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Protecting the Child, Preserving the Family, and Honoring Life

Welcome to the Blog page of the American College of Pediatricians, which we call Scribit Veritas.  Each issue of the Blog is intended to assist parents, encourage children, and enrich the family.  Read our most recent issue below, and scroll to the bottom of this page to read earlier issues.

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Pregnancy and Infant Loss: The Silent Suffering

Pregnancy can mean different things to different people, but one thing’s for sure: it’s definitely life changing! From the moment a couple sees that positive on the pregnancy test, nothing is the same. What follows are months of doctor’s appointments, morning sickness, anticipation, anxiety, and more.

But for some parents, this life-changing experience takes an unexpected turn. While they’d been planning on welcoming a new child into their life, complications can lead to either death during pregnancy or shortly after birth. These losses during pregnancy or infancy are unfortunately both all too common and often overlooked. 

The purpose of this post is to raise awareness of the unspoken pain so many parents face, as well as give you some tools to help those who are struggling with grief.  

The Loss

According to the US Department of Health and Human Services, about one million pregnancies each year end in some kind of loss (1), whether that be a miscarriage (loss before 20 weeks pregnant) or a stillbirth (loss after 20 weeks pregnant but before or during delivery). Anywhere from 10-25% of all known pregnancies end in miscarriage alone (2). In addition to these losses during pregnancy, about 24,000 babies die after birth while still in infancy (3).

While these losses don’t affect everyone in the exact same way, losing a baby before, during, or after birth has a serious impact on the parents. Research shows that miscarriages can take a big emotional toll on both women and men, even if the baby was lost very early on in pregnancy (4). Research also shows an equally strong reaction to stillbirths as families struggle to cope “for years and sometimes decades” (5).

With all of the emotions and grief to sort through, parents need support now more than ever. Unfortunately, they often don’t receive the support they need to cope with their loss (6).

So what can we do to help our loved ones cope with the tragedy of pregnancy or infant loss?

Helping Loved Ones Cope

Helping loved ones deal with loss during pregnancy or infancy can be really tricky. Often times, these parents may need help from professional counselors as they work through their grief. (They also may benefit from support groups online or the free bereavement materials from March of Dimes.)  But there are a few things we can do as friends and family members to acknowledge their loss and support them in the process. 

The American Pregnancy Association suggests a few ways to help your loved one cope with a miscarriage (7). These also apply to stillbirths or the loss of an infant as well. 

  • Listen. As part of the grieving process, a parent may just need someone to tell their story to. Genuinely listening with love can go a long way as they try to heal. 
  • Validate their feelings. Let them know that their grief and emotions are normal, and that this is all a part of the healing process. Even if it’s been some time, don’t tell them it’s time to move on or get over it. 
  • Be ready to talk about the baby. They may not always be ready to talk about the baby, but when they are, be there. Talking about their baby is a healthy part of coping with grief.

Break the Silence

So many mothers and fathers struggle alone with the loss of their baby. But it doesn’t have to be that way! This pregnancy was still life-changing and still should be talked about. As friends and family, we can be there to support those who are experiencing the grief of losing their child so they don’t have to suffer in silence.

 

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Picture retrieved from https://www.pexels.com/photo/affection-baby-birth-black-and-white-266055/

References

1. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2013). Child Health USA 2013. Rockville, Maryland: U.S. Department of Health and Human Services. Retrieved from 

https://mchb.hrsa.gov/chusa13/perinatal-health-status-indicators/p/fetal-mortality.html

2. American Pregnancy Association. (2017, May 2). Miscarriage: Signs, symptoms, treatment and prevention. Retrieved from http://americanpregnancy.org/pregnancy-complications/miscarriage/

3. National Institute of Child Health and Human Development. (n.d.). How many infants die every year? Retrieved from https://www.nichd.nih.gov/health/topics/infant-mortality/topicinfo/Pages/statistics.aspx

4. Leis-Newman, E. (2012, June). Miscarriage and loss. Monitor on Psychology, 43(6), 56. Retrieved from http://www.apa.org/monitor/2012/06/miscarriage.aspx

5. Cacciatore, J. (2013, April). Psychological effects of stillbirth. Seminars in Fetal and Neonatal Medicine, 18(2), 76-82. Retrieved from

http://www.sciencedirect.com/science/article/pii/S1744165X12001023

6. Cacciatore, J. & Bushfield, S. (2007). Stillbirth: The mother’s experience and implications for improving care. Journal of Social Work in End-of-Life & Palliative Care, 3, 59-79. Retrieved from http://www.tandfonline.com/doi/abs/10.1300/J457v03n03_06

7. American Pregnancy Association. (2017, April 19). After a miscarriage: Supporting friends & family through loss. Retrieved from http://americanpregnancy.org/pregnancy-loss/

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When Extracurricular Activities Stop Being Beneficial

I know of many parents, including some of my own aunts, uncles and friends, that spend the majority of their day helping their children participate in extracurricular activities. They meticulously organize each hour of the day to accommodate and fit in each child’s separate activities. I have an aunt, for example, who, with her three young children, is constantly running around to soccer, basketball, dance, theater, gymnastics, piano, swimming, and church activities. My grandparents are often pulled in to help take them places when the two of them can’t spread themselves thin enough to cover it all. 

The oldest of their daughters described her day as “busy” and “different every day depending on the activity”. When I was a young girl, I had maybe one or two extracurricular activities and spent most of my after-school time simply playing around the neighborhood or inside with my siblings. 

So the question arises: When do extracurricular activities stop being beneficial? Let’s look at the Pros and Cons.

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Teens & Depression

Depression–or feeling sad, frustrated, and hopeless about life, accompanied by loss of pleasure in most activities and disturbances in sleep, appetite, concentration, and energy–is one of the most common psychological problems among adolescents. According to previous research done at the American Psychiatric Association in 2013, 20 to 50 percent of U.S. teenagers experience mild to moderate feelings of depression, but bounce back after a short time. What’s even more worrisome is the 15 to 20 percent of teens who have had one or more major depressive episodes. That rate is comparable to that of adults! About 5 percent of teens are chronically depressed–gloomy and self-critical for many months and sometimes years.  

Many parents wonder what causes depression. I’ve heard many parents express some of the following questions about depression:  Is it real? What causes it? Is it genetics? Is it something happening at school? Puberty? Is it my fault?

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Avoiding Teratogens in Pregnancy

The word teratogen comes from the Greek word, teras, meaning “malformation” or “monstrosity” (Berk, L., Development Through the Lifespan, p. 81). During pregnancy, it’s extremely important to take care of yourself and your baby, and many mothers don’t know about teratogens, or certain aspects of their environment that could cause damage during the prenatal period. However, many effects of teratogens go beyond immediate physical damage. Some health effects are delayed and may not show up for decades. 

Here are three of the most common teratogens.  Recognizing them and understanding their effect on your body, and that of your unborn children, will help you know what to avoid. 

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Emergency Preparedness

In February of 2017, in the middle of one of the coldest winters in years, it was also the wettest.  The water couldn’t sink into the frozen ground so it pooled. Fields quickly turned to ponds and small lakes and roads became rivers.  No one in our area had seen anything like it, and only a few were prepared for the waters. Entire roads were flushed out and homes were sunk in less than a day.  Rumors about the local dams overflowing were spreading. Even though my spouse worked for the city and assured me the rumors were false, I began to worry.

We have some camping supplies, but if we had to leave in a hurry, or even hunker down at home, we could be in trouble.  I looked at my daughter and realized I had no water storage for food or formula if needed.  

It was a wakeup call.

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How to Talk to Kids About Visiting the Doctor

For most children, experience with a doctor starts at day one. It’s probably a good thing babies can’t remember their birth. No baby, child, or adult would want to go back to the doctor if they associate the doctor or hospital with pain and discomfort.  One bad experience can set a person against it forever. But going to the doctor is essential for a person’s health.

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Answering Your Child’s Questions About Sex

The “talk” is one that many avoid, and many others hope will only require a quick fill-in of information they do not already know. For many, the “talk” that we have with our children about sexual development can be very intimidating. According to the Department of Health & Human Services (2016), many parents assume that we must talk to our children about EVERY aspect of sexual development all in one sitting. Parents hope that their children will hear everything and that any curiosity they have will dissipate. In order to more fully understand this difficult step, we must ask ourselves the basic questions that give us a clearer picture as to WHY our children are turning to sexual intercourse or inappropriate media. According to the government-funded study referenced above, anxiety almost always precedes inappropriate behavior. This anxiety is often manifested in questions linked to sexual development. These questions include the following:

  • Why is my best friend getting attention from boys?
  • What is this feeling that I feel when I see inappropriate images?

The “talk” isn’t meant to be one perfectly worded explanation of anything and everything pertaining to sex.

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Why Breastfeeding is Best and Should be Encouraged by Society

Many mothers today differ in their opinions on what’s better for their newborn: breastfeeding or bottle-feeding? Nutrition is especially crucial for development in the first two years of the baby’s life because it’s brain and body are growing so rapidly. 

Babies need both enough food and the right kind of food. In early infancy, breastfeeding is ideally suited to their needs, and bottled formulas try to imitate it. 

Today, 79% of American mothers begin breastfeeding after birth, about half stop by 6 months (Centers for Disease Control and Prevention, 2014a). The U.S. Department of Health and Human Services (2011) advises exclusive breastfeeding for the first 6 months and including breast milk in the baby’s diet until at least 1 year. 

Here are seven reasons to breastfeed, according to its nutritional and health advantages:

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Communicating Confidence

 

Growing up I didn’t have a very close relationship with either of my parents. To this day we don’t have very many conversations that include many words of affection, unless it’s me communicating to them. I’ve learned throughout my life the importance of having loving communication with those around me, especially with children.

Our children will remember the things we do, but more than that, they’ll remember the things we tell them, teach them, and help them to believe. As we communicate with love, we can help them to believe in themselves and gain self-confidence.

Carl Pickhardt, a psychologist and author of 15 parenting books, says a kid who lacks confidence will be reluctant to try new or challenging things because they’re scared of failing or disappointing others.

This can end up holding them back later in life and prevent them from having a successful career.

So, as parents, it’s our job to help them to love themselves while they’re young, thus securing their self-confidence in the future. This can seem like a hard task, but we can start by simply communicating confidence, or incorporating phrases that help them recognize their value and potential, thus coming to believe it. Here are a three phrases that you can start using today to begin communicating confidence:

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Benefits of Skin-to-Skin Contact During Infancy

 

When my first child was born, they immediately placed her on my bare chest for an hour of uninterrupted skin-to-skin time. At that particular hospital, they call it the “Sacred Hour”. The doctor informed my husband and me that the sacred hour meant keeping the room quiet for the baby to hear only our voices. She would be placed on my chest with no testing, cleaning, or interruptions for a whole hour. It allowed us to promptly begin bonding with our baby. “Skin-to-skin contact helps your baby stay warm, relax, transition, breathe easier, as well as promote breastfeeding” (Labor & Delivery). For us, this was a wonderful start to our bonding experience with our daughter. However, bonding does not stop after that hour ends. It is an ongoing process that happens every day you are caring for your child. “You may not even know it’s happening until you observe your baby’s first smile and suddenly realize that you’re filled with love and joy” (Ben-Joseph, 2018).

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