Jun 15, 2010

The Sticker Experiment: Success is Claimed

Today marks a turning point in our family life. For the first - and I mean FIRST - time in oh, three and a half years, our twin girls stayed in their beds and obeyed my command to go to sleep. ON THEIR OWN. WITHOUT ME LYING ON THE FLOOR OR IN ONE OF THEIR BEDS. And...here's the piece de resistance: by 8.30 pm!  O frabjous day! O night of wonders whose time I never thought would come!!

Now I don't want to give the - completely false - impression, that we have never been able to manage our children's sleep routine. Oh contraire! There was definitely an eight-month period there, between about 9 months and one-and-a-half, where we happily trotted our two babies off to their cots each night at 7.30 and they fell asleep and stayed there until breakfast time.  But before that... and after that... it's been tricky to put it mildly.

I imagine we are similar to many "working families" (our government's current favourite phrase. still trying to work out what it means. think they are trying to round up everyone in that): in general, our biggest issues are TIME and SLEEP. Both have been the consistent running thread in our lives since the kids were born, always to some degree colouring everything else.

From the very earliest days, our babies were night-owls, and they have always gone to bed just that little bit (or sometimes lots) later than whatever time all other children in the country seem to be going to bed. (We never did manage the fabled "7 o'clock").  I have to say that, after those initial fairly hideous 10 weeks, they did tend to be pretty good overnight, generally only waking once and easily settled after the night feed.

But the bad time has always been the evening. When they were babies it would start around 5pm and continue until 9 or 10 at night. Nothing seemed to work initially. Eventually we found our saviours, of sorts: sleep school (thank you, thank you, thank you, kind nurses of South Eastern Private Hospital!), reflux diagnosis (thank you again, sleep school nurses - diagnosis made first night of sleep school after I had asked our GP, pediatrician and health nurse about my baby seeming to be in discomfort and told by all it was nothing) and a battery-operated swing.  That swing was a lifesaver. Though I know it wasn't the case every night, all my memories of those times are that I was alone in the evenings (husband working) and with the swing was finally able to settle two babies simultaneously. We used that swing until M was 6 months old and it was creaking and barely moving under her weight. Wonderful thing it was.

We did do controlled crying at different stages, but could not always manage it because A would get hysterically upset and vomit everywhere within a couple of minutes. That kid could go from zero to nutcase in less time than you would think it was possible! No, it wasn't just us - I had others witness this!

All this leads into one of my "favourite" motifs: that of the firm and loving parent applying sensible routines, controlled crying and mental discipline and producing a beautifully sleeping baby.  I know that has happened. I have friends and family who have achieved it. But here is the thing - they haven't ALL achieved it with ALL of their children, ALL the time.

I used to hate hearing this from people who would be talking admiringly about a mother they knew who was calm and firm and had a well-trained baby: "Calm mother equals calm baby".  Grrrrr. How about this for the real truth: "Calm baby equals calm mother"!
I think I did everything right, I really do. And I know this much about the sleep and stress battle that we had with our babies: they started it!!

It was my mother who offered the wisest words: "Lots of things work, but nothing works all the time."
So true. You can't program babies - they're not machines. Things work - but not forever either.

We have tried our best to apply consistent routines. But there is no doubt, it is very hard when both parents work full-time.  There is not much out there about managing this stuff when everyone's working. The cultural ideal, and most of the literature (pop culture, books, articles, advice, etc) is of the mum who stays home for the first one or two years, and then works part-time (three days at most) and is home with the kids by late afternoon. (Of course we know why this is: all the full-time-workers are too busy to write any articles!)
I can tell you from experience, having worked part-time and full-time over the years, that there is a HUGE difference between getting home at 4.30 and getting home at 6.30, and between working 3 days and working 5. Not that part-timers don't have it tough - they definitely do. So does everyone. But I have always blamed the fact I work full-time and that 3 or 4 days of the week the girls are at daycare until 6pm, for our sleep issues.
I completely understand why women who are able to, even with tremendous personal and financial sacrifice, give up work while their kids are little. It is just so hard!

Anyway, back to the present. A and M are now four and a half. For a week now they have been going to bed at 8pm every night. And tonight, for the first time, I said good-night and left the room and they stayed there and fell asleep.

How did we do it?
The obvious way I suppose - that modern classic, the sticker reward chart.
I would never have thought this would be so effective so quickly - chiefly because I have been in the habit of giving my kids whole sheets of stickers for fun and diversion from an early age (devaluing the currency, a wise father told me once). But lo - set up a reward chart, explain how it works, and dole out one sticker of choice every morning following a successful 8pm bedtime, and it has worked a treat.
Two little sets of shining eyes are firmly on the prize: a new DVD of choice for each of them after sticking to this for 8 days.
(Alvin and the Chipmunks and one of the [eugh!] Barbie movies, at this stage).

But as always with kids, there is no such thing as a controlled experiment. A possible contributing factor to today's success: two 3-km walks today with their dad to drop off and pick up the car for urgent repairs at the garage.

Nah, it's gotta be the reward chart.... And my calm, kind but firm manner of course.

Jun 6, 2010

Happiness and Disappointment

Some quick thoughts on a topic that I have been ruminating on for a long time.

We are animals. Life is a struggle. We are not "meant" to be happy. We are meant to BE. That's it. If we are happy, that's a bonus. Happiness, actually, is wonderful and stands out because it is fleeting, rare or in the past. You have moments in time where you know you feel happy; you have times in your life where you are aware things are pretty good and you are on the whole happy; or you look back on times past and realise (or believe) you were happy.

Someone I know once said "If you look back in your life at the times you were happy, it's usually when you were busy." I think this is true.

I also think our minds exist to get us through the day and pass on our genes, and just cause us wonder and grief and anguish as a neat little side-trick.

I've posted a link below to an article I absolutely love, by someone who said all this much better than me. Catherine Deveny, in her former column in The Age newspaper published on 16 Feb 2010, took my breath away with this article. It's one of the best things I have ever read and I thank my sister who passed it on to me.

Favourite quote: "Life's not fair, but it is great. You don't get what you deserve, you get what you get."

I am really not a member of the Flat Earth Society

Don't you hate feeling like a flat-earther? You know that uncomfortable feeling that you may be out of step with intelligent and rational society, when you're not wholly on-side with prevailing beliefs. (Hello, global warming...I do believe - sort of - with some aspects - but the stridency of the movement and the labelling of any dissent as from "climate change deniers" does not sit well with me). Anyway, this is about vaccines.
Now, I am pro-vaccines. No question. I get impatient with people who forget about the horrible sicknesses children used to get and the numbers that died from these diseases in the past, in an age (fairly recent!) when the spectre of losing a child from illness was very real. It is wonderful that we live in an age where our worrying minds can relax about child mortality and can use those worry-neurons for fretting about social, educational and parenting issues instead. Once upon a time these aspects were neglected because people's focus was more solidly on keeping their children alive. So yes, there IS such a thing as progress. (I loved my Popper philosophy at uni, and it is useful not to be blinded by an overly-credible belief in forward progress at all times....but still).

Anyway, about the flu vaccine. I am not going to talk much about swine flu, because despite reading a lot about it and giving it some thought, I just am not sure. Who knows?? (Answer: no one, until some more time passes).

Something happened in Australia in recent months which is very worrying. A number of little children who had had the seasonal flu vaccine got bad fevers and convulsions, and a two-year-old died. This was a shock. I have to admit without giving it any thought I had believed the seasonal flu vaccine to be completely safe and proven so over many years. Though I haven't done it, I would not have been too worried getting my kids vaccinated against seasonal flu.
Following more adverse reactions in multiple states, it has now been recommended the seasonal flu vaccine not be given to children younger than 5, until the cause of the problem can be proven and the vaccine changed if warranted.

So that was one thing. Another worrying thing happened a couple of weeks ago. I heard a medical expert on a radio news program talking about this, and he said that when they looked more closely at the data of the children with adverse reactions, they found that these reactions were in fact not unusual. The problem it seems, is with the tracking of results after clinical vaccination trials. Here is something I didn't know: in a vaccine trial, the participants are not tracked for adverse reactions. Instead, adverse reactions are measured from statistics as people present at hospitals. This was news to me and I was shocked!
Then I did some more reading. The reason is due to the sample size of the test population. As adverse reactions are very rare, there are never enough people participating in a trial to properly measure adverse reactions, or to seperate problems from things due to other causes from those due to the vaccine. So they also cannot categorise all the adverse reactions and their probability. These things are only truly known once the vaccine is rolled out to millions of people.
This is explained on the website of the US Centres for Disease Control and Prevention which you can read here:

It also explains something else I could not understand.
Even after all these horrifying reactions among children to the "normal", "safe" seasonal flu vaccine, governments and doctors insisted the new swine flu vaccine was safe for children under 5.
How could this be? The cause of the problems with the seasonal flu vaccine is still not known. The seasonal flu vaccine has been used for years; the swine flu vaccine is about a year old and still not widely taken up. Didn't make sense.

Here are the elements of the answer as far as I can make out:
- the swine flu vaccine is known to be safe for children under 5, because there were extensive trials done testing dosages on children under 5 (I remember when this was going on - I was interested that people participated in these trials. I love and believe in science but unless there were rabid pigs breaking down my door and the people being quarantined with swine flu had symptoms worse than the sniffles they seemed to have, don't think I would enter my kids in tests for a new vaccine against a new disease. On the other hand I knew this was probably ignorant).

- something else I didn't know. The seasonal flu vaccine is not exactly a vaccine that has been in use for years because every year it is different! because flu strains differ every year. Didn't quite know this I don't think!

- however, the seasonal flu vaccine "base" is well tested and known to be safe (though all vaccines will have small numbers of people react adversely).

So you put all that together and conclude that most probably the swine flu vaccine is perfectly safe (for most) and the seasonal flu vaccine usually is too but possibly not ever safe for children under 5, OR there may be something more likely to cause adverse reactions in little kids in this year's batch.

Another point in passing -
I had wondered before how it could be possible that a vaccine was developed for swine flu so quickly and still be safe - but I have read something that explained that; to simplify it lots, basically they have had a lot of practice developing vaccines over the years and these days can roll out new ones very quickly as they just have to add the new ingredient to the base recipe.

I still have a slight question though, if adverse reactions are not individually tracked during trials, and if this batch of seasonal flu vaccine caught everyone by surprise with the child reactions but later data analysis has found the pattern "not unusual", then how can they be REALLY sure the swine flu vaccine is safe for little kids? Were the trials done differently?

Some quick comments lest anyone actually read this and think any of it irresponsible. First, I do NOT believe there is any kind of conspiracy by government and Big Pharma to roll out unsafe vaccines. I do not think there is a conspiracy by the Australian government to offload its swine flu vaccine stockpiles to get their money back or save face over the criticism it was over the top with its swine flu pandemic response plan. (No wait - actually I do kind of believe this one! Simple economics mean it must at least be a TINY bit of a factor... ;-) ! )
I believe the swine flu vaccine is (most probably) safe. I definitely believe in vaccinations for children, and I don't believe that vaccines cause autism.

But I do think - to my shock and disappointment - there have probably always been risks for children under 5 from the flu vaccine, which we have not been educated enough about. It's heartbreaking, the trust that all the parents had, who routinely vaccinated their kids with the flu shot this year. And it's a real shame, if this spurs on more parents to decide not to vaccinate their kids against the other stuff.


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