Early childhood Kenya: October 2013

Thursday, 31 October 2013

Breastfeeding for beginners

Highlights

If you've just started breastfeeding, you're doing the right thing for you and your baby.

But if breastfeeding doesn't come naturally at first, don't worry. Plenty of new mums and babies have to practise and persevere until they get the hang of it.

Is it true that breast is best?

Yes, breast milk is the best food for your baby. It's the healthiest way to feed her.

Breast milk is a complete food. It contains at least 400 nutrients, as well as hormones and disease-fighting compounds, that aren't present in formula milk. Its nutritional make-up even adjusts to your baby's needs as she grows .

Feeding your baby only breast milk for up to six months (exclusive breastfeeding) is particularly good for her. It can improve your baby’s cognitive development . So being breastfed could even make her more intelligent.

Babies who are exclusively breastfed from birth are also much less likely to be ill in their first year of life . Being breastfed may help your baby to fend off illnesses such as:

We can't say that exclusive breastfeeding reduces the risk of children ever developing

eczema . But babies who are breastfed for any period of time do tend to have lower rates of severe eczema than babies who were always formula-fed. It's also possible that breastfeeding delays when your child first develops eczema .

Breastfeeding helps to build a special bond between you and your baby. And in the long-term, breastfeeding may help your baby to stay healthy. Studies have shown that adults who were breastfed as babies, when compared with those who were formula-fed:

had lower blood pressure
had lower cholesterol levels
were less likely to become obese
were less likely to develop type 2 diabetes

Breastfeeding is good for you, too, and may help you to lose weight

(Unicef and DH 2010). In the long term, it also helps to:

lower your risk of breast cancer
protect against ovarian cancer before the menopause
reduce your risk of developing type 2 diabetes.

How long will I be breastfeeding for?

Health organizations or specialists recommend that your baby has only breastmilk for the first six months of her life. It also recommends that you carry on breastfeeding after your baby has started on solid foods, until the end of her first year and beyond, if you'd like to (WHO 2002, Unicef and DH 2010).

Continuing to breastfeed while introducing solid foods to your baby may benefit her immune system. She may also be less likely to develop health conditions such as coeliac disease (Henriksson et al 2013) and type 1 diabetes .

Most mums aim to breastfeed for between three months and 12 months, and some choose to breastfeed beyond the first year (extended breastfeeding). A lot depends on your individual circumstances and how you feel about it.

How can I prepare for breastfeeding?

Staying healthy is as much as you can do to prepare your body for breastfeeding. But learning as much as you can about breastfeeding before your baby is born will help you when the time comes.

How do I start breastfeeding?

Feeds can take anything from five minutes to 40 minutes, so find a comfortable place before you start. In the early days of breastfeeding, when you're still trying to get the hang of it, creating the right atmosphere is important.
If you're easily distracted by noise, find somewhere quiet. If you tend to get bored, you may want to feed with the radio or television on, but only if breastfeeding is going well. Try different spots until you find what works for you.
Hold your baby in a position that won't make your arms and back ache. Have cushions or pillows nearby to support you or your baby. Laid-back breastfeeding involves lying on your back, so that your baby can rest on your body, while your hands are free to support her. Or try the cradle hold, which means cradling your baby across your chest, raised up on a cushion or pillow. It depends on what's most comfortable for you.
Get yourself and your baby in a relaxed position before you start feeding. Pay attention to how your breasts feel when your baby latches on. She should take in a big mouthful of breast tissue.
If you have large breasts, you may find it more comfortable to lie on your side while feeding or you may want to try holding your baby under your arm in a rugby ball position.
If latching on hurts, break the suction by gently inserting your little finger between your baby's gums and your nipple, and try again. Once your baby latches on properly, she'll be able to do the rest.

How easy is breastfeeding?

Though some women take to breastfeeding easily, many new mums find it hard to get going. So if you're feeling discouraged, you're not alone. Talk to your community midwife, or ask to be referred to a breastfeeding specialist, if you're having problems. She can watch you feed your baby, and suggest ways to make it easier.

Breastfeeding takes practice, and is a skill that you and your baby will be learning from scratch. Give yourself as much time as you need to get it down to a fine art. Take it a day, a week, or even just one feed, at a time.

Can I breastfeed in public?

You may feel shy about breastfeeding in front of other people. But you have the right to breastfeed in public places in England, Scotland and Wales. The rules differ slightly in Northern Ireland, but you have some protection under the Sex Discrimination Act. In Kenya, we are yet to know which is the stand but as of now there is no problem breastfeeding in public.

You may feel comfortable about breastfeeding in front of others. However if you feel self-conscious, there are tops that allow you to breastfeed discreetly. Shirts that you have to unbutton will make you feel exposed as you feed and buttons are fiddly to deal with. Stretchy tops you can pull up, work well.

If it makes you feel more comfortable, drape a scarf, muslin or blanket over your shoulder and chest while you feed. This will give you and your baby privacy. Make sure your baby can breathe easily, though.

Some larger shops have mum-and-baby rooms where you can sit comfortably and feed.

Breastfeeding your baby when she's hungry is your first priority, so try not to feel self-conscious about doing what's best for her.

What should I buy for breastfeeding?

Buy at least two or three comfortable breastfeeding or nursing bras so your breasts are properly supported. These have hooks or zips that you can easily undo when your baby needs to feed. (If you can afford)

Make sure that your bras fit properly, and that any flaps open completely. If only a small part of your breast is exposed, the bra may press on breast tissue and lead to blocked ducts or mastitis.

You may prefer to wait to buy bras until after your baby is born, to make sure that they will fit you perfectly. But bear in mind that getting out of the house with a newborn isn't easy, so think about going in late pregnancy. Many department stores have staffs that are trained to fit nursing bras after 36 weeks of pregnancy.

You may find that your breasts have a tendency to leak, as even another baby's cry or the sight of a baby can stimulate milk flow. Keep a supply of washable or disposable breast pads handy, and consider buying a light-weight nursing bra for night time, so you can wear breast pads while you sleep. If you're planning to express your breast milk, you may want to consider buying a breast pump.

Can I breastfeed after I go back to work?

If you're going back to work, it doesn't mean you have to stop breastfeeding. If your workplace has a nursery, you may be able to visit your baby during the working day, and breastfeed her as usual .

If you can't visit your baby during the day, you may want to express milk. Or you may choose to breastfeed only when you are with your baby, and give her formula milk during the day (mixed feeding).

Let your employer know in writing if you want to breastfeed after you return to work, so a risk assessment can be carried out. This is to make sure that your workplace is safe for a breastfeeding mum.

It's good news for employers, too. Mums who are supported to carry on breastfeeding after they return to work take less time off. And some research suggests that exclusively breastfed babies are less likely to be ill than babies who are formula-fed.

Wednesday, 30 October 2013

Seven signs that your child loves you

1. Your newborn stares into your eyes — he's actually working hard to memorize your face. He doesn't understand anything else about the world, but he knows you're important.

2. Your baby thinks about you even when you're not around. Between eight and 12 months old, he'll start to scrunch his face and look around when you leave the room — and he'll smile when you return.

3. Your toddler throws wicked tantrums. Nope, those screaming fits don't mean he's stopped loving you. He couldn't show he was so hurt and angry if he didn't trust you so deeply.

4. Your toddler runs to you for comfort when he falls down or feels sad. Children this age may not truly understand the meaning of "I love you," but their actions speak louder than words.

5. Your preschooler gives you a flower picked from the garden, a finger-painted heart, a sparkly stone or another gift.

6. Your preschooler wants your approval. He'll start to be more cooperative around the house and he'll look for chances to impress. "Look at me!" will become a catchphrase.

7. Your school-age child trusts you with secrets, such as his first crush or his most embarrassing moment. You're his confidante, even if he shies away from your hugs in public.

signs that your child loves you

Developmental milestones: teething

Highlights

Teething can be a long drawn-out process for your baby (and you). In fact, the move from that gummy grin to a mouthful of gleaming teeth can take your baby his first three years to complete.

When will my baby get his first tooth?

Most babies sprout their first tooth at around six months. But your baby may have his first white cap, usually in the front at the bottom, any time between three months and his first birthday.

Your baby's last teeth, which are the second molars, found in the upper and lower back of his mouth, are usually in place by his second year. So by your baby's second birthday, he should have a full set of 20 baby teeth.

Will teething be painful for my baby?

The arrival of your baby's first tooth won't be much fun for either of you. Your baby may be in pain and drool for a month or two before his tooth appears. You could be up at night trying to console him while he waits for a tooth to break through.

To ease his suffering, your baby may start biting, but not out of anger or hostility. Give him something to bite on, or rub his gums gently with a clean finger to help soothe the ache.

Your baby's gums can also become inflamed when he cuts a tooth, which may make his cheeks appear red and swollen. You may worry that your baby has a fever or diarrhoea when a tooth is about to come through, but teething shouldn't cause illness. If your baby seems ill, it's more likely he's coming down with a cold, an infection or a tummy bug. Take him to your doctor if you are concerned.

For some babies, teething can be a fairly painless mouth makeover. One week your baby is sporting a toothless grin, and the next a jagged white edge may appear on the gum surface, without causing much upset.

Celebrate your baby's first tooth by taking lots of pictures, and note its arrival date in his baby book! Your baby's teeth will sprout one after another. After the arrival of the two bottom front teeth, expect the top two middle teeth, then the teeth along the sides and back. Tooth development is hereditary, so if you got your teeth early, chances are your baby will, too.

How can I help my baby through teething?

You can't do anything to encourage your baby's teeth to appear, but you can comfort him if he's in pain:

Give your baby something cool to chew on, such as a chilled teething ring or a whole, peeled carrot that's been in the fridge. Stay near your baby when he is chewing anything in case of choking.
If your baby is older than four months, you can rub sugar-free teething gel for babies on his gums. You can buy this from your pharmacy.
If your baby is older than six months, he may get relief from eating cold foods, such as apple puree or yoghurt, straight from the fridge.
If your baby is really in distress, you can give him the correct dose of sugar-free infant paracetamol, as long as he is three months or older. Always follow the correct dosage instructions on the packet. Ask your doctor or pharmacist if you are unsure how much to give your baby.
Some parents swear by homeopathic teething powder, which you can buy from your pharmacy. However, there isn't any medical evidence that it works. Not everyone can afford it too! Teething is natural anyway.

If your baby has a temperature, or if he is inconsolable, see your doctor. Your baby may have an ear infection or other illness.

How should I care for my baby's teeth?

Once your baby's teeth arrive, it's up to you to keep them clean. It's best to start brushing your baby's teeth as soon as they start to come through.
Once your baby has teeth, try not to put him to bed with a bottle or breastfeed him to sleep. Formula and breastmilk can pool in your baby's mouth at night and lead to tooth decay.

Check with your dentist about giving your baby fluoride (in form of toothpaste). Fluoride can help prevent tooth decay but it's important to give the right amount. Too much may damage your baby's developing teeth.

In a few areas fluoride is added to drinking water, but in most areas water isn't fluoridated. This can mean babies may need a supplement

. Your local water supplier should be able to tell you how much fluoride is in your drinking water.

Your dentist may offer your baby fluoride drops on prescription if he thinks your baby needs them.

Make brushing your baby's teeth a fun part of his bedtime routine. Show him how to move the brush around on his teeth. Use a soft baby toothbrush and a smear of toothpaste, and find one that says 1000ppm fluoride on the tube label.

You don't have to brush in a certain direction, just try to get any bits of food out, and clean the surface of his teeth and his gum line.

If your baby doesn't like the taste of the toothpaste, try another brand. If he does indulge in sweets, at a birthday party for example, make sure to brush his teeth soon after he eats. You can also encourage him to finish up with something savoury.

My baby is 10 months and there's no sign of a tooth yet. Should I be worried?

Many babies don't sprout their first tooth until they are a year old, so try not to worry if your baby is still giving you gummy smiles. If you still don't see any sign of a tooth appearing by the time your baby is one, mention it at his next check-up. If your baby was born early, he may start teething a little later.

If your baby has signs of teething, but also seems to be in huge amounts of pain and is crying inconsolably, see your doctor. Teething can be painful, but shouldn't be a terrible ordeal for your baby.

How long will my baby have his first teeth for?

Years! Your baby's milk teeth won't fall out until his permanent teeth are ready to come through. This will happen when he's about six years old.

Monday, 28 October 2013

How to help your baby walk

Learning to walk is one of the most important achievements in your baby's life, as it's big a step towards independence.

As he moves from standing, to tottering around unaided, to running, skipping and jumping confidently, he'll be leaving babyhood behind.

When will my baby be able to walk?

Over the course of your baby's first year he will gradually gain coordination and muscle strength, and learn to sit, roll over, and crawl. Your baby will then probably move on to pulling himself up. He may be able to stand holding on to something when he's between six and 10 months.

From then on it's a matter of gaining confidence and balance. Most babies take their first steps by their first birthday. By the time they're 15 months old most toddlers are walking unaided, though often with uneven steps.

Try not to worry if your baby takes a little longer. Some children don't walk until they are 17 or 18 months old. Babies who bottom-shuffle tend to walk later than babies who crawl.

How will my baby learn to walk?

Newborn to two months

From birth, your baby has the reflex to brace his legs against a surface he feels under his feet. If you hold your newborn upright on your lap, supporting his head, you'll feel him trying to use his legs. He's not trying to walk, it's just his instincts kicking in. His legs aren't nearly strong enough for him to even stand. This reflex will disappear after a couple of months.

Five months to 10 months

By the time your baby is about five months old, if you let him balance his feet on your thighs, he'll bounce up and down. Bouncing will be a favourite activity over the next couple of months.

Many babies love jumping up and down in their door bouncer. If you have a door bouncer limit the time your baby spends in it to three 15-minute sessions a day, at the most.

As your baby learns to roll over, sit and crawl his muscles will continue to strengthen. Between eight and 10 months he will probably start trying to pull himself up to stand while holding onto furniture. If you prop him up next to the sofa, he'll hang on for dear life.

As your baby gets better at standing over the next few weeks, he'll start to cruise (moving around upright while holding onto furniture). He may then feel confident enough to let go of any support and stand unaided. Once your baby is ready to let go of the furniture, he may be able to take steps when you hold his hands. Your baby may even stoop to pick up a toy when standing.

Nine months to one year

At nine or 10 months your baby will begin to work out how to bend his knees and learn to sit after standing. This is harder than you might think!

By 11 months your baby will probably be able to stand without support, stoop, and squat. By 12 months he may walk while gripping your hand, though he may not take his first steps alone for a little while longer. Most babies make those early strides on tiptoe with their feet turned outward.

At 13 months, your baby may be walking on his own, but probably a bit unsteadily. If your baby still hasn't stopped cruising, it just means walking on his own is going to take a little longer. Some children don't walk until they are 17 or 18 months old.

How can I help my baby to walk?

As your baby learns to stand, he may need some help working out how to get back down again. If he gets stuck and cries for you, don't just pick him up and plop him down. Instead, show him how to bend his knees so he can sit down without toppling over, and let him give it a try himself.

You can encourage your baby to walk by standing or kneeling in front of him, holding both his hands as you help him walk towards you.

You could also buy him a toddle truck or a similar toy that he can hold onto and push. Look for toddle toys that are stable and have a wide base of support. Baby walkers can cause accidents (by tipping over) so it's best not to use them. They are also not developmental appropriate.

As your baby learns to walk it's a good idea to keep his feet as free as possible. If cramped by tight shoes or socks your baby's feet can't straighten out and grow properly.

You can delay buying shoes until your baby is walking around outside or on rough or cold surfaces. Going barefoot helps him improve his balance and coordination.

When you do buy shoes for your baby, try to get his feet measured by a qualified fitter. A fitter will check the fit and ensure there is room for growth.

Make sure your baby has a safe environment in which to practise walking. Keeping the floor space clear will help him to walk around easily. Childproof your home and never leave your baby alone, in case he falls or needs your help.

My baby is 15 months. Should I be concerned that he isn't walking yet?

As long as your baby is bearing weight on his legs and shows an interest in learning new things, you don't have to be concerned. If your baby took a little longer than other babies learning to crawl, chances are he'll need a few more months for walking as well. Babies develop skills differently, some more quickly than others.

If your baby seems to be lagging behind a lot and isn't walking by 18 months, talk to your doctor or health visitor. Remember that if your baby started to move around by bottom shuffling before he learned crawl, then he may walk later.

The speed at which a baby learns a new skill is often inherited from his parents. If you or your partner walked early or late, then there is a chance your baby will be the same.

Keep in mind that if your baby was born early (before 37 weeks of pregnancy), he may reach this and other milestones later than other babies.

How to help your baby learn to walk

Main problems faced by children of Kenya

Realizing Children’s Rights in Kenya

Despite having ratified the International Convention on the Rights of the Child, Kenya has yet to implement these undertakings in their entirety. Poverty, drought, high population growth, internal conflicts, political stalemate and the growing problem of refugees are among the many factors that have limited and impeded the application of almost all the CRC’s principles in the country.

Population: 41 million

Pop. Ages 0-14: 42.3 %

Life expectancy: 55 years

Under-5 mortality rate: 84 ‰

Main problems faced by children in Kenya:

Poverty

Kenya is the victim of extreme and endemic poverty. Half of its population lives below the poverty line, on an average of US$ 2 or less per day. Stark disparities in income and standards of living – plus a steady rise in inequalities – are rendered all the more striking in view of the country’s position as the commercial and financial center of that region of Africa.

The problem is exacerbated by Kenya’s high population growth rate of 2.69% a year, which strains the support capacity of state and non-governmental relief resources – especially as the highest birth rates are recorded among the lowest income segments. Over half the burgeoning population comprises of children below 18 years.

The high poverty rate exerts its most extreme effects on the welfare of children, limiting their right to access clean water, healthy food, medical care, education and protection of basic freedoms.

Health

Kenya is a victim of drought, rising food prices and an influx of Somali refugees; consequently, it has not been able to ensure that its children are adequately nourished. There has been an increase in malnutrition, which has facilitated the spread of many maladies from measles to polio.

Another complex problem is the spread of AIDS. Close to 3% of the population suffers from HIV-infection. A major proportion of victims are children – affected directly (through being infected by the virus) and indirectly (through being orphaned by parental deaths).

Lack of awareness, hygiene, infrastructure, medical material and qualified personnel are factors that foster the rapid spread of HIV and other maladies. The impact of these drawbacks is reflected in the extraordinarily high infant mortality rate, with over 8% dying before the age of 5 years.

Education

Poverty, labour, inadequate infrastructure and child marriage are all factors that prevent children from receiving an education. It is estimated that 30% of them do not attend school.

For a country to escape poverty, all of its children need to have access to a decent education.

Violence against children

In Kenya, violence against children takes a variety of forms: physical, mental, sexual and moral. It occurs in both the home and at school. In the latter sphere, cases where children have been assaulted and even raped by their teachers are not uncommon; with girls who have been victims of rape often becoming pregnant and being forced to drop out.

Child prostitution – with all its attendant evils – is another problem. Though prohibited by law, it remains difficult to deal with. Its intractable nature is reinforced by the steady rise in the number of poor children, as well as the number of children orphaned on account of AIDS. These factors, in conjunction with sex tourism, have contributed to an increase in the incidence of child prostitution.

Child labour

Owing to ineffective legislation and extreme poverty, the percentage of children forced to forego an education for work remains high: affecting 26% of all youth aged between 5 and 14 years.

Many children work on plantations under deplorable conditions; others are employed as domestic helpers. These jobs are invariably physically and morally exhausting, and lead to apathy and hopelessness. Children who cannot find work often resort to begging in order to help support their families, gravitating towards a non-productive existence on the streets of the larger cities.

Child refugee

This year Somalia, one of Kenya’s immediate neighbors, has been the victim of one of the worst droughts in recent history. As a result, numerous families have sought refuge and relief in Kenya, only to find the latter slow in materializing: with serious – and often fatal – consequences for the children, who comprise the majority of refugees.

Refugee camps have been set up at Dadaab. Many of the refugees arrive at these camps in a weak and dehydrated state, suffering from severe malnutrition. The humanitarian aid made available to them from local and international sources remains woefully inadequate to combat the crisis, and many children face a constant struggle between life and death.

An estimated 2 million children in this region are chronically undernourished.

Detention of children

With regard to preventive detention of offenders, children are often locked up in the same facilities as adults, frequently being forced to share cells with both men and women. Consequently, physical and sexual abuse of incarcerated children is a common occurrence.

An especially alarming feature of this situation is the high number of innocent children below the age of 4 years languishing in Kenyan prisons. This is due to the fact that many female inmates bring their children with them when serving sentences, having no one to look after such infants during the mother’s absence.

Female genital mutilation

Female genital mutilation is still practiced in several parts of Kenya. The procedure itself is both painful and humiliating, as well and unsanitary and extremely dangerous. Young girls subjected to it frequently suffer from hemorrhages and various infections; and fatalities are all too common. Survivors of this barbaric practice often suffer permanent physical disability and lifelong psychological damage.

Child marriages

The practice of child marriage remains widespread within certain ethnic groups. More than 25% of Kenyan girls are married before the age of 18. These young girls are in no position to understand what marriage entails, and invariably face a future of unrelenting hardship and incessant toil. The offspring of such unions begin life at a severe disadvantage.

Right to identity

Only 60% of births in Kenya are reported and officially recorded. As a result, as much as 40% of all Kenyan children possess neither an official identity nor a nationality: growing up, in effect, as stateless persons with no hope of access to even the most basic human rights. For all intents and purposes, they do not exist in the eyes of society.

main problems faced by children in Kenya