Pregnancy and Influenza

Women who are pregnant and their unborn child are both at increased risk for complications due to influenza. This is due to changes in the immune system, heart and lungs during pregnancy. These changes place pregnant women at risk for complications, hospitalization and even death due to influenza. The unborn child is also at risk for numerous medical problems.

The first step in treatment is always prevention. Everyone six months of age and older should be immunized every year against influenza. Vaccination is the best way to protect you and your unborn baby from the harmful effects of influenza. It is safe for pregnant women to be immunized with the inactivated influenza vaccine during any trimester. It is not recommended for pregnant women to receive the live attenuated influenza vaccine which is also called LAIV. This vaccine is administered via nasal spray.

Receiving the influenza vaccine during your pregnancy decreases the risk your new infant will come down with influenza during the first six months of life. This is especially important since your child cannot receive an influenza vaccine until six months of age. If you are pregnant and you come down with influenza you also place your child at risk for premature delivery or being small for gestational age.

The flu shot is recommended during pregnancy by the Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists. There is a long record of safety for this immunization being given safely and effectively to pregnant women. Millions of pregnant women have been immunized and there is no evidence of harm to the pregnant woman or their baby.

If you are pregnant and come down with influenza you should receive antiviral treatment as soon as possible. You should not wait for a confirmation test. If your doctor suspects you have influenza that suspicion is enough to begin treatment. It is important for treatment to begin within 48 hours of onset of symptoms. This is why it is important for you to see your doctor early in your illness. There is also proven benefits to beginning treatment after this 48 hour period. The medication that is prescribes is called oseltamivir and it has been proven to be safe for your developing baby when given while you are pregnant.

Flu vaccine and antiviral treatment can make a difference for both you and your unborn child. Get vaccinated and seek medical attention if you become ill with influenza symptoms while you are pregnant.

 

Parent-Directed Parenting

Parent-directed parenting strategies are built upon the parent leading the child. They are most commonly used in the preschooler or early school-aged child. This type of parenting is different from child-directed approaches where the parents follow rather than lead the interaction.  In child-directed intervention the focus is on social attention and nonverbal communication. Self-esteem and a positive parent-child attachment are the goals. In parent-directed intervention verbal communication is primary and the focus is on compliance through contingency management, limit setting and problem solving. Reasoning skills are emphasized and clear, concise and consistent verbal direction is delivered by the parent.

Parent-directed approaches involve telling your child what to do rather than what to stop doing. Children are told and not asked what to do. Directions are broken down into small, specific segmented activities. Parents must avoid multistep directions and the specific behavior that is sought must be concrete and developmentally appropriate. Polite and respectful directions are delivered in a non-threatening normal tone of voice and all directions are explained either before a direction is given or after a direction is obeyed.

When a direction is given and your child does not comply then a time out warning is given. The child is again given the initial command and told he or she will have to go to the time out chair if the command is not obeyed. If the child complies praise is given and the reason for the praise is labeled.

If your child disobeys for the second time then the child must go to the time out chair for several minutes. The child can be released from the chair after this period by giving a command that describes the quiet sitting and asks the child if he or she is now ready to follow the original command. The command needs to be repeated in the same way it was given the prior two times. If the child answers yes or nods that the command will be obeyed then their answer is acknowledged and the child is released from the time out chair and allowed to resume activities.

If your child gets out of the time out chair without your approval then the child is told he or she will go to the time out room. If the three minute timer is restarted and he or she gets out of the time out hair again without your permission the child is taken to a time out room for one minute and then returned to the time out chair to resume the three minute timer. If the child complies or does not comply then the same routines previously described are followed. For each of the successful steps an obeying behavior is always acknowledged and labeled praise is given.

Many parents find it helpful to perform several 5-10 minute sessions each week of parent directed commands for the preschool and early school age child. These sessions reinforce spontaneous parent-directed interventions and speed up your child’s willingness to comply with directions and strengthens the development of problem solving and reasoning skills.

Child-Directed Parenting

Your ability to anticipate and respond to the behavior of your child determines the type of parent leader you are.  Leadership is an essential part of parenting. As a parent leader you must choose parenting responses and an emotional vocabulary that allow you to listen, connect and respond to your child with unconditional love.

Uncertainty of how to respond and interact with a child is a common dilemma for parents. It is a barrier you must and can overcome by following specific child directed responses. These techniques can reshape the way you respond to your child and improve the way your child responds to you.

Toddlers and preschoolers are at the perfect age for child directed parenting. By respecting their choices and providing freedom and encouragement positive behaviors are supported and negative behaviors are eliminated. The foundation of this strategy is to follow your child’s lead and avoid questions, criticism and both direct and indirect commands.  Questions often have hidden commands and criticism suggest disapproval and not listening to your child. Focus on correction without criticism by avoiding authoritarian command words like: “no”, stop”, “quit”, “that’s wrong” and “don’t”. This eliminates unhealthy interactions which damage your child’s self-esteem, self-worth and self-image.

Unless there is a safety or security concern, ignore negative behaviors and use praise, reflection, reporting and imitation to positively influence your child’s behavior. These techniques decrease the risk of negative interaction between you and your child. It is also important to choose words, a tone of speech and gestures that show your love and enthusiasm for being your child’s parent. Your words and actions must say to your child: “I love being your parent and being with you.”

Praise is the most essential parenting response. It increases positive behavior and like enthusiasm generates a positive attachment between you and your child. Make sure praise is genuine and not reflexive. When giving praise, identify or label what you are praising. An example is: “Thank-you for putting your hat and coat on.”

Reflection, reporting and imitation are three other parenting techniques. Somewhat similar to praise each involves a mirroring of your child. Reflection relies on repeating or paraphrasing your child’s words. This invites your child into a conversation with you. It shows your child you are listening and tells your child you understand what he or she is saying. This type of two-way communication enhances speech and social reciprocity skills and helps you connect with your child. Reporting describes what your child’s is doing and improves your child’s attention span. Imitation is the last technique.  In this technique you repeat and perform whatever behavior your child is doing. Each of these techniques shows your child you are interested in and approve of their words, actions or behavior and want them to continue.

If you make these leadership techniques part of your parenting responses you will change the way you relate to your child and the way your child relates to you.  By allowing your child to lead you signal to your child your approval and stimulate positive cooperative and parallel play which support your child’s ability to give, share and take turns. Child directed parenting techniques are simple to master and easy to perform.  By avoiding questions, criticism and commands and utilizing the above techniques you support the development of a positive attachment between you and your child and encourage positive behaviors in your child.