute to the costs of gasoline, maintenance, and insurance as listed here: ____________________________________________________

I agree to the following restrictions, but understand that these restrictions will be modified by my parents as I get more driving experience and demonstrate that I am a responsible driver.

For the next _____ months, I will not drive after ________ pm.

For the next _____ months, I will not transport more than _______ teen passengers (unless I am supervised by a responsible adult).

For the next _____ months, I won't adjust the stereo or air conditioning/heater while the car is moving.

For the next _____ months, I will not drive in bad weather.

I understand that I am not permitted to drive to off-limit locations or on roads and highways as listed here: ___________________________________________________________

I agree to follow all the rules and restrictions in this contract. I understand that my parents will impose penalties (see below), including removal of my driving privileges, if I violate the contract. I also understand that my parents will allow me greater driving privileges as I become more experienced and as I demonstrate that I am always a safe and responsible driver.

Penalties for contract violations

Drove after drinking alcohol or using drugs 
No driving for ______ months.

Got ticket for speeding or moving violation 
No driving for ______ months.

Drove after night driving curfew 
No driving for ______ weeks/months.

Drove too many passengers 
No driving for ______ weeks/months.

Broke promise about seat belts (self and others) 
No driving for ______ weeks/months.

Drove on a road or to an area that is off-limits 
No driving for ______ weeks/months.

Signatures

Driver __________________________ Date ________________

Parent promise: I also agree to drive safely and to be an excellent role model.

Parent (or guardian) __________________________ Date ________________

Parent (or guardian) __________________________ Date ________________

What are the warning signs of suicide?The following warning signs may be signs of a mental health problem, such as a mood disorder, or they may relate directly to suicidal thoughts or behavior:

• Changes in functioning, such as
  • A drop in grades
  • Neglect of personal appearance
  • Neglect of responsibilities
• Changes in emotions, such as
  • Appearing sad, hopeless, bored, or overwhelmed
  • Having spells of severe anger
  • Appearing more anxious or worried
• Changes in behavior, such as
  • Getting in trouble, being rebellious, aggressive, or impulsive
  • Running away
  • Withdrawing from friends or family or having a big change in friends
  • Changing eating or sleeping habits
  • Losing interest in activities
• Use of drugs or alcohol
• Victim of sexual or physical abuse
• Sexual feelings or confusion about sexual orientation that the teen finds unacceptable
• Self-harmful behavior, such as cutting or anorexia
• Talking or writing of suicide or death
• Making a suicidal gesture, such as taking a small amount of pills

Myths and facts you should know

Myth: Teens who kill themselves are obviously depressed. Fact: It's not always obvious. Parents are sometimes "the last to know" their teens are so depressed and desperate. Teens are often very good at hiding their problems. While depressed adults may seem deeply sad and hopeless for quite a while, depressed teens may seem happy much of the time as they swing rapidly in and out of depression.

Myth: People who talk about suicide do not do it.
Fact: Teens who talk about suicide or wanting to "run away," "get away," "disappear," "end it," or "die" are much more likely to kill themselves than those who do not. Talk of suicide or death should be responded to right away.

Myth: "If he really wanted to kill himself, he would have done something more lethal." 
Fact: A non-lethal attempt, such as taking a small number of pills or making scratches on the wrist, may be followed by more lethal behavior at a later time. In addition, the non-lethal attempt may indicate deep emotional problems not obvious otherwise. Suicide attempts or "gestures" should be taken very seriously with prompt safe­guarding and intervention.

Myth: "She's just doing it to get attention."
Fact: This is true at times, but the behavior can still be lethal. A teen not intending to die may still take too many pills or miscalculate when someone will rescue her

What is anorexia?

People with anorexia have a distorted image of their bodies and such an intense fear of becoming fat that they hardly eat and become dangerously thin. Many people with anorexia also vomit and overexercise, and they may abuse diet pills to keep from gaining weight. If the condition gets worse, they can die from suicide, heart problems, or starving to death.

People with anorexia focus all of their energy on staying thin. Much of their time is spent thinking about food. For example, people with anorexia may

• Eat only a small number of "safe" foods, usually those low in calories and fat.
• Cut up food into tiny pieces.
• Spend more time playing with food than eating it.
• Cook food for others but not eat it.
• Exercise compulsively.
• Wear baggy clothes to hide their bodies, or complain that normal clothes are too tight.
• Spend more time alone and isolated from friends and family.
• Become more withdrawn and secretive.
• Seem depressed or anxious.
• Have a decrease in activities, motivation, or energy level.
• Do things to keep their minds off their hunger, such as chewing food 30 times before swallowing.

Effects of anorexia

Over time, anorexia can lead to kidney and liver damage, bone damage, and heart problems. When the body is starved of food, many physical changes occur like

• The constant feeling of being cold because the body has lost the fat and muscle it needs to keep warm. (People with anorexia may exercise even more to try to get warm).
• Dizziness, fainting, or near-fainting.
• Bones sticking out and skin shrinking around the bones. The stomach may look like it's sticking out (often causing anorexics to think they're still fat).
• Hair loss.
• Brittle hair and fingernails.
• Dry and rough skin.
• Menstrual periods stopping (or not starting at all if a girl developed anorexia before her first period). This condition is called amenorrhea.
• Stomach pain, constipation, and bloating.
• Stunted growth that could be permanent.
• Anemia (low red blood cells) causing tiredness, weakness, and dizziness.
• Loss of sexual function in boys.

Treatment

The earlier an eating disorder is recognized, the higher the chances are of treatment working. Treatment depends on many things, including the person's willingness to make changes, family support, and the stage of the eating disorder.

Successful treatment of eating disorders involves a team approach. The team includes many health care professionals working together, each treating a certain aspect of the disorder. Treatment should begin with a visit to a pediatrician to see how the eating disorder has affected the body. If the effects are severe, the person may need medical treatment or even need to be hospitalized.

In treating anorexia, increasing the person's weight is crucial. If this person refuses to eat, hospitalization may be needed so that adequate nutrition can be ensured.

Counseling is an important part of treatment. Counseling helps people with eating disorders understand how they use food as a way to deal with problems and feelings. It helps them improve their self-images and develop the confidence to take control of their lives. Family therapy usually is needed to help family members understand the problem, how to be encouraging and supportive, and how to help manage the symptoms. Nutrition counseling with a registered dietitian also is recommended to assist patients and families in returning to healthy eating habits.

Living with an eating disorder is very hard on teens and their families! The wear and tear on the body is tremendous. Without help, a person with an eating disorder can have serious health problems, become very sick, and even die. However, with treatment, a person can get well and go on to lead a healthy life.

What is bulimia?

Bulimia is an eating disorder that is harmful to a person's physical and mental health. People with bulimia eat large amounts of food in a short time (binge). Guilt and fear then cause them to get rid of the food (purge) by vomiting or other means such as overexercising.

People with bulimia have a difficult time controlling their eating behavior. They may be afraid to eat in public or with other people because they are afraid they won't be able to control their urges to binge and purge. Their fear may cause them to avoid being around people. They also may

• Become very secretive about eating food.
• Spend a lot of time thinking about and planning the next binge, set aside certain times to binge and purge, or avoid social activities to binge and purge.
• Steal food or hide it in strange places, like under the bed or in closets.
• Binge on foods with distinct colors to know when the food is later thrown up.
• Exercise to "purge" their bodies of food consumed.

People with bulimia often suffer from other problems as well, such as

• Depression and thoughts of suicide
• Substance abuse

Bingeing and Purging

During a binge, people with bulimia eat large amounts of food, often in less than a few hours. Eating during a binge is almost mindless. They eat without paying attention to what the food tastes like or if they are hungry or full. Binges usually end when there is no more food to eat, their stomachs hurt from eating, or something such as a phone call breaks their concentration on bingeing.

After bingeing, people with bulimia feel guilty and are afraid of gaining weight. To ease their guilt and fear, they purge the food from their bodies by vomiting or other means. They also may turn to extreme exercise or strict dieting. This period of "control" lasts until the next binge, and then the cycle starts again.

Bulimia becomes an attempt to control 2 very strong impulses—the desire to eat and the desire to be thin.

Effects of bulimia

Bulimia can cause serious damage to the body. For example,

• Teeth start to decay from contact with stomach acids during vomiting.
• Weight goes up and down.
• Menstrual periods become irregular or stop.
• The face and throat look puffy and swollen.
• Periods of dizziness and blackouts occur.
• Dehydration caused by loss of body fluids occurs (treatment in a hospital may be needed).
• Constant upset stomach, constipation, and sore throat may be present.
• Damage to vital organs such as the liver and kidneys, heart problems, and death can occur.

Treatment

The earlier an eating disorder is recognized, the higher the chances are of treatment working. Treatment depends on many things, including the person's willingness to make changes, family support, and the stage of the eating disorder.

Successful treatment of eating disorders involves a team approach. The team includes many health care professionals working together, each treating a certain aspect of the disorder. Treatment should begin with a visit to a pediatrician to see how the eating disorder has affected the body. If the effects are severe, the person may need medical treatment or even need to be hospitalized.

People with bulimia also may need to be hospitalized to treat medical complications, replace needed nutrients in the body, or stop the cycle of bingeing and purging.

Counseling is an important part of treatment. Counseling helps people with eating disorders understand how they use food as a way to deal with problems and feelings. It helps them improve their self-images and develop the confidence to take control of their lives. Family therapy usually is needed to help family members understand the problem, how to be encouraging and supportive, and how to help manage the symptoms. Nutrition counseling with a registered dietitian also is recommended to assist patients and families in returning to healthy eating habits.

Living with an eating disorder is very hard on teens and their families! The wear and tear on the body is tremendous. Without help, a person with an eating disorder can have serious health problems, become very sick, and even die. However, with treatment, a person can get well and go on to lead a healthy life

What is puberty and what's going to happen to my body?

Puberty is the time in your life when your body starts changing from that of a child to that of an adult. While there's no "right" time for puberty to begin, girls usually start a little earlier than boys—usually between 8 and 13 years of age. Puberty for boys usually starts at about 10 to 14 years of age.

In general, here's what you can expect.

Breasts

Girls. The first sign of puberty in most girls is breast development—small, tender lumps under one or both nipples. The soreness goes away as your breasts grow. Don't worry if one breast grows a little faster than the other. By the time your breasts are fully developed, they usually end up being the same size.

When your breasts get larger, you may want to start wearing a bra. Some girls are excited about this. Other girls may feel embarrassed, especially if they are the first of their friends to need a bra. Do what is comfortable for you.

Boys. During puberty, boys may have swelling under their nipples too. If this happens to you, you may worry that you're growing breasts. Don't worry—you're not. This swelling is very common and only temporary. But if you're worried, talk with your pediatrician.

Hair

Girls & Boys. During puberty, soft hair starts to grow in the pubic area (the area between your legs and around your genitals—vagina or penis). This hair will become thick and very curly. You may also notice hair under your arms and on your legs. Boys might get hair on their faces or chests. Shaving is a personal choice. However, if you shave, use only an electric shaver.

Zits

Girls & Boys. Another change that happens during puberty is that your skin gets oilier and you may start to sweat more. This is because your glands are growing too. It's important to wash every day to keep your skin clean. Most people use a deodorant or antiperspirant to keep odor and wetness under control.

Don't be surprised, even if you wash your face every day, that you still get pimples. This is called acne, and it's normal during this time when your hormone levels are high. Almost all teens get acne at one time or another. Whether your case is mild or severe, there are things you can do to keep it under control. For more information on controlling acne, talk with your pediatrician.

Curves and Muscles

Girls. As you go through puberty, you'll get taller, your hips will get wider, and your waist will get smaller. Your body also begins to build up fat in your belly, bottom, and legs. This is normal and gives your body the curvier shape of a woman.

Boys. As you go through puberty, you'll get taller, your shoulders will get broader, and as your muscles get bigger, your weight will increase.

Sometimes the weight gain of puberty causes girls and boys to feel so uncomfortable with how they look that they try to lose weight by throwing up, not eating, or taking medicines. This is not a healthy way to lose weight and may make you very sick. If you feel this way, or have tried any of these ways to lose weight, please talk with your parents or your pediatrician.

Does size matter?

Boys. During puberty, the penis and testes get larger. There’s also an increase in sex hormones. You may notice you get erections (when the penis gets stiff and hard) more often than before. This is normal. Even though you may feel embarrassed, try to remember that unless you draw attention to it, most people won’t even notice your erection. Also, remember that the size of your penis has nothing to do with manliness or sexual functioning.

Wet dreams

Boys. During puberty, your testes begin to produce sperm. This means that during an erection, you may also ejaculate. This is when semen (made up of sperm and other fluids) is released through the penis. This could happen while you are sleeping. You might wake up to find your sheets or pajamas are wet. This is called a nocturnal emission or "wet dream." This is normal and will stop as you get older.

Periods

Girls. Your menstrual cycle, or "period," starts during puberty. Most girls get their periods 2 to 2½ years after their breasts start to grow (between 10–16 years of age).

During puberty, your ovaries begin to release eggs. If an egg connects with sperm from a man's penis (fertilization), it will grow inside your uterus and develop into a baby. To prepare for this, a thick layer of tissue and blood cells builds up in your uterus. If the egg doesn't connect with a sperm, the body does not need these tissues and cells. They turn into a blood-like fluid and flow out of your vagina. Your period is the monthly discharge of this fluid out of the body.

A girl who has started having periods is able to get pregnant, even if she doesn't have a period every month.

You will need to wear some kind of sanitary pad and/or tampon to absorb this fluid and keep it from getting on your clothes. Most periods last from 3 to 7 days. Having your period does not mean you have to avoid any of your normal activities like swimming, horseback riding, or gym class. Exercise can even help get rid of cramps and other discomforts that you may feel during your period.

Voice cracking

Boys. Your voice will get deeper, but it doesn't happen all at once. It usually starts with your voice cracking. As you keep growing, the cracking will stop and your voice will stay at the lower range.

New Feelings

In addition to all the physical changes you will go through during puberty, there are many emotional changes as well. For example, you may start to care more about what other people think about you because you want to be accepted and liked. Your relationships with others may begin to change. Some become more important and some less so. You’ll start to separate more from your parents and identify with others your age. You may begin to make decisions that could affect the rest of your life.

At times you may not like the attention of your parents and other adults, but they too are trying to adjust to the changes that you’re going through.

Babies can become seriously ill quickly and any infection may be dangerous, so don't take chances; as illness at this age requires immediate attention.

Call your pediatrician if your baby has these symptoms.

• Has a temperature over 102.2o F (39oC) for more than half an hour.
• If your baby is too cold and too hot
• If your baby's breathing is very noisy and rapid
• If your baby throws up green vomit or vomits and cries uncontrollably as if in pain.
• If your baby shows that an area is tender to the touch
• If your baby has a low volume over a 24-hour period
• If your baby has blood in his urine or in his faeces
• Refuses two successive feedings, or does not demand to be fed for six hours
• If your baby seems particularly irritable or restless or seems abnormally quiet or drowsy.
• If your baby has a taut, bulging fontanelle when he isn't crying.

BABY'S IMMUNIZATION CHART 

Birth B.C.G. Hepatitis B Vaccine- 1st dose Oral Polio Vaccine - 1 (dose) 6 Weeks (One and a half months) D.P.T. - 1st dose  Oral Polio Vaccine- 2 (dose) Hepatitis B Vaccine- 2nd dose Hemophylis Influenza B (HIB) - 1st dose 10 Weeks (Two and a half months) D.P.T. - 2nd dose Oral Polio Vaccine- 3 (dose) Hemophylis Influenza B (HIB) - 2nd dose 14 Weeks D.P.T. - 3rd dose Oral Polio Vaccine- 4 (dose) Hemophylis Influenza B (HIB) - 3rd dose 6 months  Oral Polio Vaccine - 5 (dose) Hepatitis B Vaccine- 3rd dose 9 months Measles Vaccine 15-18 months  MMR (Mumps, Measles, Rubella) - 1st Dose D.P.T.- I Booster Hemophylis Influenza B (HIB) - Booster 5 years MMR - 2nd Dose D.P.T. -  II Booster Oral Polio Vaccine 6 (Dose) 10 years TD (Tetanus, Diphtheria) 15 years  TD

BCG 

Bacille Calmette-Guérin (BCG) is a live vaccine developed in 1921 to protect babies and young children against the most severe forms of Tuberculosis (TB) such as TB meningitis and military TB. In countries where TB infection and TB diseases are common, the World Health Organisation strongly endorses the continued use of BCG in national immunisation programme to minimise the harmful effects of TB infection in the first year of life.

 A nodule appears 3-4 weeks after BCG vaccination. It may soften or ulcerate in 2-4 weeks. No application or fomentation is necessary. It heals, leaving a scar, indicating effective vaccination.

DPT

 DPT vaccination is given to immunize babies against the diseases diphtheria, pertussis (whooping cough) and tetanus. The vaccine is administered as three dosages within 6 months and a booster at 18 months and at 4-6 years of age. There may be mild fever and pain, redness and swelling at the site of the injection. A small painless lump may remain for a few weeks. For fever and pain, paracetamol syrup/tablet may be given. 

OPV

OPV is oral polio vaccine administered as drops for protection against polio.

HBV (Hepatitis B)

A hepatitis B injection for jaundice is given shortly after birth while the mother and child are still in hospital.

Hemophylis Influenza B (HIB)

Hemophylis Influenza B vaccination is taken for protection against Meningitis, Pneumonia etc. The vaccination causes redness, warmth, or swelling where the shot is given, or fever in some children within a day of vaccination and may last 2-3 days. 

There are other vaccinations developed for protection against diseases, but which has not been made mandatory by the government in India. These vaccinations may be given to the child after consulting a doctor. These include Pneumococcal conjugate vaccine (PCV), a vaccine used to protect infants and young children against disease (Pneumonia ) caused by the Streptococcus pneumoniae which can be given at 6 weeks, 10th and 14th weeks respectively followed by a booster dose at  15-18 months.  Rotovirus vaccineprotects children from rotaviruses, which is the leading cause of severe diarrhea among infants and young children. The vaccine can be given after 6 weeks of age. The Varicella vaccine is a live virus that protects against the viral disease, Chickenpox caused by Varicella Zoster Virus (VZV). This vaccine is given after 15 months, then a booster dose at 4-6 years. Hepatitis A vaccine against hepatitis A Virus (Jaundice), is administered first at 12 months, then another dose at 6 months of age. Human pappiloma Virus (HPV) vaccine is a vaccine against some types of Human Pappiloma viruses which causes cervical cancer and genital warts. It can be taken between the age group of 9 and 25 years. There are also vaccines available against Typhoid, H1N1 etc.   

BATHING YOUR BABY 

Bathing is an enjoyable time between you and your baby. Your new born baby during the first six weeks does not necessarily need a full bath every day. A soft wash cloth or cotton wool and some warm water will do to clean him up especially till the baby's umbilical cord drops off. It is important not to get the belly button area wet, where the umbilical cord is still attached. 

Once you start on the water bath routine, it is very good for your babies health if you massage him with any baby oil before bathing. This is practiced traditionally in some countries. It is a wonderful way to lavish your baby with the attention she needs and loves. This massage aids food absorption, promotes sleep, builds immunity and develops muscle tone and coordination. 

Bathing Tips

• Until your baby's navel has healed, do sponge baths (cleaning only the parts of your baby that really need attention-her hands, face, neck and diaper area).
• Make sure that you have everything ready before the bath so you will not have to leave your baby. Never ever leave the baby alone in the bath even for a second.
• Always test the water with your elbow, the water should feel just warm. The temperature felt by the hand may feel right, but may scald the delicate skin of the baby.
• If you use a baby bathtub, it will make bath time easier for you. 

You will need 

• Towel (two preferably, one for the head and the other for the body) 
• Cotton balls
• If you want to massage your baby take ordinary baby oil or almond oil which is soothing to the skin. Instead of baby oil, you could use cooled paste of turmeric powder mixed with milk, boiled together provided your baby does not have an allergy.
• Baby Soap (instead of soap you can use green gram flour or besan flour)
• Foam Pad or rubber mat ( to lay on the bottom of the sink so that she won't slip)

How to bathe your Baby

• Always clean the baby's face first. Dip a cotton wool or wash cloth in warm water and squeeze out excess water. Wipe her eyes from the inside corner to the outside. Use a clean part of the washcloth or a separate piece of cotton for the other eye. Don't use soap on her face.
• Again with another piece of cotton wool or washcloth wipe her ears- over and behind each year with the washcloth.  Don't try to wipe inside.
• Wash her body with a soapy cloth or in warm water in a tub. Lower him into the tub with his head supported on your arm and your hand holding her firmly around her shoulder and upper arm. Be sure to wash in between creases in her neck, arms and legs. Wash her bottom carefully from front to back. Hold her firmly with both hands while lifting her out of the water as she will be slippery.
• After her body is washed, wrap her in a dry towel on your lap and dry him thoroughly in between creases as well.
• Hold her head in one hand and supporting the back along your forearm like a football, pour water gently from the tub on the head and do not splash water on her face. Wash the hair and scalp using circular movements with a little soap or shampoo.
• Pat his head dry with a fresh towel.
  
  

  HANDLING YOUR BABY

  Holding Your New Baby
  From an early age, your baby needs closeness and comfort as well as food, warmth, and sleep. To begin with you will probably feel quite nervous about handling and cuddling him: your hands seem so clumsy, his limbs so floppy, his head and neck so fragile.
  Picking your baby up
  When your baby is lying on her back, slide one hand underneath your baby's neck and head and support her back and bottom with your other arm. Life her gently and slowly, so that her body is supported and her head can't loll back. Carefully transfer her head to the crook of your elbow or your shoulder, so it is well supported. Be careful that his head doesn't loll back. `
  Putting Your Baby down
  Put one hand underneath her head and neck, then hold her under the bottom with the other. Lower her slowly, gently supporting her until the pad or mattress is taking her weight.
  Slide your nearest hand out from under her bottom. Use this hand to lift her head a little so you can slide out your other hand, and lower her head down gently. Don't let her head fall back on to the surface, or jerk your arm out quickly.
  Holding your new born baby against your shoulder
  Help upright like that this, your baby feels secure. Take her weight with one hand under her bottom, and support her head with the other hand.

  CHILDREN'S HEALTH

  Introduction

  Children's health, or pediatrics, focuses on the well-being of children from conception through adolescence. It is vitally concerned with all aspects of children's growth and development and with the unique opportunity that each child has to achieve their full potential as a healthy adult.

  Children's health was once a part of adult medicine. It emerged in the 19th and early 20th century as a medical specialty because of the gradual awareness that the health problems of children are different from those of grown-ups. It was also recognized that a child's response to illness, medications, and the environment depends upon the age of the child.

  There are many aspects to children's health. Any organization of these aspects of child health is necessarily arbitrary. For example, the topics could be presented in alphabetical order. However, it seems most logical to start at the beginning -- with the factors that determine a child's healthy growth and development.

  Growth and development

  A healthy child's development actually begins before conception with the parents' health and their genetic legacy. It continues on to conception and through the prenatal period. During this time, there is naturally considerable overlap between pediatric concerns for the fetus and obstetrical concerns for the mother.

  Once the baby is delivered, there are new and important matters to ponder, such as breastfeeding,newborn screening tests and sleeping safety. All too soon, there are health-care appointments to be kept, for example, for well-baby checkups and immunizations. These are followed by other challenges, such as when to introduce solid foods and to start toilet training.

  The field of pediatrics recognizes classic stages in growth and development, but these are artificial since a child's growth and development constitute a continuum. A baby changes at an astonishing rate during the newborn period and early infancy. Before you know it, the baby becomes a toddler, next a child and, after a little more than a decade, is already a teen. It is a busy, challenging period.

  Children's illnesses

  Unfortunately, even the healthiest baby can get sick. It is worth knowing the signs and symptoms of the common childhood illnesses as well as the treatment and prevention of these illnesses. There are a number of common childhood conditions such as ear infections and even tonsillitis, which may be unavoidable. But children are also subject to serious infectious diseases, some of which can be prevented by immunizations.

  Children may be born with health problems. For example, a cleft lip or palateis evident at birth. But some equally common birth defects, such as heart malformations, may not be immediately apparent. Birth defects of all kinds are a consequential concern for children and their parents. It is estimated that between 2%-3% of all children are born with birth defects.

  Children's injuries

  It may not be possible to prevent a specific birth defect or an illness, but it should be possible to protect a child from an accident and injury, such as from common cuts andburns. Considerable progress has been made in the safety arena, for example, in the rapid recall of dangerous toys. The mandated uses of car seats, safety belts, and bicycle helmets are also examples of advances in child safety.

  But other major areas of safety concernremain -- such as the all-too-frequent drownings of children in swimming pools, their accidental swallowing of household cleaning products, their being burned by a hot stove or heater, or being accidentally shot with a firearm. The list is endless. All of us must exercise continued vigilance and make every effort to be sure that a child's environment is made as safe as it possibly can be.

  Children's behavior

  In addition to a child's physical well-being, there are also concerns about a child's behavior and emotional health. Major challenges include autism,Asperger's syndrome, learning disorders, and ADHD (attention deficit hyperactive disorder).

  But children may also be plagued by nightmares, sleeping difficulties, and irrational fears. Many children have trouble expressing their anger in an appropriate fashion. A major area of study is the effect on children of watching violence on television and playing violent video games.

  As children get older and more independent, their chances of developing eating disorders such as anorexia and bulimia increase, especially among girls who worry about being overweight. The specter of drug and substance abuse appears. Smoking also often starts in response to peer pressure. And then there are those tattoos and body-piercing.

  
  

  Children's mental illness

  Suicide is now the second leading cause of death during the teen years. Majordepression and bipolar disease may underlie suicide attempts and suicide.

  It was once thought that children were not subject to these mental illnesses because children had not yet developed the ability to feel hopeless and helpless about the future. That is clearly untrue. It is now widely acknowledged that children are susceptible not only to major depression and bipolar disease but also to anxiety disorders, phobias and posttraumatic stress disorder. Here again the treatment must be appropriate for use in the pediatric age range.

  Family health & children

  Family health looks at children's health and well-being in the context of their family unit. The health of the family as a whole plays a major role in determining the health of each child within that family. This applies not only to children's physical health but to their emotional health as well.

  Our society professes the ideal that every child should grow up in a household under the care of a pair of loving adults who possess appropriateparenting skills. The reality today is that divorce, single parenting, and step-parenting are common. Adoption and foster-parenting are not uncommon. Surrogacy with sperm and egg donors make for some unusual parenting combinations. The traditional household is not the only type of household in which children are growing up today.

  The provision of adequate child care and supervision -- and the prevention of child abuse and neglect -- need to be openly addressed. One of the most tragic situations is the physical injury, emotional damage, or even death that occurs because a caregiver has shaken, burned, hit, or sexually assaulted a child.

  Community health & children

  Community health goes beyond the family to the community as important to the health and well-being of children. Children need a healthy and safe environment in which to grow up.

  There is a big difference between living on a farm, in a small town, in the suburbs, or in an inner city. A neighborhood with prostitutes, drug dealers and drive-by shootings is an unhealthy community in which to raise children. Not to mention the need for children to grow up in a healthy environment that provides clean air to breathe and clean water to drink.

  Other community links that can influence the health of children include schools, sports programs, and learning resources such as libraries. To paraphrase the phrase "It takes a village to raise a child," it might be said that "It takes the community to raise a healthy child."

  Health care for children

  It is important to emphasize that children are not just small adults nor should they be treated as little adults. Child health care and the specialty of pediatrics are concerned with providing optimal and appropriate care to all children; and in fact pediatrics has expanded to include not only young children but young adults as well, since a large portion of our 18-21-year-olds continue to be dependent on their parents into their 20s.

  Getting appropriate, high-quality health care for a child is not always easy. Existing programs for child health are not available to all families that need them. There are serious gaps between those eligible for health care and a parent's ability to afford health care. Too many children fall between the cracks, not only in the U.S., but in the world as a whol

  
  

  
  
  

SOURCE:HEALTHCHILDREN.OGR/Medicinenet.com