Saturday, November 14, 2015

Effects of physical abuse and neglect

I am choosing to write about my mother in law’s experiences as a child.  She was the oldest of 11 children born into a low SES, with an alcoholic, abusive father.  All of the children and her mother were abused.  Betty, as the oldest tried to protect the younger ones by taking the brunt of the abuse especially if her mother was already incapacitated.  The abuse got so bad that eventually some of the younger kids were sent to live with relatives periodically to avoid having the state getting involved and removing the children.  Even the family doctor didn’t report the abuse (this was in the 1930-1950).  Betty married at age 18 to my father in law partially to escape the abuse, and to hopefully have a normal life.  Betty and all of her siblings suffer from depression, one of which committed suicide, one was institutionalized at age 45, and 3 of her sisters went on to be sexually abused later in life as teenagers and young adults.  All of her siblings were able to complete high school, marry, and have children of their own, but some married abusive spouses and all of them have had difficulty holding down a steady job.  Betty was never able to work outside the home because she had panic attacks, had OCD, and suffered from life long depression.  She wrapped herself in a protective blanket of solitude to the point of missing out on family outings, not being able to have large family gatherings, her sole focus of life was her husband and 4 children.  Her children are all grown, her husband of over 50 years passed away suddenly from pancreatic cancer and now she is lost in a never-ending sea of sadness, loss, emptiness, and depression.  She refuses to associate with extended family beyond her sons and 2 of her youngest grandchildren.  The abuse she and her siblings suffered has affected them all in different ways but the negative effects were life long.  This has also impacted her four sons in that now they see women as being helpless depressive creatures and have developed an apathy when faced with spouses suffering from depression. 

            When you asked us to think about a different part of the world that might be suffering stress, my thoughts immediately went to the Syrian refugees fleeing their homeland, without food, shelter, transportation, no money, no resources except for each other.  Many have lost contact with their families or have seen their families killed.  How will this war impact this generation of Syrians and the rest of the world as it responds to this disaster and violence?  Will these children become immune to the violence, will they suffer further neglect and abuse?  There are relief efforts but the magnitude of the problem is so far reaching, there is going to be a huge human toll in this.  Refugees are fleeing in boats, many being capsized in the sea, a few surviving and maybe making it to a country that will accept them.  Some countries have tried to accept the thousands of people fleeing, but soon these countries had to start limiting how many could come into their countries because of the stress it was putting on their own country.  So even though, some steps have been taken to reduce the stressors by providing food, clothing, and some semblance of shelter, this kind of toxic stress that has no end in sight will hugely impact the survivors and the people who they impact.

Friday, November 6, 2015

SIDS Reduction Strategies

Sudden Infant Death Syndrome (SIDS) is meaningful to me because it is preventable in many cases by implementing safe sleep practices and because I know four families who have been affected by this tragedy. 
According to the Iowa SIDS Foundation, “Sudden Infant Death Syndrome (SIDS) is the sudden and unexplained death of an apparently healthy infant younger than one year of age.  SIDS is the unexpected death of an infant, which remains unexplained after a thorough case investigation, including the performance of a complete autopsy, death scene investigation, and review of the medical history.  SIDS is known as a diagnosis of exclusion, meaning all other medical causes that may have contributed to baby's death have been examined and excluded. (Iowa SIDS Foundation, 2015)  According  to the CDC  approximately 3,500 infants die suddenly each year and approximately 24 % are due to improper sleep practices. (CDC, 2013)
The safe sleep practices are easy to implement, yet when parents are not getting sleep or caregivers are not successful in getting young children to sleep, many times they will revert back to practices that might have short term benefits of getting a child to sleep but they can in some cases kill a child.  Many people think that it is only a concern for babies under 6 or 12 months of age, but there are increasing numbers of sleep related deaths in older toddlers as well.  It is imperative that we spread the word about safe sleep.  It is especially for infants being placed in childcare, as a high percentage of SIDS deaths happen in the first day or week of child care.   Many times extended family will not understand the importance of following the safe sleep policies and will recall how, “their child slept just fine on their stomach”, this can intimidate new parents or caregivers.
            Safe sleep practices include: 1) Always placing children under 12 months  of age on their back to sleep on an approved sleep surface, not on a couch or in an adult bed; 2) Make sure there is a tight fitting sheet and no loose bedding; 3) Dress the child in only 1 additional layer than an lightly clothed adult might wear; 4) Keep the room temperature at 68-70 degrees so you don’t overheat the baby; 5) Do not let infants or toddlers sleep in car seats when they are not being transported; 6) Do not let infants or toddlers sleep in swings, bouncy seats, or other containment devices; 7) Share a room, not a bed with infants; 8) Once breastfeeding is established encourage the use of a pacifier when sleeping; 9) Decorate the room, not the bed (no bumper pads), toys or other loose materials; 10) No smoking around baby or in the environment they live in.
            This impacts my work as 3 of the 4 families I know personally, the babies died in child care and the providers I work with were the ones who had to make those calls to mom and dad and tell them that their baby was dead.  None of these childcare workers were purposefully doing something dangerous to harm the child, but yet they were.  One of my providers is now facing being charged with a felony and may be sent to prison because she let a child (17 months old) sleep in the car seat at the request of mom and that’s where they found him dead.  She is no longer allowed to operate her childcare business, may lose her home and almost lost custody of her own newborn because of this incident, it is a tragedy for both families.  I have been trained on safe sleep practices and am going to start training this in each of my three counties very soon.  Our state is making it a mandatory class for all childcare providers to take annually, because of the high number of SIDS deaths in childcare.

References:
November 1, 2015.

Iowa SIDS Foundation, 2015, http://www.iowasids.org/, retrieved November 1, 2015