Why most men don’t have enough close friends | CNN

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CNN
 — 

Friendships aren’t just about those you sit with on the school bus or play alongside on your childhood baseball team — they are a core component of the human experience, experts say.

But making and retaining deep, meaningful friendships as an adult is hard, especially for men, according to research.

Less than half of men report being satisfied with their friendships, and only about 1 in 5 said they had received emotional support from a friend in the last week, compared with 4 in 10 women, according to a 2021 survey from the Survey Center on American Life.

The falling off of friendships between men begins around middle and late adolescence and grows starker in adulthood, said Judy Yi-Chung Chu, who teaches a class on boys’ psychological development at Stanford University. And those who do maintain friendships with other men say they tend to have lower levels of emotional intimacy than women report.

“Boys don’t start emotionally disconnected; they become emotionally disconnected,” said Dr. Niobe Way, a researcher and a professor of applied psychology at New York University.

All humans have the innate capacity and desire for close, emotionally intimate connections with others. We need these relationships for survival as babies and then to thrive as we get older, Chu said.

Research has shown close friendships protect our mental and physical health, she added. And men who prioritize those relationships are fighting off one of the most harmful things to human health — loneliness, said Dr. Frank Sileo, a psychologist based in Ridgewood, New Jersey.

“What (men) are at risk of losing is this sense of not being alone in the world or not being alone in their experience,” Sileo said. Research has shown “disclosure of emotional distress improved (men’s) emotional well-being, increased feelings of being understood and resulted in less reported loneliness,” he added.

Just as many men strive to eat right, exercise, succeed in their careers and raise children, men should prioritize developing friendships as adults, he said.

When Sileo first began conducting research on male friendships in 1995, many participants assumed his survey was about homosexuality, he said. Such stereotypes that male bonding would be, or become, sexual in nature are inaccurate but revealed some of what may be holding some men back from deep friendships, he added.

Assumptions nearly 30 years later might be different, but social pressures remain that make it difficult for men to express the vulnerability and intimacy needed for close friendships, Sileo said.

We are all born with two sides of ourselves: the hard side that is stoic and independent and the soft one that is vulnerable and interdependent, said Way, author of “Deep Secrets: Boys’ Friendships and the Crisis of Connection.”

The hard side has been characterized as masculine and inherently preferable, and the soft side has been seen as feminine and lesser than, Way said.

Boys receive messages that growing up and “manning up” mean shedding that soft side — a mindset that neuroscience, social science and developmental psychology all show is harmful to them, Way said.

“We gender relationships as feminine,” Chu said. “If that’s a feminine thing, it becomes a weakness or a liability if (men) admit to needing friendships.”

Characterizing the gender of these experiences has a clear impact, Sileo said. Men who were more emotionally restricted, focused on power and who scored high on surveys measuring homophobia are less likely to have intimate and close friendships, he said.

And the drive to toughen up and never show vulnerability that restricts men from friendships can lead them to loneliness, violence and anger, Way said.

“We live in a culture that clashes with our nature,” she said. “If we raise children to go against their nature, we shouldn’t be surprised if some of those children grow up to struggle.”

Heterosexual men seeking closeness might turn to those they see as better at building relationships and feel comfortable exploring their vulnerability with: the women in their lives and their romantic partners, Way said.

It may seem like a good solution, but it works neither for the men nor the women they look to, Sileo said.

Putting everything on a romantic partner can strain a relationship, he said, whether it is going to a female partner exclusively for emotional support or depending on her to cultivate friendships and get-togethers for holidays and weekends.

It is crucial to have multiple people to go to for support for different perspectives, Chu added.

“(Men) need to know it’s not just a woman thing,” she said. “They need to know that men can do it, too.”

Community is important, and keeping struggles, questions and concerns with one person or one relationship doesn’t always provide the best help to see them through, Way said.

“A male partner thinks it’s betrayal to talk to another person,” Way said, “but the female partner is saying, ‘Please do it, please get other perspectives.’”

If you are wishing you had close friendships or that the ones you have went deeper, experts say it’s OK to start small.

You don’t even have to disclose your own vulnerabilities at first, Chu said.

“A very powerful place to start is listening and asking real questions,” she said. “All people love when they can trust that this situation is safe and that someone is genuinely interested in them.”

The key is to move beyond banter and general niceties and ask questions you find meaningful, such as what friends like about their jobs or what happens to their feelings after breakups, Way said. Don’t worry. It’s not rude to do so. Most people report wanting to be asked these questions, she said.

Each relationship has its own rules and protocol, and it’s good to work within these, Sileo said. You might start asking something of a friend and find that person is hesitant to talk about it, Chu said. If this is the case, you can jump in and offer your own vulnerability by talking about how that topic might be bothering you or how you’ve been thinking about it.

Sometimes the rules of the relationship might mean avoiding the vulnerability of sitting face-to-face, Sileo said.

In those cases, find an activity such as the gym, work or a community project where you can connect side by side through a shared purpose, Sileo added.

And if you need to build friendships from scratch, follow the lead of the women in your life and ask someone to grab coffee or a bite to eat, Way said.

Putting in time, effort and intention is the key, Sileo said. Showing up and spending time is crucial to building those important friendships.

“Quality counts here,” he said. “If you can have a handful of friends that are quality, that’s better than having a slew of friends.”

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We all need ‘Sushi Tuesdays’: Lessons in understanding and finding a way forward after suicide | CNN

Editor’s Note: If you or someone you know is struggling with mental health, help is available. Dial or text 988 or visit 988lifeline.org for free and confidential support.



CNN
 — 

When Sam Maya, a beloved husband, father, friend, stockbroker and coach, died by suicide 16 years ago, he left a note. He apologized to his wife, Charlotte, for being a burden and telling her and their two sons, then 6 and 8, that he loved them.

In her recent heartbreaking memoir, “Sushi Tuesdays: A Memoir of Love, Loss and Family Resilience,” Charlotte Maya bears witness to Sam’s life, death and the aftermath with a singular purpose: to humanize the face of suicide and help readers develop a fluency in discussing mental health.

She spent nearly a decade writing “Sushi Tuesdays,” beginning with a blog by the same name, an homage to the weekly ritual she created after her husband’s death.

Every Tuesday while her kids were at school, Maya set aside her overwhelming to-do list as a lawyer and widowed single parent. Tuesdays began with a yoga class, then therapy, followed by whatever she needed most: perhaps going back to bed, going on a hike or heading to a solo sushi lunch.

I met Maya in a memoir workshop last year. I have a family history of mental illness and suicide, so I connected with her work and motivation for sharing her story.

In 2021, suicide was the second leading cause of death for Americans ages 10 to 34, the fifth for ages 35 to 54, and the 11th leading cause of death nationwide, claiming the lives of more than 48,000 people, according to the US Centers for Disease Control and Prevention.

The suicide rate among men in 2021 was nearly four times higher than the rate of women, according to the CDC. Research supports the assumption that men typically choose more effective and lethal means, such as firearms, to complete suicide, according to Dr. Ashwini Nadkarni, a psychiatrist and researcher at Brigham and Women’s Hospital in Boston.

Additionally, men are less likely to seek treatment for depression due to gendered expectations that equate masculinity with emotional stoicism, Nadkarni said.

Suicide is a national health crisis, Maya told me, but when we hear of such a loss, we often attribute each death to the unique problem the deceased faced, such as financial or legal troubles.

These stressors don’t explain suicide, she said. “Lots of people lose money, and they don’t take their own lives. They figure things out.”

When her husband died, Maya knew he had back pain and was stressed about work and money, but she didn’t think these things added up to being suicidal. In retrospect, she can now spot clues, such as his review of his will shortly before he died.

“I wanted to turn back the clock after Sam died,” she said. “I felt so strongly that if I could get back to that morning, I could have changed everything. It’s hard to reckon with what cannot be undone, to face straight into what I did or didn’t do, where I failed, where Sam failed.”

“Whenever I say that Sam made a mistake, the mistake I mean is that he didn’t ask for help,” Maya said. “It’s hard to say you’re suffering when you’re suffering, so let your loved ones know you are available to help.”

Asking people directly about suicidal thoughts may reduce, rather than increase, suicidal ideation, according to a 2014 review of scholarly literature in the journal Psychological Medicine.

That does require that people look for and notice signs that others may be struggling, such as changes in mood, behavior, appetite or sleep habits or that they are giving away cherished possessions.

The writer has since remarried. The combined family includes Gregory Stratz (from left), Tim Stratz, Jason Maya, Parker (the dog), Charlotte Maya, Danny Maya and Daniel Stratz, here in 2011.

Speaking directly about mental health became a trademark of Maya’s single parenting. She aimed for her boys “to live full and fruitful lives, not defined by their father’s suicide, not limited by their father’s suicide, but also not ignoring their father’s suicide.”

Her sons grieved their dad in their own ways, including denial (one pretended his father was on an extended business trip) and rageful episodes that ended with destroyed Lego sets and tears. Maya mourned with them about the “daddy-shaped space in their hearts” but promised that someday they’d be able to say, “I survived my father’s suicide, and I can do anything.”

“It can be awkward to say yes when people ask to help,” Maya said. “Because I was so shocked and overwhelmed, I just said yes. I recommend that course of action to people. Let people show up and help you.”

The support from Maya’s village was so vast that she wrestled with which of her friends would be fully fledged characters in “Sushi Tuesdays” and which would have cameo appearances.

She dealt with this challenge — and the confusion caused by many friends with names starting with the letter J — by cleverly referring to her friends, collectively, as “The Janes.” Given her background as a lawyer, she thought of them as Jane Doe No. 1, Jane Doe No. 2 and so on.

In the book, readers meet District Attorney Jane who helped with the coroner’s office, Engineer Jane who gets the boys to school each day on time and Prayer Warrior Jane who prays for Maya while she’s “not exactly on speaking terms with God.”

One friend, identified not as a “Jane” but as “Bess” in the narrative, is Katherine Tasheff, a college friend from Rice University. When Sam Maya died, Tasheff was a single mother living on a budget in Brooklyn and couldn’t travel to California to visit. So, she did what she could: She wrote her friend an email. And then another. And another. Morning and night for 365 days following Sam’s death.

The emails were always heartfelt and genuine but often mixed with dark humor. In one, Tasheff wrote, “We did an informal poll on whose husband was most likely to take his own life, and I want you to know that Sam came in last place.”

Almost immediately, Charlotte Maya replied, “Dead last?”

This kind of banter fueled Maya, who told her therapist to “call 911” if she ever lost her sense of humor. Finding moments of levity, she said, helped her hold onto her humanity. “Humor doesn’t cancel out what is devastating,” Maya told me. “Just like gratitude cannot cancel out what is horrifying. What’s important is having the capacity to hold both of those things.”

After her husband's death, Charlotte Maya says moments of levity helped her hold on to her humanity.

Seven years after her husband died, in 2014, Maya felt ready to write about surviving his suicide. Tasheff acted with her signature hadn’t-been-asked swiftness, setting up a blog site for sushituesdays.com within an hour.

By then, Maya had met and married the most eligible widower in her town, now nicknamed Mr. Page 179 because that’s where he shows up in the book. They each brought two sons to the marriage. (Coincidentally, each has a child named Daniel, so they now have two Daniels.)

Maya continues to honor her Tuesdays with therapy and yoga, a hike with a friend, and sometimes a sushi lunch.

She urges everyone — especially single parents and anyone managing anxiety or depression — to carve out a similar weekly ritual, even if it’s just an hour to “treat yourself with the same compassion as you treat your dearest friends.”

The coping mechanisms that Maya relied on in her grief may further explain the gender disparity in suicide rates, according to psychologist Lauren Kerwin.

Men may be less likely to have strong support networks or to engage with them when in stress or emotional pain and may be more likely to use maladaptive coping strategies, such as substance abuse or isolation, Kerwin said.

Seeking social connection and professional help is critical to preventing suicide.

“Now, more than ever, we have a better understanding of the neuroinflammatory basis for depression — the medical framework gives us a model in which to consider depression as a medical condition and one which can be treated,” said Nadkarni, the Boston psychiatrist.

If you see warning signs or are worried about someone who may be struggling, the American Foundation for Suicide Prevention recommends you assume you are the only one who will reach out. Find a time to speak privately and listen. Let people know their life matters to you and ask directly if they are thinking about suicide. Then encourage them to use the national suicide hotline by calling or texting the 988 Suicide & Crisis Lifeline, contact their doctor or therapist or seek treatment.

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When older parents resist help or advice, use these tips to cope | CNN



KFF Health News
 — 

It was a regrettable mistake. But Kim Sylvester thought she was doing the right thing at the time.

Her 80-year-old mother, Harriet Burkel, had fallen at her home in Raleigh, North Carolina, fractured her pelvis and gone to a rehabilitation center to recover. It was only days after the death of Burkel’s husband, 82, who had moved into a memory care facility three years earlier.

With growing distress, Sylvester had watched her mother, who had emphysema and peripheral artery disease, become increasingly frail and isolated. “I would say, ‘Can I help you?’ And my mother would say, ‘No, I can do this myself. I don’t need anything. I can handle it,’ ” Sylvester told me.

Now, Sylvester had a chance to get some more information. She let herself into her mother’s home and went through all the paperwork she could find. “It was a shambles — completely disorganized, bills everywhere,” she said. “It was clear things were out of control.”

Sylvester sprang into action, terminating her mother’s orders for anti-aging supplements, canceling two car warranty insurance policies (Burkel wasn’t driving at that point), ending a yearlong contract for knee injections with a chiropractor and throwing out donation requests from dozens of organizations. When her mother found out, she was furious.

“I was trying to save my mother, but I became someone she couldn’t trust — the enemy,” Sylvester said. “I really messed up.”

Dealing with an older parent who stubbornly resists offers of help isn’t easy. But the solution isn’t to make an older person feel like you’re steamrolling them and taking over their affairs. What’s needed instead are respect, empathy and appreciation of the older person’s autonomy.

“It’s hard when you see an older person making poor choices and decisions. But if that person is cognitively intact, you can’t force them to do what you think they should do,” said Anne Sansevero, president of the board of directors of the Aging Life Care Association, a national organization of care managers who work with older adults and their families. “They have a right to make choices for themselves.”

That doesn’t mean adult children concerned about an older parent should step aside or agree to everything the parent proposes. Rather, a different set of skills is needed.

Cheryl Woodson, an author and retired physician based in the Chicago area, learned this firsthand when her mother — whom Woodson described as a “very powerful” woman — developed mild cognitive impairment. She started getting lost while driving and would buy things she didn’t need, then give them away.

Chastising her mother wasn’t going to work. “You can’t push people like my mother or try to take control,” Woodson said. “You don’t tell them, ‘No, you’re wrong,’ because they changed your diapers and they’ll always be your mom.”

Instead, Woodson learned to appeal to her mother’s pride in being the family matriarch. “Whenever she got upset, I’d ask her, ‘Mother, what year was it that Aunt Terri got married?’ or ‘Mother, I don’t remember how to make macaroni. How much cheese do you put in?’ And she’d forget what she was worked up about, and we’d just go on from there.”

Woodson, author of “To Survive Caregiving: A Daughter’s Experience, a Doctor’s Advice,” also learned to apply a “does it really matter to safety or health?” standard to her mother’s behavior. It helped Woodson let go of her sometimes unreasonable expectations.

One example she related: “My mother used to shake hot sauce on pancakes. It would drive my brother nuts, but she was eating, and that was good.”

“You don’t want to rub their nose into their incapacity,” said Woodson, whose mother died in 2003.

Barry Jacobs, a clinical psychologist and family therapist, sounded similar themes in describing a psychiatrist in his late 70s who didn’t like to bend to authority. After his wife died, the older man stopped shaving and changing his clothes regularly. Though he had diabetes, he didn’t want to see a physician and instead prescribed medicine for himself. Even after several strokes compromised his vision, he insisted on driving.

An adult child needs to show empathy and respect for the autonomy of an aging parent.

Jacobs’ take: “You don’t want to go toe-to-toe with someone like this, because you will lose. They’re almost daring you to tell them what to do so they can show you they won’t follow your advice.”

What’s the alternative? “I would employ empathy and appeal to this person’s pride as a basis for handling adversity or change,” Jacobs said. “I might say something along the lines of, ‘I know you don’t want to stop driving and that this will be very painful for you. But I know you have faced difficult, painful changes before and you’ll find your way through this.’ “

“You’re appealing to their ideal self rather than treating them as if they don’t have the right to make their own decisions anymore,” he said. In the older psychiatrist’s case, conflict with his four children was constant, but he eventually stopped driving.

Another strategy that can be useful: “Show up, but do it in a way that’s face-saving,” Jacobs said. Instead of asking your father if you can check in on him, “Go to his house and say, ‘The kids really wanted to see you. I hope you don’t mind.’ Or ‘We made too much food. I hope you don’t mind my bringing it over.’ Or ‘I wanted to stop by. I hope you can give me some advice about this issue that’s on my mind.’ “

This psychiatrist didn’t have any cognitive problems, though he wasn’t as sharp as he used to be. But encroaching cognitive impairment often colors difficult family interactions.

If you think this might be a factor with your parents, instead of trying to persuade them to accept more help at home, try to get them medically evaluated, said Leslie Kernisan, author of “When Your Aging Parent Needs Help: A Geriatrician’s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, and More.”

“Decreased brain function can affect an older adult’s insight and judgment and ability to understand the risks of certain actions or situations while also making people suspicious and defensive,” she noted.

This doesn’t mean you should give up on talking to an older parent with mild cognitive impairment or early-stage dementia, however. “You always want to give the older adult a chance to weigh in and talk about what’s important to them and their feelings and concerns,” Kernisan said.

“If you frame your suggestions as a way of helping your parent achieve a goal they’ve said was important, they tend to be much more receptive to it,” she said.

A turning point for Sylvester and her mother came when the older woman, who developed dementia, went to a nursing home at the end of 2021. Her mother, who at first didn’t realize the move was permanent, was furious, and Sylvester waited two months before visiting. When she finally walked into Burkel’s room, bearing a Valentine’s Day wreath, Burkel hugged her and said, “I’m so glad to see you,” before pulling away. “But I’m so mad at my other daughter.”

Sylvester, who doesn’t have a sister, responded, “I know, Mom. She meant well, but she didn’t handle things properly.” She learned the value of what she calls a “therapeutic fiblet” from Kernisan, who ran a family caregiver group Sylvester attended between 2019 and 2021.

After that visit, Sylvester saw her mother often, and all was well between the two women up until Burkel’s death. “If something was upsetting my mother, I would just go, ‘Interesting,’ or ‘That’s a thought.’ You have to give yourself time to remember this is not the person you used to know and create the person you need to be your parent, who’s changed so much.”

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Let us now praise single moms | CNN



CNN
 — 

Roughly 24 million, or one-third of all American children under age 18, are living with an unmarried parent, according to a 2018 Pew Research Center analysis of US Census Bureau data. And 81% of those single parent homes are headed by a mom.

This has been a growing trend since the late 1960s. The number of kids being raised by mostly single moms has more than doubled between 1968 and 2017.

Yet despite growing up in the middle of this trend, in the 1970s and ’80s, when divorce was increasingly common and “Kramer vs. Kramer” felt like the documentary of our childhood, and despite being part of a generation of latchkey kids who came home from school while parents were still at work, I was, I confess, embarrassed to be raised by a single mom when I was growing up.

For the majority of my 12 years of Catholic school, I was the only student who lived with one parent. And for that reason, I was also, demonstratively, the poorest kid in my school. We lived off one paycheck, or paychecks when my mom held multiple jobs at once. The modest child support went to school tuition.

Like most kids, I didn’t want to be different. I wanted to be “normal.” “Why can’t we just be normal?” I’d often lament to my mom.

I was embarrassed by our car, which broke down; embarrassed that we didn’t seem to go anywhere for vacation; that I didn’t have brand-name clothes (thank God for school uniforms that greatly leveled the playing field); or video games; or cable TV; or anything else that my classmates had. I was embarrassed that my dad, who lived in a neighboring state, never came to any school events.

And I was teased for it. “Why don’t you get a new car?” “Your gym shoes are fake Nikes.” “Do you even have a dad?” I was often angry. I got into a lot of fights. When the principal’s office called home because I got into it with another kid, it was always my mom who had to come in.

Of course, my mother, like all parents, only added to that embarrassment. She was, and still is, artistically inclined and health-conscious. We went to museums and art stores instead of amusement parks and toy stores. I went to a summer camp run by cloistered monks … in heavy brown robes. My mom performed in community theater and sometimes roped me into bit parts. We went to clown school … together. At Christmas, I often got books and clothes. And my mom shopped for groceries at health food stores, which was much more unusual back then and involved a lot of bulk foods, homegrown sprouts and warm, freshly ground peanut butter. I had an all-carob Easter one year. I was embarrassed by my un-tradable school lunches and embarrassed at meals when friends spent the night.

Sitting under a framed movie poster of Richard Attenborough’s “Gandhi,” my friend would stare at an unappetizing breakfast bowl of “natural” cereal I poured for him out of a bulk food bag. His breath would blow a few rice puffs out of the bowl and across the table. “We can drizzle honey on it!” I’d say, as if that would solve everything. And then he’d go home to eat his Honeycomb or Count Chocula or whatever.

“Why can’t we just be normal?”

There has been a lot of research over the decades that has shown children of single parents report more family distress and conflict and live at a lower socioeconomic status compared to those growing up in two-parent households. Two-parent families usually have more income and are generally able to provide more emotional resources to children, and that’s also a reflection of how little the United States in general does to support working mothers with parental paid leave and access to more health services and quality education.

And of course, it’s difficult to compare single parenting outcomes to hypothetical alternatives. For many, a single mom can create a much safer or more stable environment than living with an abusive parent and spouse. Just growing up in an unhappy marriage has an effect on children.

A 2017 study, however, looked at the long-term effects of single parenthood on kids and found that it had nearly no impact on their general life satisfaction. The authors also found no evidence “supporting the widely held notion from popular science that boys are more affected than girls by the absence of their fathers.” What mattered most in terms of thriving, they concluded, was the quality and strength of the relationship between children and parents.

A separate 10-year study on single parenting that collected data from 40,000 households in the UK came to a similar conclusion last year. “There is no evidence of a negative impact of living in a single parent household on children’s wellbeing, with regard to self-reported life satisfaction, quality of peer relationships, or positivity about family life,” the report states. “Children who are living or have lived in single parent families score as highly, or higher, against each measure of wellbeing than those who have always lived in two parent families”

Speaking for myself, I’d go further and say there were benefits to being raised by a single mother, that it was foundational to becoming the adult I am now.

Being raised by a single parent required an Emersonian amount of self-reliance. I got myself to school in the morning, figured out how to apply to college, paid my way through that education and embarked on a career with no shortcuts or introductions. Our poverty made me class-conscious even as I earned my way into the middle class myself. My role model for what women are and should be was smart, strong, independent and deserving of all respect.

Even my childhood embarrassment was character-building, giving me a deeper sense of self-worth that is dependent neither on material things nor the opinion of those I don’t admire.

I’m not embarrassed now. Being raised by a single mother means the opposite to me today: I have a pride in her for enduring so much (including the indignity of a son perpetually embarrassed by our situation).

But even as a kid, I thought of her as a role model of resilience and resourcefulness. She imparted integrity, a love of the arts and a sense of occasion for the things I loved, like “Star Wars” and Orioles baseball. Before the age of 10, I was exposed to classical music, classic film, anti-nuclear activism, boxing (as participant) and yoga (long before it was a thing people did at gyms). And her exuberant creativity meant she was also a lot of fun growing up. We once invented a board game about the holidays of the world’s religions. On weekend mornings, we went to a park near a music conservancy to hear musicians practice while we ate our granola breakfast.

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  • Nothing about the financial and logistical stress of our years together kept her from raising a responsible, decent, curious, creative and accomplished son with very high life satisfaction. She gets more credit for that than any other individual, except maybe me. I’m not embarrassed, I’m grateful.

    Let us now praise single mothers. All of them. The “weird” ones. The struggling ones. The driven ones who choose to parent alone. The widowed, who didn’t. The brave ones who divorced for the well-being of their kids and/or themselves. They are all raising about 19 million children right now, and they need all the support they can get.

    This story was original published in October 2019. It has been updated.

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    Kids need to gain weight during adolescence. Here’s why | CNN

    Editor’s Note: Michelle Icard is the author of several books on raising adolescents, including “Fourteen Talks by Age Fourteen.”



    CNN
     — 

    I’ve worked with middle schoolers, their parents and their schools for 20 years to help kids navigate the always awkward, often painful, sometimes hilarious in hindsight, years of early adolescence.

    Most of the social and development stretch marks we gain during adolescence fade to invisibility over time. We stop holding a grudge against the kid who teased us in class for tripping, or we forgive ourselves our bad haircuts, botched friendships and cringy attempts at popularity.

    But one growing pain can be dangerously hard to recover from, and ironically, it’s the one that has most to do with our physical growth.

    Children are supposed to keep growing in adolescence, and so a child’s changing body during that time should not be cause for concern. Yet it sends adults into a tailspin of fear around weight, health and self-esteem.

    Kids have always worried about their changing bodies. With so many changes in such a short period of early puberty, they constantly evaluate themselves against each other to figure out if their body development is normal. “All these guys grew over the summer, but I’m still shorter than all the girls. Is something wrong with me?” “No one else needs a bra, but I do. Why am I so weird?”

    But the worry has gotten worse over the past two decades. I’ve seen parents becoming increasingly worried about how their children’s bodies change during early puberty. When I give talks about parenting, I often hear adults express concern and fear about their children starting to gain “too much” weight during early adolescence.

    Parents I work with worry that even kids who are physically active, engaged with others, bright and happy might need to lose weight because they are heavier than most of their peers.

    Why are parents so focused on weight? In part, I think it’s because our national conversations about body image and disordered eating have reached a frenzy on the topic. Over the past year, two new angles have further complicated this matter for children.

    Remember Jimmy Kimmel’s opening monologue at the Oscars making Ozempic and its weight-loss properties a household name? Whether it’s social media or the mainstream press, small bodies and weight loss are valued. It’s clear to young teens I know that celebrities have embraced a new way to shrink their bodies.

    Constant messages about being thin and fit are in danger of overexposing kids to health and wellness ideals that are difficult to extract from actual health and wellness.

    Compound this with the American Academy of Pediatrics recently changing its guidelines on treating overweight children, and many parents worry even more that saying or doing nothing about their child’s weight is harmful.

    The opposite is true. Parents keep their children healthiest when they say nothing about their changing shape. Here’s why.

    Other than the first year of life, we experience the most growth during adolescence. Between the ages of 13 and 18, most adolescents double their weight. Yet weight gain remains a sensitive, sometimes scary subject for parents who fear too much weight gain, too quickly.

    It helps to understand what’s normal. On average, boys do most of their growing between 12 and 16. During those four years, they might grow an entire foot and gain as much as 50 to 60 pounds. Girls have their biggest growth spurt between 10 and 14. On average, they can gain 10 inches in height and 40 to 50 pounds during that time, according to growth charts from the US Centers for Disease Control and Prevention.

    Boys do most of their growing between ages 12 and 16 on average. They may even grow an entire foot.

    “It’s totally normal for kids to gain weight during puberty,” said Dr. Trish Hutchison, a board-certified pediatrician with 30 years of clinical experience and a spokesperson for the American Academy of Pediatrics, via email. “About 25 percent of growth in height occurs during this time so as youth grow taller, they’re also going to gain weight. Since the age of two or three, children grow an average of about two inches and gain about five pounds a year. But when puberty hits, that usually doubles.”

    The American Academy of Pediatrics released a revised set of guidelines for pediatricians in January, which included recommendations of medications and surgery for some children who measure in the obese range.

    In contrast, its 2016 guidelines talked about eating disorder prevention and “encouraged pediatricians and parents not to focus on dieting, not to focus on weight, but to focus on health-promoting behaviors,” said Elizabeth Davenport, a registered dietitian in Washington, DC.

    “The new guidelines are making weight the focus of health,” she said. “And as we know there are many other measures of health.”

    Davenport said she worries that kids could misunderstand their pediatricians’ discussions about weight, internalize incorrect information and turn to disordered eating.

    “A kid could certainly interpret that message as not needing to eat as much or there’s something wrong with my body and that leads down a very dangerous path,” she said. “What someone could take away is ‘I need to be on a diet’ and what we know is that dieting increases the risk of developing an eating disorder.”

    Many tweens have tried dieting, and many parents have put their kids on diets.

    “Some current statistics show that 51% of 10-year-old girls have tried a diet and 37% of parents admit to having placed their child on a diet,” Hutchison said in an email, adding that dieting could be a concern with the new American Academy of Pediatrics guidelines.

    “There is evidence that having conversations about obesity can facilitate effective treatment, but the family’s wishes should strongly direct when these conversations should occur,” Hutchison said. “The psychological impact may be more damaging than the physical health risks.”

    It’s not that weight isn’t important. “For kids and teens, we need to know what their weight is,” Davenport said. “We are not, as dietitians, against kids being weighed because it is a measure to see how they’re growing. If there’s anything outstanding on an adolescent’s growth curve, that means we want to take a look at what’s going on. But we don’t need to discuss weight in front of them.”

    In other words, weight is data. It may or may not indicate something needs addressing. The biggest concern, according to Davenport, is when a child isn’t gaining weight. That’s a red flag something unhealthy is going on.

    “Obesity is no longer a disease caused by energy in/energy out,” Hutchison said. “It is much more complex and other factors like genetics, physiological, socioeconomic, and environmental contributors play a role.”

    It’s important for parents and caregivers to know that “the presence of obesity or overweight is NOT an indication of poor parenting,” she said. “And it’s not the child or adolescent’s fault.”

    It’s also key to note, Hutchison said, that the new American Academy of Pediatrics guidelines, which are only recommendations, are not for parents. They are part of a 100-page document that provides information to health care providers with clinical practice guidelines for the evaluation and treatment of children and adolescents who are overweight or obese. Medications and surgery are discussed in only four pages of the document.

    Parents need to work on their own weight bias, but they also need to protect their children from providers who don’t know how to communicate with their patients about weight.

    “Working in the field of eating disorder treatment for over 20 years, I sadly can’t tell you the number of clients who’ve come in and part of the trigger for their eating disorder was hearing from a medical provider that there was an issue or a concern of some sort with their weight,” Davenport said.

    Hutchison said doctors and other health providers need to do better.

    “We all have a lot of work to do when it comes to conversations about weight,” Hutchison said. “We need to approach each child with respect and without (judgment) because we don’t want kids to ever think there is something wrong with their body.”

    The right approach, according to American Academy of Pediatrics training, is to ask parents questions that don’t use the word “weight.” One example Hutchison offered: “What concerns, if any, do you have about your child’s growth and health?” 

    Working sensitively, Hutchison said she feels doctors can have a positive impact on kids who need or want guidance toward health-promoting behaviors.

    Kids can misunderstand doctors' discussions about their weight and internalize incorrect information.

    Davenport and her business partner in Sunny Side Up Nutrition, with input from the Carolina Resource Center for Eating Disorders, have gotten more specific. They have created a resource called Navigating Pediatric Care to give parents steps they can take to ask health care providers to discuss weight only with them — not with children.

    “Pediatricians are supposed to ask permission to be able to discuss weight in front of children,” Davenport said. “It’s a parent’s right to ask this and advocate for their child.”

    Davenport advises parents to call ahead and schedule an appointment to discuss weight before bringing in a child for a visit. She also suggests calling or emailing ahead with your wishes, though she admits it may be less effective in a busy setting. She said to print out a small card to hand to the nurse and physician at the appointment. You can also say in front of the child, “We prefer not to discuss weight in front of my child.” 

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    Chinese postpartum confinement, called ‘zuo yue zi,’ is gaining Western appeal | CNN


    Hong Kong
    CNN
     — 

    You cannot carry heavy things. You should sleep more. No working. No household chores.

    And the list goes on as Carol Chan explained her postpartum instructions for new mom Taylor Richard.

    Chan is a “pui yuet,” also called a confinement nanny, who lives with families after a baby is born. She prepares meals and herbal medicines, takes care of the baby and provides guidance on being a new mother.

    Richard, a content creator from Canada, traveled to Hong Kong to become a model and fell in love with her husband, Tom, there. They married in November 2018, and Richard gave birth to their son, Levi, in March 2022.

    Richard decided to hire Chan, who lived with the family for a month and spent an additional month helping out.

    Richard vlogged about her experience with Chan on her YouTube channel, and that video went viral with 2.9 million views. The reaction was mostly admiration and praise from Richard’s primarily Western followers.

    The concept of Chinese confinement — “zuo yue zi,” or “sitting the month”— is when a new mother stays at home for one month to allow her body to rest after giving birth.

    During that time, the pui yuet makes dishes catering to the mother’s physical needs and helps her with milk production and other concerns. The pui yuet also cares for the mother with massage, body wraps and lessons on how to take care of the new baby.

    Richard and Chan declined to share the cost of Chan’s services. Few entities track the pricing of nannies in Hong Kong on a consistent basis because most negotiations are directly between clients and the nannies.

    The estimated cost for a pui yuet in Hong Kong ranges from 63,800 Hong Kong dollars (US $8,100) to 268,000 Hong Kong dollars (US $34,100) for 26 to 30 nights for a live-in nanny, according to a 2021 survey by the Consumer Council, a statutory body in Hong Kong dedicated to protecting consumer rights. The council, which surveyed 19 companies or organizations that provide postnatal care, also reported that the cost of a pui yuet working eight hours a day for 26 days ranges from 21,000 Hong Kong dollars (US $2,600) to 34,000 Hong Kong dollars (US $4,300).

    This tradition isn’t without criticism, and some have questioned whether the traditional methods of confinement in the Chinese community are too extreme and may be dangerous. In 2015, a new mother in Shanghai following the custom died of heatstroke after wrapping herself in a quilt and turning off the air conditioner, state media reported.

    Chan has gotten calls from the US and UK to be a pui yuet after a YouTube video about her went viral.

    In recent years, some people have adapted the tradition to more modern ways, taking advantage of available technology. It’s important to turn the air conditioner on when the weather is hot, Chan said, or else you could get sick. The traditional practice had been to avoid anything cold regardless of the weather.

    Richard, now 34, said she loved the time she spent with Chan.

    “It meant everything! My husband and I both don’t have any family members in Hong Kong, and as new parents we were pretty clueless,” she said via email. “Having someone take care of my body and gently guide me through my transition into motherhood made for a very positive beginning of my baby’s life. I’m forever grateful for Carol!”

    Richard was the first Western mother whom Chan cared for in her 12-year career. But since Richard’s YouTube video went viral, Chan said she’s gotten calls from Westerners asking for her services from as far away as the United States and United Kingdom. She’s now headed to Vancouver, British Columbia, in July to work as a pui yuet for a family there for a month.

    The kind of care Richard received is expensive, whether the new parents live in Hong Kong or elsewhere. One US location, Boram Postnatal Retreat, opened last year in New York City.

    “It was very challenging to get the concept received by others,” cofounder Boram Nam told CNN. “It was a lot about the education process — information is abundant up to until you give birth, and the spotlight completely shifts over to the baby — so we get into that discussion, and people get it.”

    Cofounder Boram Nam opened Boram Postnatal Retreat last year in New York for new mothers.

    But her program comes with a hefty price tag, starting at three nights for $2700.

    “This is the price we do need to charge for the level of service that we provide within the guidelines of what postpartum care looks like in the US,” said Nam, adding that she hopes eventually to get services covered by insurance. “We want to make sure this can be accessible by others, by more women, a more diverse group of people.”

    Mandy Major, owner of Major Care, a virtual postpartum doula service based in the US, has noticed a lack of postpartum education in her country.

    “We have a lack of systematic postpartum here within our health care system,” Major said. “We have a go-go, hyper-productive, hyper-independent culture, but we also don’t have paid leave.”

    Richard’s mostly Western followers on YouTube noted that pressure, commenting on the luxury of taking a month off to spend time recovering and connecting with their babies.

    “As an American woman who has given birth 4 times and been booted immediately out of the hospital expected to figure it all out on my own, I can undoubtedly say had this been an option, it may have changed my whole mothering experiences!!” one person said.

    “I returned to work 2 weeks postpartum in America,” another mother wrote. “I never felt that I was able to fully bond with my child.”

    The month of confinement came to an end for Richard last April. In Richard’s YouTube video, Chan holds Levi one last time and passes him back to his mother as she put her shoes on to leave.

    Richard’s eyes begin to fill with tears, surprising herself at her emotional reaction.

    “I feel like I’m losing a family member,” she says as the door slowly closes behind Chan, according to the video.

    Even after the confinement experience, Chan remains close with Richard’s family, stopping by for lunch occasionally and still giving baby advice.

    “If I have another baby, I would love to have it in Canada with my family, but I want Carol to come with me if I do!” Richard said in a video chat later, smiling. “I can’t imagine going through this again without her.”

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    When children are told they were born via assisted reproduction can affect outcomes, study finds | CNN



    CNN
     — 

    At age 14, Helen wasn’t bothered by the fact she was born via surrogacy.

    “My mum is still my mum. My dad is still my dad,” she told UK researchers conducting a study on the mental health and well-being of children born through egg donation, sperm donation and surrogacy. Helen is not her real name.

    “I was talking to someone at school and they said they were an accident,” 14-year-old Simon (also not his real name) told the researchers. “I know I was no accident, I was really wanted, and it makes me feel special.”

    Parents worried their children may experience difficulties as a result of learning they were conceived by assisted reproduction can stop fretting — the kids are just fine, according to the study published this week after two decades in the making.

    “When we began this study more than 20 years ago, there was concern the absence of a biological link between the child and the parents could have a damaging effect on their relationship and on the well-being of the child,” said lead author Susan Golombok, professor emerita of family research and former director of the Centre for Family Research at the University of Cambridge in the UK.

    However, at age 20, children born via egg or sperm donation and surrogacy were psychologically well-adjusted, the study found, especially if parents told the children about their birth history before age 7.

    “What this research means is that having children in different or new ways doesn’t actually interfere with how families function. Really wanting children seems to trump everything — that’s what really matters,” Golombok said.

    Clinical psychologist Mary Riddle, an associate professor of psychology at Pennsylvania State University called the study “important, in that it represents research conducted over a long period of time.”

    However, Riddle, who was not involved in the study, said the results aren’t completely applicable to the United States because surrogacy can be practiced differently in the UK in several ways.

    Called “tummy mummies” by some of the children, surrogates in the UK may become part of the family, participating in the upbringing of the child they helped bring into the world, according to Golombok’s 2020 book, “We Are Family: The Modern Transformation of Parents and Children.”

    “In the UK, intended parents often know their surrogate prior to the surrogate pregnancy whereas in the US, commercial surrogates are often matched through agencies and don’t have prior relationships with the families for whom they carry babies,” Riddle said.

    It’s also more common in the UK to use “partial” surrogacy, in which surrogates are impregnated with the sperm of the intended father and are therefore the biological mother of the child, Riddle said.

    “Here in the US, gestational surrogacy, where the surrogate mother has no genetic connection to the child she is carrying, is far more common and thought to be potentially less fraught with psychological and legal pitfalls,” she added.

    The study, published Wednesday in the journal Developmental Psychology, followed 65 children — 22 born by surrogacy, 17 by egg donation and 26 by sperm donation — from infancy until age 20. Another 52 families who did not use any assistance were also followed. Researchers spoke to the families when the children were 1, 2, 3, 7, 10 and 14.

    Young adults who learned about their biological origins before age 7 reported better relationships with their mothers, and their mothers had lower levels of anxiety and depression, the study found.

    However, children born through surrogacy had some relationship issues around age 7, “which seemed to be related to their increased understanding of surrogacy at that age,” Golombok said.

    “We visited the families when the children were 10, and these difficulties had disappeared,” she said. “Interestingly, the same phenomenon has been found among internationally adopted children. It may have to do with having to confront issues of identity at a younger age than other children.”

    Developmentally, children begin to notice and ask questions about pregnancy between the ages of 3 and 4, said clinical psychologist Rebecca Berry, an adjunct faculty member in the department of child and adolescent psychiatry at New York University’s Grossman School of Medicine.

    “To satisfy their curiosity they’ll begin to ask questions about babies and where they came from as a way of trying to understand why they are here,” said Berry, who was not involved with the study.

    Children as young as 7 will already have a basic understanding of genetics, and can be surprised when they learn they aren’t genetically connected to one or both parents, said Lauri Pasch, a psychology professor at the University of California San Francisco, who specializes in infertility and family building.

    “Our current thinking is that it is best for parents to share the story of donor conception with their children at a very early age, so that if I were to ask their child when they are an adult when they learned that they were donor conceived, they would respond that they ‘always knew,’” said Pasch, who was also not involved in the study, via email.

    “This allows the child to grow up with the information, as opposed to learning it later in life, when it comes as a surprise or shock and can hurt their trust in their parents and their identity development,” she added.

    When it came to maternal anxiety and depression, there were no differences between families formed by surrogacy and egg or sperm donation and families with children born without assisted conception. Nor were they any differences in the mothers’ relationships with their partners at home, the study found.

    However, mothers who had babies via donor eggs reported less positive family relationships than mothers who used sperm donation, likely due to insecurities about lack of a genetic connection to their children, Golombok said.

    Young adults conceived by sperm donation reported poorer family communication than those conceived by egg donation, the study found. That’s perhaps due to a greater reluctance on the part of fathers to disclose they are not a genetic parent, Golombok said.

    Only 42% of parents who had conceived via sperm donor had revealed the child’s birth history by the time their children were age 20, compared to 88% of egg donation parents and 100% of parents who used surrogacy.

    When asked, many of the children said they weren’t concerned about how they were conceived.

    “A lot of the children said ‘It’s not a big deal. I’ve got more interesting things going on in my life,’ while others said ‘Actually it’s something a bit special about me. I like talking about it,’ Golombok said. “I think it’s really nice to hear from the children themselves and I don’t think any other study has done this.”

    Once told, a child needs to revisit the birth history from time to time, so parents should be sure any conversation is an ongoing one, Golombok said.

    “There is this idea parents will tell the child and that is it. But you need to keep having these conversations to give the child a chance to ask questions in an age appropriate way as they grow older,” she said.

    “Many of the parents in our study use children’s books that were specifically designed for this purpose,” Golombok added. “Then they could bring the child’s own story into the narrative.”

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    Is Guinness really ‘good for you’? | CNN

    Editor’s Note: Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.



    CNN
     — 

    Guinness, like other Irish stouts, enjoys a seasonal popularity every St. Patrick’s Day. It has also been touted as being “good for you,” at least by its own advertising posters decades ago.

    But can this creamy, rich and filling beer really be added to a list of healthy beverages? Or is its reputation just good marketing? We researched the beer’s history and talked to brewing experts and break out the good, the not-so-great and the ingenuity of Guinness.

    The original Guinness is a type of ale known as stout. It’s made from a grist (grain) that includes a large amount of roasted barley, which gives it its intense burnt flavor and very dark color. And though you wouldn’t rank it as healthful as a vegetable, the stouts in general, as well as other beers, may be justified in at least some of their nutritional bragging rights.

    According to Charlie Bamforth, distinguished professor emeritus of brewing sciences at the University of California, Davis, most beers contain significant amounts of antioxidants, B vitamins, the mineral silicon (which may help protect against osteoporosis), soluble fiber and prebiotics, which promote the growth of “good” bacteria in your gut.

    And Guinness may have a slight edge compared with other brews, even over other stouts.

    “We showed that Guinness contained the most folate of the imported beers we analyzed,” Bamforth said. Folate is a B vitamin that our bodies need to make DNA and other genetic material. It’s also necessary for cells to divide. According to his research, stouts on average contain 12.8 micrograms of folate, or 3.2% of the recommended daily allowance.

    Because Guinness contains a lot of unmalted barley, which contains more fiber than malted grain, it is also one of the beers with the highest levels of fiber, according to Bamforth. (Note: Though the US Department of Agriculture lists beer as containing zero grams of fiber, Bamforth said his research shows otherwise.)

    Bamforth has researched and coauthored studies published in the Journal of the Institute of Brewing and the Journal of the American Society of Brewing Chemists.

    Here’s more potentially good news about Guinness: Despite its rich flavor and creamy consistency, it’s not the highest in calories compared with other beers. A 12-ounce serving of Guinness Draught has 125 calories. By comparison, the same size serving of Budweiser has 145 calories, Heineken has 142 calories, and Samuel Adams Cream Stout has 189 calories. In the United States, Guinness Extra Stout, by the way, has 149 calories.

    This makes sense when you consider that alcohol is the main source of calories in beers. Guinness Draught has a lower alcohol content, at 4.2% alcohol by volume, compared with 5% for Budweiser and Heineken, and 4.9% for the Samuel Adams Cream Stout.

    In general, moderate alcohol consumption – defined by the USDA’s dietary guidelines for Americans as no more than two drinks per day for men or one drink per day for women – may protect against heart disease. So you can check off another box.

    Guinness is still alcohol, and consuming too much can impair judgment and contribute to weight gain. Heavy drinking (considered more than 14 drinks a week for men or more than seven drinks a week for women) and binge drinking (five or more drinks for men, and four or more for women, in about a two-hour period) are also associated with many health problems, including liver disease, pancreatitis and high blood pressure.

    According to the National Council on Alcoholism and Drug Dependence, “alcohol is the most commonly used addictive substance in the United States: 17.6 million people, or one in every 12 adults, suffer from alcohol abuse or dependence along with several million more who engage in risky, binge drinking patterns that could lead to alcohol problems.”

    And while moderate consumption of alcohol may have heart benefits for some, consumption of alcohol can also increase a woman’s risk of breast cancer for each drink consumed daily.

    Many decades ago, in Ireland, it would not have been uncommon for a doctor to advise pregnant and nursing women to drink Guinness. But today, experts (particularly in the United States) caution of the dangers associated with consuming any alcohol while pregnant.

    “Alcohol is a teratogen, which is something that causes birth defects. It can cause damage to the fetal brain and other organ systems,” said Dr. Erin Tracy, an OB/GYN at Massachusetts General Hospital and Harvard Medical School associate professor of obstetrics, gynecology and reproductive gynecology. “We don’t know of any safe dose of alcohol in pregnancy. Hence we recommend abstaining entirely during this brief period of time in a woman’s life.”

    What about beer for breastfeeding? “In Britain, they have it in the culture that drinking Guinness is good for nursing mothers,” said Karl Siebert, professor emeritus of the food science department and previous director of the brewing program at Cornell University.

    Beer in general has been regarded as a galactagogue, or stimulant of lactation, for much of history. In fact, according to irishtimes.com, breastfeeding women in Ireland were once given a bottle of Guinness a day in maternity hospitals.

    According to Domhnall Marnell, the Guinness ambassador, Guinness Original (also known as Guinness Extra Stout, depending on where it was sold) debuted in 1821, and for a time, it contained live yeast, which had a high iron content, so it was given to anemic individuals or nursing mothers then, before the effects of alcohol were fully understood.

    Some studies have showed evidence that ingredients in beer can increase prolactin, a hormone necessary for milk production; others have showed the opposite. Regardless of the conclusions, the alcohol in beer also appears to counter the benefits associated with increased prolactin secretion.

    “The problem is that alcohol temporarily inhibits the milk ejection reflex and overall milk supply, especially when ingested in large amounts, and chronic alcohol use lowers milk supply permanently,” said Diana West, coauthor of “The Breastfeeding Mother’s Guide to Making More Milk.”

    “Barley can be eaten directly, or even made from commercial barley drinks, which would be less problematic than drinking beer,” West said.

    If you’re still not convinced that beer is detrimental to breastfeeding, consider this fact: A nursing mother drinking any type of alcohol puts her baby in potential danger. “The fetal brain is still developing after birth – and since alcohol passes into breast milk, the baby is still at risk,” Tracy said.

    “This is something we would not advocate today,” Marnell agreed. “We would not recommend to anyone who is pregnant or breastfeeding to be enjoying our products during this time in their life.”

    Regarding the old wives’ tale about beer’s effects on breastfeeding, Marnell added, “It’s not something that Guinness has perpetuated … and if (people are still saying it), I’d like to say once and for all, it’s not something we support or recommend.”

    Assuming you are healthy and have the green light to drink beer, you might wonder why Guinness feels like you’ve consumed a meal, despite its lower calorie and alcohol content.

    It has to do with the sophistication that goes into producing and pouring Guinness. According to Bamforth, for more than half a century, Guinness has put nitrogen gas into its beer at the packaging stage, which gives smaller, more stable bubbles and delivers a more luscious mouthfeel. It also tempers the harsh burnt character coming from the roasted barley. Guinness cans, containing a widget to control the pour, also have some nitrogen.

    Guinness is also dispensed through a special tap that uses a mixture of carbon dioxide and nitrogen. “In Ireland, Guinness had a long history of hiring the best and brightest university graduates regardless of what they were trained in,” Siebert said. “And they put them to work on things they needed. One was a special tap for dispensing Guinness, which has 11 different nozzles in it, that helps to form the fine-bubbled foam.”

    The foam is remarkably long-lasting. “After you get a freshly poured Guinness, you can make a face in the foam, and by the time you finish drinking it, the face is still there,” Siebert said.

    The famous advertising Guinness slogans – including “It’s a good day for a Guinness” – started through word of mouth, said Marnell. “In 1929, when we were about to do our first ad, we asked (ourselves), ‘What stance should we take?’ So we sent around a group of marketers (in Ireland and the UK) to ask Guinness drinkers why they chose Guinness, and nine out of 10 said their belief was that the beer was healthy for them. We already had this reputation in the bars before we uttered a word about the beer.

    “That led to the Gilroy ads that were posted,” Marnell explained, referring to the artist John Gilroy, responsible for the Guinness ads from 1928 to the 1960s. “You’ll see the characters representing the Guinness brand – the toucan, the pelican – and slogans like ‘Guinness is good for you’ or ‘Guinness for Strength.’ But those were from the 1920s, ’30s and ‘40s.”

    Today, he said, the company would not claim any health benefits for its beer. “If anyone is under the impression that there are health benefits to drinking Guinness, then unfortunately, I’m the bearer of bad news. Guinness is not going to build muscle or cure you of influenza.”

    In fact, Guinness’ parent company, Diageo, spends a lot of effort supporting responsible drinking initiatives and educating consumers about alcohol’s effects. Its DrinkIQ page offers information such as calories in alcohol, how your body processes it and when alcohol can be dangerous, including during pregnancy.

    “One of the main things we focus on … is that while we would love people to enjoy our beer, we want to make sure they do so as responsibly as possible,” Marnell said. “We would never recommend that anyone drink to excess, and (we want to make people) aware of how alcohol effects the body.”

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  • See the latest news and share your comments with CNN Health on Facebook and Twitter.
  • And again: Most health providers in the US would advise forgoing all alcohol if you are pregnant, nursing or have other health or medical issues where alcohol consumption is not advised.

    So responsibly celebrate St. Patrick this year a little wiser about the health benefits and risks with one of its signature potables.

    This story originally published in 2017.



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    Canadian siblings born four months early set record as the world’s most premature twins | CNN



    CNN
     — 

    For expectant parents Shakina Rajendram and Kevin Nadarajah, the doctor’s words were both definitive and devastating: Their twins were not “viable.”

    “Even in that moment, as I was hearing those words come out of the doctor’s mouth, I could still feel the babies very much alive within me. And so for me, I just wasn’t able to comprehend how babies who felt very much alive within me could not be viable,” Rajendram recalled.

    Still, she knew that there was no way she would be able to carry to term. She had begun bleeding, and the doctor said she would give birth soon. The parents-to-be were told that they would be able to hold their babies but that they would not be resuscitated, as they were too premature.

    Rajendram, 35, and Nadarajah, 37, had married and settled in Ajax, Ontario, about 35 miles east of Toronto, to start a family. They had conceived once before, but the pregnancy was ectopic – outside the uterus – and ended after a few months.

    As crushing as the doctor’s news was, Nadarajah said, they both refused to believe their babies would not make it. And so they scoured the Internet, finding information that both alarmed and encouraged them. The babies were at just 21 weeks and five days gestation; to have a chance, they would need to stay in the womb a day and a half longer, and Rajendram would have to go to a specialized hospital that could treat “micropreemies.”

    The earlier a baby is born, the higher the risk of death or serious disability, the US Centers for Disease Control and Prevention says. Babies born preterm, before 37 weeks gestation, can have breathing issues, digestive problems and brain bleeds. Development challenges and delays can also last a lifetime.

    The problems can be especially severe for micropreemies, those born before 26 weeks gestation who weigh less than 26 ounces.

    Research has found that infants born at 22 weeks who get active medical treatment have survival rates of 25% to 50%, according to a 2019 study.

    Adrial was born weighing less than 15 ounces.

    Rajendram and Nadarajah requested a transfer to Mount Sinai Hospital in Toronto, one of a limited number of medical centers in North America that provides resuscitation and active care at 22 weeks gestation.

    Then, they say, they “prayed hard,” with Rajendram determined to keep the babies inside her just a few hours longer.

    Just one hour after midnight on March 4, 2022, at 22 weeks gestation, Adiah Laelynn Nadarajah was born weighing under 12 ounces. Her brother, Adrial Luka Nadarajah, joined her 23 minutes later, weighing not quite 15 ounces.

    According to Guinness World Records, the pair are both the most premature and lightest twins ever born. The previous record holders for premature twins were the Ewoldt twins, born in Iowa at the gestational age of 22 weeks, 1 day.

    It is a record these parents say they want broken as soon as possible so more babies are given the opportunity to survive.

    “They were perfect in every sense to us,” Rajendram said. “They were born smaller than the palm of our hands. People still don’t believe us when we tell them.”

    The babies were born at just the right time to be eligible to receive proactive care, resuscitation, nutrition and vital organ support, according to Mount Sinai Hospital. Even an hour earlier, the care team may not have been able to intervene medically.

    “We just didn’t really understand why that strict cut off at 22, but we know that the hospital had their reasons. They were in uncharted territory, and I know that they had to possibly create some parameters around what they could do,” Rajendram said.

    “They’re definitely miracles,” Nadarajah said as he described seeing the twins in the neonatal intensive care unit for the first time and trying to come to terms with what they would go through in their fight to survive.

    “I had challenging feelings, conflicting feelings, seeing how tiny they were on one hand, feeling the joy of seeing two babies on the second hand. I was thinking, ‘how much pain they are in?’ It was so conflicting. They were so tiny,” he said.

    These risks and setbacks are common in the lives of micropreemies.

    Dr. Prakesh Shah, the pediatrician-in-chief at Mount Sinai Hospital, said he was straightforward with the couple about the challenges ahead for their twins.

    He warned of a struggle just to keep Adiah and Adrial breathing, let alone feed them.

    The babies weighed little more than a can of soda, with their organs visible through translucent skin. The needle used to give them nutrition was less than 2 millimeters in diameter, about the size of a thin knitting needle.

    “At some stage, many of us would have felt that, ‘is this the right thing to do for these babies?’ These babies were in significant pain, distress, and their skin was peeling off. Even removing surgical tape would mean that their skin would peel off,” Shah told CNN.

    But what their parents saw gave them hope.

    Kevin Nadarajah sings to Adiah.

    “We could see through their skin. We could see their hearts beating,” Rajendram said.

    They had to weigh all the risks of going forward and agreeing to more and more medical intervention. There could be months or even years of painful, difficult treatment ahead, along with the long-term risks of things like muscle development problems, cerebral palsy, language delays, cognitive delays, blindness and deafness.

    Rajendram and Nadarajah did not dare hope for another miracle, but they say they knew their babies were fighters, and they resolved to give them a chance at life.

    “The strength that Kevin and I had as parents, we had to believe that our babies had that same strength, that they have that same resilience. And so yes, they would have to go through pain, and they’re going to continue going through difficult moments, even through their adult life, not only as premature babies. But we believed that they would have a stronger resolve, a resilience that would enable them to get through those painful moments in the NICU,” Rajendram said.

    There were painful setbacks over nearly half a year of treatment in the hospital, especially in the first few weeks.

    “There were several instances in the early days where we were asked about withdrawing care, that’s just a fact, and so those were the moments where we just rallied in prayer, and we saw a turnaround,” Nadarajah said.

    Adiah spent 161 days in the hospital and went home on August 11, six days before her brother, Adrial, joined her there.

    Adrial’s road has been a bit more difficult. He has been hospitalized three more times with various infections, sometimes spending weeks in the hospital.

    Both siblings continue with specialist checkups and various types of therapy several times a month.

    But the new parents are finally more at ease, celebrating their babies’ homecoming and learning all they can about their personalities.

    The twins are now meeting many of the milestones of babies for their “corrected age,” where they would be if they were born at full-term.

    “The one thing that really surprised me, when both of them were ready to go home, both of them went home without oxygen, no feeding tube, nothing, they just went home. They were feeding on their own and maintaining their oxygen,” Shah said.

    Adiah is now very social and has long conversations with everyone she meets. Their parents describe Adrial as wise for his years, curious and intelligent, with a love of music.

    “We feel it’s very important to highlight that contrary to what was expected of them, our babies are happy, healthy, active babies who are breathing and feeding on their own, rolling over, babbling all the time, growing well, playing, and enjoying life as babies,” Rajendram said.

    These parents hope their story will inspire other families and health professionals to reassess the issue of viability before 22 weeks gestation, even when confronted with sobering survival rates and risks of long-term disability.

    “Even five years ago, we would not have gone for it, if it was not for the better help we can now provide,” Shah said, adding that medical teams are using life-sustaining technology in a better way than in previous years. “It’s allowing us to sustain these babies, helping keep oxygen in their bodies, the role of carbon dioxide, without causing lung injury.”

    Adiah and Adrial’s parents say they’re not expecting perfect children with perfect health but are striving to provide the best possible life for them.

    “This journey has empowered us to advocate for the lives of other preterm infants like Adiah and Adrial, who would not be alive today if the boundaries of viability had not been challenged by their health care team,” Rajendram said.

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    Why hard feelings are good for teens | CNN

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    CNN
     — 

    For many parents, the “Is it normal?” game begins early on. I’ve sent question after question to family and friends, and of course, all worried parents ask our No. 1 frenemy, Google.

    Is it normal my fetus isn’t moving a lot in the morning? Is it normal my baby doesn’t nap? Is it normal that my 6-year-old can’t read? Is it normal that my 10-year-old has only lost four baby teeth?

    For all the talk of helicopter parents and their snowflake children, most parents I know are more concerned with whether their child’s development would be considered normal by experts than whether they are raising a prodigy.

    When the teen years arrive, the “Is it normal?” instinct can go into overdrive. Adolescence is marked by many changes, including ones that manifest physically and, their more challenging counterpart, ones that manifest emotionally. The moods and deep feelings are intense, and — for parents worried about teen mental health following the pandemic — cause for panic amid reports of heightened depression and anxiety among adolescents.

    But difficult feelings are often not a cause for concern, according to psychologist Lisa Damour in her new book, “The Emotional Lives of Teenagers: Raising Connected, Capable, and Compassionate Adolescents.” Not only are sadness and worrying healthy and natural parts of being a teenager, but the ability to experience these feelings (without a parent panicking) and to learn how to cope with them is developmentally necessary.

    CNN spoke to Damour about why we’ve become less tolerant of big feelings, how to handle them when they arise, and the ways parents can, and can’t, help.

    This conversation has been edited and condensed for clarity.

    CNN: You want to help parents distinguish between a teen in a mental health crisis, which is more common now, and a teen who is sad and moody but not in crisis. Why is this important?

    Lisa Damour

    Lisa Damour: We certainly have a teen mental health crisis, and part of what contributes to the crisis isn’t just that teenagers suffered in the pandemic but also that we don’t have a clinical workforce to provide as much care as they deserve.

    But not all kids who are in psychological distress are having a mental health concern. Psychologists see those as two different things, and though it is uncomfortable for all involved, typical adolescent development comes with plenty of psychological distress. My aim in writing this book was to support parents in knowing the difference between distress that is natural to being a teenager and when a teenager may be facing a mental health concern.

    CNN: How do you know the difference?

    Damour: Psychologists fully expect to see distress in humans, and especially in teenage humans. When we become disturbed is by how that distress is managed. We want to see that teens can manage distress in a way that does no harm to themselves or others. This might include talking about feelings with people who care for them, finding healthy outlets for the distress and seeking habits that help them find relief.

    What we don’t want to see is for them to find relief through something that comes with a price tag, things like using a substance or harming others.

    The other time we become concerned is when one emotion is calling all the shots, like when they are so anxious that their anxiety is governing all their decisions, or so sad that depression is getting in the way of their typically forward development.

    CNN: Why is it so hard for parents to see hard feelings, including sadness and anxiety, as part of a healthy adolescence?

    Damour: There is a lot of commercial marketing around wellness that can give people the impression that they are only mentally healthy or their kids are mentally healthy if they are feeling good, calm or relaxed. This is not an accurate definition of mental health.

    Since the pandemic, parents are more anxious than ever about teens suffering emotional distress.

    Also, in the wake of the pandemic, what I am observing is that parents saw their kids go through an extremely hard time and are now surrounded by headlines about the ways in which teenagers especially suffered. It makes sense that parents are feeling more anxious than ever about their teenagers experiencing emotional distress.

    In light of what we have all been through, and what our kids have been through, it can be very hard to get used to the idea that distress can be a sign of a teenager’s mental health. If a boy gets his heart broken and is very sad and he is in a lot of pain, it is proof that he is working just as he should. If a kid is unprepared for a test and it’s coming fast, and she feels anxious — that’s uncomfortable but appropriate.

    One of the aims of this book is to prove that mental distress is not only inevitable — it is part of mental health and experiencing it is part of how kids grow and mature.

    CNN: Many of us feel permanently short on time. How does that impact how we tend to our teens’ emotional distress?

    Damour: As much as we can appreciate theoretically that teenagers are going to get upset and have bad days, that doesn’t mean that this is easy to deal with at night when the parent is tired, and the teenager is having a meltdown. In that moment, the very expectable and well-meaning response is for the parent to want to make the stress go away and jump into advice giving and problem-solving so that the teenager doesn’t feel that way anymore. But parents discover that this doesn’t work as well as they hope it will.

    CNN: You point to deep listening as a better approach, which is often not as easy as it may sound. What is it?

    Damour: The metaphor I find that helps us listen is to imagine that you are an editor and your teenager is your reporter. They are reading you an article, and when they come to the end of it, it is your job to produce the headline.

    This exercise helps us tune in to what a teenager is saying and hear and distill what it is they are communicating. It also keeps us from doing what we so often do, which is have an idea and wait for the kids to pause so we can share it.

    Parents may worry, but experiencing mental distress is part of how teens grow and mature.

    If you come up with a good headline, teenagers often feel completely heard and get all the support they need. And even if you don’t, teenagers know us well and know when we are listening and giving them support without an agenda and trying to understand what they are really saying.

    What helps with anyone experiencing difficulty, but especially teenagers, is to experience compassion. It is such a generous gesture to just hear someone out.

    CNN: Does all emotional processing need to be verbal?

    Damour: There are many other healthy ways kids regulate emotions besides talking. Listening to mood-matching music is a very adaptive way to regulate as the experience of listening to the music catalyzes the emotion out of them. Teenagers also discharge emotions physically — by going through a run, jumping on a trampoline or banging on drums. Sometimes they will discharge them through creative channels like drawing or making music.

    As adults, we should not diminish the value of emotional expression that brings relief, even if it doesn’t come in the verbal form to which we are most accustomed.

    CNN: Should parents ask to join in? To listen to the music with them or go on the run?

    Damour: No, because what we ultimately want is for our teens to become autonomous in dealing with their hard feelings.

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