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Waking during the night is not abnormal. What is abnormal is a child who wakes and then demands, indeed has come to expect, attention from his parents in the middle of the night. The problem usually begins because the parents will go to the child soon after he wakes up, rather than let him cry.

There are two ways that parents can deal with children who wake during the night and have learned to expect a feed or cuddle. They can either wean the child from this habit ‘cold turkey’ or else do it by ‘extinction’ over a period of time. Which of these is used depends on the preference of the parents — both are likely to be effective. Parents need to be sure they want to implement the treatment regime, then pick a starting date. Often a relationship with a health professional can be reassuring and supportive during this time.

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These drugs include allopurinol (to reduce production) and probenecid and sulfinpyrozone (to improve excretion).

Colchicine is still used both to treat acute attacks and for prevention. It can be used with the other newer drugs.

In these days of screening medical tests, we find a number of men with high levels of uric acid who have not yet had an attack of gout.

Some doctors advocate treating them to prevent its onset, but most are reluctant to treat biochemical levels alone, waiting until gout shows itself with an acute arthritis rather than embarking on lifetime treatment.

Sufferers should take heart that proper treatment is available, as gout can be potentially serious as well as painful.

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Many women experience depression following removal of the womb, others lose all interest in sex. These side-effects can be prevented if proper care in explaining to women what the operation entails is given before the operation.

This must be given in language the woman can understand. It may need to be repeated, especially if the woman is worried, as she may not take it all in the first time.

Then following the operation repeated counselling may be necessary.

The number of hysterectomies is increasing. This is not because doctors are increasing their incomes, but because of the changing expectations of women.

In the past many tolerated discomfort from heavy periods or pain from many of the pelvic disorders. Now a new generation is not prepared to tolerate these symptoms and demands relief, and, often, operation is the only effective treatment.

Women, being better educated and more insistent on their rights, properly demand operation rather than tolerate severe discomfort.

An added bonus for many women is removal of the risk of pregnancy.

Far from a hysterectomy being a defeminising operation, it can, and should be, a liberating factor in her life, taking away the tyranny of pain, discomfort and ill-health.

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Only a few of the important but less common abdominal disorders are described on the following pages. It is not an exhaustive list of complaints, nor does it give more than brief general information. But it may offer some extra detail if a parent hears of the complaint or wishes to have some added knowledge.

As I have emphasized earlier, this book is intended to be used only as a general guide. It is not a do-it-yourself compendium, and is not intended to be used that way. Whilst many simple ailments may be treated at home by parents, others require proper medical diagnosis and supervision in treatment. Never begrudge money or time spent in having the best possible attention for your child. It may pay handsome dividends and may be life-saving.

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The fillings should be given careful thought. It is easy to make or marr the value of the sandwich with the contents. High-protein fillings include meat, cheese, and egg. Many ‘health food’ products are now commercially available, such as nut-meat and similar lines which are high in protein. Most of these contain gluten, the protein fraction of wheat. They can be used directly, or in conjunction with other items.

In fact, many sandwiches are far more appetising when they are combined with other products. For instance, any of the above protein items can readily and tastefully be included in a nice, thick, salad sandwich. Salad products give the sandwich a light, crunchy, attractive appearance and sensation when eating.

Use only a small amount of butter. Many mothers will use unsaturated margarine in preference. Adding a vitamin extract, such as Marmite, can upgrade the value of the sandwich.

Some mothers do away with bread altogether. This is replaced by a crisp salad. It is simple to prepare in a plastic, airtight dish and convey to school where it is eaten at the appropriate time.

Rather than include cakes and sweet biscuits, a packet of nuts, raisins, dried apricots (or peach or apple) and sultanas is far better. It is easy to make up a different pack each day—this can contain any one or a combination of the items suggested. Other items can be included that are of nutritional value.

A piece of fruit each day is also a good idea. It is wise to alternate these from day to day if possible, For example, have an orange one day, an apple the next, apricot or peach the next. This will depend on availability and price, but variation will cover a wider range of vitamin requirements. And it will often be more economical than cake and biscuits, which have little nutritive value.

The lunch pack can be broken up into segments that may be used for play lunches and lunch itself. Either let the child decide what to eat and when, or do this by making individual servings. It is so simple to wrap some nuts and pieces of dried fruit and place this parcel on the top, for morning recess.

An easy-to-prepare lunch pack consists of a couple of slices of cheese together with a few short pieces of celery. Or some cheese and a slice of fresh pineapple. There are unlimited possibilities.

The simplest and best beverage is, of course, cold water. When some chipped ice is added, this is the most refreshing drink available. It is far more thirst-quenching on hot days than sugar-based aerated beverages which contain about 420 kJ (100 calories) per glass. The latter frequently increase the body’s heat factor, even though they might be served cold.

Orange and lemon drinks are excellent. But their value can often be destroyed by adding loads of sugar. Freshly squeezed orange juice with no sugar is an excellent, healthful and refreshing drink. It is also high in vitamin C which is essential for good health.

If you encourage your child to buy his or her food, or if it is more convenient, first discuss the basics of healthy eating. Recommend fruits, nuts and dried fruits in preference to sweets and lollies. Meat pies and pastry are nutritionally useless, so try to phase a child out of this unhealthy habit. It is far better never to let it start.

Spending a little time and thought can pay handsome dividends. Why not opt for the sensible way, and prepare your children’s lunches yourself. Enlist their assistance and you can readily teach them the basics of healthful living, and long term good health.

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