December 2006 : Ask the Experts

The man I am marrying has two young children from a previous marriage. I will become “stepmom” soon. What suggestions do you have for a smooth transition? I want to nurture a healthy relationship with my soon-to-be husband’s children, but I also want to respect their relationship with their mother, too.

Getting married is very exciting for a couple; remarriage can be too, but the accompanying friction of merging families is a source of stress and frustration. The key to a successful stepfamily is a strong couple bond. When the couple is united and operates as a team, the children feel more secure at home.

Nurture your couple relationship by scheduling regular adult time, during which you and your spouse relate to one another as “adults,” not merely parental figures. Research findings and clinical experience discourages stepparents disciplining stepchildren within 18 months of getting married. That period is instead better spent building and solidifying a relationship with the stepchildren. Be consistently respectful and sensitive to the biological parent in the other household, to avoid dividing the children’s loyalties and to foster a positive relationship between the two households.

Following the tips above will promote belonging and togetherness in your stepfamily. —Yaffa Balsam, LMFT

I’ve read that children under two should avoid all TV and kids 2 to 6 years old should watch only one to two hours. Is that realistic?

I have a lot of biases when it comes to young children and TV or TV in general. I certainly understand how helpful it can be to park a child in front of TV or a video for an hour while mom gets her chores done or manages a shower.

Here’s the thing, though—what is your child not doing when they are in front of the TV? They are not using their bodies, they are not developing their social skills, they are not utilizing their imaginations, they are not learning to read, playing puzzles, handling clay, taking something apart, putting something together, helping with dinner, playing with the cat, laying in the sun, catching bugs, looking at books, being read to, daydreaming or chasing their sister. Instead, they are literally mesmerized by a flickering screen, subjected to questionable content, limited use of language and passive absorption of marketing strategies, both in the contents of the shows and the commercials.

Two hours is a lot of time to take out of a child’s life and experience of themselves and the world. We’re talking about 730 hours a year—the equivalent of more than 30 24-hour days.

I also don’t buy educational TV as the tool to teach the alphabet, with the possible exception of ESL homes. Most children’s programming consists of rapid-fire storylines, quick, stimulating editing cuts, encouraging short attention spans. Some feel shows such as these lay the groundwork for inattentive, over-stimulated children over time.

My preference is not to use TV at all, instead providing access to a variety of other activities, which cultivate children’s innate ability to entertain themselves. When using TV with the 2 to 6-year-old crowd, consider doing so rarely and not routinely. Routine is reserved for activities that strengthen our children and nourish their core development, not potentially diminish it. —Victoria Schlicht, LMFT

My husband and I are parents of two young children. In addition to saving for college and setting aside a savings account for them, it occurred to us to write a Will. Where do we start? What about custody arrangements for our kids? Should we hire a lawyer? What other things should we consider?

As a parent, it is critical to plan for the inevitable because we never know when a crisis might occur. Writing a Will and deciding the fate of your most important assets—your children—requires legal advice.

I recommend sitting down with a probate attorney who can walk you through the necessary steps of looking at life insurance options, writing a Will and determining the allocation of monetary assets, the house and all your belongings. But, an even more crucial part of this process is figuring out who will have custody, or even visitation rights, of your kids should you pass away.

Natural parents have the right to make custody decisions regarding their kids, so making decisions together as a couple is ideal. However, for parents who are divorced or separated, or in the unfortunate case that both parents can no longer care for the children, meeting with a family lawyer is crucial.

Are older siblings, stepparents or grandparents in the picture? If there is a strong, significant and emotional relationship between the kids and any of these relatives, requesting custody or visitation to be granted to them may be in the child’s best interest.

While making sure to not worry or upset them, ask your kids how they like staying at grandma or grandpa’s, or when an older sibling or even a long-term (non-marital) boyfriend or girlfriend babysits them—just to hear what they have to say. Most importantly, consult those persons and do your own thoughtful evaluation to determine if they are suitable candidates for being caretakers for your children should the worst happen.

This might be an easy decision for some couples, yet tougher for others.
Some questions to ask yourselves: Have my children formed a bond with the respective third party? Are they financially and emotionally stable? What is their living situation like? Have they raised children themselves? Or do they already have a role in raising my kids?

Going through this process is one of the most important things to do in deciding the future of your children. —Lisa Hughes

Female Matters

My family is complete and my husband and I are done having babies. As can be expected, things are not the same in my private parts since childbirth. Can a leaky bladder and fallen vaginal organs be repaired and tightened at the same time? Is surgery my only option? Why type of surgeons are able to do these aesthetic vaginal surgeries?

I hear this complaint daily. Moms are facing the effects of childbirth trauma, the pull of gravity and the stretch of aging. Moms are leaking urine with every laugh, cough, sneeze or jump. They have uncontrollable urges to go to the bathroom and often don’t make it on time, soiling their underwear along the way. They feel a fullness and heaviness in their pelvis and feel chronically constipated. They even have to push on their vaginal area to get their stools out. Many even feel or see a bulge coming out of their vaginas. Not a very glamorous reward for bearing children. This often resulted in loss of intimacy and femininity.

In the past, women lived entire lifetimes with these symptoms and hesitated to discuss these problems with their physicians. Often their doctors would not feel comfortable or knowledgeable in suggesting a treatment plan other than “Do your Kegels!” Even when surgery was advised, women knew of the high failure rates of traditional gynecologic procedures, such as a “bladder lift,” and chose to forgo the multiple painful surgeries and prolonged hospitalizations. Vaginal plugs called pessaries were tried to keep the internal organs from falling out. Sometimes it worked, but often times it failed. More often than not, the lady did not want to place a rubber device internally. No one wanted to be passed along from family practice doctor to gynecologist to urologist to colorectal surgeon to plastic surgeon. Chasing around your kids did not allow time for all those doctor visits.

Fortunately, things have changed over the past decade. Gynecologists learned urology. Urologists learned gynecology. The subspecialty of urogynecology was born and aesthetic vaginal surgery became mainstream. A scant handful of urogynecologists are trained in aesthetic vaginal surgery and a careful look into each surgeon’s credentials is paramount. Once found, that single specialist is able to handle incontinence problems with the use of minimally invasive “slings,” repair fallen bladders and rectums with modern meshes, suspend or remove prolapsed uterus and correct the disfigurement caused by traumatic childbirth or genetics in a cosmetically pleasing manner. You can feel feminine again! —Red M. Alinsod, MD