Daddy! You can tell me a really good story about a crocodile that has an elephant’s trunk and sharp teeth. B E P P E , 3 Y E A R S O L D
that gives you new perspectives and offers both joy and challenges. What can it be like? What is it like being a child? What to do as a parent? Parenthood is a lifelong under-
taking that changes as the children grow up. Life with children is meant as a guide for this journey, a book to search through when you have got a specific question, or to read through from start to finish. With this book as an inspiration we hope that you can gather knowledge, tips and advice, receive support and reassurance! This book also introduces you to how the Swedish child healthcare works and to the main principles of the UN convention on the rights of the child. The authors are Marie Köhler, paediatrician, Antonia Reuter, psychologist and Johanna Tell, child healthcare nurse. With their
life with children
l
iving with a child is both fun and difficult. An adventure
Life with
cHildReN
three different professions within child healthcare they contribute considerable knowledge from their various fields.
You can’t describe what it’s like to have children, a family. It’s something completely different… You think about the children, you think about other children’s situations. F O UA D, 4 8 Y E A R S O L D
77412458.2.1_Omslag_ENG.indd Alla sidor
ISBN 9789177412458
9 789177 412458
2020-06-29 14:25
Life with
cHildReN Marie Kรถhler Antonia Reuter Johanna Tell
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© 2020 The Authors and Gothia Fortbildning AB ISBN 978-91-7741-245-8 Copying is illegal! The reproduction of the contents of this book, in whole or in part, is forbidden under copyright law without the permission of the publisher, Gothia Fortbildning AB, Stockholm. This applies to the text and illustrations and applies to all forms of reproduction. Translation: Kristoffer Ohlin Editor: Linnéa Isheden Cover and layout: Anna Hild
Thank you A great big thank you for the children’s drawings made by Beatrice, Jonatan, Måns and William. Thank you to Paiman and Fouad who agreed to be interviewed. A huge thank you to all the children that were interviewed: Adam, Alva, Beppe, Ludvig, Sude, Thea.
Second edition, first print This is a shortened, translated edition of the fourteenth edition of Leva med barn, published in 2020. Printing: ADverts, Lettland 2020
Gothia Fortbildning Box 22543, 104 22 Stockholm Kundservice 08-462 26 70 info@gothiafortbildning.se www.gothiafortbildning.se
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Contents The first time together
7
Becoming a parent
8
Becoming a family
10
Newborn 12 Bonding 14 Crying 15
What does the baby need?
21
Eating 22 Sleeping 54 Be cared for
The child’s development and health
65
83
Moving around
84
Talking and telling
88
Playing and exploring the world
91
Sick and sad
95
Child healthcare
105
Children’s surroundings
115
Children and the sun
116
Children and the cold
118
Children and tobacco
119
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Children and alcohol
120
Children and medication
122
Children and drugs
122
Children and traffic
122
Children and safety
124
Children and media
131
Life with children
139
Parent interview
140
Who stays at home?
144
What is best for the children?
146
Will and wants
149
Being together
150
Getting angry with each other
151
Never violence!
153
Leaving each other
154
Fighting for children’s rights
158
Links 159 Authors and co-workers
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All children have the same rights and equal value. No one can be discriminated against. In all actions concerning children, the best interests of the child shall be a primary consideration. Every child has the right to live and develop. Every child has the right to express their opinion and to be listened to. A SUMMARY OF THE MAIN PRINCIPLES IN THE UN CONVENTION ON THE RIGHTS OF THE CHILD
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The first time together
7
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Becoming a parent Becoming a parent is one of life’s greatest events. A new human being has
entered the world and you have a new important mission in life. Some times it can be difficult to make the most of the time you have. Everything moves so fast and everything has changed. When do you become a parent? Is it when the child is born, or long before that? We usually count birth as the moment it happens, but the process of becoming a parent starts a lot earlier. The positive pregnancy test offers a challenge – is it really true? When the baby starts to move the change becomes more apparent. Maybe you get a chance to hear the baby’s heartbeat on a visit to the midwife. Who is in there? An “us” starts to form. The delivery is often a strong experience, the tension is high and you can feel absolutely exhausted afterwards. At the same time, you finally get to see your baby. After the delivery parent and child get to know each other better and eventually get into the rhythm of feeding, sleeping and being close to one another. You will adapt to the child’s routines and your daily pattern will begin to change. We become parents in different ways, some as stated above, others by adopting a child or by becoming a foster parent. In those circumstances there are different preparations than through pregnancy before you meet the child. We can experience a great deal of pressure as a new parent, we feel we need to meet the expectations set out, not only by ourselves and others, but expectations are often raised additionally by advertising and media. The great change in your life, your situation in life generally and the high expectations on being a “perfect” parent can negatively affect the euphoria and make you feel insecure, lonely and sometimes sad. It is ok to feel like this – many do. We need time, in peace and quiet, to find our own ways of being with the baby and to create this new, exciting and different sense of community. It will not happen by itself – it will take time and a great deal of work. 8
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Before you have a child it can be difficult to visualise how life is going to change, how it is all going to be. Some people already have a set agenda and clear goals for parenthood. Others wait and see. At the same time as it may feel as you are writing a whole new chapter in life, you already have your own history with your own experiences from the family you grew up with. Your own traditions, habits and ways. How your relation has been to your parents, siblings and other important people in your life will affect your parenthood and the relation and interaction with your child. As a parent you may have many questions and worries. Is my baby developing as expected? How much do babies need to sleep? What sort of food is good for my baby? Can we leave our child with someone else and go away for the weekend? Is it really just a mild cold? Do small children need friends? How will I be enough as a parent for my child? These are questions and experiences that you can share with other parents. Being a parent can offer times of joy and happiness but also times of uncertainty, insecurity and a feeling of inadequacy. The first few years are full of surprises as your baby develops very quickly. From being tiny and completely dependent on you, most children can move around in their world more or less independently, exploring it on their own at 2 years of age. We no longer have a compliant little infant that falls asleep in our arms, but an active, stubborn little tot that express their emotions more clearly. Becoming a parent means we will have our children with us, no matter where we go. They are an important part of our lives, and we in theirs, forever.
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Becoming a family What comprises a family? Some grow up in a traditional mother-fatherchild family, while others carry a different set of experiences. You might have had parents that have separated, been single or you might have grown up with parents of the same sex, in a foster family, stepfamily or been adopted. Some of us do not have a role-model when we start a family, and end up forming relationships and family life that suit our child’s needs. From a child’s perspective, the parenting itself is more important than what individual parts make up the family. The type of family is not integral for the child’s development and health. The important part is that the parent can offer care, create a safe environment and contribute to a good upbringing. That there is someone who really wants to be your parent and that they will not give up on you. Experiences from your own childhood have a great impact when you are starting your own family. And they are pattern forming – for good and for bad. If you feel you need more help and support it might be useful to speak to your named child healthcare nurse at your local BVC (child healthcare centre). There are often good reasons to look back at your own childhood to see how patterns from then affect the situation you have now. But childhood is not everything. There are also strong forces in society, often pulling in separate directions, which can sometimes make it difficult to find sustain able ways of coexisting and positive solutions for both parent and child. Compared to many other countries we generally have a good situation here in Sweden. The standard of living is high for most people, and there is good social security. We have come a long way in terms of equality and it is easier for parents to both work and look after their children. Reforms in Föräldraförsäkringen (the bundle of benefits and laws aimed at ensuring children’s and parents’ rights), allowing you time off work to look after a sick child and financial contributions to extend your salary has helped, as well as increased opportunity to work shorter hours whilst you have small children. Good childcare and pre schools have played a significant role for many children and families. 10
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Society has developed in other ways that have not made it easier for children and parents. The size of the children’s groups in preschools has increased. Parents of small children work full time to a higher extent. Stress within the work life has increased. Unemployment, poor economy and a housing shortage are rocking families’ life to the core. The financial divide between families is increasing and children’s opportunities therefore vary. It can simply be very difficult to make life work. 11
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Newborn Birth is something of a miracle! In the space of a few hours the conditions change radically for the baby, who comes out from the warmth, darkness and soft rocking in the waters within the protective barriers – out to us, the light, the cold and all the invading impressions in this new world. During a few life changing seconds the baby’s body takes over responsibility for sustaining it with life: Circulation is re-routed, lungs are filled with air, and the first cry clears the airways. The umbilical cord is cut. The child meets their parents with open eyes and can already from the start tell the difference between light and dark. The gaze wanders around the room, looking for landmarks, avoiding strong light. The child starts reorienting themselves, searching for their mother’s breast and starts sucking. It is not long ago that newborn babies were considered completely helpless, that they could not fix their gaze, could not with their own powers find their way to the breast, feel pain or recognise voices. Now we know better. The infant’s abilities to see, listen, taste, feel and smell are very well developed and they have impressive abilities from birth. During the pregnancy your baby can hear muffled sounds. After birth all the sounds change and reach the child’s eardrums more directly. In the uterus the baby will constantly feel their mother’s heartbeat as a constant pulse of life. After birth those sounds are more distant. When you hold your baby close to your body, those heart beats are closer again, a sound of comfort and security. When the baby cries from hunger or when they are not feeling well, instinct tells you to pick them up, put them against your shoulder and rock them gently. The motion, the closeness and the sounds of your heart will calm the baby. Birth is a great transition, and it is important to create a peaceful environment around the baby, especially during their first hours and days. The infant can at an early stage control the amount of impressions by turning their face away, avoiding eye contact and yawning when they get overwhelmed or something feels foreign. When they are newborn, babies sleep most of the time. The child will immediately start adapting to their new environment and to their new experiences. Us adults are also prepared to look after an 12
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infant, we touch and familiarise ourselves with the baby in a similar way, regardless of where we are in the world. One can say we have a natural talent that we can rely on when we have a baby. There is a mutual curio ity, openness and closeness to one another. From the very beginning we start communicating with each other. We smile, laugh, cry and cuddle. We babble, sing, tell and read stories. In this way language becomes a natural part of the baby long before they can utter a single word. The newborn will move in pace with our speech, responding to the rhythm of language, even though it may not be visible to the naked eye. It seems as if the baby is prepared for a conversation long before they can say a single word. The child has an innate ability to communicate in the same way as they are prepared to start walking, even before their bodies and balance allows it. Newborn – and already a person with their own personality, temperament and language. During their first few months, the baby sees best at around 20–25 centimetres distance, roughly the same distance as the one between the mothers and baby’s face during breastfeeding. From birth the infant can follow who is talking, but will only lock their gaze for a very short time. The child is attracted more to faces than other things, and more so to faces they already recognise. They can now copy facial expressions, grimaces, opening and closing the mouth and sticking their tongue out. In reality children and parents end up copying each other. 13
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Bonding During their first years in life babies connect to one or several caregivers. The development of a sense of security and trust for one another during the first time is important for both parent and child. The newborn baby is working intensely on getting a close connection to their parent, and there is no guide book or manual on how to interpret your child’s expressions of their needs and wishes. It is a matter of gradually getting to know and understand one another. Connection, emotional intimacy and being attentive is extra important as the child is completely reliant on an adult to care for, feed, protect and offer them security and comfort whenever they need. At birth the brain is very immature and the development of the brain is reliant on the connection between the baby and their environment. The baby constantly needs a caring adult and is easily overwhelmed by strong emotions and impressions that they cannot handle on their own, they need help from their parent to adjust and soothe. The adult needs to soothe, be close, put words to what is happening and how it can feel as well as comfort. The infant uses all their senses to get to know their environment. They learn early on who or whom responds to their needs and will gradually learn to rely on and feel comfortable with them – Those people are there for me. What we commonly call maternal or paternal instinct can be there in some parents from the very first moment with their child, but it is not uncommon to find that the expected immediate sense of joy does not appear and that the love is more of a gradual development. Children connect to several people very early in life, and there appears to be a “connection hierarchy” where some relationships become more important than others. The most important people are the ones that have been a fixed point in the child’s existence, often the parents but also siblings and other family members. A possible explanation to this behaviour is that the child needs multiple people to seek protection from. It seems the baby can have a close and regular relationship with between one and five people. 14
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When the child is around four months old they start following their parents with their gaze, they become happier and smile more when they see their parent and they are much easier to soothe and comfort by the parent than by a stranger. This shows that the child is starting to feel safer and more secure with one or a few select people. After another few months it becomes even more apparent when the child curiously explores the environment, keeping their parent under supervision while exploring, and often returns to the parent to show them something. The parent has become the “secure base”. The child now prefers to be looked after by only a select few, and becomes apprehensive and shy to strangers. The way that the child becomes restless and sad when it is time for the parent to leave and go away is part of their natural development, and these feelings needs to be respected. The child needs time to get to know the person who is going to look after them. One way is to let the child see the person and the parent together and that the parent then shows the child they think this person is good and trustworthy. As the child grows older they become more secure in themselves and can manage better on their own. To have a close and secure relationship with the parents and other people contributes greatly to that development.
Crying Crying is the baby’s first comment on life outside the womb. The cry is there to be heard. It has exactly the strength, pitch and intensity to quickly and efficiently wake up a person who is deeply asleep. It is meant to be like that, and nothing to be worried about – even if it is hard to be happy when it happens many times the same night. The infant mainly uses the crying to tell you something is not right. It is an instinctual primitive force that is crucial for the child’s survival. The only thing the baby can do is to try and get their parents attention and, if necessary, cry. It is an early and obvious way of communication, and easy to understand. You cannot miss it, something is wrong and the child needs you. 15
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Life with children
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PaRent inteRview Fouad 48 years old, art, photo and film teacher Paiman 31 years old, student Caros 7 years old, goes to school Criska 3.5 years old, goes to preschool BOR: 3.5 years old, goes to preschool
Paiman to settle into the new situation, but to Paiman this was never an option. – That’s just how it is in Kurdistan. You don’t think in that way. When you get married this means that you are going to start a family, have children. But I enjoyed being pregnant. I went to school at SFI (Swedish for Immigrants) and did well.
In 1998 fouad was visiting his old home
And when I wasn’t in school I sat in the
town of Erbil in northern Iraq. He had then
library and read children’s books to learn
been living as a single man in Sweden for
the language.
16 years, after having escaped the war be-
Throughout the interview Paiman and
tween Iran and Iraq. There, in the library in
Fouad return to the meaningfulness of lan-
Erbil Fouad met Paiman.
guage. Partly Paiman’s own struggle to con-
– We talked and it felt completely natu-
quer the new difficult language, partly the
ral. It may have been love at first sight, says
bilingualism of their children. Paiman and
Paiman, who worked as a librarian.
Fouad decided very early on to only speak
In Iraq you can’t have a relationship like
Kurdish at home. They wanted to give
you can here. So we got engaged after two
their children a link to their past and their
weeks, Fouad adds.
families and to preserve the strong bond
Six months later they got married in
between parent and child that a mutual
Erbil and after an additional six months
native tongue offers. Also, says Paiman, bi-
Paiman landed in Stockholm.
lingualism makes you more intelligent and
– I wasn’t going to move anywhere before I med Fouad. When I got here every-
gives you the ability to solve problems in different ways.
thing was completely new and alien, the
To have one family here and one over
husband, the country, the language and I
there with a link in between. It is two cul-
got pregnant immediately. It was a really
tures that enrich you too. The language
tough time, especially getting to grips with
makes that contact seamless, says Fouad. The agreement has among other things
the language, it became like a handicap, Paiman recollects.
meant that Paiman has translated Swed-
Fouad told us that he would have hap-
ish children’s books into Kurdish in order
pily waited to have a baby, in order to allow
to be able to tell stories in her own native
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PaRent inteRview tongue. Kurdish children’s books are in fact
leave. Fouad says he mostly enjoyed being
very rare.
home with Caros.
– I read three books every day. I prepared
– I really enjoy children and I’ve worked
at home in the daytime to have the transla-
with children in daycare. For me it was completely natural to take
tion ready by the evening. The children have learnt Swedish throughday care and school. But even before they got to reading stories Paiman and Fouad had a difficult time. Caros was born with stomach problems and for three months he cried a lot and slept poorly. Paiman was constantly tired. She couldn’t sleep in the daytime when Caros slept. She was quite depressed. – I had no strength to do anything else at home than to look after my son. And poor Fouad, says Paiman. You were up with Caros at night and then you got up to go to work at six! With Fouad’s help, the parental group she saw and the midwife she could
”You can’t describe what it’s like to have children, a family. It’s something completely different ... You think of the children, you think of how other children live.
Paiman eventually got a job, and then
did a lot of things together. – What did we do? Caros asks, who is sitting with us at the dining table. – We went out for walks, sometimes we walked to playschool and we were at home. We played and I cooked and we waited for Paiman to come home ... Caros wanted to be nursed as soon as she got home. – I thought you could only have maternity leave! Caros adds surprised. Then he thinks for a while and adds: – But I remember when you were at home and we were
watching Teletub-
bies. That was a favourite. Fouad explains that liv-
den is very different compared to life in Kurdistan, both in good and bad ways: – Over there most mothers stay at home
there was Fouad’s turn to take parental
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he was one year old, so we
ing with children in Swe-
ask for advice, she managed to get through the difficult time.
care of Caros. At that point
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PaRent inteRview and have five, six, seven children. And all
have to have the same starting conditions
children play with each other out on the
and receive the same amount of help. When Caros was three and a half Criska
street. They grow up together and look after
came to the world. Paiman explains that
each other. – And they sleep whenever they want,
everything was so much easier that time
Paiman adds. They see the same films as
around. No colic, the routines were already
adults do.
established and she felt she wasn’t as inse-
– In a way it’s easier there, Fouad contin-
cure in herself anymore. Caros remembers
ues. Here they can’t run around in the same
the beginning of his siblinghood with his
way. Here you spend more time at home and
little sister mostly taking all his stuff. Now it’s different.
the children need to learn a lot of things.
– If I didn’t have a little sister then I
Fouad turns to Caros: – If you were to ask your father anything in Kurdistan, about how you came to
wouldn’t have anyone to play with. Only my friend Patrik, he says. Fouad adds: – She likes you very much and longs for
be or something about religion you’d get a slap. Certain questions are just not asked.
you to come home.
And you don’t talk to children in that way
– Yes, and instead of hugging daddy she
... There is also no tradition of doing home-
hugs me! Says Caros with a certain pride in
work or telling stories to children.
his voice. – What do you give to your children that
– I think the children in Kurdistan are wilder than they are here, says Caros. They
is particularly Kurdish? I ask. – The language and the over the top lov-
sell food and work instead of going to school
ing, says Paiman.
…
Fouad adds that all Kurds kiss all the
Paiman and Fouad have ten siblings each, but despite it still being common for
time, loudly and on the cheeks. – The louder the noise, the more love,
Kurdish families to have many children they both think that two is enough.
Paiman explains and laughs.
– You must have time to live as well, says
To have a child meant that Fouad had
Fouad. Now we can give them what all chil-
to change his life dramatically. Especially
dren need. It doesn’t work to try and have it
his social life. Before he had children he
like in Kurdistan, where ten children share
would often go out and had a large social
two small rooms. If my children are to be
circle. – Now that we have kids we have to
able to compete with others then they also
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PaRent inteRview Fouad lets the silence enhance the
share our lives with them too. Now we’re with the family and we do things together.
meaning of his words.
– It is a different lifestyle. I would for in-
– They run to me when I get home. They
stance never have bought a car if I didn’t
will be here after I’m gone … When I see
have kids. But with the car we can easily
them learn something it’s like I also gain
get out and do things.
that knowledge. You do everything for your children, not
– You become social in a different way, Paiman adds. Now we meet other families
just for yourself.
more and I stay in touch with many moth-
Both Paiman and Fouad see their par-
ers that have children in the same school
enthood as a way of themselves experi-
as Caros.
encing a childhood they both lacked.
I ask what the best thing with having
– Before, when I was alone, I’d heard
children is. Before Fouad and Paiman have
about children’s stories, but now I know
a chance to answer, Caros offers up his
who all the characters are, says Fouad. – I’ve not had that much fun. There were
view on why it’s good to have parents: – They help out. It is fun to play games with them and read books …
no playgrounds, no films, says Paiman and clarifies that it was not that her par-
And the worst part?
ents were mean. It was just the way it was
– When they get angry …
where she grew up, for everyone. Fouad himself started to work for his
Fouad is searching for the words before he answers: – You can’t describe what it’s like to have children, a family. It’s something
father after school when he was seven, to contribute to the family budget and to earn some pocket money.
completely different … You think of the
– Here it’s completely different, says
children, you think of how other children
Fouad. Here there is a safety and security,
live.
and children don’t need to think about
– And you get to buy more food, says Caros. – Yes you do, Fouad smiles. I like children and to now have two children, my
working. They should play and learn, so that they can become healthy people when they grow up and so they can help themselves and others.
own children.
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Who stays at home? It used to be considered the obvious choice for the mother to stay at home and look after the children during the first year. It was her who had brought the child into the world, she was the one who nursed the child and she was therefore considered, for natural reasons, to be closer to the child than the father/partner. Nowadays we know that it is important from the very beginning that the child develops a close emotional bond to both their parents. It is especially important if we want our children to be able to live in a richer, more open and more gender equal relationship than what we have today. It is not just the child that gains from getting to know their parents better during the first year. The parents also have a lot to gain. The joint bundle of benefits and rights offered to parents in Sweden, called Föräldraförsäkringen, which can roughly be translated to the parental allowance or the parental rights, offers the other parent to 10 days off work at the time of the child’s birth. The rights also give parents 480 days of shared parental leave. The days can all be shared amongst the parents as they so wish, apart from 90 days that are reserved for each of them. Since the parental allowance was changed an ever-increasing number of fathers have decided to stay at home, for not just one but several months. It creates the basis for an emotional relationship between father and child with a depth and quality that was quite uncommon in the past. Men with previous experience of children, and who have not been on parental leave previously tend to point to what a difference it actually makes to stay at home. To both be parents, in name but also in practice, is meaningful for the continued sense of community. You share responsibilities, chores and joys also when it comes to the children, you speak the same language as you have the same experience. Children and parents are offered, through the Swedish parental rights, the opportunity to have an equal relationship within the family, where both parents become equally involved in the care for their children and the children get to experience an intimate and close relationship with both their parents. Follow-up studies that have 144
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been conducted on families where parents have shared the parental leave have shown that within this group there are fewer separations, divorces and higher birth numbers. Ongoing research has also shown that parents who share the parental leave have a better understanding of each other’s day to day life as well as what it takes to look after and spend time with a child. Sometimes there is no choice. Especially when you live alone with a child and for various reasons cannot receive help from the other parent. Bear in mind that the most important thing for the child within the first few months, the close bond to at least one adult, can be created anyway. This situation is not the least bit strange to the baby. It is a lot more difficult to understand why there sometimes are two parents in the house – but only one that you really get to know. 145
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Daddy! You can tell me a really good story about a crocodile that has an elephant’s trunk and sharp teeth. B E P P E , 3 Y E A R S O L D
that gives you new perspectives and offers both joy and challenges. What can it be like? What is it like being a child? What to do as a parent? Parenthood is a lifelong under-
taking that changes as the children grow up. Life with children is meant as a guide for this journey, a book to search through when you have got a specific question, or to read through from start to finish. With this book as an inspiration we hope that you can gather knowledge, tips and advice, receive support and reassurance! This book also introduces you to how the Swedish child healthcare works and to the main principles of the UN convention on the rights of the child. The authors are Marie Köhler, paediatrician, Antonia Reuter, psychologist and Johanna Tell, child healthcare nurse. With their
life with children
l
iving with a child is both fun and difficult. An adventure
Life with
cHildReN
three different professions within child healthcare they contribute considerable knowledge from their various fields.
You can’t describe what it’s like to have children, a family. It’s something completely different… You think about the children, you think about other children’s situations. F O UA D, 4 8 Y E A R S O L D
77412458.2.1_Omslag_ENG.indd Alla sidor
ISBN 9789177412458
9 789177 412458
2020-06-29 14:25