Coping with the presence of a second child

(Part 1 of 2)

Donya Betancourt, Pediatrician, Jakarta

The happiness and love that your first baby brought into your life is beyond measure, and now you are thrilled to learn that you are expecting another child.

Although you have been through pregnancy and childbirth before, you now have many new considerations and added responsibilities to prepare for with the coming of your second child.

Fortunately, preparing for a second child can be as rewarding and special as the first time. Being aware of the changes involved in having a second child is the best way to prepare for this joyous event and helping your older child understand what to expect can lessen anxiety for everyone.

Depending on the age of your older child and the amount of maternal needs that are still required such as continued breast feeding or transportation to school appointments. Sleeping and meal schedules will fluctuate and her once organized schedule may be stretched to its limit.

Mothers may also tire more easily, even before the baby is born, since caring for an older child while pregnant takes a lot of energy. After the birth, the first six to eight weeks can be particularly demanding, because your main job will be trying to get your infant on a feeding and sleeping schedule, while anticipating your older child's needs and changing emotions.

One positive change that a second child brings is an increased confidence in a mother's own abilities, knowledge and experience. That is, the things that seemed so difficult with your first breastfeeding, changing diapers, handling illness will seem like second nature to you instead of a full-blown crisis.

Physically, you are likely to be sore and very tired, particularly if you had a difficult birth or caesarean delivery. If you have decided to breastfeed your child all night, feeding sessions will be especially tough.

If you work outside the home, you may be unsure about the future of your career. Making a decision about whether to return to your job is an important one; enlist the support of your family and friends when weighing all of your options.

Do not be surprised if you feel concerned about bonding with your new child. It may be difficult to understand that you will have just as much love for your new arrival as you do for your older child -- but you will. As moms and dads often report, a parent's love somehow doubles when another child is born.

You will notice that you have little or no time for yourself during the first few months following delivery. Sleepless nights and everyday tension can be overwhelming, so be sure to make time for being alone a priority for you.

Likewise, you and your partner will notice that you are rarely spending time together, so be sure to have an occasional date once things settle down.

Take peace of mind in knowing that all things that seem overwhelming and difficult now, will pass in a relatively short period of time and the rewards for the love and joy that your second child brings to you will last a lifetime.

Next week is the very important issue of how to deal with your first child.

-- Dr. Donya

When a nasal spray is needed

Dear Dr. Donya

How are you? I hope you are always in good health. May I ask you about the safety of a nose spray for children. It is called Mometasone Furoate Aqueous nasal spray.

A pediatrician in Singapore, who gave that spray for my 5-year old daughter, advised that she should continue using it for an additional week after recovery. But her pediatrician in Jakarta suggested that it is better to stop using it once she has recovered.

Therefore, I wonder what is the right and safe way to use a nasal spray. Could you please give me your opinion on this matter? If you need more details on the medicine for your reference, do let me know.

I appreciate your kind advice.

Thank you and Regards

Yun Yun

Dear Yun Yun,

Doctors have different opinions. Allergic rhinitis depends on severity of your daughter's symptoms and her response. Nasonex is an intranasal steroid, basically it is used in mild persistent or moderate intermittent rhinitis which means she has symptoms less than 4 days in 1 week and less than 4 weeks in 1 year.

If she falls in to this category, intranasal steroid is recommended for at least 2-4 weeks, then she needs to do a follow-up visit to the same doctor to evaluate and control medication.

However, if the doctor did not think that she had allergic rhinitis he/she may prescribe a short-term treatment. So if that is the case you can stop immediately after she gets better or use it for 1 more week, as I think there is not much difference. Anyway, this medication, if used and controlled by a doctor, has low systemic side effects.

Best regards,

Dr. Donya