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acknowledgements, I wanted the Arab reader to realize that the book
came as a result of a project on which there was a lot of
consultation, research, and cooperation. This in itself is a novelty
to the Arab reader.)
The idea for the
guidebook came about from an awareness of the importance of the first
five years of life in the development of the human being, especially
his personality; also from an appreciation of the big role that the
family, especially the mother, plays in this stage of development.
The development of
the human element is the basis and objective of any socioeconomic
development. The development of this element structurally and actively
depends a great deal on what he receives and what influences him in
the home. The role of the mother stands out here in the development of
the personality of the human being and citizen. Therefore, the Arab
woman should be aware of her important responsibility in bringing up
her children according to available scientific information and proper
knowledge. This book is a humble attempt to contribute in that
It was not put
together to be the last word on the subject. We hope to get all the
comments that both mothers and specialists have for future effort.
This book was
prepared especially for the Arab woman, that is, relevant to her needs
and in harmony with her environment. As such, we had to know the
prevailing custom s and practice s in Arab society, in an effort to
tie what is good and useful from it with modern scientific knowledge
while eliminating misconceptions and harmful practices. We do find
differences in local customs between one Arab country and another but
if we look at basic attitudes in childrearing, we find one Arab
culture! Therefore our book addresses the Arab woman wherever she may
How was this book
In order to know the
prevailing customs in Arab society and the specific problems of this
stage of development (from pregnancy to five years), library research
was carried out to collect information on the physical, mental and
social growth characteristic of this period.
Then we interviewed
people who have been working with mothers and children: doctors,
midwives, social workers, and nursery school teachers in the cities of
Beirut and Tripoli and some villages in Lebanon. We learned some of
the pressing problems they felt in working directly with mothers and
After writing the
chapters, we took parts of them to mothers with no higher than
elementary education, to read and comment on. This gave us an idea of
the extent of the mothers understanding of the book and the
comprehensiveness of the book on the topics under discussion.
The last stage was
putting the book in draft form and sending it to WHO, UNESCO, FAO and
specialists in various Arab countries. Their valuable comments were
incorporated into the final draft.
This book was able
to come out as a result of a UNICEF Project, as part of its total
efforts in the service of the Arab child. UNICEF gave me the
opportunity to work full time on this project and build it on a basis
of research, and consultations with doctors and specialists. The Ford
Foundation cooperated by giving UNICEF a grant for the project that
provided us with research assistants and consultants.
I would like to
extend special acknowledgements to Mr. James McDougall, Regional
Director, UNICEF, and to Mr. Courtney Nelson, Ford Foundation
Representative for the Middle East, for their personal concern for the
project, and for providing it with the necessary support to complete
to all who helped realize this project, especially:
Dr. Jamal K. Harfouche: for reviewing the manual in parts and
as a completed draft, and for her valuable comments.
Dr. Ali El-Hassan and Dr. M. Selim for their comments on some
Misses Fakhury, R. Madi, and H. Hallab for their valuable
contribution as research assistants, collecting information and
interviewing pediatricians, midwives, and social workers and teachers.
Dr. Afif Demechkiey for editing the book.
Mrs. S. Khoury and Mrs. S. Shaloohy for typing drafts and
Mr. Farid Haddad for illustrating the manual and designing it.
May I be permitted
to thank my husband Ali Othman for being unusually patient in
discussing endless questions about Arab society.
In closing, the most
this cooperative effort hopes to achieve is to realize its objectives
and become one stone in the new Arab structure.
Why the Guidebook?
(I tried to
explain why the guidebook has been written and to relate it both to
national pride and to personal needs and motives. Here is a
You might be
expecting your first child or maybe you have just become a mother very
recently. In both cases, you are so happy with the fact of your
motherhood that you have decided to shower your baby with all the love
and tenderness in the world.
However, you know
that love and tenderness are not enough to bring a baby up and you are
anxious to know the best possible ways of providing your baby with
good health and security. You feel apprehensive about the colossal
responsibility that will be yours. Perhaps an awareness of this
feeling provided our primary motive in trying to put this manual
within your reach, to help you in caring for your child.
The objectives of
the guidebook are basically threefold:
First, to emphasize the importance of the early years of life
in relation to the development of a human being in general, and his
future abilities, skills, attitudes and values, specifically. Doctors,
psychologists, and educators believe that what happens in this early
period influences to a great extent the future growth of the
individual physically, mentally, and socially, and may lead to
patterns and traits that are difficult to change later in life.
Second, to indicate the importance of the role of the mother in
the child’s growth. It is a role that starts with conception. Her
uterus is the natural environment where the embryo forms and grows
until birth. After birth, she is feeding her child with her milk. This
organic biological relationship ends with weaning, but the child is
still dependent on her for its needs: feeding, cleanliness, clothing
and protection from diseases and dangers, as well as giving the child
the opportunity to develop mentally. Also, her responsibility is to
teach him good habits and various skills such as language and thought,
self-reliance, and values that will influence his future ability to
learn both outside the school and inside it. Every Arab mother should
be aware that the child who is not given enough opportunities to
develop mental abilities and acquire good habits early in life will
lose its chance to become a creative person able to contribute to the
building of a better Arab society.
Third, we belong to an ambitious nation that boasts a glorious
past, but we are aware that it is a developing nation highly motivated
towards evolution and modernization. We do have a good heritage that
has been passed from one generation to the other. This heritage has
many good traditions that we must retain but it does also have some
harmful practices that are obstacles to progress and, therefore, we
must try to leave them behind.
If we look into the
area of childcare, we find that we love children. The child’s ties
with the mother are strong, but so are they with all the members of
the family: the father, the older siblings and the grandparents. The
harmful practices are the result of traditional misconceptions, such
as not cleaning the babies’ faces, and especially their eyes, so
that they will not be beautiful and, therefore, will he protected from
the evil eye. Such practices are starting to disappear as a result of
education and the spread of knowledge. Fear of vaccination, viewing
obesity as a sign of health, or using fear-provoking situations to
control the child’s behavior are some other traditional
misconceptions about childrearing.
We don’t want to
copy blindly from the West, the rationale being that they have reached
the peak of modernization; but, at the same time, we don’t want to
fossilize our traditions and not make use of the good results of
modern science in the fields of nutrition and education, for example.
The woman on the
threshold of motherhood today is in conflict between the old and the
new. She asks herself, “Shall I follow the advice of my mother and
grandmother literally? Or shall I refuse everything that comes from
them just because it is traditional?” To her, we hope that this
manual will be a help in her ambivalence.
In the manual itself
after discussing pregnancy and some of its major problems, we have
divided the period of birth to 5 years as follows:
The child in its first year;
The child from one to three;
The child from three to five.
This is followed by
chapters on First Aid, Nutrition, and Children’s Diseases, as
reference chapters for the mother who would like to know more about
The first five years
that we have dealt with in this manual are the important years of the
pre-school period. Though each age group has its own characteristic
problems and issues, a number of important issues repeatedly come up
in every one of the three stages. We have stressed concern for
protection from disease, malnutrition, and accidents, keeping in mind
that infant mortality in developing countries could reach between 40
to 50% of total deaths, as compared with 5% for developed countries.
An introductory page
discusses the sex of the future child, touching on the preference for
boys in Arab countries and the tradition of condemning “mothers of
girls.” An attempt is made to clear up misconceptions about the
mother’s responsibility in determining the sex of the child. It also
discusses the changing attitude toward women in Arab countries and the
new opportunities for women to work and have vocations plus the
unchanging fact that girls will be the mothers of future generations
and, therefore, have double responsibilities and opportunities.
How it occurs;
The fertilized ovum already has the determined characteristics
of the individual, those that are inherited;
The individual’s personality and development are the result
of both heredity and environment;
Environment is responsible for socially learned traits and
characteristics, hence, the importance of the family in the early
Conception and 3 months
3 months to 6 months
6 months to 9 months
What the pregnant mother should do to protect herself and her
What the pregnant mother should avoid.
The Child in its First Year
Introduction to the First Year of Life
How it is
characterized by rapid growth: from an immobile, relatively helpless
creature to a creature with specific abilities and a definite
awareness of the physical and social world around him, and with
certain likes and dislikes.
Do parents, and
especially the mother, have a role to play during this period besides
providing the child with nutritive food and protection from disease
and accidents? Does the intellect or mind grow during this period? How
is this manifest and what can be done to stimulate growth and
principles about growth are briefly discussed.
That a healthy body is the right vehicle for the development of
a healthy mind, especially in the early years.
That a child becomes ready to learn as the result of
maturation, so teaching tasks and skills before the child is ready
becomes a futhe frustrating exercise.
Every child has his own rate of development. Though this book
presents different stages of development and corresponding average
ages, what is important for each individual child is not the specific
age, but the sequence. Symptoms of extreme retardation, however,
should be acknowledged and an effort made to find out what is wrong.
and Its Mother
This subject is
given a lot of attention, not just because of the novelty of the
situation for the new mother but because we found that there is a high
percentage of infant mortality during the first month of life in Arab
countries. This is often due to ignorance and unhealthy traditional
practices related mainly to treatment given to eyes, umbilical cord,
and nipples, as well as to the use of pillows and over-bundling the
child. The mother who has just delivered is also bound by many
traditional practices, some of them very useful, but some quite
harmful. Harmful practices would include not moving for 40 days and
not bathing during this period. Useful practices would include feeding
with high-protein foods such as chicken and chicken soup and sweets
and nuts, even in the poorest homes. The new mother is also spared bad
news or anger during this period, but could suffer from over-visiting.
It is traditional for women to come in at any the to have coffee and
chatter in the same room with the mother and the baby, even if the
visitors or their accompanying children are sick.
information is given along with an explanation of the traditional
practice, whether useful or harmful, on the following topics. Special
stress is given all through the chapter on the value of
Care of the mother who just delivered, mainly hygiene (bath and
clean nipples) and diet.
Care of the newborn:
Warmth: excessive heat is as bad as cold (traditional fear of
cold results in overclothing and overbundling)
Eyes- wipe eyes with pre-boiled water or cold tea (traditional
practice of Kohl is not in itself harmful, but its application can be
a source of infection)
Umbilical cord - clean with alcohol (traditional practices vary
from use of talcum power to ground coffee applied in an effort to dry
it; such practices often cause infection)
Nipples - leave swallowed nipples of newborn that have milk
untouched. (Traditional practice is to squeeze milk out to relieve
baby -- another source of infection.)
Bath - Traditional practice of “salting’” -- rubbing salt
for 3 days over babies’ bodies is not necessary and may lend to skin
chafing. Steps in bathing a child:
Do not use powder, but olive oil, which is found in most Arab
Clothes - swaddling: the traditional practice of tying the
baby, though it has become more tolerable, is still widely practiced.
The physical disadvantages of swaddling are discussed.
Clothes should be made from washable cotton
How to diaper
How to clean diaper area
How diapers should be cared for
Amount of sleep typical and needed, during this period
How essential it is for growth
Role of mother in timing sleep
a separate cot for the child to avoid cases of strangulation
when an exhausted mother could sleep over child
some sort of regularity in feeding and bathing helps both
mother and child
Shaking or rocking child to sleep is very traditional, to the
point where children never sleep unless carried or shaken to sleep
sleep: the practice of putting a child on its stomach and not on its
back is encouraged and advantages discussed.
The preferable way
to feed is to breast-feed and not bottle feed (bottle feeding became
very fashionable recently because of a false belief that western
babies are healthy (fat) because they are bottle fed).
Why mother’s milk is better
Advantages of breastfeeding to mother herself (there is a
widespread belief among middle class mothers that breastfeeding spoils
the beauty of their breasts)
Conditions that are conducive to breastfeeding
How to breastfeed
Timing breastfeeding to establish some schedule that the baby
is encouraged to follow. A happy medium between giving the breast at
every cry and turn of the baby and a rigid time schedule.
Night-feeding: breastfeed the child at night until it starts
sleeping through, a sign that it isn’t needed anymore.
Conditions that prevent breastfeeding.
is discussed as an alternative when breastfeeding is not possible.
Stress on method, mainly sterilization, choice of milk (kinds of milks
available discussed), left-over milk (a source of intestinal trouble
in our countries).
This is discussed at
length - - both the why and the how. Research reports show that the
most critical period of growth for Arab children is from 6 months to 2
years where malnutrition and infections form the two components of a
vicious circle. The problem is the result of improper feeding during
the period of transition between milk diet, weaning, and regular
family diet. A schedule of feeding is suggested built around local
foods with inexpensive mixtures as alternatives to expensive high
The advantages of
the gradual method of weaning, both physical and psychological, are
stressed as an alternative to the traditional. The traditional is
abrupt weaning by using bitter substances on the breast or separating
the child from its mother by sending it to relatives. Gradual weaning
becomes a simple and healthy process if the child has been introduced