Health Considerations

From time to time parents may bring children that have a bug or illness to class. Kalma adheres to the Department of Health Guidelines for all classes. Such regulations are followed by Schools and nurseries, most parents will be considerate and be aware of avoiding classes should their little ones be sick. From time to time it may be necessary to remind your private group of the guidelines especially around winter or if a little one has chicken pox, or scarlet fever. Most parents will email or message to tell you why they are missing a session. Always ASK the parent if you can make the group aware should an illness be doing the rounds. Its courteous for those in class. There is never any need to mention names or details but use the opportunity to bring parents attention to the guidelines. Please see this for exclusion: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/658736/Exclusion_table.pdf

Immunisation

At times after a child has had an immunisation it can leave them distressed and uncomfortable for several days, waiting at least 24 hours after immunisation and avoiding the area of injection for 48 hours can be beneficial. If a parent feels they can still attend the class as the infant is unaffected encourage this as the parent/carer can still join in with the stretches and learn exercises to do with the child at home.

Guidelines for Yoga with special needs

Lots of sensory- use props and sounds
Helps strengthen the body use exercises
Use exercises for alignment and symmetry
Do diagonal stretches to cross the midline of the body
Do not do any hip openers with exception of a half lotus
Do not do any inversions
Encourage lots of eye contact and talking to the infant

The above is a guide only for integrating a special needs baby into your class, medical advice should always be sought before commencement of a baby Yoga class by the parent/carer and its useful for a teacher to research the requirements.

To deepen your knowledge and understanding of special needs it is recommended that you do the ‘Yoga for autism’ training course.

(All definitions regarding ‘health considerations’ are taken from NHS.co.uk website)

Cerebral Palsy

Cerebral palsy is a general term used to refer to a set of neurological conditions (condition that affects the brain and nervous system) that affects a Childs movement and coordination.

Cerebral palsy is caused by damage to the brain, this normally occurs before, during or soon after birth. The symptoms of cerebral palsy vary from child to child. Some children will have problems walking, while other children will be profoundly disabled and require life-long care.

Children with Cerebral palsy often have other related conditions such as:

Epilepsy
Learning difficulties
Incontinence
Impaired vision and/or hearing
Difficulties speaking or understanding other people speak
Delayed growth
Curved spine (scoliosis)
Drooling (unintentional loss of saliva from the mouth)

Cerebral palsy is not a progressive condition, meaning that it will not get worse as the child gets older. However, cerebral palsy can put a great deal of strain on the body, which can cause problems later on life.

There is no cure for cerebral palsy, but there are a range of treatments that can help relieve symptoms and help increase a child’s sense of independence and self-esteem.

Initial symptoms

The symptoms of cerebral palsy will normally become apparent in the first three years of the Childs life. They may show signs of being slower in achieving important developmental milestones such as learning to roll over or crawl, walk or speak. You may find children with this condition may also suffer with their muscle tone-this is the unconscious ability to contract or relax your muscles as needed.

There are two types of muscles tone:

Hypertonia- increased muscle tone in which the child can appear stiff or rigid.

Hypotonia- the opposite of above in which the child may appear floppy.

Some children may show signs in the first 3 months of Hypotonia which can later progress to Hypertonia. A typical trait of Cerebral Palsy is children favouring one side to the other which makes the posture appear unusual.

There are many types of Cerebral Palsy and these types along with explanation can be found on the NHS website.

Yoga and Cerebral Palsy…

Encouraging Yoga practice and relaxation can enormously help reduce high muscle tone, which is characteristic of most children with cerebral palsy. Holding a posture will give the muscles and tendons a relaxing stretch, releasing overall stress and tightness throughout the muscles and joints. At the same time that postures relax the body, they also provide just enough resistance to exercise low muscle tone areas of the body. In this way postures improve high and low muscle tone problems in children with cerebral palsy.

One of the most important parts of Yoga practice for children with cerebral palsy is its ability to stretch and realign the spine. Postures flex and twist the spine in all directions. Reducing the pressure on the radial nerves facilitates the release of muscular tension throughout the body and enhances overall nerve function. As a result, the child is able to develop a greater range of movement and coordination as well as greater independence and better self-esteem.

Do any Yoga moves which strengthen the body and give alignment and symmetry as well as stretch which involves both sides of the brain such as diagonals. Baby lotus would be OK but just gentle…may need more massage to loosen up the body before Yoga practice starts.

Avoid any stretches that involve hip openers where the legs are separated…only do ones that have the knees together and do not do inversions.

Down’s syndrome

Down’s syndrome is a genetic condition that occurs because of an extra chromosome. When a baby is conceived, it inherits genetic material from its parents. The genetic material is usually transferred to the baby in the form of 46 chromosomes – 23 from each parent.

Down’s syndrome is caused by a fault with a chromosome called the 21 chromosome. In most cases of Down’s syndrome, a child inherits an extra 21 chromosome, meaning they inherit 47 chromosomes instead of 46. When a person’s genetic make-up is unbalanced in this way, it can affect their physical and mental characteristics. Down’s syndrome can affect you in many different ways. Some of the most obvious symptoms are those which affect your physical appearance.

Physical Features

People with Down’s syndrome tend to have a number of typical physical features. Some people with the syndrome may only have a few of these features, while others may be more severely affected.

Physical features of Down’s syndrome may include:

eyes which slant up
small ears
flat back of head
protruding tongue
small mouth
flattened nose bridge
white spots on the iris (the coloured part of the eye), known as Brushfield spots
short fingers
broad hands with a single crease across the palm
loose skin on the back of the neck
vertical skin folds (epicanthic folds) between the upper eyelids and inner corner of the eye
loose joints (babies in particular may seem ‘floppy’)
poor muscle tone (hypotonia) and low birth weight

Development

The physical development of children with Down’s syndrome tends to be slower than that of other children of a similar age. They may also be slower to develop socially and mentally.

For example – it might take them longer to learn to speak or to read. All people with Down’s syndrome will have some degree of learning disability, although some people are more severely affected than others.

If a child has Down’s syndrome it will not stop them from developing at all. Many people with the condition can still learn all of the physical, mental and social skills that most other people acquire; they just do it at a different pace.

How Yoga can help a child with Down’s Syndrome

Yoga postures help to stretch, tone and strengthen the entire body. The postures also benefit the internal organs and help to balance and revitalise the endocrine glands. For this reason children with Down’s syndrome who practice regular Yoga practices of posture and breathing techniques, have a beneficial effect on the central nervous system. It develops body awareness, concentration and memory.

Do any Yoga moves which strengthen the body and give alignment and symmetry as well as stretch which involves both sides of the brain such as diagonals. Baby lotus could be ok but just gentle.

Avoid any stretches that involve hip openers where legs are separated. Only do ones that have the knees together and do not do inversions. Some babies/children with Down’s syndrome suffer Atlanto Axial Instability which causes them to have neck problems – therefore exercises such as forward rolls, bridge, shoulder stands and any movements where forward neck positions are used should be avoided.

ADD/ADHD

Attention deficit hyperactivity disorder (ADHD) is defined by two broad groups of behavioural problems: inattentiveness and a combination of hyperactivity and impulsiveness. Common symptoms within these groups include a short attention span, restlessness, being easily distracted and constant fidgeting. ADHD is the most common behavioural disorder in the UK. It is estimated that the condition affects between 3-9% of school aged children and young people. ADHD can be a life-long condition and many children who have it continue to have symptoms in adolescence and adulthood. However, it is still uncertain as to whether ADHD can occur in adults without first appearing in childhood. Children naturally have a tendency towards the kind of behaviour that ADHD causes, but this behaviour should not be confused with ADHD. There are several criteria that must be met for a child to be diagnosed with ADHD.

Symptoms of ADHD tend to start at an early age and they may become more noticeable when a child’s circumstances change – such as starting school. Many people with ADHD also have additional problems such as sleep disorders, low self-esteem and learning difficulties. However, ADHD has no effect on intelligence. There is no cure for ADHD but it can be managed using medication. There are several medical treatments for ADHD all of which should be accompanied by psychological educational and social therapies.

Symptoms of ADD/ADHD

The symptoms of attention deficit hyperactivity disorder (ADHD) can be catergorised into two broad groups of behavioural problems – symptoms of inattentiveness and symptoms of hyperactivity and impulsiveness. It is not fully understood whether these problems are an extreme form of normal behaviour or part of a separate range of behaviour altogether. The symptoms of ADHD in children and adolescents are well defined. The main symptoms of each behavioural problem are detailed below:

Inattentiveness

a very short attention span
being very easily distracted
being unable to stick at tasks that are tedious or time consuming
being unable to listen to or carry out instructions
being unable to concentrate
constantly changing activity or task

Hyperactivity

being unable to sit still, especially in calm or quiet surroundings
constantly fidgeting
being unable to settle to tasks and
Excessive physical movement.

Impulsiveness

being unable to wait for a turn
acting without thinking
breaking any set rules and
little or no sense of danger

It is thought that up to 35% of children with ADHD also have learning difficulties. However, it is important to remember that ADHD has no effect on intelligence.

How Yoga can help a child with ADD/ADHD

Yoga is a blend of stretching, relaxation, meditation and advanced breathing technique and has helped millions of people worldwide leave stress and anxiety behind. A recent study determined what was already assumed, Yoga did in fact produce a significant drop in hyperactivity, anger and tension.

During and after a Yoga session participants heart rate decreased while breathing slowed. Learning the art of slow, steady, relaxed breathing during times of anxiety is perhaps the greatest benefit that Yoga therapy delivers for those with ADHD.

When breathing is relaxed more oxygen is able to make its way to the brain, leading to better concentration and a heightened state of alertness. This benefit occurs in all people of all ages, regardless of their prior ability to focus.

Anxiety or stress is part or all of our lives but can be particularly damaging for those suffering from ADHD. Stress can become particularly severe for adults at work or at home. Stress is magnified in ADHD children by the structured dynamic created by the classroom environment and can make homework difficult to complete. Struggles to interact with other children (one of the major symptoms of an ADHD child) may be exasperated by a strictly structured school environment. These two factors may partially explain why Yoga classes for kids are now being offered in some elementary schools and studios worldwide.

Common ailments

Asthma

Asthma causes the airways of the lungs (the bronchi) to become inflamed and swollen. The bronchi are small tubes that carry air in and out of the lungs. If you have asthma, the bronchi are more sensitive than normal and certain substances or triggers can irritate them. Common triggers include house dust mites, animal fur, pollen, tobacco smoke, cold air and chest infections. When the bronchi are irritated, they become narrow and the muscles around them tighten which can increase the production of sticky mucus or phlegm. This makes it difficult to breathe and causes wheezing and coughing and it may make your chest feel tight.

The severity of the symptoms of asthma differs from person to person, from mild to severe. The narrowing of the airways is usually reversible – occurring naturally, or through the use of medicines. However, for some people with chronic (long-lasting) asthma, the inflammation may lead to an irreversible obstruction of the airways. A severe onset of symptoms is known as an asthma attack or ‘acute asthma exacerbation’. Asthma attacks can be life-threatening and may require hospital treatment.

Triggers

In 2005 in the UK, 1318 deaths were caused by asthma. Over 5m people in the UK have asthma. Asthma in adults is more common amongst women than men. The cause of asthma is not fully understood but it is thought to be a combination of genetic (inherited) and environmental factors. Asthma often runs in families and you can inherit the susceptibility to asthma which is then triggered by certain factors in the environment. Factors include exposure to air pollutants such as cigarette smoke or certain substances that can cause allergic reactions (allergens) such as pollen or animal fur.

How Yoga can help a child with Asthma and Bronchitis

By regular exercise of Yoga postures and breathing, the constriction of the bronchial tubes gets very much reduced. Slowly the capacity of bronchial tubes increases to a great extent. By this type of performance once can control the attack of asthma to a great extent. Chest opening postures can also help to clear the lungs of mucus lining the airways.

Epilepsy and Seizures

Epilepsy is a condition that causes somebody to have repeated fits. The medical term for an epileptic fit is seizure. Epilepsy is a relatively common condition affecting around 456,000 people in the UK. Epilepsy usually begins during childhood, although it can start at any age. Around one in every 280 children is affected by epilepsy. The cells in the brain, known as neurons, communicate with each other by using electrical impulses. During a seizure, the electrical impulses are disrupted, which can cause both the brain and the body to behave strangely. The severity of the seizures can differ from person to person. Some people will simply experience a ‘trance-like’ state for a few seconds, or minutes, whereas others will lose consciousness and have convulsions (uncontrollable shaking of the body).

Types of epilepsy

There are three main types of epilepsy:

symptomatic epilepsy – where the symptoms of epilepsy are due to damage or disruption to the brain
cryptogenic epilepsy – where while no evidence of damage to the brain can be found, there are other symptoms such as learning difficulties, that suggest damage to the brain has occurred and
idiopathic epilepsy – where no obvious cause for epilepsy can be found

How Yoga can help in Preventing Seizures

Yoga exercises help prevent or stop seizures. An imbalance in your body and mind can cause seizures. By practicing Yoga exercises regularly, you can maintain a balance between your mind and body. Therefore, practicing Yoga exercises, breathing exercises and relaxing your mind through meditation can help in preventing seizures.

Tension is an eminent trigger for seizures as well however, practicing Yoga exercises can help overcome it. Thus Yoga proves to be a great stress reliever. Inversions should be avoided.

Heart murmurs

Innocent Heart Murmurs

Innocent murmurs are heard when blood moves noisily through a normal heart. Sometimes these murmurs occur when:

Blood is flowing faster than usual through the heart and blood vessels attached to the heart
An increased amount of blood is flowing through the heart.

Illness or conditions that can cause blood to flow faster than usual through the heart include:

Fever
Anemia
Too much thyroid hormone in the body (hyperthyroidism)

Many, if not most children, will have a heart murmur heard by their doctor at some time in their lives. After childhood, the most common cause of an increased amount of blood flowing through the heart is pregnancy. Most murmurs found in pregnant women are innocent. They are due to the extra blood that women’s bodies make while they are pregnant. Innocent murmurs are sometimes due to changes to the heart resulting from heart surgery or from ageing. The most common cause of abnormal murmurs is congenial heart defects. Congenital heart defects occur where the heart, heart valves, or blood vessels attached to the heart do not develop normally before a baby is born. Some babies are born with a combination of heart defects. Common defects that cause murmurs include:

Congenital septal defects, which are holes in the wall (septum) that separates the right and left sides of the heart. They account for more than half of abnormal murmurs in children.
Congenital valve defects, which include narrow valves that do not allow enough blood to flow through them and leaking valves that do not close properly.

How Yoga can help children with a Heart Murmur

Relaxing activities such as Yoga and meditation are beneficial to maintain low levels of stress. Inversions should be avoided.

Reflux

Gastroesophageal reflux (GER) occurs when stomach contents come back up into the oesophagus (the tube that connects the mouth to the stomach) during or after a meal. A ring of muscle at the bottom of the oesophagus opens and closes to allow food to enter the stomach. This ring of muscle is called the lower oesophageal sphincter (LES). This sphincter opens to release gas (burping) after meals in normal infants, children and adults. When the sphinct opens in infants, the stomach contents often go up the oesophagus and out the mouth (spitting and vomiting). GER can also occur when babies cough, cry or strain. Most infants with GER are happy and healthy even though they spit up or vomit.

How Yoga can help a child with Reflux

Yoga will help you to digest your food in a much better way. If the food is digested efficiently, it will be difficult for GER to really get hold of you. Certain postures and breathing exercises can also help strengthen your gastric system, making it less susceptible to GER or acid reflux. It is best to avoid inversions, heavy squeezing of the tummy and too much rocking.

Hypotonia

Hypotonia is a medical term for decreased muscle tone. If you have decreased muscle tone your muscles will take on a floppy ‘rag doll’ appearance and you may have problems using the affected muscles.

Healthy muscles are never fully relaxed as they retain a certain amount of tension to allow them to be used when needed. This tension is known as muscle tone. Decreased muscle tone is not the same as muscle weakness, although in some cases of hypotonia, muscle weakness can develop in combination with decreased muscle tone.

Types of Hypotonia

Hypotonia is not a condition in itself; it is a symptom of another underlying condition.

There are two main types of hypotonia:

Congenital hypotonia – where the symptom of hypotonia is present at birth and
Acquired hypotonia – where the symptoms of hypotonia develops after birth as the result on an underlying medical condition, injury or trauma.

Congenital Hypotonia

Congenital Hypotonia is usually caused by genetic (inherited) conditions that disrupt the normal development of the nerves, muscles and brain. Genetic conditions that are known to cause congenital hypotonia include:

Down’s Syndrome – which is the most common cause of congenital hypotonia
Marfan Syndrome – a condition that affects the connective tissue ( a layer of tissue that helps to maintain your body’s structure and integrity by supporting the bones, muscles and organs) and
Dyspraxia – a poorly understood condition that causes problems with movement, coordination and language.

For many children with congenital hypotonia, tests are unable to find any evidence that they have an underlying condition. This sometimes is referred to as benign congenital hypotonia (BCH).

However BCH is a controversial term that is not accepted by all health professionals. Some experts argue that BCH is not a proper diagnosis and that it is simply a label that is used when a complete diagnosis cannot be made.

Acquired Hypotonia

Acquired Hypotonia can develop after an illness, infection or injury causes damage to the brain and/or nervous system. For example, this can occur in conditions such as:

Muscular Dystrophy – where there is a gradual weakening and damage of the muscles (this is the most common cause of acquired hypotonia).
Serious infections such as Meningitis which is an infection of the outside membrane of the brain or encephalitis which is infection of the brain itself
A serious head injury and
Myasthenia Gravis – a condition where the immune system attacks healthy muscles

How common is Hypotonia?

It is difficult to estimate how many people are affected by hypotonia in England because it can be caused by so many different conditions.

What is known is that although many of the conditions that cause hypotonia are uncommon, they certainly are not rare. For example, 600 babies are born with Down’s Syndrome in the UK each year and there are 2,000 cases of bacterial meningitis (the most serious type of meningitis) in England and Wales.

How Yoga can help a child with Hypotonia

Yoga will help to strengthen the muscles and joints and breathing and relaxation will help to relieve the stress.

Hydrocephalus (water on the brain)

Hydrocephalus is when excess fluid (cerebrospinal fluid) builds up on the brain. CSF has three main functions protecting the brain, removing waste and providing the brain with nutrients. The brain constantly produces CSF about a pint a day while old fluid is absorbed in to the blood vessels. However if this process is interrupted the level of CSF can build up quickly, creating the pressure. This excess fluid causes pressure on brain which can damage it. The damage can cause a wide range of symptoms including:

Headaches
Being sick
Blurred vision
Difficulty walking

Hydrocephalus can usually be treated with a piece of equipment called a shunt in the brain to drain the fluid. It’s a thin tube that’s surgically implanted in the brain, draining the excess fluid. If left untreated Hydrocephalus can be fatal. There are three types of Hydrocephalus:

Congenital Hydrocephalus (present at birth) – usually from infection mum has had rubella or mumps. Or birth defects like spina Bifida.

Acquired Hydrocephalus (develops after birth) – can affect children or adults. It usually develops after an injury or illness. For example, it may occur after a serious head injury or as a complication of a medical condition, such as a brain tumour.

Normal Pressure Hydrocephalus – only usually develops in older people, can sometimes develop after an injury or a stroke, but in most cases the cause is unknown, NPH is poorly understood.

How Yoga can help a child with Hydrocephalus

Yoga will help to strengthen muscles both in core and trunk to help with crawling and walking whilst maintaining flexibility. Coordination stretches and brain gym will help keep the brain active on both hemispheres. Vestibular workouts will help with balancing. Suggested exercises are ones for upper body such as plank and wheel barrow when they are toddling. Head holding and Tummy time to strengthen upper back and neck for non-mobile babies. Avoid and upside down or inversions, roley poleys forward rolls etc

What is Post-natal depression?

Postnatal Depression is what happens when you become depressed after having a baby. There may be an obvious reason, but often there is none. It can be particularly distressing when you have looked forward to having your baby through the months of pregnancy. You may feel guilty for feeling like this or even feel that you can’t cope with being a mother. It can last for weeks or several months.

Mild PND can be helped by increased support from family and friends. More severed PND will need help from you GP, health visitor or, in some cases, mental health professionals. Around 1 in every 10 women had PND after having a baby. Without treatment it can last for months or rarely, years.

Post-natal depression signs

Depression

You feel low, unhappy and wretched for much or all of the time. You may feel worse at particular times of the day like mornings or evenings. Occasional good days give you hope but they are followed by bad days which make you despair.

Irritable signs

You may get irritable with other children, occasionally, with your baby, but most often with your partner. He or she may well not understand what is happening.

Tired signs

All new mothers get pretty weary, but depression can make you feel so utterly exhausted that you feel physically ill.

Sleeplessness signs

Even though you are tired, you can’t fall asleep. You wake at the crack of dawn even if your partner has fed the baby overnight.

Not Hungry signs

You lose your appetite and forget to eat, which can make you feel irritable and run down. Some people eat for comfort and then feel bad about putting on weight.

Unable to enjoy anything

You find that you can’t enjoy or be interested in anything. Listed below are some common issues…

Sex

Your partner may want the comfort and intimacy of sex again – but you’re just not interested. Of course, there are other reasons to lose interest in sex after having a baby – it may be painful, you may be too tired or you may be just trying to adjust to the new situation – but PND will take away any desire or enthusiasm. If your partner does not understand this, they may feel rejected.child

Unable to cope

PND can make you feel that you have no time, can’t do anything well and that you can’t do anything about it. You may find it hard to organise a routine with your baby.

Guilty

Depression changes your thinking and makes you see things negatively. You may feel guilty, useless or that you are responsible for feeling like this.

Anxious

You may worry so much that your baby might scream, or choke, or be harmed in some way that you are afraid to be alone with him or her. Instead of feeling close to your baby, you may feel detached. You can’t work out what your baby is feeling or what your baby needs. Even if you have strong loving feelings for your baby, you can still feel anxious. Most new mothers worry about their baby’s health, but PND can make this overwhelming. You may find that you need reassurance all of the time from your partner, the health visitor, the GP, your family or a neighbour. You may feel panicky – your pulse races, your heart thumps and you may feel that you have heart disease or are on the brink of a stroke.

You may wonder if you have some dreadful illness, or if you will ever have any energy again. The fear of being left alone with all of this can cause even the most capable person to cling desperately to their partner, not wanting to be left alone.

How Yoga can help a mother with Postnatal Depression

By regulating our breathing pattern we can balance the brain, linking the rational left hemisphere with the more sensory right hemisphere.

Yoga brings about hormonal balance and stabilises the endocrine system. The practice of relaxation techniques based in Yoga (or any type of relaxation techniques that deliver what they promise) balances cortical activities and the nervous and endocrine systems, thus reducing the body’s redisposition to react to stress. As a result, the body produces less adrenaline, noradrenaline and cortisol, all stress hormones and a state of harmony is achieved.