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SEX AND CHILDHOOD: TALKING ABOUT SEX? HOW MUCH INFORMATION IS ENOUGH

So how much information is enough? How do you know when you have gone far enough? There's no doubt that it's a sensitive balance. Some parents are over-protective, worried that the child will be distressed when in fact it's the parent who is distressed. You don't feel comfortable with the subject, so your anxiety is projected onto the child. It's important to point out here that if a child seems inordinately distressed by the subject, for no apparent reason, it's worthwhile considering whether they might have suffered some sort of unpleasant or traumatic experience of a sexual nature that you don't know about. Sadly, sexual abuse of children is too common to ignore that possibility.
Each person's comfort zone will be different when it comes to sex. Working out what you are and are not comfortable with (and why) is an integral part of accepting your own sexuality. If a parent finds it simply too difficult to deal with the issue, there are things you can do to make it easier, like reading up on the subject to prepare yourself. It may help to ask for assistance from another trusted adult who you know to be sensible and well-informed. That's not to say that you just abdicate the responsibility, but rather enlist the help of that close friend or relative ... maybe to sit in on a few conversations to get the ball rolling. If you check out the local bookstore or library you will find a book, with explanations and diagrams, that will help too.
Is it possible to give a child too much information? Is there a point where sex education becomes abusive? Child psychiatrists tell us that this can happen when the words are being said more for the benefit of the adult than the child — 'You have to listen to this because I don't want you to go through what I had to go through!'; when the information is forced upon them at a time when the child is clearly not interested; when the child is distressed by what they are hearing and your explanations don't settle them.
It's easy to tell when a child has lost interest in a subject. They haven't yet learnt the adult social skill of appearing to be fascinated by a conversation while their mind goes over the shopping list. They generally won't tell you that they're upset but they will certainly let you know if they're bored. There are signs that the attention span has reached its limit. Have they fallen silent? Are they staring off into the distance? Have they tried to change the subject? Have they said 'This is boring!'? Has it become a one-way lecture?
If the answer is 'yes', then it's time to stop and wait until another opportunity arises. There's plenty of time.
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EPILEPSY AND PREGNANCY

Women with epilepsy are quite often concerned about getting pregnant. There appear to be five reasons for this concern. They wish to know:
if they are likely to hand their epilepsy on to their children;
whether their fits will get worse during pregnancy;
whether it is safe for the baby that the mother should take anticonvulsants drugs during pregnancy;
if there will be any problems in the newborn baby from these drugs;
if they can safely breast feed the baby.
With regard to handing on epilepsy to one’s children – as mentioned earlier, if one parent has epilepsy, the chances of one of the children having epilepsy are no greater than in the population at large. If both parents have epilepsy, it would appear that the risk of a child having epilepsy is about 10 per cent. So in fact the chance of a child inheriting epilepsy, particularly idiopathic epilepsy, is negligible.
As far as seizures during pregnancy are concerned, the situation is not as clear as it might be. There is evidence that for some women, seizure control may deteriorate, while for others there may in fact be no change or even an improvement. A patient told me recently that “she would like to remain pregnant forever” as she had not had a single fit during her pregnancy, compared with six fits in the preceding nine months!
As a general working rule, it is suggested that people who have more than one grand mal fit a month are those who are most likely to have a deterioration in seizure control during pregnancy. The deterioration, if it occurs, is most likely during the first three months of pregnancy. There are a number of theories why this may happen, but none has been proved. It may be of value to check the blood anticonvulsant levels during pregnancy, especially if there is a deterioration in seizure control. The blood levels may fall, necessitating an increase in dosage during the pregnancy.
The main concern for parents is whether the anticonvulsants can harm the unborn baby (foetus). It is known by most people with epilepsy that this is a potential hazard. The effects include physical abnormalities in the baby, a process known as teratogenesis. Abnormalities have been reported in the offspring of mothers on all the commonly used anticonvulsants with the exception of carbamazepine. This is particularly applicable to phenytoin, barbiturates and sodium valproate. Babies born to mothers who have been on carbamazepine have not been shown to have any physical abnormalities, but have a smaller head size than other babies. This has not been shown to be any handicap to the babies who have been followed up for five years.
The risk of abnormalities in the baby is difficult to assess, but it seems to be most common in mothers on polytherapy (receiving numerous drugs), especially if they are on three or more anticonvulsants. The risk in mothers on phenytoin, with or without other medications, appears to be about a 10% chance of the baby showing features of the ‘foetal hydantoin’ syndrome. This syndrome consists of cleft palate, abnormalities of the fingers, possible heart abnormalities and mild mental retardation. Thus, at present, if it is possible, it would seem wise to try to change patients over to carbamazepine before conception. This may not be possible in all patients and, of course, many women will first visit their doctor when already pregnant, at which time there is no purpose in making the change.
Anticonvulsants taken by the mother during pregnancy may have some effects on the baby immediately after birth, as they are transmitted to the baby across the placenta. These include the possibility of a mild bleeding tendency and some drowsiness. In mothers who have been taking barbiturates, the infant may occasionally show features of a withdrawal reaction with irritability, jitteriness and poor sucking. None of these features is [...]

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