Wednesday 28 February 2007

Perfect timing

I have an article in the Guardian about natural family planning. Please follow this link, http://www.guardian.co.uk/g2/story/0,,2022065,00.html, to read it online, or see below for my original piece.

Can natural family planning really be as effective as the pill? New research suggests that it is, says Sarah Ebner - once you have learned the ropes
Tuesday February 27, 2007
The Guardian

Women rejoice! Finally there appears to be an effective method of contraception which is in sync with your body. Except that it isn’t new at all as latest research suggests going back to basics. Could natural family planning - which removes the need for hormones, injections and the delightfully named intrauterine devices - really be the answer?
“Women know about all types of contraception from the pill to the cap, but nobody talks about what you can do naturally,” says Toni Belfield from the Family Planning Association. “If you’re taught right, then this is a method you can use for life.”
The new research, which is published in the journal Human Reproduction, showed that one particular method of natural family planning was just as effective as the pill. The Sympto-thermal method or STM, uses two indicators - body temperature, and changes in cervical mucus - to identify the most fertile phase of a woman’s menstrual cycle.
“This puts contraception under a woman’s control,” says Toni Belfield. “It’s easy to learn, it can enhance a relationship, and it’s also very easy to stop if a woman decides she does want to become pregnant.”
Rebecca is just one woman who was eager to try the Sympto-thermal method. The 25-year-old musician began using it after a bad experience with an IUD (intrauterine device) which left her in constant pain and bleeding. Ironically, she only started using that because the vaginal ring – which contains a combination of oestrogen and progesterone – had left her unhappy and suffering from mood swings.
“I loved the fact that STM didn’t require hormones, or putting anything unnatural in my body,” she says. “It wasn’t going to give me any pain, and was also going to make me more aware of my body. I was very happy to try it.”
Rebecca, 25, and her husband Geoff, were taught how to use the method by Jane Knight, a specialist nurse who runs a NHS fertility clinic in Oxford. Now Rebecca takes her body temperature each morning, is aware of any changes in her cervix and monitors any changes in her cervical secretions.
“STM has helped me to be aware of my fertility cycle,” says Rebecca. “It did take a little time to get used to, but then it became obvious. It hasn’t been at all problematic.”
Professor Petra Frank-Hermann, from the University of Heidelberg, led the new research.
“For a contraceptive method to be rated as highly as the hormonal pill, there should be less than one pregnancy per 100 women per year when the method is used correctly,” she says. “The pregnancy rate for women who correctly used the STM method in our study was 0.4%, which can be interpreted as one pregnancy occurring per 250 women per year. Therefore, we maintain that the effectiveness of STM is comparable to the effectiveness of modern contraceptive methods such as oral contraceptives.”
Of course, natural family planning has been around for years, and has often been used by those who oppose contraception on religious grounds. But the so-called rhythm method – which simply involved counting the days of the menstrual cycle - has long caused despair in family planning circles.
“It went out with the ark,” says Toni Belfield. “People talk about rhythm and natural family planning as a kind of Russian roulette, but once you know the signs and symptoms of your body, they’re so powerful. There really shouldn’t be any stigma about it.”
According to the most recent statistics, the pill, which is used by nearly a quarter of women, is still the most common method of contraception in the UK. The second most popular method of contraception is the condom, used by 22 per cent of couples, with around four per cent using hormonal injections or implants, and another four percent using IUDs. Condoms are the only barrier against sexually transmitted diseases, but have a 2 per cent failure rate, as opposed to around one percent for the pill and IUDs. Diaphragms and caps are only around 92 to 96 per cent effective.
“Natural family planning is successful, but less than one percent are using it,” says Toni Belfield.
Jane Knight, who runs the website, www.fertilityuk.org, has taught hundreds of women the natural family planning method.
“Many of them are at a time in their lives where they don’t want to be using pills anymore,” she says. “They’re often in their mid twenties to thirties and in a steady relationship. We need to get away from the idea that this is for particularly well-educated women. It’s a lot simpler if you’re a bit more in touch with your body, and it’s a method which needs both partners to be committed, but it’s not just for the educated.”
It’s true that anybody can use this natural method, but it certainly does need commitment. It’s not for the scatterbrained, as women must keep daily records, and according to Jane Knight, there’s a “learning phase” of around three months. However, this can take longer if a woman is stopping a hormonal contraceptive, as hormones can interfere with the calculations.
Perhaps more importantly, anyone following STM has to realise that there will be certain times each month – when a woman is most fertile, and according to some, most lustful - when sex is simply not allowed. The obvious solution would be to use a condom, but Toni Belfield says that might not be the only answer.
“There are other things you can do in the fertile time, just not penetration,” she says. “And all those other things can enhance a relationship.”
Rebecca agrees. “Eventually we’re hoping never to use the barrier method at all,” she says.
It all sounds perfect, if you’re organised, but it’s clearly not suitable for people who are still looking for their perfect match. After all, it might be difficult to explain that you’re abstaining from sex because of your chosen method of contraception.
Some people also feel that natural family planning is not for the young.
“If someone undergoes the necessary training, it’s very effective,” says Catherine Evans, from Brook, the sexual health charity for young people. “But it doesn’t protect you against sexually transmitted infections, so it’s not a method we would promote.
“Unless you’re in a relationship where there’s no risk of infection, we don’t think it’s a good idea. We would recommend using condoms.”
Rebecca admits that the first time she and Geoff “took the leap” into having sex with no other contraception, it was “a little scary.”
“But we did it,” she says. “And I feel that we’re learning more all the time. Taking these steps has led me to become more curious in other ways. It’s made me more aware of what’s going on in my body and I feel it’s really changed our sexual life in a positive way. It’s really liberating.”

The Family Planning Association can provide more details about natural family planning, and also about NFP teachers.
www.fpa.org.uk

'I didn't want hormones or condoms'

Penny Warren and her husband Martin, an Anglican minister, came across the natural family planning method 26 years ago through the Couple to Couple League, an American-led organisation which aims “to share the Good News of Natural Family Planning”.
The couple are enthusiastic proponents, still use the method and teach it too. They have three children, and live in North Devon.
Penny, 47, says:
“I was looking for something which didn’t involve going to the doctor. I didn’t want hormones or condoms and I didn’t fancy IUDs.
Martin was studying in Cambridge and Couple to Couple were running a course. Although it was run from a Catholic perspective and we aren’t Catholic, we went to four sessions (across four months) and it taught us the basic rules.
What we learnt, very clearly, was how to take your temperature and how to chart it. We were also taught how I could use my mucus signs, which change throughout your cycle. I was told what to look for, and charted this alongside my temperature.
We were advised not to use the method while we were still learning, but that wasn’t a problem for us, because we weren’t sleeping together at that point.
From our experience, it’s been terrific. We haven’t ever found it difficult to manage - it becomes an everyday habit, like brushing your teeth - and I wouldn’t swap it for anything. The only problem comes when your body’s feeling very fertile, you’re crying out for sex and you can’t have it!
Lots of people say they can’t follow this type of family planning, perhaps because they don’t have regular periods. But the whole point is that it’s personal to you, so it can work for anyone. What it does is teach you exactly what’s going on with your body. I know my body really well and that’s very liberating for a woman.”

More on The Couple to Couple League in Great Britain can be found at: http://www.cclgb.org.uk/

Tuesday 20 February 2007

What's the alternative?

Today I have an article in the Guardian about alternative therapies and the boom in using them to treat young children.
To read it online, click on http://www.guardian.co.uk/g2/story/0,,2016867,00.html
Otherwise, read on....

Risky alternative?
More and more parents are taking their children to complementary therapists. But just how safe and effective are such treatments? Sarah Ebner reports

There's a baby boom in the world of complementary medicine. Therapists are treating more and more infants, as many parents abandon long waits at the doctor's surgery in favour of costly visits to alternative practitioners.
"There's much more of an awareness of what we do," says June Tranmer, who specialises in paediatric acupuncture at the Healing Clinic in York. "We have had hundreds of children coming through our doors and the numbers keep going up."

Probably the most popular treatments are baby massage and yoga - the infant Leo Blair was reputedly taken to baby massage sessions run by beauty therapist Bharti Vyas - as well as homeopathy and even acupuncture, kinesiology (which claims to diagnose imbalances through analysing movement) and chiropractic. But why is the next generation having these treatments? Alternative therapists usually spend longer with their patients and claim remarkable results. So for parents with money and initiative, they are an attractive option.

Caroline Hind took her twins, Corem and Jaimie, to see Tranmer at the end of last year. The boys, who turn two at the end of this month, had whooping cough. "There was nothing the doctor could do, as it was really a nursing issue," says Hind. "We suffered broken nights with the boys coughing so much they were sick." Tranmer spent an hour with the family, before carrying out acupressure and cupping treatments. "It was a really calming experience for them, and for us," says Hind. "Everything was so gentle. Afterwards both babies slept through the night." The whooping cough didn't go away completely, but Hind is sure the treatments helped. "I suppose you never know for sure, but it did seem to make a difference," she says. "I think doctors are very good at serious illnesses, but for allergies, migraines and the sorts of things where they're at a bit of a loose end, this is a good option. Medicine is so reliant on drugs. This is a gentler alternative."

Many medical professionals, however, disagree. "I remain sceptical until there's good evidence," says paediatrician Jethro Herberg. "My antagonism is proportional to the degree of harm they can do. At best they are benign and, at worst, can do an awful lot of harm. Herbal remedies are littered with case studies where they have done damage. People have an inconsistent view ... If they go to the doctor, they demand an extremely high level of proof that what they're getting is efficient and not harmful. But they'll go and see an alternative practitioner, with no idea whether it could be harmful, or not."

Tranmer admits there is not a "huge body" of research, but questions who would finance it. "You can't do research for nothing, and drug companies won't fund us," she says. "Anyway, if you see a child screaming in pain, and they're better after you treat them, how do you deny it is working?"

Edzard Ernst, professor of complementary medicine at the Peninsula Medical School in Exeter, agrees that more evidence is needed. "Without proof, we only have hearsay and clinical experience, which can be misleading," he says. "Little children are very fragile and, to me, there is an ethical imperative to find more evidence. The official bodies - the NHS or Wellcome Trust, which have no commercial interest - should fund research."

In the meantime, Ernst is dubious about the benefits of treating infants this way. "Gentle massage is definitely very good for babies, but kinesiology is nonsense," he says. He also believes that acupuncture could be downright dangerous. "Everything is so tiny in a baby. In a jiffy, a needle could be in the heart or lung." Although, as acupuncturist, Vera Wong, points out, actual needles are rarely used on babies. Acupressure is more common: "We use skin rollers, toy tractors and spring-loaded pointers usually used on adult ears," she says.

According to Ernst, the main determinant of whether a child is treated with alternative medicine is whether its parents also use it. However, homeopath Jo Redmond, director of the Health Works clinic in east London, says they are treating more young families and more black and Asian patients. "People think it is only a white, middle-class domain, or only for people who have treatments themselves. We are seeing parents who are fed up with doctors, and don't want endless prescriptions."

Around three quarters of Redmond's 1,000 patients are babies and small children. Ruqiyah Henry is one of those. She was seven months old and suffering from severe eczema when her parents, Aa'isha Henry and Abdul Raheem, took her to the homeopath. "She was scratching all the time," says Henry, "waking up in the night and she was so distressed. It was awful to see her unhappy."

The doctor had prescribed hydrocortisone cream and antibiotics. "The cream was so strong I was concerned about putting it on her face. The eczema came back each day ... I didn't want her to be on a steroid cream for ever." When one of Henry's friends suggested homeopathy, she decided to give it a go. Interestingly, her health visitor also recommended it. "The doctor said there was no cure ... she would have to grow out of it. The homeopath said she could be cured," she says.

After two monthly sessions, during which Ruqiyah was given homeopathic pills nearly every day, her eczema cleared up. "Her skin is so soft and smooth," says Henry. "I can't believe the results." With treatments at around £30, Henry wishes it was available on the NHS. "We're not rich at all," she says, "but it is worth it."

Despite these results, homeopathy has not been proved clinically effective. Ernst, who has just published a review of homeopathic trials, claims "there is no good evidence" it works for children.

And while Herberg sympathises with parents "driven to distraction" by a difficult baby, "it shouldn't surprise anyone that children get better," he says. "A lot of these alternative therapies treat the mother rather than the baby, and placebo also has a measurable effect."

Redmond naturally disputes that view. "How does the placebo effect work with babies and animals?" she asks. "Colds and skin problems can't clear up just because mum's calmer and happier".

Saturday 17 February 2007

Goodbye Mary, Hello Manny

Today I have an article in the Weekend Section of the Daily Telegraph. But there's no need to click on, as I've reproduced it in full, below...

Now it's Manny Poppins
Sarah Ebner meets the parents who prefer a shot of testosterone to a spoonful of sugar
By Sarah Ebner

She may be wowing them in the West End, but it appears that Mary Poppins is out of fashion. According to those in the know, if we want to ensure that our sons and daughters grow up to be well-rounded individuals, we need a modern solution. The woman who was "practically perfect in every way'' has a rival: the manny.

If you've never heard the term, you're a few steps behind in the childcare stakes. For the uninitiated, author Holly Peterson is here to shed some light on the issue. As one of the characters in her new book, aptly named The Manny, explains: "It's a manny. M for male nanny... Think of it as the older brother we all dreamt of, but with the patience only money can buy.''

Peterson first heard about mannies soon after having her third child. She felt that her son, Jack, then three, was being "squashed'' by spending days with his older and younger sisters, as well as his mother and nanny.

Now it appears that mannies are all the rage. Gwyneth Paltrow and Britney Spears are fans, and the attractions seem obvious. It's not so much a spoonful of sugar, as a shot of testosterone around the house. Not only do mannies keep temptation at bay (female nannies, as Jude Law discovered, can be a bit too distracting), but they happily play in the garden for hours, and seem genuinely interested in sports, Lord of the Rings, Spider-Man and snails.

"Boys play differently to women,'' says Peterson, 42, whose children are now 10, eight and four. "The nanny is more of a comforter, while the manny is a 'throw me across the room' kind of guy. They fool around, play football and are happy to run around and around the park. I thought Jack would really benefit from it and he has.''

They may sound like a perfect playmate for any sons you may have, but what about the girls? Peterson thinks a male role model is good for them too. "Mannies have a different attitude,'' she says. "They see situations in another way.''

But hiring a manny wasn't just a way for Peterson to solve her childcare issues. It also led to a new career, as a novelist. The book - her first - sold for $1 million in the US alone, with the film rights fetching another $600,000.

The story is set in what Peterson describes as "this ridiculous, hilarious world of rich people on the Upper East Side''. It's a place she knows well as she grew up in, and still lives in, that very exclusive part of New York. Some families have one nanny per child, while housekeepers and drivers are de rigueur. However, as a Newsweek journalist, Peterson says she's a step apart. "The rich in New York are a very peculiar group,'' she says. "But 95 per cent of my friends are not in that world.''

Peterson's book, out next week, is certainly being published at the right time, as mannies have become increasingly popular in Britain. My Big Buddy (http://www.mybigbuddy.com">www.mybigbuddy.com>), an agency specialising in male nannies, recently launched in London. And Gumtree (http://www.gumtree.com), a website used by working parents to look for childcare, reports that searches for "male'' or "male nanny'' have gone up sevenfold in the past few months.

With increasing numbers of single parents, as well as older fathers who might struggle to run around a football pitch, mannies may well fill a gap. But one recent survey suggested another reason for the rising demand. In an apparent blow against sisterhood, almost 80 per cent of mothers admitted that they felt threatened by attractive female nannies, while 94 per cent said they would consider a male nanny instead. "We simply don't have enough men on our books,'' says Oliver Black, director of Tinies, the supplier of childcare staff which carried out the survey. "Only five per cent of our nannies are male.''

One of those is Craig Smith, 20, who works as a manny for Alison and Michael Goff in Sevenoaks, Kent. Craig looks after the Goffs' three sons, Hamish, 10, Louis, eight, and Theo, three. "I couldn't imagine doing the same thing every day,'' says Smith, who explains that he always wanted to work with children. "Every day is different and really rewarding too.''

Smith describes his three charges as "sporty and boisterous'' and much of his time is spent ferrying them to and from different sports activities. But he also attends mother and toddler clubs with Theo and plays "a lot'' of football with all three. Smith cooks for the boys too (although he admits that the domestic side is not his strong point).

"My friends are builders, carpenters and electricians. They laughed their heads off when I told them what I was going to do. But when I say that I've been playing in the garden, they're a bit jealous.''

He is sure that he got the job because the children are boys, but Alison Goff insists that's not true. "People assume that because I have boys, I wanted a male nanny, but he was the best person I interviewed,'' she says.

"I admit I've been surprised to see how the kids are happier with him, perhaps because he loves the rough and tumble and is physically fit and active. If you have three boys, it's no good having someone who wants to plait hair and paint fingernails.''

Holly Peterson would agree. Then again, she seems to have it all the book deal, the investment banker husband, and even a nanny and a manny.

But for those of us in the real world, choosing the perfect child-carer might never be the same again.

Thursday 8 February 2007

Bullying: The lies that led to death and devastation

Today I have an article in the Independent about the issue of false accusations of bullying in schools.
If you want to read the article online, here's the link, http://education.independent.co.uk:80/schools/article2246762.ece

If you don't want to click and move on, then here's the piece in full....

When Lucy Cochrane was accused of bullying, her school was obliged to investigate. But the allegations were false - and now Lucy's parents are dead. What went wrong?Sarah Ebner reports on a tragic case

The Children's Commissioner, Sir Albert Aynsley-Green, has warned that relentless bullying is driving some children to the brink of suicide, while the number of children counselled by ChildLine about bullying rose by 12 per cent last year.

But what of those children who are accused of bullying, but aren't guilty? Just as it took years to recognise that charges of assault against teachers can be false, so people are starting to realise that accusing another child of bullying may simply be a way of getting them into trouble. And that trouble can have devastating results.

At the end of last year, Michael and Jane Connor were convicted of the murder of another set of parents, Maureen and Alex Cochrane. Their daughters, Natalie Connor and Lucy Cochrane, had been at the same schools and at some stage had fallen out.

Lucy, who has learning difficulties, was regarded by school staff as a pleasant but vulnerable girl who was bullied by Natalie. However, it was Natalie who claimed to her parents that Lucy was the bully, accusing Lucy of assaulting her at a dance class at school. A subsequent police investigation found the contentions to be entirely baseless, but they still had to be investigated.

Natalie's allegations, which were described during the Connors' murder trial at Manchester Crown Court as "groundless and an invention", goaded her parents and contributed to the ill-feeling between the families. The Connors plotted to set fire to the Cochranes' house and Michael Connor subsequently poured petrol through the letter box, killing both parents and seriously injuring Lucy.

Michael and Jane Connor were convicted of double murder, and Natalie Connor was convicted of manslaughter and causing grievous bodily harm with intent and arson.

Clearly this was an extreme case, but the prosecution lawyers agree that the false bullying allegations exacerbated the situation. Such claims are not entirely unusual.

"Contrary perspectives and malicious reports will always be part of bullying disputes," says Sir Albert, while John Stead, education adviser for the NSPCC and a former head teacher, agrees that false accusations are "certainly something that you come across". However, he adds, when a child makes a false accusation, it is often a cry for help.

"It's never straightforward," says Stead, who is also the Anti-Bullying Alliance co-ordinator for Yorkshire and Humberside. "Sometimes it's quite deliberate because a child wants to get someone else into trouble, but sometimes it may be that the child is unhappy because of something else, such as other children not playing with them. Occasionally there's almost a sense of delusion - the child actually believes they are being bullied."

Still, Stead is keen to emphasise that he believes most bullying accusations are true. "The danger is that children who are being bullied are ignored," he adds.

Joanna Ross (not her real name) accepts that it's important not to dismiss children who accuse others of bullying. However, she is also concerned that increased openness about the subject of bullying may be leading to false accusations. She's convinced that more care is needed with young children.

Ross's son Leo, 10, was accused of seriously bullying a younger boy towards the end of last year. The trouble began in the summer term when class teachers discussed bullying and then asked the children to fill in forms saying whether they had been bullied. One child - who was friendly with, and in the same class as, Ross's younger son, Callum - said that he had been bullied, by Leo and two of his friends. This boy, David, said that the older boys had told him to go away and said they didn't want to play with him.

Callum Ross says their teacher told David, then seven, that such behaviour was not bullying. However, the forms were filled in, and Leo and the two other boys were accused.

"Everyone thought it was minor," says Ross. "I spoke to David's father and he said that his son simply wanted to join in with the older boys and then when they didn't want him to, he would poke, prod and kick them. They would respond by cuffing him and telling him to go away. Neither of us was really concerned."

After the summer holidays, there were new, more serious allegations. David accused the boys of punching him, kicking him and kneeing him in the groin. He also said that they had "threatened to bully him more than he'd ever been bullied before".

"It was quite ironic, because one of the boys he had accused had been off sick on the days he specifically said some of these things had happened, so I really thought they couldn't be true," says Ross. "Still, it was awful. The previous term I had told Leo to keep away from David, and he assured me that he had, but as one of the oldest boys in the school, the younger ones want to play with him and his friends. David's father then came to speak to me and said he hadn't been concerned before because it was rough and tumble, but that now he felt it was getting serious. He thought there was no smoke without fire.

"He also said that the bullying had gone on for two years, even though for a lot of that time, David had been coming to my house to play with my younger son. He alleged that three times a week Leo and his friends had been kicking him, punching him and threatening him. He also said that they had been bullying his sister, Ruby, and held her upside down, threatening to drop her on her head.

"I was really worried about the whole thing, but most of it just didn't ring true. It's not simply that I would defend my own son, but the fact that when I started asking around, no one had seen any of this so-called bullying. The children attend a very small school, but none of David's friends knew anything about it, none of the teachers said that David had seemed unhappy or hurt and, despite him accusing Leo of forcing his head into the toilet on more than one occasion, no one had seen him with his hair wet or in tears."

John Stead says that falsely accusing another child of bullying is one way to seek attention.

"There aren't any easy answers when you've been falsely accused," he adds. "The biggest way we protect against false allegations is to look into it as soon as possible."

Ross agrees that, once the allegations had been made, the school had to look into them, and that they did so fairly. At this point Ruby admitted that she had made her story up, but David stuck to his.

"I think he was in a bit of a trap," says Ross. "His father had asked him many times if the accusations were true and he could have got into more trouble if he'd backed down."

However, Ross has a problem with the way the school initially went about encouraging the reports of bullying.

"The school gave out these forms and a lot of children felt they needed to fill them in," she says. "I think the school handled that badly, and I also felt the onus was on me to disprove everything. I thought they should have given my son some defence mechanism."

"Schools need to talk about what is and what isn't bullying and encourage children to talk about it," says Stead. "And I do believe we should be asking children every year how safe the school is. But I'm not sure we should be asking them to specifically name people."

Joanna Ross has some sympathy towards her son's accuser because of his age, and also because she thinks he might well have been unhappy.

"The family had moved a lot and were actually about to leave again to live abroad," she says. "It probably was disconcerting for David. His mother sent me an e-mail saying that they weren't going to pursue the accusations, that she didn't want any bother and that they would leave school a few weeks early. She also said that only the boys would 'know the truth' of what had happened.

"But that view has left my son and his friends under a cloud. If the school had actually believed David, my son would have been expelled. It's left him vulnerable and having learnt a funny lesson, that you can say bad things and get away with it.

"You have to take bullying seriously, but you also have to analyse it. Parents have to accept that children can be mean, but that's not necessarily bullying. There are noticeable symptoms when it comes to a child being bullied, but David wasn't unhappy, crying on the way to school or upset during the school day.

"If a small child picks on a big child they are in a win-win situation. If a big child lashes out, then he'll be accused of bullying. I've told Leo that he must now always walk away."