Guest post: Chris Whittle MBChB and BMedSci (hons) and founder of High Street Huddle
Each of us has very different experiences of healthcare; from a one off broken bone to the solemn last days of a much loved parent or grandparent. Any experience as a child will likely not be remembered well; it may be a distant memory of nurses and doctors and beeping machines.
Of course, after becoming a parent the health service experience changes; I speak as a healthcare professional who sees this on a daily basis. I thought it useful, therefore, to write a little about three major health issues concerning new parents: vaccinations, breast versus bottle feeding, and operations.
The big issue that comes up often now in the post-Andrew Wakefield era – If you don’t know already, Wakefield was the author of the studies that claimed a link between the MMR vaccination and autism.
His findings have since been judged to be not only fraudulent and unreproducible, but even unethically collected with “a callous disregard for any distress or pain the children might suffer as a result”.
Fortunately the wounds of his wrongdoings are healing, and parents are coming back around to an objective discussion about vaccinations.
I am clearly of one side of the fence in a very two sided debate, but I thought it useful to give you some numbers surrounding just one of the conditions that one vaccination protects against, just so you get an idea:
With mumps – one of the three conditions protected against by the MMR vaccination – 1 in 20 mumps infections will cause pancreatitis, 1 in 20 will get temporary hearing loss (at a crucial developmental stage in children), 1 in 4 males post puberty (i.e. if they hadn’t been vaccinated) will get testicular swelling (with 1 in 10 affecting sperm count), and 1 in 20 females post puberty with mumps will experience swelling of the ovary (oophoritis).
While you can read more about the MMR vaccination itself here , I think one look at the numbers above show how common these complications to many preventable conditions are, and while it is easy to say ‘my child will be ok if everyone else is vaccinated’ this clearly has a logical flaw to it. Not only that, but as mentioned above if a future outbreak were to occur, post-pubertal effects can still have profound effects, a long time after skipping a vaccination that didn’t seem necessary at the time of mass herd immunity.
Breast vs bottle
An ever ferocious debate – the most recent form of which has been under the ‘#bressure’ hashtag – calls for breastmilk nutrients for optimum development on the one side and lessening the burden of not being able to provide the best for your baby on the other. And while as health professionals it is easy to feel guilty about the emphasis that we put on the old ‘breast is best’ slogan, I was surprised to see a recent survey conducted by ChannelMums showed most pressure was deemed to come from other mums as opposed to healthcare professionals. So what can we do about this?
Perhaps the answer is two fold. The first is awareness; awareness of the benefits of breast feeding where possible, and within that education about both the alternatives and the problems with expression that are likely to occur (breast thrush, mastitis, etc) so that they do not arrive unforeseen at a time when the likes of PND are lurking in the background. The second means is proactivity; by healthcare staff and by mums who are able to help. Support groups allow ongoing discussion of problems with breastfeeding, allowing easier transitions from breast to bottle and vice versa where applicable. Proactive donation is also there as an option.
What to expect if your child is having an operation
This final tenet I have experience with that may help to allay anxieties; it is obviously a difficult thing to do as a parent and in fact many parents believe they are going to fine until that last moment when their little one is no longer under their control and supervision. Of course there are many dependable variables around what to expect, but speaking in general terms, if a child is to have a non-emergency operation there are a couple of things that are useful to know about the anaesthetic:
Local anaesthetic cream – the ‘magic cream’ that contains local anaesthetic to numb the skin on the back of the hands. This is good to know about because if of the right age, your little one may enjoy the mystery of it all and it can be worth making up a little game about it. Knowing about its inevitable use in advance can help you to be one step ahead!
Accompaniment – the majority of anaesthetists will allow one parent down to the anaesthetic room (beside the theatre); so choosing who goes can best be based on who is most likely to be a calming influence.
Mask – if the anaesthetist chooses to use a mask for the anaesthetic, things go one of two ways; if old enough to follow a story with sufficient distraction your little one will breathe away until drifting off to sleep. Sometimes a preemptive story about a spaceman mask can be appropriate and helpful. If, on the other hand, they don’t buy the story or the sight of the mask sends them into a frenzy then it is best to remain as calm as you can yourself and to talk to them gently until the deep inhalation they take in between cries allows sufficient anaesthetic gas to take effect. An important thing to note is that in either scenario a significant amount of wriggling is quite normal as they drift off to sleep if it is a ‘gas induction’ being used; this is quite normal and is part of the anaesthetic taking effect. Although it can look distressing it won’t be remembered, and the next thing that they will remember is waking up in a recovery area with some friendly nurses. As soon as your child is awake enough, you’ll be allowed in to see him or her.
I hope the writing above gives some clarity to issues that require clarification, some fuel to the debate and thought around those that need discussion and more awareness. Please feel free to contact me about issues discussed as they are all part of our ethos at High Street Huddle – to bring new parents together and forward into an easier world for our little ones.
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