Is your child falling sick frequently? Do you have to visit your child’s pediatrician frequently? You are right; there can be problem in your child’s immune system. Immune system does a remarkable job of defending you against disease-causing microorganisms. But sometimes it yields to the invader, that is, a germ which when gains entry makes you sick.

We see often that children are the victims of such a weak immune system; it may be partially due to the incomplete development of their immune system. There are so many other factors which contribute to lowering of immune system and that causes your child to fall sick often. Many parents have a misconception that giving healthy food, vaccinating their child, hygienic measures, immediate medical care can keep their child healthy and immune against any diseases.

Why then are children who are always protected against cold, rain, dirt, who are  grown in ultra clean surroundings, in houses with clean floors, where air purified and conditioned (A.C) , kept away from germs as much as possible and are given best possible and immediate medical care, frequently fall sick and need frequent medical care, compared to those children who are devoid of all such facilities, who live in rural areas, who in contrary expose themselves to rain & cold winds, play and roll in mud and hardly use hand wash, thus exposed to lot of germs  still remain healthy ??

Don’t you think we are preventing the child’s body to develop a strong immune system which is only possible by repeated exposures to germs, bad weather etc?

Development of Immune system in child:

1. Mainly two types of immune system, Innate & Adaptive start developing during fetal life itself; the immune components are transmitted through placenta during fetal life and through mother’s milk during infancy. The immune system of the baby keeps maturing at different stages.

2. In childhood, the immune system is not fully developed, so the child is prone to get frequent infections.

Role of Vaccinations:

1. Immunity is also provided through vaccination, the basic vaccines like Measles, Mumps, Rubella (MMR), Polio vaccine, DPT vaccine etc sensitize baby’s immune system against those infectious diseases for which they are given.

2. Too many vaccines are added these days, and a question arises, by giving so many vaccines are we not weakening body’s own immune system? If you feed everything from outside how does body’s immune system develop?

3. The adverse effects of certain vaccines are still debated in developed countries.

What hampers your child’s immunity?

1. Indiscriminate use of antibiotics and steroids: In countries like India where over the counter (OTC) medicines are easily available and so many quack (unqualified) doctors prescribe antibiotics and steroidal medicines, immunity is at great risk.

2. Ultra clean environments, extreme hygienic measures, over protection of children against germs, cold, sunny, rainy climates, too much hand washing (Bunti Tera hand wash slow hai kya?)  Etc can weaken the immune system of children.

3. There are studies done by American scientists and Harvard medical school researchers which state that ; Asthma, eczema, hay fever and childhood diabetes are all being fuelled at childhood in which youngsters rarely roll in the mud, splash in puddles or play with animals.

4. It is said that without exposure to dirt and germs early in life, the immune system doesn’t learn how to control its reaction to everyday invaders such as dust and pollen.

5. Asthma, eczema, hay fever and diabetes is being fuelled by indoor lifestyles

Role of Homeopathy in building Healthy Immune system:

1. Homeopathy helps in building healthy immune system by augmenting the body’s own defenses. The homeopathic medicines are both considerably smaller and safer in dose and more individualized to the person they are being used to treat.

2. Although homeopathic medicines are thought to stimulate the body’s own defenses, how they do so remains a mystery. One study published in the European Journal of Pharmacology showed that a homeopathic medicine, Silicea, stimulated macrophages (macrophages are a part of the body’s immune system which engulfs bacteria and foreign substances). How or why Silicea was able to have this action or why exceedingly small doses of it are so active is unknown.

3. Homeopathy is a gentle yet effective healing system of medicine which doesn’t interfere with body’s natural immune system but it strengthens it.

4. Thus homeopathy helps in protecting and strengthening the natural immune system of the child, so that the child’s body itself develops the ability to fend off or fight against the infectious germs and diseases.

How to strengthen Immunity?

Parents should understand that, as the child grows its immune system is conditioned (designed) according to the threats (germs, bad weather, infectious diseases) it faces. These threats act as stimulants to the immune system to grow accordingly. It is just like a new car which has to overcome the challenges before it is Okayed, before it is launched in the market. The designing engineer has to modify, redesign the car, trial run has to be conducted many times till the car is able to overcome all the threats or challenges. In a similar way child’s immune system gets modified, redesigned only after repeated attacks of infections in childhood.

1. Avoid keeping children too clean, bringing them up only in ultra clean, indoor based life styles can wreak their immune system.

2. Allow your child to play out door, let them walk bare footed, play in mud.

3. Don’t restrict them indoors, even though there is cold weather, sun or rain, allow them to play at least for some time.

4. Let them get some sun: moderate sun exposure is essential for synthesis of Sunshine vitamin (Vit-D) which is very much essential for growth of bones and also helps in development of immunity.

5. Mother’s milk is the best: The formula foods can’t replace breast milk; mother’s milk is rich in immune components, essential nutrients which are must for the healthy development of child’s immune system.

6. Making child drink ultra filtered and boiled water is not good, such children get frequent stomach upsets, diarrhea.

7. Avoid giving junk foods, over feeding the child etc….

8. Don’t worry if you are child has lost few kilograms and jump into giving all the supplements, tinned foods. Don’t go by the advertisements. Remember nothing can replace naturally available food.

Dr. Tejaswi K.P.
Reader- Dept. of Surgery, Bhagwan Buddha Homeo Medical college, Mallathalli, Bangalore

Surabhi Homeo clinic, No 823, 6th Main 7th Cross, BEL layout, Vidyaranyapura, Bangalore-97
Mob-97311 33819    Email: drtejas2000@rediffmail.com

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How to prevent increasing of diabetes  in children? Inculcating healthy eating habits and some physical activity like walking, outdoor sports, yoga etc can prevent increasing diabetes in children.

The incidence of diabetes (both Type 1 and Type 2) in children is increasing with every passing year. Diabetes is a silent disease and hence, its symptoms are not usually visible unless it is very severe. Some indicators of diabetes when it is severe are sudden loss of weight, extensive thirst and frequent urination. This is more common in Type 1 Diabetes rather than Type 2 Diabetes.

 The leading causes of Type 2 diabetes are sedentary lifestyle and  family history of Diabetes in parents. Obesity also increases the risk of diabetes.  Out of 50 obese children, around 4 of them will be already meeting criteria for diabetes! Not only type 1 diabetes is on the rise, even type 2 Diabetes has also become very common among children in the city. The major causes of type 2 diabetes are, genes i.e, diabetes is transmitted to the child from his/ her mother/father and environmental factors.

Lack of exercise coupled with long hours spent on electronic gadgets and television are some of the major factors contributing to the rise in diabetes among children.  Access and intake of high calorie/high glycaemic foods also make children susceptible to type two diabetes.

Diabetes often gets overlooked as the symptoms are not much prevalent. Inculcating healthy eating habits and encouraging them to participate in some kind of physical activity like walking, outdoor sports, yoga etc can prevent or delay the onset of diabetes. Annual Height weight check-up and tracking your child’s BMI level can help prevent your child from developing diabetes.

Dr. Subramanian Kannan

Consultant, Endocrinology

Narayana Health City 

Mazumdar Shaw Medical Center,
Bommasandra,
Bangalore

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What are the Remedies to stop Bed Wetting? in fact Bed-wetting or nocturnal enuresis,  is not a behavioural problem. Many children do feel embarrassed or ashamed by it.

 Causes of Bed Wetting

• Heredity: It is associated with certain genes. That is if one parent or both parents seem to have been faced with this problem in their childhood, then there are around 50% chances that their child will also be a bed wetter. However, the child usually stops at the same age that the parent did.
• Physical causes that increases the chances of bed-wetting
• Children with a small bladder than normal suffer from this problem.
• Problem in valve that controls the flow of urine from the Bladder.
• Urinary tract infections,
• Constipation exerts pressure on the Bladder.
• mental retardation and developmental disorders
• Neurological causes: In some children, the brain takes longer to develop voluntary control over certain bodily functions. Thus, a child may wet the bed because exercise control over the Bladder may yet not be achieved.
• External stress: Children who are stressed due to events such as moving to a new home, beginning school, conflict between parents, the arrival of a new child, being abused, etc are believed to be more likely to suffer from bed-wetting. In these cases, a child, who did not wet the bed at night, may have started doing so due to stress.

Remedies to stop Bed Wetting

• During the day, let your child hold the urine for a long time. This will encourage bladder control. This exercise may help her strengthen her bladder muscles.
• Plenty of fluid in-take during the day and only small quantities during night.
• Take her to the toilet to empty her bladder just before she sleeps
• Make sure that the baby is not stressed while going to bed
• Involve your child in daily activities like arranging bed, laundering the sheets.
• Do not make her very conscious of the fact that her bed wetting is a major problem for you. She may get disturbed and lose her sleep over it – causing some other kind of problems.
• Wake her up in a few hours and empty her bowels once or twice a night.
• Once she realizes how nice it is to feel dry and clean for a few days, she may get motivated to try a bit more on her own.
• A child already going through mental distress due to this problem should be rather comforted and reassured from your end that he is perfectly normal and that you both jointly will find a better way to deal with it.
• Child’s frequency of bed wetting may also increase with a sudden drop in temperature. So make sure  child is properly dressed and warm. Cover him with a blanket, if required.

Psychological Impact on Children

• Many children suffer from self esteem problem.
• They have feeling of failure and start to distinguish themselves from others.
• Feel guilty about their doing.
• They are teased by their own family members and sibling.
• They are afraid of their friends, as they don’t want their problem known to their friends.
• They feel bad as they cannot go for sleep over’s and overnight trips. Children who are unable to join in these gatherings may find themselves missing out on spending quality time with their peers or family.
• They are also sometimes subjected to punishments.

Dr.C.Dinakar ,Vydehi Hospital

Whitefield, Bangalore – 66
Ph: 080-28413381/2/3/4 www.vims.ac.in

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7^th May 2019 -the World Asthma day and the theme “STOP asthma”. Many children are suffering from asthma due to myths and doubts. Here we have answers for frequently asked questions

Many parents of children suffering from asthma end up with poorly controlled asthma due to myths and many doubts are often not addressed in office management in clinics due to lack of time. We can address some of the issues which are frequently asked questions by many parents and we shall address a few of them.

The world Asthma day is celebrated on 7^th May 2019 and this year the theme is STOP for asthma. STOP means:

• S – Symptom Evaluation
• T – Test Response
• O – Observe and Assess
• P – Proceed to Adjust Treatment

Is it asthma?

Asthma is a disease of the airways in the lungs, wherein the airways become swollen, narrow and sensitive to irritants, which leads to recurrent attacks of cough, breathlessness, noisy breathing and chest discomfort.  The number of cases have been on the considering the changes in lifestyle and environment. Diagnosis of asthma in children under age 5 can be challenging as the symptoms may indicate other conditions. With older children Pulmonary function tests that measures how well the lungs work can be done.

Why do the children suffer from Asthma?

Children who have inherited a genetic predisposition, and exposed to inducers in the environment develop inflammation of airways, the hallmark of asthma. The most common triggers of asthma in children is a cold apart from dust, pollen, smoke and other irritants including air pollutants.

Can we recognise if child is at more risk of Asthma?

A family history of allergy and asthma is a predominant risk factor. If one parent has been diagnosed with allergies or asthma, the risk of the child developing asthma is approximately 50%, while if both parents have been diagnosed allergies and or asthma the risk of the child developing asthma is 75%.

Which allergens to be avoided?

What foods to avoid in an asthmatic child?

Generally avoiding the food items calling them “cold” items, like some fruits are not advisable. Rarely a child can be allergic to certain foods, such as milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish, and food additives.

Does child need allergy testing?

In general, in day to day practice allergy testing does not add much to the lines of management.

Will an air cleaner help child’s asthma?

It is not as effective with smaller particles such as dust and pollen. A HEPA (high-efficiency particulate air) filter has been proven to be effective in decreasing pet dander.

Child becomes breathless after running. Should he avoid games?

Children who have exercise-induced asthma (EIA) develop asthma symptoms after activity such as running, swimming, or biking. The time varies from 5-20 minutes post exercise before symptoms appear. With the proper medications, kids with EIA can usually play sports without a problem. Control asthma not exercise.

What are relievers and controllers?

Controllers are medicines that reduce inflammation in asthma, that work by reducing the swelling in the airways. The most effective of them being steroids. These medicines help to reduce severity of asthma if taken regularly as instructed. However, they must be taken regularly, even if child is not wheezing. Relievers are airway openers by dilating the narrowed bronchi and provide rapid relief airways known as bronchodilators. They only relieve symptoms but not airway inflammation. We must use controllers for long term and relievers for short term, and not vice versa.

Should we use nebulisers or inhalers?

Meter dose inhalers with spacers are preferred over nebulisers. Buying nebulisers by parents to use them for just relief of symptoms, and not taking long term medications are not advisable.

What is a spacer and is it necessary to use a spacer?

A spacer is a chamber that attaches to the MDI and holds the burst of medication. This allows child to breathe the medication into his lungs at his own pace. Spacers are recommended in children due to increased drug delivery.

Why steroids?

Steroids are the most effective anti-inflammatory medicines. They are safe in mild to moderate doses which most asthmatics use. Inhaled steroids are the best way to manage infants with asthma. Depending on young child’s age, one may use inhaled asthma drugs via MDI with spacer. It may need a mask in younger children less than three years.

How to know if child’s asthma is controlled? Should child take asthma medications even though he/she is feeling better?

Children feel better with relievers and some duration of controller medication makes the parents feel that they are “cured”, while on the contrary, still there will be inflammation in the airways. The parents should follow instructions of the paediatrician and continue the controllers which will be slowly stepped down and finally stopped. They should not abruptly stop medications. In older children paediatricians advise pulmonary function tests before stopping controllers.

How should one talk to people at child’s school about asthma?

It’s important that your child’s teachers, coaches, and school nurses know about his or her asthma. Talk to doctor about the best way to handle these discussions. Make sure that child has an “asthma action plan” and the proper medication at school with detailed instructions that include the location of the medicine or permission for child to carry it. Ask child’s doctor to help personalize this plan based on child’s asthma and treatment.

 What Are the Goals of Treating Child’s Asthma?

The goals of asthma treatment for child are:

Child should be able to-

• Live an active life, engage in activities without restrictions
• Be able to attend school every day.
• Is free of any breathing difficulties during the night.
• Use medications to control asthma with minimal or no side effects

Prof. Dr Subramanya N K
Pediatrics
Vydehi Institute of Medical Sciences and Research Center
White field, Bangalore – 560066
Ph 080 28413381/2
secretaryrespiratorychapter@gmail.com

subramanya.nk@gmail.com

The author is also The Honorary secretary of IAP National respiratory Chapter, an all India National academy in Pediatric Pulmonology.

Dr Farzeen,
Senior resident of Pediatrics,
Vydehi Institute of Medical Sciences and Research Center
Bangalore 560066.

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Media Icon of Bengaluru in association with manufacturer of quality homeopathic medicines – Dr. Pattar’s Gold Pharma, had organised a Health Education programme in the series of programmes of Arogya Nandana project, on 25^th June 2018, in BHARATH VIDYA NIKETHAN School at Kumara Park west extension.This programme was inaugurated by Mrs. Uma Ramesh, drama artist and Director of a Travel Agency, Mysuru. Retired textiles engineer and managing trustee of Kamadhenu Educational Seva Trust, Mr. Shankar Shetty presided over the function.

The main theme of the discussion was “how to improve concentration and memory power in children”. The medical experts participated were Dr. P.V. Pattar a HOMEOPATHY and NATUROPATHY Doctor, President of Sri. Dhanvanthari Arogya Dhamand research centre limited at Gurlapur (Moodalagi) Belgum District and Dr. Promod V. Pattar M.D. Gold Pharma.

Mr. N.V. Ramesh, retired programme executive Akashavani and programme co-ordinator, Arogya Nandana Project, Mr.Shrikrishna Mailengi managing editor of Vydyaloka and Health Vision magazines, Mr. Pratap a diet expert and Mrs. Usha Shekhar Principal of the school graced the occasion. Students’ teachers and few parents participated.

The edited version of the dialogue is presented for our readers

Ramesh: –What is Homeopathy? How it is different from other Health systems?

Dr. P.V. Pattar: – Ayurvedaprepares medicines utilizing leaf –fiber-roots. Homeopathy puts these raw materials in rectified spirit for 40 to 50 days. Later medicine is extracted.

Ramesh: – lay man says in Homeopathy, you give same small round sugar pills for everyone. How it is?

Dr. P.V. Pattar: – No. they are not same. When we prepare pills from sugar and milk powder, there is no medicine. When we add different medicines, pills absorbs. After analysing the disease of patients, medicines are given.

Ramesh:- May I ask the gathering, a common question? What is meant by Health?

Usha Shekhar: –Health is Wealth and fortune. This is absolutely necessary for the total development of personality.

Ambika(Parent): –Health is needed to give energy to body.

Soundarya(Teacher): – Energy needed for all activities by the body, is Health.

Nirmala Shankar Shetty(Housewife): –Basis of Health is the food. i.e., Milk, fruits, vegetables, and Greens.

Ravi Shekar: –As a retired officer and as a senior citizen, according to my experience, balanced food protects Health.

Mohan (Parent): –Health is property. It is very important. Health will not come on its own. For this we have to do physical exercises, running, yoga and get energy. For earning livelihood, Health is important.

Ramesh:-May I define Health as, physical, Mental and Spiritual wellbeing.

Dr. P.V. Pattar: – Both physical and Mental Health have mutual dependence.

Dr. Pramod: – Yoga balances Health. But Don’t addict to TV and mobile

Shrikrishna Mailengi: – From good food we have a Healthy body and Healthy mind. Children and students should eat good home food. They must play outside.

(Several Parents narrated problems about mental concentration and memory power of their children).

Mohan: – My son is studying in 3^rd standard. If I ask him any question, instead of replying, he repeats my question.

Dr. P.V. Pattar: –Please don’t ask your ward repeatedly to study, especially when you are watching T.V. If you aredoing so and make your ward to sit in different roomfor studying, tell me how he /she can study?

Ratna(Teacher): –(pointing to a student) – This student can talk very well. But still he sits idle. He can write, but he does not mingle with other children. He repeatswhatever we say andremembers various phone numbers.

Mamatha(Mother): –My son does not write homeworks. He is very naughty. If I askhim to read, he replies “Let us watch T.V”.

Dr. P.V. Pattar: – (in response to teacher and mother) – Parents have to create good reading environment at home. Being elders and parents, if you see TV from morning till night, how can you ask your children to read and not to see TV? Will those children read? Can they get motivation and inspiration from you? There should be a daily time table for reading.

Shankar Shetty: –As a parents your dedication is very important for motivating your child to read. To increase their concentration allow them to read independently, but observe. Spend time with your ward and not with TV, it is important to control addiction to it.

Dr. Pramod: – Tell me, what do you see in TV?

Student: – Cartoon.

Dr. Pramod: – What do you get from that?

Kishore (Student): –Nothing.

Anitha(Mother): –He knows and handles mobile and TV very well.

Dr. Pramod: – This proves his intelligence, so it is our duty to help him to utilize this productively. Correct your wards mistake in a pleasing way with love and affection. Motivate for outdoor activities and provide a platform for physical activities like playing, running, cycling, swimming etc. Avoid giving mobile phone to your ward.

Pratap (diet expert): –To get energy for the body, do exercises. Parents please avoid TV for the sake of your children. And provide a healthy and nutritious food. We should know that it is part of parenting. Physical activities is as important as food, if not it accumulates to form obesity.

Dr. P.V. Pattar:-I will give you few tips for your good health. As soon as you get up in the morning, drink 100 ml. warm water. Never eat dairy, bakery and fast food. Eat fresh sprout. Daily recite Om in your normal voice. If you practice Pranayama that is control of breathing, your health will get better.

Dr. Pramod:- parents are role models for their wards, so please act accordingly to take your ward in a right path instead of giving instructions.

Uma Ramesh: – Everyone has to protect his/her health. One should prepare fresh nutritious food every day by using ingredients available at home. Try to make your food attractive for your wards.

Ramesh: – Earlier kitchen was the health center of our family. Fresh, clean and healthy food were prepared daily. But now TV, Internet, Mobile, Facebook has diverted attention of the family members. Now refrigerators and bakery items has made its place in our life.Our children have been addicted to eat these foods.  All this will ultimately affect your physical and mental health leading to poor concentration and weak IQ.

Shankar Shetty: -Parents should follow healthy lifestyle as your children will try to follow and imitate you. Help your ward in improving their concentration to perform well in their studies and ultimately life.

(Medical checkup: Simultaneously medical checkup of students was held. Dr. P.V. Pattar and Dr. Pramod Pattar spoke with the children in detail and individual attention was given to needy children and parents. They analysed individual shortcomings and they suggested solutions. Many parents got solutions for problems of their children. On this occasion, Dr. P.V. Pattar distributed free homeopathy medicines produced by his own Gold Pharma Company, necessary for increasing concentration and memory power of children.)

Dr. P.V. Pattar:-Don’t addict to TV and mobile

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Dr M.Padmajarani

Child abuse or maltreatment comprise all ways of physical, emotional or sexual abuse, negligent treatment and commercial exploitations, leading to potential harm to the child’s health, development, dignity or trust to a person under the age of eighteen.

Child sexual abuse refers to a situation where an adult utilize a child for sexual inspiration. Filthy spotlight (of the genitals, female nipples, etc.) to a child with purpose of indulging sexual desires, physical contact with a child, or using a child to produce child pornography.

Sexual abuse comprise:

• Assault, including rape and sodomy
• Touching or Fondling a child
• Exhibitionism- Forcing a child to exhibit his/her private body parts
• Photographing a child in nude
• Aggressive kissing
• Sexual press on a child while travelling or marriage situations
• Divulging a child to pornographic equipment

Who commits the crime?

Child Sexual abuse can be committed by person who take care of a child including family members, relatives, friends, doctors, other medical personnel and tutor. Unfortunately this is done to satisfy the desires of the other person. These may take account of but is not limited to:

• Compulsion of a child to slot in in any unlawful action.
• Manipulative use of a child in prostitution or other unlawful sexual activities.
• Exploiting child through pornography.

Effects

• Psychological effects: Abuse may have both short-term and long-term harm, including psychopathology in later life. It leads to depression, anxiety, eating disorders, poor self-esteem, sleep disturbances, and dissociative and anxiety disorders. Children may go regressive in behaviours like thumb-sucking and bed-wetting. Victims may refuse to go to school, involve in social activities, learning and behavioural problems, attention deficit/hyperactivity disorder (ADHD), conduct disorder, and oppositional defiant disorder (ODD). Child sexual abuse victims are reported almost four times as many incidences of self-inflicted harm.
• Injury: Depending on the age and size of the child, and the degree of force used, child sexual abuse may cause internal lacerations and bleeding. In severe cases, damage to internal organs may occur, which, in some cases, may cause death. Causes of death included trauma to the genitalia and sexual mutilation.
• Infections: It may cause infections and sexually transmitted aliments. Depending on the age of the child, due to a lack of sufficient vaginal fluid, chances of infections are higher. Vaginitis has also been reported.
• Neurological damage: Traumatic stress may causes remarkable changes in brain functioning and development. It also leads to reduced corpus callosum area and increased electrophysiological abnormalities .

How to talk to kids about abuse

Talking about abuse is an not easy task. Nevertheless, like many significant dialogue, it’s not something to remain to talk about until it comes up on its own. Indeed, by then it may be very late.

Getting Started…

Child at 4 yrs age can comprehend the basic notions of good touches, bad touches and confusing touches.

So, please mark on calendar to sit with children to talk about these 3 matters:

Describe the 3 different types of touch

• Good touches are those touches that make us feel happy, safe and loved. Most of the touch we get is good touch.
• Bad touches are those touches that hurt us; they feel like an “ouch.” Examples are kicking, hitting and biting.
• Sexual abuse touch is explained as “forced or tricked touch of private body parts.” The key words are forced and tricked.

Teach child that a some one is forced to do something you don’t want to do or don’t understand. Or they play a trick where someone lies, fools, pretends or calls something a game, that isn’t a game, so they can touch private body parts or have touch theirs.

Tell children that sexual abuse is confusing because it doesn’t necessarily hurt; the touch can feel good, but it is not okay.

Teach child to say NO: Children need to know that they can say NO to any touch that they do not want—even if the person touching them is an adult or someone they know.  Teach child that they have the right to trust their own feelings and to ask questions when they feel uncomfortable or confused by someone’s behavior.

Tell them it’s okay to speak up: Teach child that when abuse happens, it’s never the child’s fault and that it is okay to break promises they make about abuse.

Keep the conversation going: As you talk with your children about abuse, keep in mind that you may need to revisit the discussion as they get older.

Teach child The Underwear Rule: About one in five children falls victim to sexual violence, including sexual abuse. Help child to prevent this. Teach them that a a part which is covered by underwear should not be touched by others, nor they should touch others.

The Underwear Rule has 5 important aspects.

• Your body is your own: Children should be taught that their body belongs to them and no one can touch it without their permission. Children have the right to refuse a kiss or a touch, even from a person they love. Children should be taught to say “No”, immediately and firmly, to inappropriate physical contact, to get away from unsafe situations and to tell a trusted adult.
• Good touch – bad touch: Children do not always recognise appropriate and inappropriate touching. Tell children it is not okay if someone looks at or touches their private parts or asks them to look at or touch someone else’s private parts. The Underwear Rule helps them to recognise an obvious, easy-to-remember border: the underwear.
• Good secrets – bad secrets: Secrecy is a main tactic of sexual abusers. That’s why it’s important to teach the difference between good and bad secrets and to create a climate of confidence. Every secret that makes them anxious, uncomfortable, fearful or sad is not good and should not be kept; it should be told to a trustworthy adult (parent, teacher, police officer, doctor).

Other helpful hints to accompany The Underwear Rule

• Prevention and protection are the responsibility of an adult: When children are abused they feel shame, guilt and fear. Adults should avoid creating taboos around sexuality, and make sure children know whom to turn to if they are worried, anxious or sad. Children may feel that something is wrong. Adults should be attentive and receptive to their feelings and behaviour. There may be many reasons why a child refuses contact with another adult or with another child. This should be respected. Children should always feel that they can talk to their parents about this issue.
• Reporting and disclosure : Children need to be instructed about adults who can be part of their safety network. They should be encouraged to select adults whom they can trust, are available and ready to listen and help. Only one member of the safety network should live with the child; the other should live outside the immediate family circle. Children should know how to seek help from such a trust network.
• Known perpetrators: In most cases the perpetrator is someone known to the child. It is especially difficult for young children to understand that someone who knows them could abuse them. Keep in mind the grooming process that abusers use to win the trust of children. Informing parents regularly about someone who gives gifts, asks to keep secrets or tries to spend time alone with a child must be a set rule in the house.
• Unknown perpetrators : In some cases the perpetrator is a stranger. Teach your child simple rules about contact with strangers: never get into a car with a stranger, never accept gifts or invitations from a stranger.
• Help : Children should know that there are professionals that can be particularly helpful (teachers, social workers, ombudspersons, physicians, the school psychologist, the police) and that there are help lines that children can call to seek advice.

Why The Underwear Rule?

About one in five children falls victim to some form of sexual abuse and violence. It happens to children of every gender, every age, every skin colour, every social class and every religion. The perpetrator is often someone the child knows and trusts. The perpetrator can also be a child. You can help prevent this happening to your child.

Good communication with children is the key. It implies openness, determination, straightforwardness and a friendly, non-intimidating atmosphere.

The Underwear Rule can help you with this

A child is never too young to be taught The Underwear Rule because abuse can happen at every age. If you find it uncomfortable to talk about this subject with your child, please remember that it is probably more difficult for you as an adult than it is for a child.

What to do if you suspect abuse

• When you suspect your child has been abused, it is very important not to be angry with your child.
• Do not make your child feel as if they have done something wrong.
• Do not interrogate the child.
• You could ask what may have happened, when and with whom, but do not ask why it happened.
• Try not to be upset in front of your child. Children can easily feel guilty and may hold back information.

• Try not to jump to conclusions based on little or unclear information.
• Reassure your child that you will do something about it, and contact someone who could help, like a psychologist, child care specialist, doctor, social worker or the police.
• special help lines and centres responsible for helping child victims of sexual violence have been set up.

How to response

Treatment

The initial approach to treating a person who has been a victim of sexual abuse is dependant upon several important factors:

• Age at the time of presentation
• Circumstances of presentation for treatment
• Co-morbid conditions

The goal of treatment is not only to treat current mental health issues, but to prevent future ones.

Children often present for treatment in one of several circumstances, including criminal investigations, custody battles, problematic behaviours, and referrals from child welfare agencies. The three major modalities for therapy with children and teenagers are  family therapy,  group therapy, and  Individual therapy.

Which course is used depends on a variety of factors that must be assessed on a case by case basis. For instance, treatment of young children generally requires strong parental involvement, and can benefit from family therapy. Adolescents tend to be more independent, and can benefit from individual or group therapy. The modality also shifts during the course of treatment, for example group therapy is rarely used in the initial stages, as the subject matter is very personal and/or embarrassing. Major factors that affect both the pathology and response to treatment include the type and severity of the sexual act, its frequency, the age at which it occurred, and the child’s family of origin.

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