Moms worry -- it's in our job
description. But when normal caution crosses the line it can have
serious consequences for our kids.
When
Tammy Revia's daughter, Celie, was 9 months old, she had yet to get a
cold or a fever, but Revia made a point of keeping her off public
playgrounds anyway. She also avoided exposing her baby to children with
even the slightest sign of illness and used antibacterial
wipes or
hand sanitizers
before and after touching everything from her cell phone to a
supermarket cart to door handles. "Whenever I heard Celie sniffle or
sneeze, it took my breath away," says Revia, a nurse from League City,
Texas.
Celie isn't immunocompromised or sick. But Revia's first child,
Devin, had been born prematurely, and after struggling in the NICU for
more than nine months and then finally coming home, he died just before
his first
birthday.
Now she sees danger everywhere: A disinfectant commercial discussing
hidden germs makes her heart race, mosquitoes seem like germ-carrying
mini missiles, and a bump on Celie's head makes her think subdural
hematoma. "When you've been through so much, you're just waiting for the
next bad thing to happen," she says.
Many mothers like Revia are struggling with severe anxiety, often
triggered by a real health scare that is long gone but has left an
imprint on their psyche. For some, it can lead to symptoms of
post-traumatic stress disorder (PTSD), traditionally associated with
surviving war. But even when it's not that severe, this anxiety can add
layers of stress to daily family life and put your child at risk for
behavioral problems later.
Deep-Seated Stress
Maternal anxiety isn't necessarily on the rise, but it is getting
more attention. "There's a growing recognition that anxiety levels and
depression are both high among mothers of young children," says Diane
Langkamp, M.D., a developmental and behavioral pediatrician at Akron
Children's Hospital, in Ohio. Experts point to rising rates of
premature babies
who survive the NICU and medical advances that allow children to fully
recover from a variety of traumatic illnesses. Parents of preemies, who
have lived through the trauma of seeing their tiny infant hooked up to
machines and surrounded by extremely sick babies, may have a
particularly difficult time shaking their experience. This can lead to
nightmares, depression, feeling agitated, and being hypervigilant about
their child's health long after he leaves the NICU.
Jamie Klavans went into
labor during her 35th week of
pregnancy
and gave birth to her son, Matthew, who needed emergency surgery on his
colon. Over the next 15 months, he had four more surgeries. Though
Matthew, now 5, is completely healthy, Klavans fears that he'll end up
back in the hospital. "When he was sick as a baby, we were always on the
go, and I didn't have time to process anything," says Klavans, of
Brookfield, Connecticut. But a late-night trip to the E.R. for croup
when Matthew was 22 months old brought back terrible memories and caused
Klavans to have bouts of diarrhea. For about six months, she'd wake up
in the middle of the night hyperventilating, and she felt anxious when
she was alone with her two children. After these scary symptoms, her
pediatrician suggested that she might have PTSD; she's been getting help
for it ever since.
Sometimes a woman's experience even before having children -- such as a
miscarriage,
failed IVF treatments, a difficult pregnancy, or the unexpected death
of a family member -- can set off anxiety. Moms who have been anxious or
depressed in the past or suffered from
postpartum depression
have a greater risk of being anxious about their children's health,
explains Faye Kokotos, M.D., assistant professor of clinical pediatrics
at the Children's Hospital at Montefiore Medical Center, in New York
City.
Parents' fears and perception of their child inevitably affect the
way they treat him. They may coddle him, go overboard to try to shield
him from possible pain (both physical and emotional), or avoid
disciplining him. This can, in turn, cause a child to develop behavioral
issues including separation anxiety that lasts beyond age 5,
oppositional behavior, frequent tantrums, hyperactivity, as well as
hypochondria, says Dr. Kokotos. This reaction is known as vulnerable
child syndrome (VCS). The term was coined in 1964, when researchers
discovered that a number of children with behavioral and learning
problems also had something else in common -- they'd experienced a
serious illness or a life-threatening accident early in life. Even
though the children had fully recovered, their parents continued to
treat them with kid gloves. That makes the diagnosis somewhat confusing,
as it's used to describe a child even though it's caused by a parent's
actions -- but experts say VCS is becoming increasingly common.
One way to predict whether a child may develop VCS is if her
mother or father overuses the health-care system, says Dr. Kokotos. "The
parent frequently brings her child to the doctor or emergency
department for minor symptoms or exams that turn out to be normal." It's
all part of her perception that her child is vulnerable to physical or
behavioral problems.
This was the experience for Melissa, a mom in Larchmont, New
York, who asked that her name and that of her daughter be changed to
protect their privacy. Her 6-year-old, Maya, had a liver transplant when
she was 3 months old and was hospitalized four times during her first
year. The immunosuppressant medication that Maya still takes to prevent
her body from rejecting the organ makes her highly susceptible to
infections. Melissa is justifiably protective, but she also overindulges
Maya and cuts her more slack than she does her other daughter. The
consequence: "Maya runs the show," admits Melissa. She can be dominant,
demanding that the TV be changed to her channel or screaming that she
wants to hold the leash when they walk the dog. "My older daughter says I
always give in to her," Melissa adds. "But the poor kid has had an
endoscopy and a liver biopsy. How can I not let her have what she
wants?"
Because these parents assume that any stress on their child could
harm her, they tend to discipline ineffectively. They may give in too
quickly when she cries or throws a fit. Some moms blame themselves for
their child's
premature birth or other health problems and try to make up for it in some way, such as indulging her or rarely enforcing rules.
But all children -- whether or not they have health problems --
thrive when they have limits and consistency. "If you're always giving
in to your child or not being clear about your expectations for her
behavior, then she'll develop more disruptive behaviors," says Dr.
Langkamp. Kids learn that they can get what they want and get away with
bad behavior, and they'll instinctively take advantage of that, she
says.
Tiptoeing around a "delicate" child ultimately works against him,
says Rahil Briggs, Psy.D., assistant professor of pediatrics at Albert
Einstein College of
Medicine, in New York City. "When a child faces fears and challenges,
like meeting new people, starting
school,
or getting a vaccination, she'll begin to develop a sense of mastery
and coping skills." But if she isn't given the opportunity to deal with
normal, growth-promoting stress, she'll be less able to tolerate
frustration or not be as confident in new situations.
A kid may also adopt her parents' fears of germs and illness and
start to see herself as somehow frail or vulnerable. A worried mom can
unintentionally send the message that every experience is a potential
disaster. "If Mom seems nervous every time her child falls down, the
child is likely to become nervous when she falls," says Jeffrey L.
Brown, M.D., clinical professor of pediatrics at New York Medical
College, in Valhalla.
Turning Things Around
If you think you're worrying unnecessarily about the health and
safety of your child, talk to your pediatrician. "Consider whether you
might be misinterpreting information or overreacting to physical
symptoms that aren't especially significant," says Richard J. Shaw,
M.D., associate professor of child psychiatry at Stanford University.
Your doctor should be able to help you distinguish justifiable concerns
from inflated worries. For example, many preemies have a higher risk of
illness in their first year of life, but after that it's generally no
greater than that of full-term babies. "When talking to anxious parents,
I try to point out what's normal about their child, what his strengths
are, and how well he's growing and eating," says Dr. Langkamp. If your
doctor discusses any type of abnormality in your child, make sure you
understand exactly what it means and whether you need to restrict his
activity in any way so you don't put unnecessary limits on him.
Try getting perspective on your fears by writing them down, suggests psychologist Tamar Chansky, Ph.D., author of
Freeing Yourself From Anxiety. List your worries on the left side of a piece of
paper
and the facts on the right. For example, if you're concerned that your
child will not survive an asthma attack at school, write down the steps
you've taken to prevent this (talking to the nurse, having an inhaler in
his
backpack,
for example). For 24/7 worriers, Dr. Chansky suggests devoting five
minutes each day to your scariest scenarios and considering the reasons
why they're unlikely. During the rest of the day, do your best to push
those thoughts away, reminding yourself it's worry-free time.
It also helps to talk to other parents or join a support group.
"I don't find much comfort in speaking to friends who haven't been
through this," says Tammy Revia. "I want somebody who knows what it's
like to have a sick child or who has lost a child." In some cases,
partners are the best people to talk to. But couples aren't always on
the same page. One of you might be more fearful or overprotective while
the other may want to avoid indulging your child. Keep talking to each
other about your anxieties and fears and try to come to agreements on
your approach to parenting, suggests Dr. Shaw, director of the Pediatric
Psychiatry Consultations Service at Lucile Packard Children's Hospital,
in Palo Alto, California. If that's not working, you might get help
from a professional.
Revia has found comfort in an unexpected place: the very NICU
where her son was treated. After more than a decade as a cardiovascular
nurse in that same hospital, and on what would have been Devin's fifth
birthday,
she switched to the neonatal intensive care unit. "I'd stayed in touch
with many of his caregivers," she says. "They were like extended
family." She's grateful to work with people who understand what she's
been through, and she's discovered that it's healing to give other
parents the kind of care that she and her son received. Sometimes the
monitors' alarms trigger awful memories, but Revia is working through
that: "I mentally process the alarms and within seconds I go from
overwhelmed to feeling a sense of accomplishment."
Originally published in the June 2013 issue of Parents
magazine.
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of others.
The most common signs of PPD are extreme sadness,
irritability, mood swings, or general changes in personality. Those close to
someone suffering from PPD report an overall change in the person suffering, at
times having little in common with their former self. You may not even
recognize your loved one while this battle rages in their mind. When PPD hits
it hits hard and fast. It comes on like a wave crashing onto the beach. 
