Basic Principles of Sleep Hygiene for Children

My bhabhi (sister-in-law) has an adorable 1 year old boy. This otherwise happy baby however becomes a extreemly fussy, irritable and cranky at least once/ twice a day.... Reason: Sleep time! In my practice I have come across innumerable instances of children having a lot of difficulty in falling of to sleep.

Listed below are a few tips to help get your child to sleep without a lot of fuss

Have a set bedtime and bedtime routine for your child.
Bedtime and wake-up time should be about the same time on school nights and non-school nights. There should not be more than about an hour difference from one day to another.
Make the hour before bed shared quiet time. Avoid such high-energy activities as rough play, and stimulating activities such as watching TV or playing computer games just before bed.
Don't send your child to bed hungry. A light snack (such as milk and cookies) before bed is a good idea. Heavy meals within an hour or two of bedtime, however, may interfere with sleep.
Avoid products containing caffeine for at least several hours before bedtime. These include caffeinated sodas, coffee, tea, and chocolate.
Make sure your child spends time outside every day whenever possible and is involved in regular exercise.
Keep your child's bedroom quiet and dark. A low-level nightlight is acceptable for children who find completely dark rooms frightening.
Keep your child's bedroom at a comfortable temperature during the night (less than 75 degrees).
Don't use your child's bedroom for time-out or punishment.
Keep the television set out of your child's bedroom. Children can easily
develop the bad habit of “needing” the TV to fall asleep. It's also much more
difficult to control your child's TV viewing if the set is in the bedroom.

Source: Nelson Textbook of Pediatrics

HOW TO GIVE STEAM INHALATION IN CHILDREN

Steam is a very important treatment in children for treating colds, stuffy nose and cough. Not only does it liquefy the mucus, but it also reduces nasal congestion and nasal blockage. In children the role of steam is more as they are not effectively able to cough out secretions and because medicines are more likely to cause side-effects in them.
The major problem in steam lies with the fact that no one likes taking it! Uncooperative children risk getting burnt if they do not take steam properly.
Here are a few tips on how to give safe and effective steam to your child;

• Use a steamer with a closed top- this way there is a negligible chance of the child getting burnt in case of a spill.
• Do not force the child to take steam, it is invariably preferable to try and earn their co-operation than to try and force them.
• Keep the steamer near the bedside (on the floor) with the steam jet directed towards the child's face while they are sleeping.
• For a smaller child (upto 6-8 months), keeping the baby in your lap while you take steam with a blanket/ cloth covering your face and the child is useful. Remember not to put the baby's face very close to the steam as there skin is very sensitive.
• For an older child another option is to switch on the hot and cold water in the bathroom to create a sauna like effect and get the child inside and play with him/ tell him a story etc.
• Keeping the steamer on in the bedroom is not very effective for giving steam as the room size is likely to be large. However this technique can be used in addition to the ones described (to reduce the dryness) above especially when you are using a heater/ warm air blower in the room.

Child Psychology in the Tsunami's aftermath

With the recent Tsunamis hitting the Indian shores, more may be at stake than just the people in its path. Viewing the frightening pictures and emotional coverage of this disaster on tv may be leaving scars on your young child's mind. Here's how to talk to your young child about disasters and calamities.
What You Need to Know: How children react to disaster depends on their age. When exposed to a calamity or emergency children experience a variety of emotions and need your special attention. Two typical DISTRESS reactions in children are "a-typical behaviour" or doing things they have never done; e.g. a normally friendly child becomes shy;

And "regressive behaviour" that is behaving much younger than their age; e.g. a toilet trained child starts bed wetting again.

These reactions may occur immediately after exposure to a disaster or after a few weeks. Most of the times these symptoms pass away when the child re-adjusts. If you are directly affected by the disaster, cope with it in a way that the children do not develop a permanent sense of loss.
SYMPTOMS BY AGE
1-5 Years: Bed-wetting, fear of darkness, clinging to parents, night terrors, stammering, loss of appetite, fear of being left alone, confusion.
What You Can Do: Talk reassuringly, hold and hug the child, give frequent attention, encourage him/her to express his feelings through play or words, allow to sleep in your room till they have overcome their anxiety.

5-11 Years: thumb-sucking, irritability, whining, fighting at home or school, fighting with younger sibling for parental attention, school avoidance, nightmares, withdrawal from friends, poor concentration at school, regressional behaviour, headaches or other physical complaints, fear about safety.
What You Can Do: Be patient, arraneg their play sessions with friends or adults, encourage discussions with friends and adults, temporarily reduce your expectations at school or home, give more structure to time at home including non-demanding chores, rehearse safety measures for future disasters (discuss in detail how you will cope if a similar disaster affected you in the future).

11-14 Years: Lack of sleep, poor appetite, rebellion at home, refusal to do chores, school problems like fighting, withdrawal, attention-seeking behaviour or loss of concentration; physical symptoms like headache, vague pains, upset stomach, and loss of interest in peers.
What You Can Do: Involve them with same age group activities, help to resume lost routine, encourage group discussions, give stuctured responsibilties which are non-demanding, temporarily relax expectations and give extra individual attention.

When is Professional Help Needed ?

If symptoms continue, most likely a deeper emotional problem has occured and it is advisable to seek the help of a mental health professional who has experience with children and trauma. In the absence of such a professional, your pediatrician may be consulted.

Remember, children are adept at realising the concerns of their parents and this is especially true at the time of a crisis. As parents, you should admit your concerns to your children, and also stress your abilities to cope with the situation.
Compiled with the help of New York State Office of Mental Health.