Consequences of Stress on Children’s Development

I have a friend who was a victim of abuse as a child.  I consider any type of abuse to be a form of violence and I don’t necessarily think that it has to be physical to be violence. The type of abuse that was inflicted upon her was emotional abuse from her birth father. She was the oldest sibling of four children and she often found herself feeling unfavored by her father. He frequently made her feel bad about herself.  He never said anything to make her feel good about herself. As a result she grew closer and closer to mother. She never spoke to anyone about how her father made her feel. She didn’t want anyone to know. Her mother didn’t have the means to leave her father with her four children. She had no family that she could turn too, so my friend was stuck in this situation until she turned 18 years old and moved away from home. Her mother was finally able to leave her abusive husband when my friend was 19. But this was too little too late.   As a result, my friend does not have much of a relationship with her father. But she can also ee how her relationship with him, or lack there of, affected her relationships with men as she dated. She was drawn to guys who were emotionally abusive like her father. Although she wasn’t happy, she didn’t know anything else and she made excuses for them. She did finally meet a wonderful guy, but the way he treated her was difficult for her to handle. She wasn’t used to being treated this way by a man and she pulled away in the beginning. But he fought hard for her and she overcame her relationship issues. They just got married about a year ago. Her father walked her down the aisle, but not once did he tell her how beautiful she looked on her wedding day. She wasn’t surprised but this is still sad.

I was reading up on poverty in Ethiopia. There is alarge percentage of people in Ethiopia with AIDS or HIV. Many die every year. I read that are about 5 million children in Ethiopia who have been left orphaned or in poverty from AIDS. Many of these children end up living on the streets, sometimes making a living as sex workers. They are left with no shelter and no food, often begging in the streets. This effects their biosocial development. They are not getting proper, if any, nourishment for their bodies and brains.  At night the girls are often harassed by men who want to use them for sex (exposing them to HIV).  Many young girls who are out on the streets end up pregnant and stop going to school and start doing drugs. Because of the poor conditions and because many are unable to support themselves, about a 1/4 of all children in Ethiopia are involved in some way, in the work force for on average 6 hours a day. As a result even those who are in school have no time for homework, are frequently absent and often abandon school altogether. Cognitive development because they are not exposed to education and new ideas. Some even from a very young age. According to the UN Development Program, only 34 percent of Ethiopian children attend school. All of these conditions effect their psychosocial development. The daily life they are exposed to can create stress and worry for them.

Please read more at http://ipsnews.net/news.asp?idnews=43836 . The video at the bottom is particularly saddening.

Breast Feeding

The public health topic that affects development I chose is breastfeeding. I chose this topic because it is a topic of controversy for many including myself. I have a two year old son and when he was born I attempted breast feeding. He had trouble latching on so they sent a lactation nurse to my room to help us. She single handedly ruined it for me. She was very pushy and was not as encouraging as she should have been. I felt as though I was being forced to breast feed rather than being helped. I was completely turned off to breastfeeding after my encounter with this nurse. As soon as she left the room, I called my nurse and asked for bottles so I could feed my son. I noticed that people looked at me funny when they saw me bottle feed my newborn. One person in particular, a male friend of my husbands, was very opinionated on the subject. I have a problem with that. Especially from someone who has never and will never experience how difficult it can be. While I understand that it is the best thing for your baby, I do not think that people should be scrutinized if they do not want to or cannot do it.

I learned that in Africa, more than 95% of infants are currently breastfed. The importance of breast milk as a food resource of African countries is generally not recognized and I found it interesting to know that their feeding practices are often inadequate because they feed water, and other liquids, to breastfed infants consequently, making the rate of exclusive breast-feeding very low.  In a country where they do not have the financial means for formula, it would be nice if they could make the most of the resources they do have available to them (ie: breast milk). But with the rate of AIDS cases, it is often safer for babies to be bottle fed.   

I am not sure how these findings impact my future work but I do feel as though I am encouraged to try breast feeding again because it really made me sad for those women in Africa who are not able to breastfeed for fear of transferring AIDS to their newborn babies.

http://www.ncbi.nlm.nih.gov/pubmed/11943640

Childbirth

I have a son. His name is Cole and this is the story of his birth. I chose to write about his birth because it was an amazing experience for me.

I will back track just a bit and tell you a bit about my pregnancy towards the end of it. I went to the doctors for a regular OBGYN appointment at 32 weeks and they were not able to get a measurement of my little guys head because it was down to low. The did an exam and told me that they thought I was in labor. I told them they were crazy but they sent me to the hospital to check for pre-term labor anyway. I was hooked up to monitors because I was in fact contracting. They kept me for a little over 36 hours to make sure that I wasn’t dilating. I wasn’t but I didn’t get to leave there without a few steroid shots and Doctors orders that I would be on limited bed rest until 35 weeks. I was thrilled! (can you sense the sarcasm?)

A few weeks went by and I had an appointment on Monday, December 21st (35 weeks) to see if I would be allowed to come off bed rest. They told me yes and I went back to work on Wednesday December 23rd, just in time to see my students and give them their Christmas gifts before break. That evening I went to bed around 11:00 and was awoken with strange cramps at 1:00am.  I started timing them. They started at 7 minutes apart. I did everything I could do to keep my mind off of them while Mike was sleeping…including, showering, taking a bath, watching a movie, and calling my mom in the middle of the night. Mike woke up around 5:30, rolled over and said, “These darn dogs! I haven’t gotten much good sleep tonight.” To which I replied, “YOU didn’t sleep well? I’ve been up since 1:00 with contractions.” He jumped in the shower and got himself ready while I continued to lay around timing my contractions. I was not about to go to the hospital on Christmas Eve, not be in ‘real’ labor, and get stuck lying around in a hospital bed on Christmas Day. Well, finally around 10:30am I decided that this really was happening so I got dressed, put on make-up, fixed my hair, (yes. I really did. You do know they take pictures of you when you are in labor and after the baby is born, right?!)and jumped in the car(that Mike already had packed and warmed up for the last few hours. LOL)

We arrived at the hospital, I went to Triage and they did an exam. The Doctor said, “Looks like you are having a baby today!” And I said, “TODAY, right? A Christmas Eve birthday is bad enough but I can’t have this baby born on Christmas Day!” She laughed and said, “Yes. Definitely today. Let’s get you up to your delivery room.” Just as we were getting settled in the delivery room, I started to have contractions that felt like someone was stabbing me in the stomach… up until now they hurt, but nothing more than bad cramps that I could handle. They called for the epidural and with-in a few minutes I was feeling good again. By this time it was around 1:00pm. The waiting room was filled with my family and friends and they, a few at a time, came in to visit and chat with us. I spent the next 3 hours hanging out with my family despite being told to get some sleep. The doctor kept coming in to check me and would fill me in on how strong my contractions were because I couldn’t feel anything. Around 4:00pm I had a very big contraction that sent the baby into distress. His heart rate plummeted and they rolled me onto my side and put an oxygen mask on my face. After a few seconds his heart rate stabilized and all was well. The doctor came in around 4:30 to check my dilation, asked me to give a small push, and said, “I see hair. It’s time to go!”

She got herself set up, directed my mom to hold my head up, my sister to hold one leg, and Mike to hold the other. She explained to me that I needed to push 3 times for as long as I could per contraction and told me that we would begin on the text contraction. I pushed 9 times, during the next 3 contractions and he was born in less than 15 minutes, at 4:58pm, December 24, 2009. He weighed 5 pounds, 10 ounces and was 18 3/4 inches long.  I felt no pain or discomfort at all and I am thankful for the epidural. I was able to enjoy and truly experience everything that was happening as my son was being born. He was cleaned up and brought to us in a Christmas Stocking that said, “My First Christmas”

And just a little proud mommy side-note… my little man-made it onto the news on Christmas Day! There were no Christmas Day babies at St. Joes hospital so they did the Christmas Eve babies instead. They even said, “This Baltimore couple got ‘Cole’ in their stocking for Christmas. Their son Cole Hammel was born on Christmas eve. He was due to arrive in January but decided to make an early arrival.”

Cole Michael Hammel’s first picture.

First family picture. “Love does not even begin to describe how you feel about your child.”

Picture taken just as the news cameras were arriving.

My First Christmas

To be completely honest with you, I am not sure of my opinions on how birth effects child development. I have heard a number of arguments that an epidural affects a child’s development and that babies born to mothers who did not have drugs during childbirth are happier, easier to care for and have better motor skills. I have not read any type of proof that this is true and if it is, I can’t imagine that it is true for everyone. My child was a very easy baby,never cried unless he was hungry, started sleeping through the night before 2 months,  and had very good motor skills. He walked just days after turning 10 months old. It would also be nice to think that if a baby were born into a setting where everything was calm and soothing for them, that this would be beneficial to them as well. But that setting only lasts for a short time. But then there are visitors, first bath, shots, etc. Those are not soothing settings for a baby. And what if there is an emergency during childbirth and the setting the baby is born into is frantic and loud? Maybe I am naive to think this way but I believe that a safe delivery/birth is the most important thing.

I researched prenatal care and birth in Africa and found some quite disturbing information. About 20% of disease in children below the age of 5 is related to poor maternal health and nutrition, as well as quality of care at delivery and during the newborn period. Eight million babies die per year, before or during delivery or in the first week of life. Out of 100 women in Africa ages 15-40, 34 do not have proper prenatal care. The consequences of this is untreated hypertensive disorders leading to death and disability, or malnutrition. Iron deficiency anaemia among pregnant women is associated with roughly 111,000 maternal deaths each year. I found that countries in Africa have some of the highest maternal mortality rates in the world. Many African women die during childbirth due to the lack of hospitals, trained medical personnel, and lack of road access and transportation to the hospitals. A recent study found that 900 out of 10,000 women die due to childbirth complications. These women often give birth to their children in their home with the help of local women rather than at clinics because they are unable to find a ride to the clinic. An African woman has a 1 in 16 chance of dying in pregnancy or childbirth.  Due to the high maternal mortality rate, many children are left motherless each year and these children are 10 times more likely to die within two years of their mothers’ death.

This is vastly different from my experience here in the United States. I can afford proper prenatal and hospital care. And there are many hospitals with properly trained medical personnel. I can not begin to imagine how awful this must be for these poor women and their children.

http://www.voanews.com/english/news/a-13-2008-05-30-voa35-66648027.html
http://www.unicef.org/mdg/maternal.html