Caring for your child from birth to adolescence

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Welcome to Childcare Essentials where you will find a treasury of evidence-based information for your child. This site will be updated regularly on the latest news and information related to child health and childcare that will assist you as a parent or grandparent. In addition every quarter you will be able to download the free Childcare Essentials magazine.

The Linguistic Genius of Infants

In a recent aricle published in The Paediatric Quarterly and presented at the USANA conference in Durban, Jacomina Du Preez of the University of Stellenbosch proposed that speech exposure to foetuses and infants should be enhanced, and a habit of shared reading should be created. Nursery rhymes in a native language seem to be ideal as they increase exposure to rhythm and phonemes (building blocks of language), and are enjoyed by parents. She states that research has shown that exposing children to nursery rhymes from an early age enhances vocabulary and later literacy...and it is fun.

Foetuses have substantial capacity for auditory learning and memory already in utero. They cry in a specific language at birth, recognise their mother's voice and can distinguish native from foreign language. They can even recognise the rhythm and rhyme of Cat in the Hat (Dr. Seuss) if it was read to them in last 4 weeks of pregnancy. Recently there have been remarkable advances in the understanding of the development of language. Unlike vision, which will develop independent of stimulation, language needs exposure to speech. Babies are brilliant statisticians, constantly keeping statistics of vowels, which they can clearly distinguish at 6 months. There even seems to be a time-limited window of opportunity to learn a second language, and a second language centre opens up in the brain between 6 and 10 months.

New technology has clearly shown that social interaction is the gateway to language acquisition. It has even been shown that social interaction and speaking in motherese (baby talk), will optimally stimulate the brain as measured by functional magnetic resonance imaging (MRI). Premature infants miss out on maternal heartbeat and the reception of maternal language in the intra-uterine period. After birth they are exposed to predominantly high frequency sounds in the neonatal intensive care unit (NICU) and baby wards, while all the time they are missing out on crucial language stimulations.

She states that a randomized control trial (RCT)has shown that auditory stimulation of maternal heartbeat and nursery rhyme reading, had a measurable impact on auditory cortex as measured by ultrasound. Another study has shown that shared reading in the NICU decreases parental stress and was perceived to be enjoyed by their babies, and at 3 months of age these parents were far more likely to read to their babies.

Exposure to words in neonatal wards seems to be closely linked to neurological outcomes (accounting for up to 25% difference), and singing lullabies led to autonomic stability in premature babies, and relieved stress in their mothers. A single retrospective study has shown improved neurological outcomes in premature infants that were read to regularly since birth. The Word Gap (also called The Early Catastrophe), is the difference in words heard by infants, from high and low socio economic classes. The difference is 30 million words in first 3 years of life (in United States). A child's vocabulary at 3 years is linked to word exposure, and is directly linked to school performance and career outcomes.

Reach out and Read (ROR) is a Pediatrician driven campaign that provides books and reading advice to lower socio-economic children from 6 months onwards in the US. It has been shown to increase receptive vocabulary by up to 40%, and increase literacy at school level. Neonatal units are in the unique position that the medical staff have contact with the mothers for a prolonged time period.

Exercise and Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) affects 2% to 10% of children worldwide and frequently continues into the period of adolescence. The primary symptoms of ADHD are inattention, hyperactivity, difficulty in organizing tasks, including school work and workplace responsibilities, and impulsive behaviours. Pharmacotherapies for ADHD, including methylphenidate are affordable and this is routinely used for the treatment of ADHD. However, approximately 10% to 30% of children with ADHD have inadequate clinical responses to methylphenidate treatment. In addition, treated individuals may experience short-term side effects, including insomnia, loss of appetite, and headaches, and rare side effects including mania, psychosis. Therefore, adjuvant therapies for enhancing the effects of stimulants and thereby minimizing medication doses have recently been studied. Cognitive behaviour therapy combined with medication is an effective method for improving clinical symptoms and comorbid problems in adult patients with ADHD. Psychotherapy targeted at improving low self-esteem improved ADHD symptoms and associated problems in adult patients with ADHD. As one adjuvant therapy for ADHD, exercise has been shown to improve clinical, cognitive, and scholastic performance. Several studies on healthy children have suggested that participation in physical activity and exercise is beneficial for improving concentration, reading and mathematics achievement, as well as inhibitory control. 20-min aerobic exercise has been shown to improve inhibitory control and scholastic performance in children with ADHD age 8 to 10 years. One study suggested that 6 weeks of athletic activity improved attention, cognitive symptoms, and social skills of children with ADHD. It has also been reported that 10 consecutive weeks (45 minutes daily, three times a week) of physical training improved muscular capacity, motor skills, and attention (sustained and divided) of children with ADHD.

In a recent study done in male adolescents (13 - 18 years) and reported in Medicine & Science in Sports & Exercise, three times per week of 90-minute sessions of sports therapy were scheduled as follows: 10 minutes for stretching and warming up, 60 minutes for aerobic exercise (running, jumping rope and basketball), and 10 minutes for feedback and cooling down. In this study there was increased effectiveness of methylphenidate on clinical symptoms, perseverative errors, and brain activity.

Don't forget to immunise your child

Immunisation or vaccination protects children from serious illness and complications of vaccine-preventable diseases. Vaccine-preventable diseases such as measles, mumps, and whooping cough, are still a threat. Outbreaks of preventable diseases occur when parents do not vaccinate their children. A few months ago, there was a Diphtheria outbreak in KwaZulu-Natal. In the latest issue of Chilcare Essentials, immunisation will be discussed.

The first issue of Childcare Essentials magazine is now available.

To access the magazine free, please click on the magazine tab or on the cover below, then create a user name and password and log in using your username and password.

In this issue:

- Is the modern world influencing our kids?

- An introduction to Allergic Diseases

- Strengthening the Parent-Child bond

- Have you immunised your child?

- The Art and Science of Discipline in Children

- Refractive Errors

- Want calm kids? Teach them to meditate

- Newborn skin conditions

The January 2016 issue of Childcare Essentials magazine is now available.

To access the magazine free, please click on the magazine tab or on the cover below, then create a user name and password and log in using your username and password.

In this issue:

- Rebranding Resilience - Coaching Children for Lifelong Learning

- Do you have a Thumbsucker?

- It's time to control Asthma

- Middle Ear Infections

- It's all in the words we use :

Get your kids to do what you need and want them to do

- Sleep Issues in Children

The March / April 2016 issue of Childcare Essentials magazine is now available.

To access the magazine free, please click on the magazine tab or on the cover below, then create a user name and password and log in using your username and password.

In this issue:

- The Secrets to Building Your Family Brand

- Eczema

- Hypersomnolence (Excessive Sleepiness) in Children

- The Long and The Short of Nail Biting

- It's Flu Time Again

- 9 Things to Teach your Child to Give Up to be Happy

The April / May 2017 issue of Childcare Essentials magazine is now available.

To access the magazine free, please click on the magazine tab or on the cover below, then create a user name and password and log in using your username and password.

In this issue:

- The Jaguar Primary School Challenge

- How to manage toddlers and their evolving behaviour

- Childhood Insomnia

- Autism in Children

- The Benefits of Outdoor Play

Sleep Issues in Children

Anxiety over a child's lack of sleep is a common occurrence in normal parenting. An infant sleeping through the night is a highly esteemed developmental milestone, but a child who is sleepy during the daytime may miss out on many activities necessary for normal development. Sleep disturbances occur in approximately 20 to 30% of children and 5% of adults. In the January 2016 issue and in future issues of Childcare Essentials some of the secrets of a child's sleep time will be unravelled.

The Art and Science of Discipline

The process of disciplining children is an art, as well as a science. Discipline does not work perfectly the first time, nor does it work the same for each child. The antecedents and consequences of a behaviour are not the same for every child, or for every aspect of one child's life. Every child is different, as is every situation. It is important for parents to tailor the discipline strategies to the specific child. Each and every child has different needs and this includes needs regarding discipline. For some children, taking away privileges is the most powerful form of discipline, for others it may be adding a chore. For some children, verbal praise may be enough of a reward, for others earning some sort of privilege may be most reinforcing. It may take some trial and error, but it is important that parents determine what works best for each child....Read more about this in the November 2015 issue of Childcare Essentials.

Allergic Conditions

The prevalence of allergic diseases has increased rapidly over the past two decades. In general, allergic diseases are a group of conditions where the underlying cause involves our own antibodies, especially immunoglobulin E (IgE) over reacting to what should normally be harmless protein in food or inhaled substances.

In the latest and subsequent issues of Childcare Essentials, the various allergic disorders are discussed.


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