Parental Guidance

Dr Asha Mukherjee
Ex Professor – Dept of Pediatrics
Ramakrishna Mission Seva Pratishthan
Park clinic,
Kolkata
Child below 1 year
 Watch
 Hearing, vision
 Social smile, sitting and standing,
 Food intake decreases as growth rate
slows
 [monitor with growth chart]
 Walking at 12-15 mon
 12 mo – tata bye
 12 – 15 mo – shows 4-6 body parts
 Reading can be started at 4-6 months
1 and ½ year
 2 -5 years
 Bed wetting – normal till 4 years in girls
normal till 5 years in boys
no forcing
 Hand preference – not to be changed
 Decr appetite [growth chart ]
 Active children so safety precautions
 Regular time to read or look at pictures with children
everyday
 Screen limited to 1 hr a day for quality programs,
supervised and debrief later
 2- 5 years
 Parents should acknowledge fears like nights,
toilet flush and offer reassurance
and sense of security.
Use night light , monster spray
encourage independence in self care, bathing,
feeding, dressing. This reduces conflicts.
Corporal punishments – discouraged, as child gets
habituated to it. They mimic this and strike their
parents or other children.
 Healthy sleep - basics
 1. Set a bedtime
 2. Bed time and wake up time should be same in whole week.
Not >1 hr difference
 3. Make the hour before bedtime shared quiet time
 4.Don’t send the child to bed hungry
 5. Avoid caffeine products before bedtime
 6.Regular exercise daily outside, sunlight helps maintain body
clock
 7.Quiet and dark bedroom, comfortable temp at night
24 degree
 Don’t use bedroom for time out or punishment
 No TV in bedroom
 Discipline
 Count down
 Limit setting
 Clear rules
 Frequent approvals
 Immed
 Specific
 Time limited
 Time out – 1 min / yr of age
 6 – 11 yrs
 Regular phys activity
 Sports – v . Imp – skills, team work,
fitness, accomplishment, no pressure
 Avoid power lifts, high stress, high impacts
 6 – 10yrs
 Unconditional support
 Daily conversation at dinner table or
bedtime
 No excessive pressure on academics
 Stress due to – divorce, domestic violence,
alcohol, drugs, neighb violence,
 May form gangs or get bullied
 Inside the
adolescent brain
 The changing scenario
 Previously, it was believed that the brain
was a largely finished product by 6 years.

 But now, doctors believe that brain

development continues till early 20’s,
affecting some of their higher mental
functions.
 The changing scenario
 The last part of the brain to mature is the
pre frontal cortex – area of sober
thoughts.
 During the teens, the body comes under
the hormonal assault of puberty.
 These two facts together make them
emotional tinderboxes with shaky
judgment.
 Functional MRI
 Kids and adol rely heavily on amygdala,
assoc with emotional reactions. So they
identify fearful expressions as anger or
sadness or hostility where none exists.
Their rantings like ‘that teacher hates me’
can be better understood in this light.
 Adults rely more on frontal lobe which is
assoc with planning and judgement.
 Physiological changes
 Account for adol behavior so familiar to
parents like emotional outbursts, reckless
risk taking, rule breaking, impassioned
pursuit of sex, drugs, rock n roll.
 This thrill seeking may have evolved to
promote exploration, eagerness to leave
the nest and seek one’s own path and
partner.
 Teens and adults
 Make safe choices when playing alone in a
driving simulation game.
 But teens start taking more risks in group
play that is in presence of their friends. So
most of teen crimes are committed by kids
in packs.
The phys changes also account
 For –vulnerable to addictive and stimulating
effects of drugs and alcohol. [due to dopamine]
 More immed pay offs are req as motivation
factors.[to persuade a teen to quit smoking
suggest something immediate like getting out of
football team]
 Difficulty in sleep due to delay in melatonin rise
 Case Study
 A 12 year old girl, the only child of
working parents
 Both her parents are very caring and
loving.
 Mother rebukes the daughter unfairly, for
theft.
 The daughter commits suicide the next
day.
 Seven Rules for parents
 Drawing on the latest scientific studies of
adolescents, the following advice has been
offered by psychologists.
 Rule No 1- WHAT YOU DO
MATTERS – most imp
 Good parenting should be continued into
teens, to help teenagers develop healthy
ways, stay out of trouble and do well in
school.
 What you do makes a difference. Your
kids are watching you.
 Rule No. 2- YOU CAN’T BE TOO
LOVING
 No evidence that adolescents are harmed by
pouring the praise and showing physical
affection-as long as you don’t embarrass them
in front of their friends.
 It is simply not possible to spoil a child with
love.
 Spoiling is usually the consequence of giving
the child things in place of love –things like
leniency, lowered expectation, material
possessions.
 Rule No 3 - STAY INVOLVED
 Continue to remain involved now, as in earlier
years.
 Participate in school programs.
 Get to know your child’s friends.
 Spend time together. Be there mentally and
physically
 Takes time and hard work, rethinking and
rearranging your priorities.
 Sacrificing what you want to do for what your child
needs to do.
 Rule No 4 – ADAPT YOUR
PARENTING
 Many parenting strategies need to be
modified with onset of adolescence.

 The child’s ability to reason improves, so

they will challenge you if your logic
doesn’t make sense.
 Rule No 5 – SET LIMITS
 Teens also need rules and limits
 Be firm but fair
 Relax rules bit by bit, as the child becomes
mature
 If he/she can’t handle freedom, tighten
the reins till later( after a few months?.)
 Rule No 6 – FOSTER
INDEPENDENCE

 Remember: Their want for independence is NOT

rebellion.

 Give them psychological space.

 Do not micro-manage their lives. You need let

the child do their own homework, make their
own choices, and not intervene.
 Respect the teenager’s independence
 Rule No 7 – EXPLAIN YOUR
DECISIONS
 It’s no longer good enough to say, “Because I
said so!”
The child becomes more adept at reasoning. The
more your authority is based on wisdom and
not on power –
less will it be challenged by the child.
 So your rules have be clear and adequate.

 Be consistent. If your rules vary from day to

day or you enforce them intermittently the child

gets confused.
 Do’s and Don’ts when dealing
with a teen
 Do’s
Listen to your kid
Encourage sharing – (develops >3.5yrs age)
Share your experience to guide them
Keep a non threatening atmosphere at
home
Take interest in his/her friends
Bond with your children by doing things they like
 Do’s
 Be patient
 Set a good example
 Treat your child with respect. Give the
same courtesy as you would give to
anyone else. Speak politely to him, respect
his opinion, pay attention when he speaks
to you, treat him kindly, please him when
you can. Children treat others the way
their parents treat them.
 Don’ts
 Preach your child
 Snap at them
 Ridicule or judge them
 Be a neglecting parent
 Hate them for their mistake
 Hit them under any circumstances. This
causes aggression and they become
bullies
 Healthy Eating and Junk Food
 Junk food - High in fats, CHO, sugar, salt, additives (colours,
caffeines, flavors). Low in protein, vit, minerals. Not more than
once a week. Causes obesity, high BP, diabetes, heart
diseases. May even cause - Allergies, dental caries, cancer risk,
Example –
 Ultra processed food - packaged breakfast cereal,ready
breads, instant noodles, flavoured yoghurt, margarine,
packaged snacks, chips, milk supplements
 Restaurant food - Pizzas, burgers, French fries, noodles, pastas
 Beverages – fruit drink with sugars, energy drink, carbonated
drinks, flavored drink
 Healthy food options
 Upto 6 months – exclusive breast feeding
 6 mo to 1 year - khichri,sooji,mashed
potato,,banana,boiled veg, upma, mashed
idli, curd.
 Toddler and children – dal, rice, veg, curd,
chilla, egg, idli ,dosa with homemade
batter, upma, poha, seviyaan, milk
smoothies without sugar, cooked beans,
chicken/fish ( roasted or boiled)
 Fruit juices and supplements
 No fruit juice upto 2 years
 2-5 years - 125 ml
 >5 years - 250 ml
 Fresh, homemade, no added sugar
 Always better to give whole fruits due to fibre content
and nutrition value.
 NO MILK SUPPLEMENT – needed
 Home made food – avoid using pre heated oil, maida,
refined sugar, too much salt or sugar
 Screen time guidelines – act as
a role model
 It is the total time spent per day in viewing screens.
 Not > 2 hrs /day in adol. Rule of 20x20x20 (20 min of screen foll
by 20 sec of looking 20 feet away)
 Excessive if it hampers essential activities like sleep (8-9 hrs),
meals, study, family time, physical activities (1hr a day), hobby
time.
Then screen time should be reduced
 No screen time in bedroom, dining table, bathroom, vehicle,
 Screens shut off 1 hr before sleep as blue light emitted from the
device disturbs sleep
 Avoid below 2 yrs.
 <1 hour for children between 2-5 years

 Social media and internet

Media literacy : Watch carefully, think critically.

Questions to be answered before posting on the internet:

is it true? is it hurtful? is it illegal? is it necessary?
Healthy media : promotes learning and
creativity, promotes social interaction

Implement responsible digital rules and be a

role model.
Unhealthy media : (inappropriate shows, visiting
unsafe websites, hacking,
Playing violent games, gambling, fake news,
cyberbullying, social media anxiety by the “likes
etc”, exposure to targeted advertising, breach of
privacy (if child posts personal details, pictures,
bank accounts, credit cards)
This affects physical, psych, social and academic
well being . Leads to addiction and ADHD,
stress, anxiety, depression, low self esteem.
 CAUTIONS :
Reassure of your help and love

Think before typing, posting ,sharing

Do not post inappropriate material as once posted online it

will leave digital footprints permanently.

Never meet a digital friend in person alone

Report online misbehavior to a trustworthy adult. Do not

respond. Take a break from online world. Block the sender.

Save the message to enable reporting.
Bullying – inform the parents, school , cyberpolice if continues
 Avoid multitasking. While
doing offline homework, all
digital devices should be
switched off.

 Keep children safe by co-

viewing and monitoring the
online content and interactions
.Avoid programs and games
with violent content. Also,
ensure proper privacy settings
on the computer, safe search
engines on browsers and apps,
and anti-virus software. For
young children, install protective
software to restrict access to
inappropriate websites.
 Permissible age
Facebookbook, twitter, snapchat, Instagram - 13yrs
Google plus - 13 yrs
Whatsapp - 16 yrs
Youtube - 18 yrs
13-18 yrs with parental permission
PUBG - 18 yrs
13-18yrs restricted play time
<13 yrs with parental permission
Clash of Clans – 13 yrs
Note – before allowing parents should familiarise & analyse
whether appr for age. Educate them about online safety and listen
why they need to use them.

Other issues
Body image : unhappy with their looks, so needs to focus on
what body can do for them. Parents to praise for what he can
do
 Safety :RTA is a leading cause of death. Teach them laws and
safety measures.
 Substance abuse : inform about the harms of
alcohol,smoking,drugs.
 Suicidal thoughts : inform if friends have these
 Diet : nutrition needs are higher, balanced food is req to
prevent obesity,heart diseases, diabetes, high BP.cancers in
later life. Home food emphasised
 Girls req added iron and calcium supplements
 Vaccinations : catch up on missed doses and newer vaccines
 Contd…
 Hygiene : hand washing. covering mouth,
bathing, brushing teeth, menstrual hygiene
 Sleep :8 hours at least
 Exercise : 3 - 5 times a week for 30-60
min , moderate
 Screen and social media
 Sexuality : relationship, STD, menses and
its problems