This week, we continue our Ask a Tinto Expert series with a discussion around children’s mental health with clinical psychologist, Dr Caroline Gibbs. In the podcast, we talk about how the difficulties of the last 18 months have affected our children’s mental health, including how vulnerable children have become even more vulnerable. We cover children’s anxiety and the signs that your children might be struggling, including how children often use physical symptoms, such as a tummy ache, to explain their emotions. We also discuss the best way to access mental health services and the impact children’s mental health can have on parents - and vice versa - and how we can better support them too. Thank you so much for listening. If you’d like to know more about what we discussed, here are some resources that you may find useful Anna Freud – Some very helpful Covid research and support/advice for parents and for professionals - https://www.annafreud.org/coronavirus-support/support-for-mental-health-professionals/ Sutton Trust – Early Years research - https://www.suttontrust.com/our-research/coronavirus-impacts-early-years/ Covid 19 Early Years Research Round-Up - http://www.crec.co.uk/announcements/covid-19-impact-early-years-research-round-up Digestible book aimed at parents whose children are experiencing anxiety: Helping Your Child with Fears and Worries 2nd Edition. Cathy Cresswell and Lucy Willetts – Mental Health Tier System Tier 1: Primary care and first line support: GP, school, nurses, or school-based support e.g. school counsellor Tier 2: This is what we often refer to as early help, but these tend to be more targeted services, so you might have a Child and Adolescent Mental Health Service (CAMHS) service here offering support for mild-moderate mental health difficulties Tier 3: Here you have specialist CAMHS, who would tend to see those with more severe or enduring mental health difficulties, complex: comorbidities. Here you would have an MDT approach, so you might have input from a range of professionals including talking therapists and psychiatry. This is also where specialist CAMHS sits, e.g. eating disorder services, neurodevelopmental assessment services. Tier 4: This is where our inpatient services sit and also what we call outreach services, who aim to prevent children/YP needing an admission and who may therefore offer a more intensive service, for example, several appts a week for a short period until things have settled down a bit.

This week, we continue our Ask a Tinto Expert series with a discussion around pelvic girdle pain with physical therapist, Dr Deborah Riczo. In the podcast, we break down the symptoms of pelvic girdle pain to help you understand any issues you might be having. We also give some tips on how to manage this pain, covering everything from round ligament pain and our pelvic floors to posture, strength and flexibility throughout and after your pregnancy. As always, seek professional advice from your GP or a physiotherapist if you have any unexplained aches and pains during pregnancy. Early intervention is key to keep you moving freely. Thank you so much for listening. If you’d like to know any more about what we discussed, here are some resources that you may find useful. To hear more from Dr Deborah, take a look at the following: WEBSITE - https://riczohealtheducation.com INSTAGRAM: http://instagram.com/RiczoHealthEduca...  FACEBOOK: http://www.facebook.com/RiczoHealthEd...  LINKEDIN: http://www.linkedin.com/in/deborahriczo/  TWITTER: http://www.twitter.com/DebRiczoPT/ Prenatal and Postpartum Exercises and Posture Tips Dr. Deb, physical therapist:Pregnancy & Postpartum Exercises for back, pelvic girdle, hip, leg pain Pelvic girdle pain resource https://pogp.csp.org.uk/system/files/publication_files/POGP-PGP%28Pat%29%28UL%29.pdf Pelvic floor exercises resource https://pogp.csp.org.uk/system/files/publication_files/POGP-PelvicFloor%20%28UL%29.pdf

Karen, a first-time mother, talks about the how she came to choose where to give birth. As a Vet with a husband who is an anaesthetist, they were hot on their research and took a very measured and evidence based approach to making their decision. Karen talks us through the research she did, both clinical and anecdotal through conversations with friends and how she did a full circle from wanting an elective c-section to deciding on a home birth. She talks about the benefits of having home visits from the same midwife from the home birthing team once their decision had been made and all of the other preparation, she was doing to for her upcoming birth. Resources: Give birth like a feminist. Milli Hill Hypnobirthing. Practical ways to make your birth better. Siobhan Miller. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30063-8/fulltext https://www.england.nhs.uk/wp-content/uploads/2015/07/npeu-report1-safety-of-birthplace-and-implications.pdf https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext

Ruby discusses her desire for a homebirth, what influenced her decision, the books she had read, hypnobirthing courses attended and the research she did. We also discuss and the controversies surrounding peoples birth choices and the importance of supporting women whatever their story. We discussed pregnancy in a pandemic and the benefits of choosing a home birth meaning continuity of care as you are allocated a midwife and they come to your home. Finally, we discuss the fact that Ruby’s platelets are low and this means she is starting to prepare herself for the fact that she might need to be induced meaning she will need to be in the obstetric unit for the birth. Resources: https://thepositivebirthcompany.co.uk https://www.england.nhs.uk/wp-content/uploads/2015/07/npeu-report1-safety-of-birthplace-and-implications.pdf