Keep an eye on those teen years

By Esther Williams

The teenage years which see an often awkward transition between childhood and adulthood can leave parents in a dilemma as to how to respond to the needs, both medical and emotional, of their growing teenagers. Do they consult a paediatrician or an adult physician? In the absence of an immunization schedule, or a growth chart, how can they tell if their child is developing adequately? Do their teens need counselling and how do they ensure they have the life skills necessary to cope with the pressures of these years?

Consultant Paediatrician Dr. Shanthimala De Silva, a former President of the College of Paediatricians says that the adolescent years are marked by a major growth spurt, second only to the infant period. Hence those years, she insists, must be supported by adequate energy and nutrient intakes for optimum growth and development to occur.

It is common knowledge that the first five years of a child's life are crucial. Immunization is vital as infants are vulnerable to diseases. Congenital problems, if any, need to be detected at that stage and treated, as failing to do so can result in child mortality or complications in adult life. However, "pubertal growth spurts are equally important," Dr. De Silva states. She attributes the stunted growth of many young adults in the country as revealed in national surveys to insufficient attention to this important issue.

The onset of adolescence (between ages 10-16) brings about many changes - physically, emotionally and socially and as a result new medical needs need to be met. "The stage is marked by increase in height and development of sex organs and endocrine organs that cause hormonal changes," she adds.

Particular concerns of teens include:

Eating Disorders: The rigorous schedules of today's teens, their growing independence, and their strong connections to their peers will often pull them away from home and a healthy menu schedule. Eating at fast food restaurants, snacking, and skipping meals can become common.

Further, there is increasing focus on their personal appearances, eating to compete (if they are involved in athletics), and being accepted by their peers. These factors converge to create some unique risk situations in the teen years such as being overweight or underweight and other eating disorders.

Need for a well balanced diet: With the rapid growth of muscles and bones, teens need a well balanced diet, rich in protein, calcium and iron. Notably, while adults may understand some of the linkages between healthy eating and a healthy lifestyle, the choices teenagers make are more often based on immediate results and satisfaction - influenced by peers and advertisements.

Parental supervision: Hence, a parent’s role on the food front is far from over despite their teen's busy schedule. Parents could provide a mealtime schedule keeping at hand a variety of snacks that will provide both energy and nutrients while allowing their children some freedom to make food choices. Family mealtimes should also be seen as opportune moments for communication as well as ways to ensure they eat right.

Psychosomatic disorders: Signs to watch out for among teens are complaints of chest pain, headaches, abdominal pain, or weakness in the legs. From her experience, Dr. De Silva has seen that in most cases such symptoms are caused by psychosomatic disorders. The conditions vary from person to person, brought on either by stress, fear of exams, insufficient sleep, problems in the family, bullying at school, etc.

Emotional support: Most significant of the changes in teens is their behaviour which is often withdrawn. While the child earlier depended on parents for emotional support, she now looks to peers and friends. Rather than criticising and constantly pulling them up, parents need to understand and support their teenagers. "Parents may have to accept that the child may have new ideas and prefer to be more independent, Dr. De Silva says.

Involve children in decision-making: As a step towards being supportive, the doctor thinks that parents should involve children in the planning and decision- making process. Should they deny them something, parents would need to explain their reasons. "Children want to be treated as adults and have a right to know why certain decisions are made," she adds.