‘Doctors Said Our Baby Had Epilepsy – After Months Searching For Answers, We Finally Learned The Truth’

In My Story, readers share their unique, life-changing experiences. This week we hear from Richard Poulin, 40, who currently lives in Bangkok, Thailand.

My wife and I accepted new teaching jobs in Singapore. Before leaving America, we proudly showed our newborn daughter, Rylae-Ann, to family. All was right in the world, and we eagerly boarded a plane to begin our new life.

However, when Rylae-Ann was three months old, we saw signs that all was not right.

She was missing developmental milestones. We would play games to encourage her to reach out, do exercises to practice sitting independently, and give massages to coax her to engage her core muscles. But nothing seemed to work.

One day my wife, Judy, went to look for homes while I stayed back at the hotel with our daughter. During one of the sessions, Rylae-Ann tensed her arms and legs. Her eyes briefly crossed, and her tongue made a thrusting action.

Despite it lasting a few seconds, I was concerned. I attributed it to my pushing her too hard, causing muscle cramps. I tapered my eagerness for my daughter to progress.

The fleeting actions caused enough concern that I did some Googling. I did not dare tell Judy. I didn’t want her to start worrying.

I came across an article about a girl with a deadly ultra-rare disease. I admonished myself. I had become one of those parents who Googled symptoms and ended up with an obscure diagnosis for my daughter. I closed my laptop and tried to focus on my family’s new life in Singapore.

As the days passed, Rylae-Ann's parents realised she was missing developmental milestones.

Richard Poulin

As the days passed, Rylae-Ann’s parents realised she was missing developmental milestones.

Over the next few months, our lives began to unravel. The tensing of muscles in our daughter’s tiny limbs became more intense and lasted longer; it was the only time we ever saw any movement from her.

We began to refer to them as ‘spells’. These spells came every three days like clockwork. She had trouble staying asleep. When she was awake, she looked sleepy and constantly cried.

Rylae-Ann’s developmental milestones remained paused at the three-month mark. She couldn’t hold up her head, she did not reach out and grasp things, and her eyes remained tiny slits. The photographer commented on her sleepy look when we got her identification card.

We went to doctors who reassured us that babies develop at different rates. But as the spells’ intensity and duration grew, we could no longer sit idly by. We began visiting more doctors and researching.

One rainy night, the spell lasted longer and was more intense – we were filled with fear. We rushed out of the door to the car we’d booked on a ride-sharing app and headed to the nearest hospital. I willed all the lights to turn green while Judy cooed softly into Rylae-Ann’s ear. Once we arrived, the nurses did an assessment and put our daughter at the front of the triage line.

They gave our daughter diazepam for fear she would have another seizure. A doctor came and assigned an initial assessment of epilepsy. The doctors admitted Rylae-Ann, and we were separated from her for the first time.

Judy and I discussed the diagnosis when we returned home to get clothes and necessities. What the doctor was telling us didn’t seem right, mainly because we thought what the doctor saw as a seizure was something else due to its three-day cyclical nature.

After a barrage of tests, the doctors said she had epilepsy. They prescribed her medication, and we went home. But her symptoms did not improve. The medicine left her sleeping all day and she felt lifeless when we picked her up – we stopped the drug after a few days.

We continued to visit the doctor, trying to explain why we thought it wasn’t epilepsy. Despite genetic testing, blood tests, EEGs (which record brain activity), MRI, CSF (cerebrospinal fluid) tests, and more coming back normal or inconclusive, the doctors did not change their diagnosis, so we went to other doctors. We even travelled to other countries searching for answers.

As we collected second opinions, we improved our description and came armed with digital evidence. Doctors had different opinions, including epilepsy, dystonia, cerebral palsy, and other neurotransmitter disorders. However, no definitive answer came.

Our daughter was regularly admitted to emergency care during the onslaught of medical tests. We were always in the hospital, so much so, the nurses knew our daughter by name. Most were lung-related issues such as aspiration, pneumonia, and collapsed lung. But also, a typical childhood viral infection would cause her to be extremely weak to the point that the doctors required her to be in intensive care.

Answers never came. Instead, a random Facebook post about a child with similar symptoms caught the eye of Judy’s older brother. When Judy shared the article with me, it triggered a memory of a post I saw earlier.

The name AADC stuck with me because of its similarity to a classic rock band. I remember the article discussing the extremely rare disease, affecting around 130 people worldwide since 1990.

Rylae-Ann would often end up in intensive care.

Richard Poulin

Rylae-Ann would often end up in intensive care.

I explained how it was improbable. However, Judy pointed out that although it is an extremely rare genetic disorder, many of the children were from Taiwan, where her parents are from.

AADC deficiency is a rare disease that causes a mutation in the DDC gene. This gene instructs the body to produce the AADC enzyme, which is responsible for dopamine and serotonin.

Children with AADC deficiency have little or no dopamine and serotonin. Both are responsible for several critical bodily functions to sustain life and movement.

That night, alarms were going off in my head. I sat up in bed and went to work, reading research papers about the disease. The more I read, the more I knew our daughter had this. One glaring reality was that children with this disease die early in life due to the severity of the symptoms.

One of the reports talked about how a doctor in Taiwan had completed clinical trials for an experimental, innovative treatment. There was no word if the treatment was available, but I knew we had to visit this doctor.

Rylae-Ann struggled to sit upright or feed.

Richard Poulin

Rylae-Ann struggled to sit upright or feed.

Judy’s younger brother still lived in Taiwan, so we asked him to make an appointment as soon as possible. The next day he told us we had an appointment booked a week later, the day after Christmas.

We packed our bags and landed in Taiwan on Christmas day. That night, Judy and I sat at the park drinking a small bottle of vodka, trying to process how we went from cloud nine, to falling from a cliff, to Hell over six months. As the bottle’s contents disappeared, I promised my wife we would never have a Christmas like this again.

On the day of our appointment, we met the doctor who was surprised to receive patients thinking their child had a rare disease – and even more surprised at our knowledge of the disease.

After a short observation and using the information we provided, the doctor felt confident that our daughter did, in fact, have an aromatic L-amino decarboxylase (AADC) deficiency.

“The doctor felt confident that our daughter did, in fact, have an aromatic L-amino decarboxylase (AADC) deficiency.”

I asked if the treatment in the article was available. We held our breath. “No,” he replied. Tears welled. “But, there is another clinical trial recruiting. However, it is only available for Taiwanese.”

“She is Taiwanese!” we screamed. We had recently applied for her citizenship. Although Judy is Taiwanese, she never lived there. We grew up in Thailand, where Rylae-Ann was born. Rylae-Ann only had an American passport, but her Taiwanese passport would soon be ready.

She enrolled in the clinical trial for a new exploratory treatment known as gene therapy. However, she had to wait 11 months to begin treatment – another year of trying to keep her alive and healthy.

Yet with the mystery uncovered, we had more information on how to care for her.

The 11 months also gave us time to figure out the logistics of how our daughter would participate in the study. She would have to stay in Taiwan for six months, so we decided to have Judy’s mum and nanny remain in Taiwan for that period while Judy and I took turns flying back so we could continue earning money at our new jobs in Singapore.

Judy and Rylae-Ann on the day of her surgery.

Richard Poulin

Judy and Rylae-Ann on the day of her surgery.

On 13 November, when Rylae-Ann was 18 months old, she underwent brain surgery for gene therapy. Family and friends asked us if we were worried. We weren’t. We had our backs against the wall and fought to keep our daughter alive.

While alive, she depended on us for everything. Managing work to pay the mounting health care bills was extremely difficult. There was no downtime or social life. I remember telling Judy that the lack of sleep was making me mad.

We felt blessed that our daughter would have an opportunity in life.

The surgery lasted several hours. It was Judy’s turn to be in Taiwan, so I waited for a video chat update.

The way we explain gene therapy to other parents is it involves injecting a shell of a virus into the brain. The virus normally goes unnoticed by the body, so it is able to bypass the body’s immune system. Researchers used this situation to inject good DNA into the virus. The virus then “infects” the good DNA in the body. In our daughter’s case, it was in the area of the brain where dopamine is produced.

The surgery was a success. A few days later, to Judy’s surprise, Rylae-Ann was discharged. We began physical therapy immediately.

The results came quickly. One month later, she sat up on her own. This was a huge milestone. Since then, she has continued to make progress. Every day we supported her, but we did it in a way where we could still make memories as a family.

Just over a year after gene therapy, our daughter was swimming, walking, running, and even riding a horse. Today, she is an independent child who continues to explore the world. Not only does our daughter have a chance to live, but we also have a chance to be parents.

Rylae-Ann has grown into an independent child who continues to explore the world.

Richard Poulin

Rylae-Ann has grown into an independent child who continues to explore the world.

Judy and Rich now use their spare time to help other families in the rare disease community and have launched a non-profit organisation called Teach RARE, where they work to raise awareness and teach caregivers how to combine educational activities with therapy goals.

To take part in HuffPost UK’s My Story series, email uklife@huffpost.com.

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NHS Launches ‘Virtual Wards’ To Help Kids Access Hospital Care At Home

Tens of thousands of children are set to receive hospital-level care at home as part of an expansion of virtual wards on the NHS.

The announcement is set to come from NHS chief executive Amanda Pritchard on the 75 anniversary of the health service.

The ‘hospital at home’ service will cover children in every region of England from this month, after successfully treating more than 6,400 children in a pilot scheme over the last year.

Pritchard said the NHS virtual wards programme has “provided peace of mind” to parents who have used them during trials, including in Blackpool, Dudley and Dorset.

What is a virtual ward and how does it work?

Virtual wards allow patients to get hospital-level care at home safely and in familiar surroundings, helping speed up their recovery while freeing up hospital beds.

Children on a virtual ward would be cared for by a multi-skilled team who can provide a range of tests and treatments, including blood tests, prescribing medication or administering fluids through an intravenous drip.

They would be reviewed daily by the clinical team and the ‘ward round’ may involve a home visit or take place through video calls.

Many virtual wards use technology like apps, wearables and other medical devices enabling clinical staff to easily check in and monitor patients’ recovery.

Children will be treated for a range of conditions like respiratory illness, such as asthma, and heart conditions, but from the comfort of their homes.

How is it helping children?

In Blackpool, almost 200 children have been treated on a paediatric virtual ward.

Hope Ezard, who is 21 months old, is one of them. She was born prematurely at just 29-weeks and has a rare neurodevelopmental disorder, GNB5, as well as chronic lung disease and feeding issues.

Hope has been in and out of hospital for most of her life to be treated for recurring respiratory infections, and to receive high-pressure oxygen and antibiotics.

The introduction of the virtual ward meant Hope could be moved home sooner.

Hope’s mum, Sarah, 39, said being able to receive care at home “is so beneficial to Hope, and our other children”.

“We know that in general, Hope doesn’t sleep very well when she’s in hospital and is more vulnerable to hospital infections, so there is peace of mind when she’s being cared for at home, on the virtual ward,” she said.

“She’s less likely to pick up anything that might make her more poorly, and she’s relaxed and comfortable in her own bed.

“And the fact that the brilliant community nurses are just a phone call away reduces any anxieties that we might have had.”

In Dudley, mum Anum Shazady praised the virtual ward for keeping her son out of hospital, with twice daily calls from NHS staff.

Anum said: “Now my son is on the virtual ward I can record his observations as many times as I want throughout the day, recording them onto the virtual ward pad and a member of staff calls me twice daily which reassures me that he is safe in our home environment.

“The new virtual ward is great for me and my family as it stops my son staying in hospital longer than he needs.”

Why are they expanding the scheme?

The ultimate aim is to free up hospital beds – especially ahead of winter.

NHS chief executive Amanda Pritchard said: “Virtual wards are already providing excellent care to families when their children are sick, and this expansion will enable thousands more to receive high quality care from home.

“Being treated at home can have a hugely positive impact on patients – it means they receive hospital-level care, but it also means they are not separated from their families – providing peace of mind for loved ones.

“As we look to the next 75 years of the NHS, we will continue to embrace the latest technologies and innovations to meet the changing needs of patients while ensuring that care is as convenient as possible.”

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Vaginal Seeding: Should You Swab Your Baby With Vaginal Fluid After C-Section?

Swabbing newborn babies with their mum’s vaginal bacteria might boost their early development, according to new research.

Known as vaginal seeding, the process involves transferring vaginal bacteria to a baby after a caesarean section, with a view to improving their gut bacteria.

The process reportedly originated in Australia, however over the years has become increasingly popular in the UK, too – with more and more mums asking for vaginal seeding after a C-section birth.

But there are risks attached – specifically the risk of passing on an infection from mother to child.

What is vaginal seeding all about then?

Previous research has found babies born by C-section tend to have different gut bacteria to those born vaginally.

Vaginally born babies receive their early gut bacteria from the mother’s birth canal, while C-section babies’ microbiota are dominated by bacteria found on the mums’ skin, in breastmilk and in the environment.

While the difference tends to disappear as they age, researchers suggest early gut microbiota is associated with the development of baby’s immune system and could affect their disease risk later in life.

This has led to practices like vaginal seeding – basically, mums (or dads) would rub newborns with a gauze swab containing their mother’s vaginal fluids after birth via C-section.

But there is limited clinical evidence that vaginal seeding is safe and effective.

What are the risks of vaginal seeding?

Doctors have previously warned that the process could put babies at risk of infection – particularly from group B strep (GBS), which can prove deadly in some cases. And according to Jane Plumb, chief executive of Group B Strep Support, testing for group B strep “is rarely available in the NHS”.

“[GBS] is carried by around one in four pregnant women, and although it poses no risk to the mother it can cause fatal infections in babies,” Dr Aubrey Cunnington, a clinical senior lecturer from Imperial College London, wrote in the BMJ.

“There are also other conditions that cause no symptoms in the mother, such as chlamydia, gonorrhoea and herpes simplex virus, that could be transferred on the swab.”

He spoke about how one colleague had to intervene when a mother with genital herpes, who had undergone a C-section and was about to undertake the process.

“Swabbing would have potentially transferred the herpes virus to the baby,” said Dr Cunnington.

What does the new study say?

Researchers rubbed the lips, skin and hands of 32 newborns delivered via C-section with a gauze soaked with their mothers’ vaginal fluids and another 36 newborns with a gauze soaked with saline as blind controls.

Because of the risks attached, the mothers were tested in advance to make sure they were free of infections, such as sexually transmitted diseases and group B strep.

The team found that newborns who received the microbiota had more gut bacteria found in maternal vaginal fluid six weeks after birth, suggesting that maternal vaginal bacteria successfully reached and colonised babies’ guts.

Compared with C-section newborns who received saline gauze, babies with microbial transfer had more mature bacteria in their guts at six weeks old, similar to babies born vaginally.

And no infants experienced severe adverse events during the experiment, according to the study which was published in the journal Cell Host & Microbe.

It could also boost development

The team also evaluated the babies’ neurodevelopment at three months and six months after birth, using a questionnaire.

They asked the mothers if their babies were able to make simple sounds or perform movements like crawling on their hands and knees.

Babies who had been swapped with vaginal fluid scored significantly higher in neurodevelopment at both ages, and their scores were comparable to those of vaginally born babies.

Study author Yan He, of Southern Medical University in Guangzhou, China, said they now want to determine if vaginal microbiota seeding has the potential to reduce the risk of neurodevelopmental disorders in children, such as ADHD, ASD, and intellectual disabilities.

“It is somewhat like faecal microbiota transplantation,” continued He.

“We need more data to understand this intervention and make it more precise. We may eventually uncover what exactly is beneficial in maternal vaginal microbiota, which could enable us to design therapeutics for all infants born via C-section in the future.”

Advice for parents

Dr Cunningham, who cautioned against vaginal seeding, urged mothers considering the procedure to discuss it with their doctors first so that they are fully informed and are aware of the risks involved.

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The Most Common Symptoms Of The XBB Covid Variant In Children

You’ve likely heard talk in the news about XBB1.5, an Omicron variant that has become a dominant strain of the Covid-19 virus in the US and that experts warn could soon become so in the UK, too.

According to the latest data from the Centers for Disease Control and Prevention, XBB1.5 accounted for 27.6% of overall US infections in the first week of January, inching closer to overtaking BQ.1.1 as the most common variant.

While for the most part this Omicron variant is similar to previous ones, there are a few things to know about XBB1.5, especially if you believe that it may have hit your household.

What symptoms of XBB1.5 are common in children?

Experts agree that symptoms tend to be the same as those we’ve seen before.

“I have not seen any evidence to suggest the main symptoms of XBB variant are different from previous variants,” Dr. Ruth Kanthula, a paediatric infectious diseases specialist at MedStar Health, tells HuffPost.

Common symptoms in children can include:

  • Fever
  • Fatigue
  • Achiness
  • Sore throat
  • Cough
  • Nasal congestion or runny nose
  • Headache
  • Lost sense of smell or taste
  • Shortness of breath or difficulty breathing
  • GI symptoms such as nausea, vomiting and diarrhea

“It’s hard to tell about loss of taste and smell in young kids,” says Dr. Tanya Altman, a paediatrician and author of Baby and Toddler Basics.

Altman says she has noticed that kids tend to be less interested in eating while they are sick, and ask for “more flavourful or spicy foods after they recover, which to me suggests their taste may not have fully recovered yet.”

Altman describes the majority of Covid infections that she is seeing now as mild – with kids having less serious symptoms than adults, such as shortness of breath. She adds that children seem to be recovering quickly after testing positive.

“This could be due to the fact that most of the population has some sort of immunity from previous infections or vaccines, or the virus is now weaker, and I think it’s likely a combination of both,” she continues.

It’s important to note, however, that a child can have two respiratory viruses at the same time, which may cause their symptoms to be more severe. Other viruses in heavy circulation right now include RSV and the flu, which some have dubbed, along with Covid-19, the “tripledemic”.

How contagious is XBB1.5?

The “main difference that has been observed with XBB variant compared to other Covid-19 variants is that XBB variant spreads quickly,” says Kanthula.

Because the XBB1.5 variant has quickly come to account for a large portion of infections, scientists think that it may be more highly transmissible than other variants.

mother having video call with a pediatrician while holding ill daughter in her lap.

Phynart Studio via Getty Images

mother having video call with a pediatrician while holding ill daughter in her lap.

“The XBB.1.5 variant has a mutation virologists believe is helping the virus better bind to cells and thus be more transmissible,” Johns Hopkins professor of molecular microbiology and immunology Andy Pekosz explained in a Q&A on the university’s website.

Practically, this means that the virus could infect many members of a household, or a school classroom, in a short amount of time.

In addition to being more highly transmissible, XBB1.5 also seems to be “immune-evasive,” according to Pekosz, meaning that there may be a lot of breakthrough infections in people who have previously had Covid, are immunised, or both.

What should I do if I think my child has XBB1.5?

If your child has any of the symptoms listed above, it makes sense to give them a Covid-19 test. Note that these tests will only tell you whether your child is positive for Covid-19, not which viral strain they have.

Treat your child’s symptoms just as you would any other respiratory virus, with rest, fluids and acetaminophen/ibuprofen for fever or aches. As always, says Altman, if your child has a fever for more than four days, isn’t keeping fluids down, has trouble breathing or looks really sick, call your doctor.

For infants under three months, you should contact your doctor if they have a fever of 38°C or higher or miss two feeds, as young infants can become very sick with different respiratory viruses.

Does my child need to quarantine if they are infected?

As the NHS website explains, you have Covid-19, you can pass on the virus to other people for up to 10 days from when your infection starts. Many people will no longer be infectious to others after five days.

Anyone with Covid is currently advised by the NHS to try to stay at home and avoid contact with other people for five days, and avoid meeting people at higher risk from Covid-19 for 10 days, even if those people have had a Covid-19 vaccine.

“If a child or young person aged 18 or under tests positive for Covid-19, they should try to stay at home and avoid contact with other people for 3 days. This starts from the day after they did the test,” the guidance continues.

“Children and young people tend to be infectious to others for less time than adults. If they’re well and do not have a temperature after 3 days, there’s a much lower risk that they’ll pass on Covid-19 to others.”

While it’s frustrating to have to keep your child home from school, particularly if they’re not feeling ill, Altman says: “Covid is one that you really don’t want to spread to others, especially those who are high risk, so please keep your kids home when sick, mask if you need to leave your house with sick kids and keep them away from others as much as possible.”

How can I prevent my child from getting XBB1.5?

“I think the goal now is to learn to live with Covid, just as we live with flu, RSV and other contagious respiratory illnesses,” says Altman.

Stay home when sick, wash hands, disinfect surfaces, teach kids to cover their faces when they cough or sneeze, and mask when appropriate (such as days six to 10 of a Covid-19 infection.)

Even though XBB1.5 is known to evade immunity, “based on past experience we know that vaccination can protect against developing severe disease,” says Kanthula, so you should make sure your children have been vaccinated and had boosters.

Altman says she believes that the hybrid immunity of three doses of vaccination and one illness seems to offer the most protection against reinfection.

Experts are still learning about Covid-19. The information in this story is what was known or available at the time of publication, but guidance could change as scientists discover more about the virus. To keep up to date with health advice and cases in your area, visit gov.uk/coronavirus and nhs.uk

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Why is Strep A So Awful This Year?

Families across the UK have been urged to stay vigilant about Strep A symptoms this week, following a series of tragic deaths in children.

A total of 15 children have now died in the UK from Strep A since September, according to the latest figures. This includes 13 children under the age 15 in England and two others in Northern Ireland and Wales, according to data from the UK Health Security Agency (UKHSA).

Streptococcus A (Strep A – also known as Group A Strep or GAS) are a group of bacteria that can cause a wide variety of skin, soft tissue and respiratory tract infections. These include strep throat and impetigo, but the most common illness caused by Strep A is scarlet fever, which is highly infections and has been spreading across the country.

But why are infections so awful this year? And what – if anything – can parents do about it?

Why is Strep A spreading?

Less mixing due to Covid could be part of the reason why hundreds of children are being diagnosed with Strep A-related illnesses this year. When social measures were put in place, the spread of Strep A was contained. Now, children who did not catch Strep A in 2020 or 2021 are being infected.

“It strikes me that as we are seeing with flu at the moment, lack of mixing in kids may have caused a drop in population-wide immunity that could increase transmission, particularly in school age children,” microbiologist Dr Simon Clarke, from the University of Reading, told Sky news.

What are the symptoms?

The best way to protect your kids is to know the symptoms and seek treatment quickly. It’s important to remember that Strep A causes a mild illness in the majority of children that can be easily treated with antibiotics. Symptoms include:

  • red and white patches in the throat
  • trouble swallowing
  • a headache
  • lower stomach pain
  • general discomfort, uneasiness, or ill feeling
  • loss of appetite
  • nausea
  • rash

“On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel,” Duncan Reid, pharmacist at Pharmacy2U told HuffPost UK.

Additionally, the British Islamic Medical Association explained that “the rash is more obvious in the groin/armpit area. Sometimes the flushed cheeks appear as ‘sunburned’ on darker skin with whiteness near the mouth”.

“In children with darker skin tones, the rash could be harder to spot as it may not appear red, but will be darker than normal skin,“ Dr Mabs Chowdhury, president of the British Association of Dermatologists added.

“The rash in all pigment types can have a sandpapery feel. The tongue can appear redder than normal with prominent white spots (sometimes called ‘strawberry tongue’).”

Where are the infections in the country?

The latest available data shows that in England, there were 1,062 scarlet fever infection notifications received in week 48 (the week commencing November 28).

Currently, there are large concentrations of Strep A and associated scarlet fever cases in multiple parts of the UK, with the North West particularly impacted. The below data also shows incidences of invasive group A streptococcal infection (iGAS) – a rare but serious complication of Strep A, which can be life-threatening.

Number and rate per 100,000 population of scarlet fever and iGAS notifications in England: week 37 to week 48 of the 2022 to 2023 season.
Number and rate per 100,000 population of scarlet fever and iGAS notifications in England: week 37 to week 48 of the 2022 to 2023 season.

How do parents feel?

Plenty of parents are beside themselves with worry right now as strep A continues to dominate the news. On social media and in private Whatsapp groups there’s been an outpouring of worry from parents, who are understandably on edge in case they miss the signs of illness that could progress to something far worse.

“I’m personally more worried about this than I was when Covid started,” said 35-year-old Emma Hawes from Wigan.

Hawes, who has a 13-year-old and eight-year-old, told HuffPost UK: “I am extremely anxious at the moment. I had no idea what the symptoms were so I’ve obviously been reading as much as I can.”

Diana Wilkinson, 45, has two children of primary school age. She told HuffPost UK: “I’m genuinely so worried about it. Every time I see the news it’s full of warnings of Strep A, and horrifically the number of fatalities is rising.

“Our school has been great at flagging concerns and sending out information about what to look out for, but with several cases already it feels very close to home.”

Is there an antibiotics shortage?

Some pharmacists are warning of a shortage of antibiotics – which hasn’t done much to quell concerns. However, the government has repeatedly denied it.

The National Pharmacy Association explained: “Pharmacies are having to work very hard to obtain stocks of these antibiotics and some lines are temporarily unavailable.

“We have been advised by wholesalers that most lines will be replenished soon, but we cannot say exactly when that will be.”

Leyla Hannabeck, CEO of the Association of Independent Multiple Pharmacies, claimed that authorities going on broadcast rounds saying there is supply is “misleading”.

“I want to reassure the public that pharmacies are doing everything we can to get hold of antibiotics and we are pushing the government to identify where the blockage is,” Hannabeck added.

Health secretary Steve Barclay said there was a “good supply” of penicillin, and that he had been reassured by medical suppliers. However, he said some GPs may experience shortages as stock is moved around to meet demand.

“Now, sometimes, GPs can have particular surges if they’ve got a lot of demand in an area, and that’s quite routine, we can move the stock around our depots,” he told Sky News.

Will schools close?

Currently, the Department for Education (DfE) has not updated its official advice to schools, but it is directing them to guidance from the UK Health Security Agency (UKHSA).

Parents were told to keep their children at home if they suspected that their children had Strep A, in a blog published by Dfe.

Education secretary Gillian Keegan said the department was “working closely” with the UKHSA and “monitoring the situation”, adding that the situation is “worrying”.

One school in Hull temporarily closed for a “deep clean” after several Strep A cases, but at the moment, schools on the whole are not being advised to close.

How do you catch Strep A?

Duncan Reid, pharmacist at Pharmacy2U explained: “Strep A is spread through contact with droplets from an infected person when they talk, cough or sneeze.”

“Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell. It is still possible to infect others for up to three weeks.”

“Good hand and respiratory hygiene are important to top the spread of Strep A. By teaching your child how to wash their hands properly with soap for at least 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections.”

When should parents contact their GP?

  • if you suspect your child has scarlet fever
  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • your child is very tired or irritable
  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • there are pauses when your child breathes
  • your child’s skin, tongue or lips are blue
  • your child is floppy and will not wake up or stay awake.
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The Easy Ratio That’ll Make A Perfectly Healthy Kids Lunch

Packing a nutritionally balanced lunch that your kids will actually eat can sometimes feel like a crapshoot – the second you think you have your lunch game on lock, that’s the day they’ll come home with the elaborate bento box you packed them still intact.

As parents, we feel responsible for our kids’ health and that understandably translates into a lot of stress over what they’re eating or not eating.

“Your job as a parent is to offer healthy, nutritious foods as often as possible, on a consistent schedule,” said Aubrey Phelps, a functional perinatal and paediatric nutritionist. “But it’s up to your child to decide what to do with them.”

The best way to grow a happy, healthy eater is to keep offering what you’d ideally want your child to eat – and don’t take it personally if they choose not to eat it. When it comes to school lunches, Phelps recommends keeping it simple: “Focusing on specific vitamins or minerals can miss the big picture,” she said.

If you use the following macronutrient formula to pack your kids’ lunch and vary the sources of each, you’re almost guaranteed to have a healthy, balanced meal that will keep them focused and energised at school.

The Formula

50% veggies and fruit

25% lean protein and healthy fats

25% starch or whole grains

+ fluids

The ideal school lunch formula is often referred to as the plate method – a visual representation of what a well-rounded meal looks like.

“Every child needs a healthy balance of macronutrients (protein, carbs, fat) and vitamins and minerals,” Nicole Avena, a New York-based health psychologist and author of What to Feed Your Baby and Toddler told HuffPost. “The plate method helps ensure that no one nutrient is overpowering the rest.”

If your child has a lunch that’s mostly carbs or whole grains and some protein, for instance, they’ll likely feel tired in the afternoon. Carbs not only make you sleepy due to their ability to increase tryptophan and serotonin levels in the body (both of which are sleep-inducing compounds), but they can quickly raise your blood sugar, and the subsequent drop can leave you feeling tired, Avena said. Even a larger portion of protein and smaller amount of carbs can make your child sleepy.

“Proteins and fats are often more difficult to digest than carbs and nutrients that come from fruits and vegetables,” Avena said. “This can potentially lead to fatigue, since your body needs to use up more energy during digestion.”

Making sure their lunchbox contains every element of this formula means your child will consume the balance of nutrients necessary to focus and enjoy their school day without feeling sluggish.

Let’s break down the formula.

Veggies And Fruit – 50%

Try: carrot sticks, bell pepper strips, grape tomatoes, cucumber, grapes, apple slices, watermelon, berries.

The biggest portion, or half of the lunchbox, should contain 2-3 different kinds of vegetables and fruit – preferably, two vegetables and one fruit, as children’s daily intake of vegetables tends to be lower than their fruit intake, according to a 2019 review published in the American Journal of Lifestyle Medicine.

This is actually an example of what NOT to do. Don't go heavier on fruits than vegetables, since most kids tend to eat more fruits anyway.

This is actually an example of what NOT to do. Don’t go heavier on fruits than vegetables, since most kids tend to eat more fruits anyway.

“Vegetables and fruit provide antioxidants to fight off disease, including vitamin A for skin and eye health, lutein for eye protection (from blue light) and vitamin C for immunity,” said Amy Shapiro, New York City-based registered dietitian and founder of Real Nutrition.

Produce is also rich in water to keep kids hydrated, and contains fiber for sustained energy and improved digestion.

Lean Protein And Healthy Fats – 25%

Try: chicken, turkey, tofu, edamame, hard-boiled eggs, Greek yogurt, string cheese, nuts, seeds.

“Protein is the nutrient that takes the longest to digest, so having it as part of your child’s lunch will keep them full and their blood sugar stable,” Shapiro said.

Depending on the type of protein provided, it may also contain amino acids for growth and muscle repair, zinc for immunity, and iron and vitamin B12 for energy.

On to healthy fats: “Fat helps to keep you full, provides energy and allows for the bioavailability and absorption of many of the vitamins we eat through other foods,” Shapiro said. “By including fat in your child’s meals, you’ll help them stay full longer and be more energized.”

Enough fat is often cooked into your food or a part of the meal already, so it doesn’t necessarily need to be a separate addition, Shapiro said. (Eggs and nut butters, for example, offer a one-two punch of protein and healthy fats.)

Starch Or Whole Grains – 25%

Try: whole grain bread, cereal, granola, brown rice, quinoa, crackers, air-popped popcorn.

“Carbohydrates are broken down into sugar in the body, providing energy for immediate use and reserves for later use,” Shapiro said. “Ideally, whole grains or whole wheat should be included, as they’re rich in nutrients, digest more slowly and are high in fiber to aid in balanced blood sugar and digestion.”

They also contain B vitamins, which are important for energy and metabolism.

But if your child isn’t the biggest fan of whole grains, don’t fret: “Vegetables and fruits also fit into the carbohydrate category, so you don’t always have to think about bread or grains if your child doesn’t like them,” Shapiro said.

Starchy vegetables and fruit include carrots, corn, potatoes, winter squash and bananas.

Fluids

Even just mild dehydration can cause a decline in cognitive function.

“Being dehydrated can affect reaction time, attention, memory and reasoning,” Avena said. “Children are potentially more at risk of dehydration because they’re more likely to be dependent on someone else for their fluid intake.”

Send your child to school with a large water bottle so they get enough fluids during the school day — and remind them to keep it at their desk.

“Out of sight equals out of mind,” Phelps said. “I also recommend a water bottle that’ll keep the water cold or room temp (however your child prefers) so they don’t get turned off by drinking warm water.”

It doesn’t have to be plain water, either: They might prefer fruit-infused, coconut or sparkling, or a different liquid entirely, like milk or 100% fruit or vegetable juice.

“If your kid really struggles to drink enough, consider sending hydrating foods,” Phelps said. “Soups, smoothies, juicy fruits like grapes and melon, bell peppers, even yogurt, are all hydrating options that can help keep kids on track.”

The easiest way to measure out lunchbox portions

Children are intuitive eaters – they’ll eat when they’re hungry and stop when they’re full, with the amount of lunch they eat fluctuating day-to-day – so there’s really no such thing as perfect portions to pack.

The easiest way to ensure you’re in the ballpark? Use your child’s hands as your guide.

Think of your child’s hands as a plate – palms up, pinkies together. Half of their “plate” (or one hand) should be veggies and fruits. The palm of the other hand protein, and fingers complex carbs.

“Using this method, the amounts needed change as your child grows (and so will their needed portion sizes),” Phelps said.

She’s also a fan of the bento box-style lunch containers, which are already sectioned off into child-friendly portions. You can fill one section with vegetables and fruit, one with protein and healthy fats and one with starch or whole grains sans guesswork. These ratios don’t necessarily need to be tweaked if your child has specific dietary needs.

“Appropriate substitutions are needed to ensure they have a filling and nourishing meal, regardless of the nutrition modifications that are needed,” Maya Feller, a Brooklyn-based registered dietitian, told HuffPost. The overall rule of thumb, however, generally stays the same.

Ratios and formulas should only be used as a guideline, not a hard rule, because children themselves should dictate how much they need to eat.

“If parents find their child is consistently eating 100% of foods packed throughout the day, it could be a sign they’re going through critical stages of development and require more energy,” Feller said.

It’s also important to keep in mind this is one meal out of their entire day — so if a lunchbox comes home practically full, it’s not game over. “We want to look at nutrition over the course of the day, not one meal,” Shapiro said.

When in doubt, you can check in with your kids: Ask how lunch was and make food and portion modifications based on the feedback given.

Remember: nutrition is cumulative

View your child’s nutrition over the course of a week, not a day – or a meal. “They’ll get what they need over time,” Shapiro said. “Some days are great and some days are off and it all balances out.”

The most important thing a parent can do is create a good relationship with food. That’s more important than creating the perfect lunch.

“Kids tend to be more black and white thinkers, so I don’t recommend focusing on ‘healthy’ or ‘unhealthy’ or ‘fun’ foods,” said Krystyn Parks, a California-based paediatric registered dietitian. “All food is food. All foods have a purpose.”

Perfection isn’t the goal – setting routines that work for you and your child are.

“Find your own routine, get your kids involved in the choices and don’t measure yourself against another person,” Feller said. “No one day – or meal – is going to be perfect in terms of nutrition.”

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Is It Covid Or A Back-To-School Bug? Here’s When To Keep Your Kids Off

The start of the school term often brings snot, coughs and dodgy tummies. But the last 18 months has taught us all to be hyper-vigilant about health, so we’re looking at back-to-school bugs a little differently.

Previously, we may have sent children into the classroom with a mild sniffle, but now, with Covid still a factor, parents may be wondering whether to keep kids home. We’ve also been warned that cases of norovirus are likely to spike this September, just to add fuel to the fire.

But why do kids get poorly at the start of term anyway? And when they’ve already missed so much school last year, when’s the correct time to keep them off? Dr Sameer Sanghvi, who’s clinical technology lead at Lloyds Pharmacy Online Doctor, answered our questions.

Why do kids get ill at the start of the school term?

“Often children (and teachers) get ill at the start of term because they’re suddenly exposed to lots of people, after a summer often spent mainly with a small number of family and friends,” says Dr Sanghvi.

“The more people you mix with, the more likely you are to catch and spread germs off one another. And we all know children, even after the last year, aren’t quite as good as adults at good hygiene practices like washing their hands thoroughly, covering their faces when they cough and blowing their noses etc.”

The start of term can also be very tiring, especially for young children, who aren’t as used to being sat in a classroom all day.

“When we get tired our immune systems sometimes find it harder to fight off bugs. So this can also mean kids (and anyone who works in a school) might be more susceptible to picking something up,” Dr Sanghvi explains.

“Coughs, colds and norovirus can all be very contagious, particularly in an environment like a school, where you have lots of people in one room for long periods of time.”

What are the most common symptoms of Covid in kids?

By now, we all know the importance of self-isolating if you’ve got Covid. But kids get a lot of sniffles at school, so how can you tell the difference?

“Like with adults, the main symptoms of Covid-19 in children are still a high temperature, a new, continuous cough and a loss or change of taste or smell,” says Dr Sanghvi.

“With the start of term it’s likely lots of kids will get a cough, cold or runny nose. But if you think your child has Covid-19 symptoms, you should book them a test. That’s the easiest way to confirm if it is or isn’t Covid-19.”

If it’s not Covid, is it okay to go to school?

“It can be hard knowing when to keep a child off school. Sometimes it’s okay to send them in with a mild illness, but other times it better to keep them at home,” says Dr Sanghvi.

“If your child has Covid-19 symptoms, you should get them a test and keep them off school unless they get a negative result.

“Generally speaking, if your child has a fever, they should be off school until it’s gone (unless it’s due to Covid-19, in which case they’ll need to self-isolate and follow the advice from Test and Trace).”

As a rule, if your child has been sick or has diarrhoea, they should be off school for 48 hours from the last time they vomited or had diarrhoea, she adds.

“The NHS has lots of advice for different conditions like cold sores, chicken pox, impetigo and many others, and when to keep your kids off school,” says Dr Sanghvi. “So it’s always best checking their website, and don’t forget if you’re worried about your child, you can always ring up your GP and speak to them.”

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Help, My Kid Is A ‘Whiteatarian’ Who Only Eats Beige Food

It was parents’ weekend at my daughter’s college, and we were treating her to dinner at an off-campus bistro. The waitress arrived, and she gave her order: “I’ll have the baked salmon with a side of sauteed spinach, please.”

I dropped my menu, my jaw and the mistaken notion that I knew what this kid had been up to since we’d dropped her off a couple of months ago. I had spent most of the past 18 years trying to nudge her – sometimes gently, sometimes with growing desperation º into eating something, anything, other than noodles with butter and salt, half a bagel with plain cream cheese or – her true love –Rold Gold Tiny Twist pretzels.

The idea of fish had always made her shudder. The mere mention of “green things” like spinach could lead to tears. So what was up with her dinner order tonight? She shrugged. “They serve salmon in the dining hall sometimes, and my friends all eat it. Everybody at school likes spinach, too.”

I feigned disinterest and changed the subject, but inside I was doing the parental equivalent of a victory dance. I had relinquished my title as mother of the world’s most adamant whiteatarian, all for the low, low cost of tuition at a liberal arts college that was 1,000 miles away from home.

Your kid is hardwired to act like this

Before I do any more gloating about the sight of my beloved progeny actually putting spinach in her mouth, let’s take a step back to those early years, when I was driven to frustration by a girl who refused anything that wasn’t white. What made her act that way, anyhow?

Well, mums and dads, you already know that children are annoying for lots of reasons, including a tendency toward tantrums, a love of pre-dawn wake-up times and, of course, picky eating. Would it help if I told you that their eating preferences are pretty much hard-wired into their sweet-smelling little noggins?

Look familiar?

Look familiar?

The National Institutes of Health says infants have an “innate preference for sweet and salty tastes and tend to reject sour and bitter tastes.”

And, guess what, it gets worse. “After the age of one, vegetables begin to taste very bitter to children,” Alisha Grogan, a paediatric occupational therapist who specialises in picky eating and sensory processing, tells HuffPost.

“When humans had to forage in the wild, children’s sensitive taste buds prevented them from eating anything poisonous.”

Some kids remain loyal passengers of the S.S. Sweet And Salty even as they get older, often to the exclusion of any food that might actually provide, you know, some nourishment. A range of different studies have reported that, by the time they reach age 3, between 6% and 50% of kids are described as picky eaters by their parents.

And if you think they’re doing this just to piss you off, you’re right, at least when it comes to the younger set. “Toddlerhood is when many kids start to exert their autonomy and push boundaries with parents,” paediatrician Dina Kulik tells HuffPost. Not only do they get to remind you who’s boss, they also literally make themselves happy with each bland, beige bite. “Simple sugars are easy to eat, they taste good and they provide a quick dopamine hit, much like other stimulating drugs,” she says.

Can your kid live on beige food alone?

Is a diet of pasta and bread sustainable for health? Kulik said there are concerns. “The risk of iron deficiency, especially, is high on a very starchy diet,” she says. Even though many manufactured grain-based products are supplemented, she said, kids following the whiteatarian plan are often low in iron, vitamin D, calcium and B12.

Think this bagel with cream cheese looks plain enough? Think again – those sesame seeds could even be too much for a picky eater.

Think this bagel with cream cheese looks plain enough? Think again – those sesame seeds could even be too much for a picky eater.

In the short term, anyway, the nutritional prognosis is not totally dire. One study said that, while picky eaters did tend to have lower levels of zinc and iron, their overall macronutrient intakes were not severely reduced. And many of us know at least one adult who still lives on a mostly white diet and seems to survive, if not thrive.

“Many kids can survive on white carbs alone, as long as they’re eating enough of them,” Grogan says. “Carbs often are fortified with all sorts of vitamins and nutrition. However, depending on how limited a child’s diet is, they could have some nutritional deficiencies.”

The only thing you have to fear

In the comedy special John Mulaney & the Sack Lunch Bunch, a boy named Orson Hong sings an ode in which he declares that “a plain plate of noodles with a little bit of butter is the only thing I’ll eat.” His heartfelt song is more a lament than an homage, and it’s clear that his character is anxious and fearful about ingesting anything but this classic whiteatarian meal.

Fear is a big part of what’s going on, said Amanda Smith, a programme director at Walden Behavioral Care, and it’s important for both kids and parents to acknowledge that. “Some kids might be afraid of different textures, or they might fear that a food will make them choke or vomit,” she tells HuffPost. “It can be overwhelming, scary and hard, so it’s important for parents to try to understand that.”

“Short-order cooking and pressuring a child to eat during meals can lengthen the time a child is selective about what colour foods they’ll eat.”

– Alisha Grogan, paediatric occupational therapist

Keep in mind that once they’ve passed toddlerhood, this eating pattern is about them, not you. “If an older child is still eating only white foods, they aren’t trying to punish their parents or stress them out,” Grogan says. “Eating is hard for them. One way to help is to neutralise the topic, and to avoid labelling foods as good and bad or healthy and not healthy.”

Here’s what you can do

“I suggest not fighting or negotiating,” Kulik says. She suggested an attitude of: “Here’s the plate of food. If you want it, great.” Then, she advises, “If not, don’t start a battle. There is evidence kids need to try a food more than a dozen times to realise they like it. When you simply give in and offer the carbs, they don’t learn to try anything new, and the fear and pickiness persist.”

“Short-order cooking and pressuring a child to eat during meals can lengthen the time a child is selective about what colour foods they’ll eat,” Grogan adds.

In extreme cases, a child might have what’s known as Avoidant/Restrictive Food Intake Disorder or ARFID. The disorder, Kulik explains, is characterised by “very selective eating habits or disturbed feeding patterns.”

She cites estimates that anywhere between 5% and 14% of children in inpatient eating disorder programs, and up to 22% of children in outpatient programs, have the disorder. “It’s important to note that this is a true mental disorder, and the vast majority of kids who are whiteatarians don’t have it,” she says.

Don't forget about tan foods, the close cousin to white foods.

Don’t forget about tan foods, the close cousin to white foods.

“If you have concerns, start with a visit to your child’s medical provider,” Smith suggests. “They’ll be able to assess any medical factors that could be playing a role, and they can check your child’s growth progress, weight and vital signs, and then run some lab work.”

You’ll also want to pay attention to patterns that develop at mealtimes. “If kids are having emotional tantrums or breakdowns over new foods being near them or on their plate, or if they’re gagging or throwing up when new or other-colored foods are near them, then it could be something more serious,” Grogan says.

“If your child is limiting intake to fewer than 20 foods, or you’re noticing physical symptoms relating to their diet, consulting with a health practitioner is advised,” says Sarah Appleford, a registered clinical nutritionist with an interest in children’s health, including fussy eating and gut issues.

“It’s more than just a phase if they’re refusing food at most meals, exhibiting anxiety or stress, have undeveloped eating skills or sensitivities based on texture, colour, appearance, noise or smell at the table and away from the table. Physical symptoms can include slow growth, fatigue, pallor of the skin or complaints of tummy pain or gastrointestinal upset such as constipation.”

Look to the rainbow

Along with every other awful thing, this issue is on the rise, according to the experts. “We’re seeing a growing number of kids with anxiety disorders, and extreme fussy eating behaviour is often a component,” Appleford says. But there is some good news, she adds: “Most children will naturally grow out of fussy eating as they gain more skills and confidence around food.”

“Parents can find it to be very stressful to have a child who only eats white foods, because it’s difficult to go to parties or even pack a lunch,” Grogan says. “But kids — even the pickiest — can learn to eat a variety of different coloured foods.”

In the meantime, listen to the experts and try to cut yourself (and your child) a little bit of slack. You might also want to start saving for that liberal arts college experience that will liberate their taste buds and turn them into rainbowtarians, just a few long years from now.

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Will My Child Get The Covid Vaccine? A Guide For Parents

The vaccine programme has been rolled out to more children across the UK, but it’s not open to all under 18s just yet.

Health secretary Sajid Javid said that he has asked the NHS to prepare to vaccinate the newly eligible groups “as soon as possible”. Here’s what you need to know as a parent or guardian.

Can my child get the vaccine?

Under previous advice, teens aged 16 to 17 with underlying health conditions which put them at higher risk of serious Covid should have already been offered a jab. The latest announcement extends the vaccine rollout to more vulnerable children.

Vulnerable children between the ages of 12 and 15 will now be offered a Covid vaccine. Those who’ll be offered a jab include children with severe neurodisabilities, Down’s syndrome, immunosuppression and multiple or severe learning disabilities.

The vaccine will also be offered to 17-year-olds who are within three months of their 18th birthday.

The Joint Committee on Vaccination and Immunisation (JCVI) has also recommended that children and young people aged 12 to 17 who live with an immunosuppressed person be offered the vaccine, to indirectly protect their immunosuppressed household contacts.

What vaccine will vulnerable children get?

The medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has already approved the Pfizer/BioNTech vaccine for use among children aged 12 and over in the UK, so it is likely this is the vaccine they will receive.

Why is there caution about the vaccine for kids?

The government has said it will continue to review whether or not to offer the vaccine to all under 18s.

The caution is due to a lack of available trial data, says Helen Bedford, Professor of Children’s Health at UCL. There’s also a careful balancing act between the benefits of the vaccine vs any potential negative impacts on kids.

“Healthy young people and children become seriously ill with COVID-19 extremely rarely, so there would be few direct benefits for them of vaccination but it would contribute to increasing population immunity,” she explains. “Before recommending vaccination for all children and young people we therefore need to be very clear about of the safety of the vaccines in this group.

“Although there is now good trial data and experience of vaccinating very large numbers of adults and the vaccines have been shown to be safe, we cannot automatically assume this applies to children. More information is needed from trials and experience of using these vaccines in young people and children before the programme is rolled out further.”

What are other countries doing?

Nearly half of European countries have decided to offer the vaccine to children aged 12 and over, including France, Spain, Italy and Austria. Some vaccination programmes have started, while others are imminent, with plans to vaccinate children before the new school term in September widespread.

What about long Covid?

While children are less likely to suffer severe illness from coronavirus, they aren’t untouchable. Hundreds of children in the UK are struggling with long Covid months after becoming sick.

In rare instances, some children have developed a multi-system inflammatory syndrome linked to Covid-19 which can lead to organ damage. Scientists will consider this when continuing to weigh up the pros and cons of vaccines.

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I’m From Alabama, And Gave Birth To My Rapist’s Child Because I Couldn’t Get An Abortion

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