Children's Health | Conditions, treatments and advice

Transcript

Who are you?

Hi, I am Dr. Zoe Williams. I'm a GP, author,

podcaster and media medic,

and I would love for you to come and ask me your questions about your preteens

and teenagers, whether that is in relation to their physical health,

their emotional health, their social health, or their sexual health.

What are the stages of female puberty?

So in girls puberty tends to start between the ages of 8 and

13.

And puberty is the female body transitioning from being a girl

to being a woman.

And the first changes are a rapid increase in the production

of the main female sex hormone, which is called oestrogen.

The first sign that most girls will realise is breast buds.

So this is when underneath the nipple, some tissue starts to grow.

So it can feel like a swelling, a thickening, or a bit lumpy,

and it can be a bit tender, and it actually tends to happen on one side first,

closely followed by the other. So don't be alarmed if that happens to you.

Other changes that then come along are growing body hair in places where you

might not have noticed it before.

So in the pubic region and the armpits and the hair on the arms and legs as

well, it's always been there, but it tends to get thicker and darker,

and there were lots of other changes as well in response to this oestrogen.

So it stimulates the oil glands in the skin.

It makes the skin more oily,

and this can make it more likely for you to get spots and pimples or even

acne, and that's really common. Lots of people throughout puberty get acne.

It's completely normal, but there are lots of things you can do to treat it,

and it's actually important for the skin to have that extra oil because one of

the big changes is that you start growing rapidly, so you get a lot taller,

but also you lay down body fat, particularly around the breasts,

around the hips, maybe the thighs, and that's completely normal as well.

Your hips also get a bit wider,

and this is all your body preparing in the future to be able

to carry babies and give birth to babies,

even if that's something you decide you don't want to do later on,

your body's still making those preparations, so it's completely normal.

But some people tend to lay down more body fat than others,

so sometimes you have friends that don't seem to be gaining weight and some

people gaining weight more. It's all normal, don't worry about it.

Other changes, obviously,

you start to have your menstrual cycle start to have periods,

and that usually kicks in about two years after the breast

buds, so after the first signs of puberty. And the normal ages therefore,

the normal age range for periods starting is between 10 and 15.

It does happen to some people younger than that and some people older.

But if you're under the age of 10 or over the age of 15,

it is worth speaking to your doctor just to make sure that everything's okay.

Other changes, oh, what else is the body odour as well?

So the sweat glands that are in the armpits and the pubic region,

even your feet, you might notice that your sweat starts to smell,

and that's because we have sweat glands all over our body. But in these regions,

the sweat glands are different. They're called apocrine sweat glands, and

rather than just secreting sweat, that is salty water,

there's also oil in the sweat. And that oil provides food for bacteria,

and it's the bacteria that causes the smell.

So it's really important when you start to notice that,

that you're washing every day and you're changing your clothes every day as

well. So there's lots of changes, and I think the more you know about them,

the more you can prepare for them, you know that they're normal,

you're not going to be frightened by them and look forward to it because

puberty, whilst it can be challenging,

it's also a really exciting time in your life.

Is puberty weight gain normal?

It is completely normal to gain weight during

puberty. In fact, you should be gaining weight during puberty. Two reasons.

The first one, obviously you're growing taller,

so you're going to get heavier because of that,

but also it's normal for your body to start laying down more fat tissue,

especially around the breasts, around the hips, the thighs.

And you might notice that your hips get wider as well.

It's important for your body to have a certain amount of fat tissue in order to

have your menstrual cycle every month,

and your body is preparing for you to potentially one day if

you choose to, be able to carry babies and give birth.

So these changes are completely normal. However,

what you might notice is that some people tend to lay down more fat tissue

than others. We're all different, and it's largely based on our genetics.

So for example,

I was really skinny until about the age of 18,

and my friends were getting boobs and I wasn't,

and I think I wanted more boobs,

but then I had other friends who had bigger boobs who didn't want such big

boobs. And we can have this tendency to not really want what we've been given,

but we don't have a lot of control over it.

What is really important is that we try and be as healthy as we can,

and our health is not determined completely by

our body weight. We can have a larger body and be very, very healthy.

We can have a slimmer body and be less healthy. So for example,

you might have somebody who's going through puberty and they've gained

quite a lot of weight. They've got quite big boobs, quite wide hips,

and they've put some weight on their thighs,

but actually they eat loads of fruit and vegetables and they're really active

and they walk to school and back every day and they get really good sleep

and they have really good relationships with their friends and they're generally

happy. That person, despite having a bigger body, is generally healthy.

You might have somebody who's very slim,

but they don't do any exercise and they eat a lot of junk food and they don't

get enough sleep, and there are things in their life that make them stress,

which they may not have control over, but they might. If you round it up,

that person's likely to be less healthy. So I think body weight,

we put so much emphasis as a society on body weight, and of course,

being very, very underweight or very, very overweight can impact our health.

But gaining weight during puberty is normal. Don't stress about it.

Just stress about the things you can control,

like eating loads of fruit and vegetables, being regularly active,

trying to get good rest,

and thinking about the relationships you have and trying to make your life as

stress-free as possible.

How can I talk to my daughter about puberty and periods?

The best way to talk to your daughter about periods or

anything relating to her body or anything relating to puberty is

to firstly just do it.

Do it as openly and honestly as you can.

Try and make it not a big deal.

And actually to start doing it from a young age,

ideally years before it happens. So

before the age of eight, which is when for the youngest girls,

puberty tends to kick in. In fact,

if you are somebody who's having periods yourself,

talk to her about your periods from a young age, normalise it. That way

the more we can remove the stigma or embarrassment,

and the more we can not make it a big deal,

the easier she's going to find it to have those types of conversations with you

when the time comes and the more prepared she'll be as well.

So having discussed what a period is, a menstrual cycle,

it comes roughly once a month and you lose a small amount of blood

and tissue from the lining of the womb, the lining of the uterus,

which comes out of the vagina. It can seem like a lot of blood,

but for most it's only one to five tablespoons. But it can seem a lot more,

have a conversation about the different types of period products that are out

there. Get her some pads. Let her play around with them, tampons,

let her see what they're like.

Talk about things like menstrual cups and period underwear.

And I think an example,

some girls worry that they might not be able to go swimming when they have

their period, but actually they can.

And there are now swimsuits that you can get that've got inbuilt period

protections.

So I think the question about how do you have the conversation doesn't really

matter too much, openly and honestly,

but the most important thing is that you do it.

How can I talk to my son/siblings about their sisters' puberty and periods?

When it comes to puberty and periods and body changes,

it's not information that just girls should have.

It's something that ideally everybody should know about because then we're all

in this together, and whether you are a boy or a girl,

you will know and love somebody who is going to have periods.

So I think in an ideal world,

this will be something that the whole family will be able to talk about together

and discuss. But obviously if your daughter is having periods,

she might not want everybody else to know about it.

She might want to keep it more private,

and I think that should be respected as well.

So I think this will vary from family to family.

And depending on your daughter's preferences,

she might not want everyone to know at the time she has her period.

But I certainly think it's important that other members of the household

understand what periods are, understand what period products are.

I have a two year old son,

and he already knows that the tampons in our house are for mummy and that they

go in the bathroom. And when he tries to unwrap them and play with them,

I tell him, no, they're for mummy,

they're for me because I have a period and I'll never stop telling him that.

So there should never be a point at which I need to inform him,

because he'll just always know that will be my approach.

But I think perhaps thinking about my brother,

did my brother always know that tampons were, I think he did actually,

because she used to send him to the shop to buy them.

So I think there shouldn't be any stigma. It shouldn't be embarrassing.

There shouldn't be any shame,

so therefore we should be able to talk about this stuff.

In the same way we might talk about having hay fever or having an earache.

There shouldn't be any more stigma,

but I think perhaps many of us as adults have grown up in a world where there

has been. So it's time to start changing that,

and we're the ones who are, as parents, empowered to do that.

So whether the family members are young, old, male,

female,

the more we can talk about it openly and honestly,

the better it'll be for everybody.

When will my daughter start her period?

So most girls start their periods between the age of 10

and 15, and the average age is 12.

But some girls do start at younger than 10,

and for some girls it is later than 15. But what I would recommend actually,

is if your daughter reaches the age

of 15 and hasn't had any periods so far,

then it's worth just checking with a doctor. Likewise,

if she's eight or younger and getting her first period,

it's worth just letting your GP know.

What are the different phases of the menstrual cycle?

There are four different phases of the menstrual cycle and I think we often tend

to get bogged down with the first one, which is when you have your period,

and we don't talk much about the other three,

so let's break them down and talk about all four.

So the first phase is the menstrual phase,

and this starts when you start with the first day of your period.

And this tends to last between two and eight days. So you're bleeding,

you're having your period,

and I think each phase has its sort of superpowers,

but also its downsides. So in the menstrual phase we tend to be a bit delicate.

We may have some symptoms of the period itself, so some cramps,

but also we tend to have a lower pain threshold generally.

So we might have been more likely to have headaches, feel tired,

feel a bit run down. Some people get diarrhoea as well,

and that's because the chemicals that are stimulating your womb to contract so

that you can bleed can also stimulate your bowel.

So sometimes people get period poos. So those are some of the downsides,

but it can also be a time when we can be quite focused and good at

concentrating. So it can be a good time to take it a bit more easy physically,

but get schoolwork done, get that big project done,

a really good time for planning and organising.

And whilst you might not feel like going out and going hell for leather with

exercise, doing some exercise can actually make you feel better.

So whether it's going for a walk, doing some yoga or whatever,

and if you do feel like you want to go out and go sprinting, you feel up for it,

then for some people that makes them feel good as well.

The next phase is the ovulation phase,

and this is when oestrogen,

the hormone oestrogen elevates and goes up.

And that can make us feel really good. It can give us a boost of energy.

We tend to have a higher pain threshold.

And for people out there who are athletes and competing,

this is the time when you might be most likely to get a personal best.

It's a good time to do strength training if that's something that you do.

And it's a really good time to socialise as well because you tend to be in quite

a good mood. The next phase is called the luteal phase,

and this is when the other sex hormone progesterone tends to be higher

and progesterone's quite a calming hormone. So this is a good time.

Say for example, I don't know,

you've got to give a presentation or present a project.

You might feel calmer and more able to do that.

It's also a really good time to have any difficult conversations that you might

want to have with friends or with your parents because you're a bit

calmer and maybe more rational. But you might be more hungry,

that's completely normal. You might enjoy more long distance sports,

so cross country,

that type of thing.

We tend to be better at endurance in this phase and sometimes sleep can be

a little bit disrupted.

And then the fourth phase is the premenstrual phase.

This comes before your period and you might have heard of terms like PMS,

which is premenstrual syndrome or PMT premenstrual

tension.

So this is when we're most likely to have the sort of side effects

that come with declining hormones. So it can be your breasts feel sore,

you might feel moody and irritable. You might have a short fuse,

you might have a bit of sleep disruption, food cravings,

all of those types of things. So this is really a time for self-care.

Make sure you have a nice warm bath, some time to yourself.

Whatever makes you feel good,

you might want to indulge in some sort of comfort foods. It's absolutely fine.

It is really a time to focus on looking after yourself. And again,

when it comes to exercise,

then you might find that exercise makes you feel really, really good,

or you might find that it makes you feel more tired.

But doing some exercise is definitely a benefit.

So I think the key message here is we tend to think a lot about our period,

which is the first phase,

but if we understand the rhythm of ourselves and keeping something like a period

or a menstrual cycle diary and thinking, oh,

actually that week before my period I tend to feel like this and the week after,

I tend to feel like this. Whilst you can't change your hormones,

you can change your diary and your social events to get the best

out of the way that your hormones are behaving.

What are the most common period side effects?

So when we have our period,

obviously we're losing some blood and some tissue from the lining of the

womb through the vagina. So there's the bleeding itself,

which can be a real inconvenience because you need to think about what period

products you're going to use.

Sometimes girls will just be worrying at the back of their mind.

What if I bleed through? But there are some physical side effects as well.

So the commonest one would be cramps,

crampy pains from the womb actually contracting.

Some people also get a change of their bowel habits,

so there's such a thing as a period poo because the same chemicals

in the system that are getting the womb to contract can have a similar effect

on the bowel.

So some people might get diarrhoea looser stools or be going to the toilet more

often. Some people have breast tenderness, headaches,

and generally at that time in our cycle we

are likely to have a lower pain threshold. So anything else that's going on,

a bit of joint pain, muscle pain, we might be more sensitive to it.

So those are sort of the common physical side effects.

Then there are the more emotional side effects as well.

So we might be more irritable,

feeling tired and a bit drained.

And that's why I think it's really important that as individuals we sort of

understand how we feel when we have our period and know when it's coming

so that we can put in place whatever we need to make it feel a little bit more

comfortable.

So if you do have quite painful periods and painkillers like paracetamol and

ibuprofen help, the sooner you start taking them,

as soon as the pain comes on, the better they work.

And rather than waiting for the pain to get really bad before you take another

dose, if it's safe to take another dose, then do so.

So trying to keep on top of the pain,

making sure you've got your sanitary pads or menstrual cup or tampons,

whatever you use, making sure you've got that to hand.

You've got spares in your school bag and sometimes it might be taking

some spare underwear in your bag or always having a sweatshirt or something that

you can wrap around yourself in an emergency if you do leak through.

So whilst these side effects are normal, actually,

if you are having very heavy bleeding, so say for example,

you're needing to change your sanitary protection every one or two hours,

or you're needing to use two different types or you're having to get up during

the night, that means that you're having very heavy periods,

or if it's stopping you from going to school or being able to do your exercise

or do the things you want to do, then it is worth seeing your GP. Similarly,

if you're having painful periods that aren't managed with over the counter pain

relief, and again,

the pain is stopping you from living life and doing your normal

activities,

then there are things that can be done to help settle that and control that.

So it's really important that have a chat with your parent or caregiver

and go and see your GP.

And if you want to go and see your GP without your parent or caregiver,

you are allowed to do that as well.

Is there a way to make periods easier?

There are lots of ways that we can approach making periods easier.

The things that are most bothersome about periods are the pain,

the bleeding itself,

and then also how your period can make you feel emotionally.

So let's break it down. So period pain is really, really common.

There are lots of things that we can do to alleviate pain.

So painkillers are really helpful.

Things like paracetamol and ibuprofen that you can just buy over the counter can

alleviate pain,

but they're most effective if you take them as soon as the pain starts and try

and keep on top of the pain.

Don't wait for it to get unbearable before you take them.

Try and keep on top of it.

There were lots of other things that can help as well.

Things like hot water bottles or heat pads,

ginger and chamomile tea, even dark chocolate.

A small amount of dark chocolate has been shown to help alleviate some of the

muscle cramps as well. And obviously it's delicious.

Or a warm bath, so whatever it takes.

But if your pain is not managed by those things and it's stopping you from

living a normal active life, then please do see your GP

as there are other things as well.

The bleeding itself can be a real nuisance because you've got to think about

having your period products and there's always that risk.

It's always at the back of our mind,

what if we bleed through into our underwear or even into our clothes or onto our

bedsheets? So being prepared,

knowing when your period is coming can make your period easier.

Making sure you've got access to,

whether it is pads or menstrual cups or tampons, whatever you use,

make sure you've got some in your school bag or your work bag

and making sure that you've got spare underwear and maybe even something like

a hoodie. Carry it with you. So if the worst case scenario does happen,

you can tie something around your waist.

So being prepared and that can just alleviate the general anxiety of if

something like that happens.

The third one is how it can affect us emotionally.

When we have our periods, we might feel tired,

but we might also be more irritable or a bit lower in mood.

So knowing that,

preparing for that and whatever it is that makes you feel better,

sort of self-care,

making sure that you take time to do that and letting people around as well.

So letting your friends or your family know, say my period's due in a couple of days,

so you know I tend to get a bit ratty. Don't take it personally.

That can be really helpful because if people around you know, well, one,

they won't take it personally,

but they might just be a bit kinder to you and that could make all the

difference. So I think preparation is key.

Keeping a log of when your period comes,

getting to understand the rhythm and preparing in those ways can

really help getting through your period much easier.

I have irregular periods, is this normal?

When we say irregular periods, there are kind of two meanings to that.

The first one being that the length between each period tends to change.

So we tend to say that a normal menstrual cycle length on average is about a

month, about 28 days,

but anything between 21 and 40 days is normal.

So one meaning would be that one cycle might be 28 days,

the next one might be 32 days, and it might keep changing.

Now whilst that's a nuisance because you might not know when your period is

coming, it's not concerning medically in any way.

And actually for the first two years of periods from when your periods first

start,

it's completely normal for them to be irregular and then they tend to get more

steady. The other meaning of irregular periods is missed periods,

and whilst missing one period every now and again is not

too concerning,

if you are regularly missing periods or you're missing a number of periods back

to back, then it is worth checking that out with your GP.

There can be a number of reasons if there's been significant weight loss,

significant weight gain,

if people are excessively exercising or if there's a hormone

imbalance, something like polycystic ovarian syndrome,

or even issues with the thyroid gland, which is a gland in the neck.

There can be a number of reasons.

So I think consistently missing periods is worth getting it checked.

Is it normal to miss a period?

Sometimes people do just miss a period and then

things go back to normal. That's not concerning.

You don't need to do anything about it. I think generally,

if you've missed a period, if you're sexually active,

then the one important thing to do is a pregnancy test,

because that's one of the commonest reasons why people miss periods.

But sometimes people just randomly miss a period.

It could be if they've had a particularly stressful event.

Sometimes it just happens and we never find a reason why.

So if it's one missed period and you've done a pregnancy test and it's negative,

or if you're not sexually active, don't worry about it.

But then if you're missing more periods after that,

then it's worth seeing your GP and getting it checked out.

There can be a number of reasons for lots of missed periods,

such as rapid weight loss or rapid weight gain.

Some people, if they're exercising excessively,

it could be if you've had a very stressful period or you've been unwell,

or it could be something like polycystic ovarian syndrome or a problem with

your thyroid gland. So it's definitely worth not panicking,

but getting it checked out by your GP.

How can I help my daughter with painful periods?

Period pains are the commonest symptom that people

complain about that's disruptive when they have their periods,

I think especially in younger girls as well.

And it's caused by the uterus, the womb contracting, which is normal,

and that's what it's supposed to do to enable the lining of the womb along with

that blood to shed and have the period.

Now painkillers can be really, really effective.

So things like paracetamol, ibuprofen,

my biggest tip is to not wait until the pain is unbearable and then take

painkillers. In fact,

the sooner you can take the painkillers as soon as those cramps first start,

the more effective they are and then trying to keep on top of the pain rather

than waiting for it to get really bad.

So if that means taking both paracetamol and ibuprofen, that's absolutely fine.

The pain tends to be in the lower tummy,

but it can also be in the back and it can also be in the legs.

That's completely normal. Other things that you can do,

things like hot water bottle or heat pads, can really help alleviate pain.

Hot drinks, ginger tea, chamomile tea, baths,

even hot chocolate or a small amount of dark chocolate, chocolate's been

shown to help alleviate some of the cramping, and exercise as well.

We all feel different when we have our period.

Some people feel that they want to exercise and some people don't,

but some gentle exercise,

like just going for a walk with her maybe can really help get the blood flowing

to that area, which can help alleviate some of the cramping.

So hopefully those are some helpful tips that will help you and your daughter.

What sanitary products are available and what's the difference?

There are a number of different sanitary products that are out there and

available.

The ones that I think are best known are sanitary pads and

tampons, but also now we have menstrual cups.

We have period underwear and also washable sanitary pads

as well. I think when girls are first starting their periods,

then sanitary pads are usually a bit of a go-to because it's something that's

really easy to use and you can start using it straight away.

Things like menstrual cups and tampons might take a bit of practice and getting

used to, and of course you can use those along with the pad as well,

if you want extra reassurance. Especially with a menstrual cup,

first time using it, if you're not sure that it's inserted properly,

then you can use a pad as well.

I think things that are becoming more and more popular now,

especially considering the environment alongside menstrual cups

are washable sanitary pads and period underwear,

so that's knickers,

and even things like swimsuits that have absorbent panels built

into them. So these are really great.

Whilst they might be more expensive to buy, initially, you reuse them,

so it does pay off eventually and better for the environment,

and I think young people are more conscious perhaps than their parents.

We're getting more and more conscious about their environment.

I think something else to consider,

young people worry about swimming when they have their period,

but they can go swimming when they have their period. In fact,

if they're using a tampon, that's absolutely fine to use while swimming.

And there are swimsuits available, which I think is brilliant,

which have inbuilt sanitary protection. So if the period's very, very heavy,

then on that day, often the first or the second day of the period,

it might not be the best day to go swimming,

but you can go swimming on your period.

When should I consider buying my daughter a bra?

The right time to consider buying your daughter a bra is either

when she asks you about it,

and she might be interested in exploring trying on bras or crop tops

before she's even developed her breast buds,

or the other time might be for you to raise it with her.

If you notice that she's developing in that area and you think that she might

benefit from wearing some supportive underwear to support her breasts.

Typically one of the first signs of puberty and often the first sign in girls

is breast buds developing.

So that's thickening of the tissue underneath the nipple.

Sometimes feels like a lump and it can be a little bit tender.

So this is the first sign of breast development and I think a good time really

to start exploring crop tops, starter bras, or bras with your daughter.

When do breasts stop growing?

So breasts tend to complete their development phase,

let's call it, at the end of puberty,

which could be anything between 12 and 19.

So depending on when puberty starts,

which sort of tends to last about five years.

But then they can grow at other times in our lives as well.

So if a girl or a woman gets pregnant,

then breasts tend to grow whilst breastfeeding,

they can grow as well. Or actually, if we just gain weight,

if we're laying down additional fat tissue on our body,

then some of that fatty tissue can be laid down in our breasts.

Does everyone get stretch marks?

Most people get stretch marks to different extents.

So therefore, stretch marks are absolutely normal. And it's not just girls,

boys get them as well.

So they're usually caused by a rapid period of growth,

which is why they tend to crop up during puberty.

But they can come on at other times in life as well. So sometimes in boys,

if they've started actively trying to build more muscle and they go

through a period of growth due to that,

and sometimes just due to hormones as well.

Typical places where people get them are sort of on the hips,

on the boobs, on the tummy. Also, when we have babies,

they're very common because the tummy stretches during pregnancy,

so they're completely normal. I like to call mine my tiger stripes,

and I actually really like my stretch marks.

I've got a really good relationship with them,

I think partly because I was a bit of a late developer,

so most of my friends started their periods and got boobs before I did,

and I was actively waiting for puberty to hit,

desperate to have my first period until I had one,

and then not so desperate anymore.

So when my stretch marks came on my hips,

I really celebrated them and always have. So I called them my tiger stripes,

and I encourage you to call your stretch marks your tiger stripes,

and celebrate them too.

How can I talk to my teenager about their personal hygiene?

So one of the changes that happens in puberty is

our sweat glands in certain areas, armpits, pubic area,

even our feet start to produce a different type of sweat.

So sweat that has not just salt and water, but also oil in it.

And that oil provides food for bacteria,

and it's the bacteria that smells.

So that's why people can get smelly armpits, body odor.

And that's why it's really important that once that starts happening,

children often need to increase their hygiene practices.

So it's not just their bodies that they need to wash thoroughly at least once a

day, but their clothes as well,

particularly if they're sweating in those clothes or doing sport,

it's all very well having a shower. But if you put on yesterday's clothes,

that bacteria is on there and it's still going to smell.

So I think the best way to approach this with your child, it's really tricky,

isn't it? Because we don't want to offend our child and maybe even feel

uncomfortable letting them know that they smell.

But sometimes you have to be cruel to be kind. And I think, just think about it.

If it was you, would you rather your parent let you know that there was a smell?

Or would you rather they didn't tell you and you were going about your business

and other people may be noticing?

So I think the important thing to do is follow that urge,

that gut feeling that you have as a parent, and let them know,

but just do it in a really kind way. Obviously,

please do not make too much of a joke about it and laugh at them.

You could share your own experiences. That'd be a really kind way to do it,

is to say maybe, oh, when I was your age,

I had this incident where something happened and I realised that my armpits had

started to smell and that I needed to start using deodorant and washing more

regularly.

And I think maybe you are approaching that stage now and see what they say.

They might already know.

And it might be that they need your guidance around buying an antiperspirant

deodorant, for example.

Is soap bad for your vagina?

I think this is a really great opportunity for me to explain what's the

difference between the vagina and the vulva.

So the vagina is the internal part of the female genitals.

It's the tube that connects the outside of the body with the cervix,

which is the neck of the womb. So it's internal,

whereas the vulva is the external parts of the female genitalia.

So that's the labia majora, which are the outer lips, the labia mag Nora,

which are the inner lips, the clitoris, well actually not the clitoris,

the clitoral head, because the clitoris is actually a much larger organ,

most of which is inside the body.

And then there's the vaginal opening and there's the urethral opening too,

which is the opening to the tube that connects to the bladder.

So internal is vagina, external is vulva. When it comes to washing,

using things like soap, the vagina does not and should not be washed.

It's a self cleaning organ. It washes itself.

And if you start putting soap or products,

or even just pushing water into the vagina, which is called douching,

that can affect the natural environment inside the vagina.

So the vagina sorts itself out. Don't wash it, don't clean it. Don't use soap.

Then there's the vulva, which is on the outside of the body,

which you can use soap, so gentle soap, simple soaps,

non perfumed or shower gels,

whatever you normally use to wash the rest of your body.

You can use that to wash the vulva, the outside of the body as well.

But you absolutely don't need to start using any specific perfume

products.

There are lots out there that are marketed that they alter the

smell and you don't need those. And actually,

those types of chemicals can usually do more harm than good.

So simple,

plain water or gentle soap or shower gel and water is absolutely fine for the

vulva. The vagina washes itself.

My child has acne, what will help?

So there are many, many, many different things that can help with acne.

First thing to say is that acne,

particularly in those sorts of puberty years and even early

adulthood,

is normal and actually affects more people than it doesn't

affect.

I think understanding what causes acne can be helpful.

So as we go through puberty and there are changes to our hormones,

our oil glands in the skin get stimulated. They produce more oil,

which we call seban.

Also the dead skin cells that are on the surface of the skin.

Combined with that oil can increase the risk of the pores getting blocked

up. Also,

then the bacteria on the skin can add to the equation and can cause a lot of

inflammation and swelling of those pores, and that's what causes the spots,

the white whiteheads and blackheads that people usually have.

Sometimes people get cysts, which are sort of deeper, hard,

painful lumps of the skin or scarring.

And I'll talk in a moment about that,

how that's important to see a GP if you're getting that.

So in terms of how to manage acne, first thing, understand it,

understand why you're getting it,

and then that helps us understand why the various different things that I'm

going to talk through are helpful. So first and foremost,

important to cleanse your skin twice a day with a really sort of simple

soap or face wash,

because what you're doing there is you're washing off the excess oil and you're

also washing off those dead skin cells,

so they're less likely to clog the pores. Then you need to moisturize,

which can seem a bit counterintuitive because you're removing this oil,

but if you moisturize your skin so your skin is well hydrated,

that means that your oil glands aren't going to be producing as much excess oil

because if the skin feels very dry,

that stimulates the oil glands to produce even more oil.

So cleansing and moisturizing, and if you do have oily skin,

then going for a water-based rather than an oil-based moisturiser,

and sometimes a gel can feel more comfortable as well. So play around with it,

find what works for you. The next thing is hydration.

Hydration is so important for skin.

It helps wash away the toxins in the skin that can make

acne worse. So really good hydration. And then diet, a healthy, balanced diet.

We talk about that all the time.

But I think some specifics for skin would be eating

colourful fruits and vegetables.

So trying to eat the rainbow because fruits and vegetables,

that different colours have different antioxidants, which again,

help get rid of toxins and help nourish the skin

and eating foods that have healthy fats, good fats.

So that's specifically things like avocados, nuts and oily fish.

They're really good for the skin.

And there's a bit of a myth around chocolate that I'm going to break for many,

many years. I think I was told that eating chocolate gives you spots.

It does not, which is great news.

It's true that if you eat a lot of foods that are high in sugar and highly

refined,

highly processed foods that can increase the inflammation and make it worse.

But something like chocolate, especially if it's dark chocolate,

good quality chocolate on its own,

it's not going to give you spots because it's about the entire diet.

So if you are eating mostly a good diet, eating the rainbow,

having these healthy fats,

limiting sugar and highly processed foods and highly saturated foods,

then having the occasional treat will not do you any harm.

So those are kind of the basics of looking after your skin. Oh,

and another thing is trying to avoid touching the face.

We have a lot of bacteria on our fingers, and most of us touch our face many,

many times every hour without realizing it.

So trying to get into the habit of not doing that.

And if you put oily products on your hair,

which people with Afro hair like me commonly do,

then especially try not to touch your hair and then touch your face and keeping

your hair off your face. So those are sort of the basics,

but if that's not working,

then the best source of information next will be the pharmacist,

because you can buy lots of over the counter treatments, creams, gels,

that can really help with acne.

So products containing benzoyl peroxide can be

really helpful and are often what are recommended as first line.

So benzoyl peroxide helps to get rid of some of that bacteria that

can exacerbate acne.

Other products would be salicylic acid or AHAs.

So those are things that have in skin products that help get rid of some of

those dead skin cells that can clog up the pores.

So having a chat with the pharmacist,

they can direct you and sometimes a bit of trial and error,

but these products can take about eight weeks,

couple of months to really be effective.

So I think often people try something for a couple of weeks, doesn't work,

move on to the next. So do give it a good amount of time to see if it's working.

And these products can cause a slight increased amount of sensitivity

and irritation to the skin initially. So if it's mild,

you can pass this for a few days and then it settles down or just use a very

small amount to start off and build up. If that's not working,

then the next port of call is the GP because there are lots of different

treatments that we can try.

There's certain types of antibiotics that can be used in women,

hormonal treatments can be used, and there are other drugs as well.

So there are many, many things that can be done.

And whilst acne is normal and common,

if it's affecting a person's

quality of life, mental health, stopping them living their best life,

then you don't have to put up with it because there are so many things that you can do.

Final thing is just to reiterate what I was saying about cystic acne.

So that's these hard firm bumps deep under the skin that are painful or

scarring.

Now that's the type of acne that you should definitely see your GP about.

What's the best hair removal?

So the best method of hair removal will differ from person to person

because we're all different, and we all have different practices.

So I'll talk through what the main ones are. I think first and foremost,

there's a growing movement now amongst girls and women who

don't want to remove the hair from their bodies.

So whether that's hair in the armpits on their legs, pubic hair,

and that's absolutely fine. There's absolutely no medical reason.

There's no hygiene reason why we have to remove the hair.

So that is absolutely fine if people don't want to. Not a problem,

but many people do and that's fine as well.

I think shaving is still the most common method of hair removal.

I guess it's the most accessible.

So shaving has its benefits in that it is relatively cheap.

It's easily accessible, but some of the downsides are,

particularly for people when they're starting out,

it can be a bit dangerous because it's a razor blade and lots of injuries

happen. So I think for young people who want to try using a razor,

my advice would always be to do that with an adult or a caregiver or an older

sibling or somebody who knows what they're doing and practice makes perfect.

So maybe just start off with a small area on your leg and practice a couple of

times so you don't hurt yourself.

There are other things, it's really important to moisturise the skin

afterwards. Go in the same direction as the hairs.

So I write in this in a bit more detail in my book, you grow girl.

There's some great resources online as well.

One of the downsides to using shaving is that hairs do tend to

grow back more quickly and thicker over time.

The next one to talk about probably the second most common method would be hair

removal creams.

So these remove the hair further down through the

skin closer to the follicle.

So it means that the hair removal process tends to last a bit longer.

They are probably a bit less dangerous than a razor,

especially in the beginning, they can be quite messy.

It's really important to do a patch test, first of all.

So that means before you use this cream in a sensitive area like your armpit or

your pubic region, just do a patch test.

So you can simply put a bit on your arm, on your forearm, wait two weeks,

and if you haven't had an allergic reaction,

then it's unlikely that you're going to be allergic and it's safe to use it,

but it can cause skin irritation in some people,

particularly if you're using it in sensitive areas.

All of these methods have their benefits, but they have their downsides.

Next one will be waxing.

So waxing is done professionally is really good because it removes the hair from

the follicle. So over time,

that means the hairs are likely to grow back either.

less frequent. Well, they definitely grow back less frequently,

but also grow back finer, and sometimes they stop growing over time.

But that can be quite expensive. You can do waxing at home,

but that requires quite a bit of skill depending on the

area,

and you may need some help because you have to pull the strips in the right

direction. You can injure your skin. It can be messy. So again,

it's got its pros and cons. Then there's epilation.

So an epilator is a little handheld electronic device that's kind

of like lots of tweezers altogether.

So you move it over your skin and it plucks out the individual hairs.

So it's quite painful, if you can grit your teeth and bear it

it is a good method because again, over time, like waxing,

this is going to mean that the hairs grow back less frequently because pulling

it out from the root, and it also means over time,

they're likely to grow back finer and eventually you may lose them.

This was actually what I did when I was young. My mum terrified me.

She said, don't shave your legs, whatever you do,

because they'll grow back really, really thick and dark.

So we bought an epilator from the local paper secondhand.

We did sterilise it and my auntie and my mum, I'll say,

helped me to epilate my legs, which what I mean by is that with my permission,

they actually held me down whilst they did it because it did hurt.

But over time it hurt less and less,

and that's actually what I did for years until eventually I invested in

laser,

not on my legs because actually I have very little hairs on my legs now because

I epilated. But laser,

laser hair removal is the future,

probably, it is quite expensive,

but a course of laser hair removal is done by professional.

Some professionals wouldn't offer this to anyone under the age of 18,

but some professionals will offer it to younger girls if they've got their

parents with them.

They often recommend it's not as effective when you're still going through

puberty because hormones are still changing,

which means that the stimulus for that hair growth is still

yet, there's more to come. So it might mean the hairs grow back,

but I think definitely when girls get older,

laser is a good method. It's an investment.

But if you have a course of laser treatments,

then the ideal is that you permanently get rid of that hair growth.

How can I talk to my children about sex?

I think the most important thing to say when it comes to talking to our

children about sex is that we do it.

It's really important that we do do that.

There's evidence actually to say that children who have had conversations

with their parents or caregivers about sex are likely to have a more

responsible approach towards sex. When the time comes,

they're more likely to use condoms,

they're more likely to use sexual health services.

So I think it's a really important thing to do, and also by,

as a parent, having a conversation with your child about sex,

you're giving them permission to talk about it. You're saying,

you can come to me at any time and have a conversation about this.

I think the next bit is, well, how do you do it?

And that will vary from family to family.

I think some tips are around if you're ever having a conversation with your

child about something, which might be a bit tricky,

maybe not doing it face to face. So not doing it over the dinner table,

because that can feel quite intense.

But doing it when you're in the car so that you don't have direct eye contact,

and it gives time as well. One of the real art,

having these more difficult conversations as a parent is to utilise the power

of silence.

To be uncomfortable with a bit of a break of silence,

and try not to fill that gap.

Because I think young people often need time to think about what their answers

or what their questions will be. So when the car is perfect out for a walk,

if you have a dog whilst walking, the dog is perfect,

whilst kicking a ball about is perfect as well.

How to approach the topic of sex with your child.

I think almost the younger they are, when you start talking about this,

the more relaxed it can be.

And I think rather than jumping straight into perhaps talking about

something like, have you started to think about having sex? Yet?

It's just talking about sex in a more broader context.

So it might be a TV program that you've watched together where the topic of

sex has come up. So sort of referring to that and talking about it,

I think letting your child know that it is okay to have these conversations.

They might be really embarrassed. You might be really embarrassed,

but that's absolutely fine. It's absolutely fine to say to your child, oh,

it looks like you find this a bit embarrassing, and that's okay. Or even to say,

I find talking about sex a bit embarrassing,

and that's maybe because my parents didn't talk to me about it,

but I don't want you to be embarrassed about it.

So even though it's a bit uncomfortable for me,

I really think we should have these conversations and know that you can always

come and talk to me about this stuff, and I'm not going to judge.

I'm not going to get angry. I'm here for you.

So I hope that's a few helpful tips.

How can I ask my children if they are sexually active?

Assuming your child is 16 or older,

which is the legal age for sex,

then I would say if you have a real burning urge to know whether or not they are

sexually active, you are their parent, then of course you can ask them.

You may not get the response you want. They may not want to share that with you.

They may be very willing to share with you, but you don't know unless you try.

I would say make sure you do it in a very non-judgmental manner,

in a non intense environment.

So maybe whilst you're driving in the car or out for a walk,

and I think choose your question quite carefully

and don't be alarmed if you don't get the responses that you want the first

time. They might be shocked that you've asked.

They might be embarrassed and all of that is okay.

But I would say if you feel like you want to ask, then you should ask.

I'll tell you about my friend who asked her son.

Her son was 17 and he'd been dating a girl for a while

and he'd asked if the girl could stay over at the weekend when she wasn't

there. So she and her mom thought, okay, this is it. He's going to have sex.

What do I need to do? So she went out and she bought some condoms.

She left them in his bedroom drawer, and then whilst they were in the car,

she got herself all wound up and nervous.

But she thought about it very carefully and she just said, oh,

I've left some condoms in your bedroom drawer. She thought,

not make a big deal of it. I've left some condoms in your bedroom drawer.

I'm not saying that you're going to do anything, but if you do, they're there.

And he turned around and he went, mum, that's really sweet.

But I've been using condoms already for the past six months and I'm absolutely

fine. I can get hold of my own.

And she was really shocked and flabbergasted and she just went, oh, okay, great.

Which was the perfect response.

So I think we as parents may make assumptions about what our children are doing.

The evidence says that parents aren't necessarily the best judge of when our

children become sexually active, but I think as a parent,

as long as you ask in the right way and try to be calm and relaxed,

no matter what you hear, then absolutely you have a right to ask.

My child is sexually active, do I need to do anything?

So if your child is sexually active and assuming they're over the age of

16, which is the legal age for sex, you don't necessarily need to do anything.

But it would be really great if you were able to talk to your child about

it and if they were willing to talk to you about it.

And there is evidence to say that parents who are able to have conversations,

open conversations with their children about sex correlates

with young people being more likely to use condoms

properly, more likely to access sexual health services,

and I guess more likely to just be responsible. Plus,

if they are able, it sounds like you already know that they are sexually active.

If that's because they've told you that's so wonderful, how wonderful is that,

that your child is willing to have a conversation with you about it?

I think let them know that you're really proud and pleased that you're able to

talk about this because a really wonderful thing.

So yeah, you don't necessarily need to do anything,

but it would be great if your child knew that you were willing to

do whatever it was to help them within their sexual journey.

My teenager wants their boyfriend/girlfriend to sleep over, should I let them?

Assuming that your child and their girlfriend or boyfriend is

16 and over, which is the legal age for sex,

then I guess it's up to you as a parent how comfortable you feel with that.

I think one of the real positives about this is your child obviously feels

able to be open and honest about their relationship and

that they want to spend time together.

Maybe one of the downsides is you might think you might feel uncomfortable

with them engaging in sex or sexual activity if that's what they're

intending to do under your roof. I think all of that is normal.

The most important thing is that you talk about it.

It's great that your child's being honest and open with you,

and I think it's important that you're honest and open with them in a

respectful, calm manner. So it's not right,

it's not wrong.

It depends on how you all feel about it after you've had an open,

honest conversation.

Should I encourage contraception?

I think it's always a really good idea to talk about things

openly like contraception and ideally these are conversations that would

start happening between you and your children before the age that they

first have sex.

There are lots of options for contraception. Of course.

Condoms are what are definitely recommended because they also

protect, again, sexually transmitted infections.

But if your child is in a longstanding relationship with one partner and they

want to explore other types of contraception, well that's good as well.

I think being able to come to you as a parent and make those decisions

together is a wonderful thing if they're up for it. Equally, if you think that

they may have done loads of research,

they may know more than you and pointing them in the direction of good resources

to understand more about contraception.

There are lots of great resources out there online.

You could start off with the NHS website. My book,

you Grow Girl has got a whole section on contraception and the various different

options, but maybe even researching that and looking into that together.

And then of course your GP or practice nurse is another incredible resource to

have conversations about contraception and working out

what would suit your daughter or son best?

What are the different types of contraception?

There are many different types of contraception,

and the thing that always comes out on top is condoms,

because condoms are effective at preventing pregnancy,

but also protecting against sexually transmitted infections.

So definitely the best option for people who have multiple partners

or who may be at higher risk of getting sexually transmitted infections.

When we think about the other types of contraception, there's the pill,

so there are two main different types of pill.

The combined oral contraceptive pill, which contains oestrogen and progesterone,

and then there's the progestogen only pill.

There are pros and cons to both.

It's always worth researching to find out which one will be best for anyone as

an individual. Then there are a group of contraceptives,

which we call Lark,

which stands for long acting reversible contraception.

These are things that don't require you to remember to do something every day,

like take a pill or every time you have sex, like use a condom.

So there's the injection,

there's the implant that goes under the skin in the arm,

and then there are two different types of devices that sit inside the womb.

There's the copper coil and then the IUS,

which is an intrauterine system,

and that secretes progestogen locally within the

uterus to prevent pregnancy. Now,

they're great because you don't have to remember to do something every day,

so therefore they're also a little bit better at preventing

pregnancy because it takes out the human error.

There are also things like diaphragms and various other

new things coming onto the market all the time and being tested and trialed

all the time. We're still waiting for the male pill. There've been many, many,

many, many studies looking into the male pill,

but they still haven't nailed it quite just yet. And then of course,

there's things like the rhythm methods,

and nowadays with technology utilising things like apps

and measuring basal temperature and actually monitoring the biology of

yourself as a woman so that when your fertile window is

now, whilst that is not as effective as many of the other methods,

a lot of people are stepping away from taking

hormones to prevent pregnancy.

So it's definitely something to be aware of as well and weigh it up in

the balance.

How do I talk to my children about masturbation?

Well, masturbation is completely normal and I think

talking to your children should be really letting them know that

it's normal and practically everybody has done it or does do it.

Actually, they should be exploring their own bodies,

certainly before they let anybody else explore their own bodies.

Our bodies are ours. We own them.

We have to look after them and we should understand how they work and function.

Usually how masturbation will start will be that

girls or boys will notice that. It just feels nice,

it feels pleasurable when they touch or rub themselves in certain areas.

Usually the genitals.

So for girls it could be touching or rubbing their clitoris, their vulva,

or putting fingers inside their vagina. For boys,

it's rubbing and touching, usually, most likely their penis,

and it feels nice and there were lots of myths around masturbation,

but that's the thing. It is completely normal.

I think it's something that I think we'd all agree should be private. So

if you have a child and they have sex toys and they're leaving them lying around

in plain sight, you might not feel comfortable with them doing that.

And it is something that is private and they might

not want to talk to you about it. They might feel embarrassed and that's okay.

But I think if you can have an open,

honest conversation and just really giving them permission,

letting them know that that's okay,

and actually it's completely normal that they should be learning to understand

how their bodies work and how certain things feel,

and I guess to know what they like before they engage in doing those

types of activities with another person.

What are some masturbation myths?

There are loads of myths around masturbation.

I think one of the commonest and most extreme ones that most of us have heard

is that if you masturbate, you'll go blind. I mean, well,

obviously that's not true.

I think also that girls don't masturbate. I think that's a myth.

Of course, both boys and girls and women and men masturbate

more thinking about boys, that masturbation will make you infertile,

will make your penis shrink, will change the shape of your penis,

will in some way harm you or damage you. Absolute myth.

Same is true for girls. It's not going to do you any harm. In fact,

there are actual health benefits to masturbation.

So feeling aroused and especially having orgasm releases a

cocktail of good chemicals in the brain. Things like serotonin,

the happy hormone, oxytocin, the love hormone, dopamine,

which lights up the reward centers of your brain.

These are all things that are good for you,

and there is actually evidence out there to say that masturbation is good for

your long-term health.

And I think one of the biggest benefits is that it means that people are getting

to understand and know their own bodies,

and we have more right than anyone else will ever have to

touch our own bodies to understand what feels good and to get to know

what we like from a sexual point of view.

The only time maybe masturbation

is harmful is if people are doing it to excess,

that it's having a detriment to their mental health or

affecting what they're doing socially.

If it's sort of become addiction and it's something that they're doing multiple

times every day, that's the very,

very extreme where it can be harmful. But for the vast majority of people,

they will masturbate. It is normal and it is healthy.

How can I talk to my children about relationships?

When children are going through puberty,

relationships can become very tricky in lots of ways because their relationships

with their parents will be changing,

their relationships with their friends will be changing and they are likely

to start to become interested in romantic relationships as well.

And I think sometimes as a parent, it can be very, very tricky

to talk to them about relationships,

especially if as a parent you've identified a relationship that they have with

somebody that you feel isn't healthy because your child,

particularly if they really value that friendship or it's somebody that they're

interested in romantically, even though you might think it's not healthy,

they may feel very attracted to that person.

I think as with everything as a parent,

I think if your gut tells you that you feel the need to share something with

your child, it's much better to do that in an open,

honest, kind way,

even if it offends them and you get a bit of a backlash than to keep it to

yourself and not share it.

Because even if they don't necessarily immediately act on what you've told them,

they will have listened and they will have heard and maybe later on down the

line, as they start to figure out for themselves that things are not healthy,

they're going to remember and that's going to reinforce their own feelings.

I think you can sort of educate yourself as a parent on perhaps what are some of

the signs of a healthy relationship and what are some of the signs of an

unhealthy relationship? So a healthy relationship with somebody,

you should feel safe,

you should feel that they listen to you and they're interested in what you

needs are.

You should not feel that they ever take advantage of you,

whether that is financially or otherwise.

They shouldn't make fun of you in front of other people.

They shouldn't drop you for other people.

So those are some of the guidance perhaps around what are

healthy and unhealthy relationships and maybe presenting it to your child in

that way that I've been looking at a bit of research.

Can we have a look at this resource together, which talks about relationships.

So it's not necessarily the advice's coming from you,

it's coming from another resource. You could show them this video on JAAQ.

He could show them some of the pages in my book You Grow Girl,

where there is a specific section all about this.

So sometimes taking it away from your opinion and giving them more of

a factual resource can embed it in their mind a bit more solidly as well.

How can I talk to my children about consent and boundaries?

I think we can start to educate our children about consent from a very,

very young age. Because when we think about consent,

I think we're considering around sex and other forms

of physical sexual contact.

But even with my two year old now,

if I'm tickling him and he's saying, stop enough,

I stop. And I let him know that that's his decision. He's in control of that.

No matter what somebody's doing, it's your body.

And if you want 'em to stop doing it, then that's your choice.

That's your decision.

And I think if you have children and they're young and they're playing and play

fighting, teaching them tap out. If somebody says tap out,

that means they want to stop and that's consent.

So there are ways you can start to teach consent. I think from a very young age,

if the time has come to start having conversations with your child about consent

of a more sexual nature,

I just think it's really important to be very direct and clear about it and tell

them that their body is theirs. They own it,

it's their responsibility,

and nobody has the right to

touch them or do anything to their body that they don't want to happen.

So that can be kissing. Somebody cannot kiss them if they don't want them to.

And if they've kissed somebody once, and that was fine,

they wanted to, they need consent every single time. And it's really about,

I think, empowering them.

But I think also we can teach them the language and what to actually

do.

So if you are worried that your child is going to find themselves in a situation

where they are coming into physical contact with somebody in a sexual

way,

and they feel that they may not be consenting to that and not know what to do,

tell them what you'd like 'em to do. It could be specific words like, no,

I don't want to do this, please stop. That's just an example.

But I think sometimes empowering with them with the exact instruction of what to

do if they found themselves in that scenario can be helpful as well.

How can I teach my children about self respect?

I've been asked this question quite a lot recently off the back of the book that

I wrote for girls who are growing up.

A question I've been asked a lot actually is if you could go back and speak to

your younger self, what's the one thing that you would say to her?

And the one thing I would say to little Zoe,

and I'd love to say to all young people is that you'll have many

relationships throughout your life,

but the single most important relationship you will ever have is the

relationship that you have with yourself.

And if I could go back and speak to myself, I would say

to try and have at least as much love and respect for yourself

as you do for the other people in your life that you care about.

Because we can be so mean to ourselves, especially as girls and women.

If we get one spot on our face,

we can look in the mirror and that's all we see,

and we can start using negative language towards ourselves,

and that can be really damaging for our confidence. Whereas actually,

if it was our best friend who had that exact same spot and that exact same

space, I mean place,

you wouldn't say that to them. You wouldn't say those mean things to them.

You wouldn't think differently. You wouldn't think they were less beautiful.

You wouldn't think that they were less anything.

You'd just see them exactly as they are,

as they're wonderful selves that just happen to have a spot.

So we can use that same love and respect and kindness when we're talking to

ourselves as we do to our best friend or our mum or our sister.

Then we can grow up keeping hold of that self-respect

and that can make a big difference to our confidence throughout life.

My child is confused about their sexuality, what can I do to help?

So the best thing you can do to help is let them know that you are available to

have open, honest,

non-judgmental conversations.

And it's completely normal to be confused about sexuality

for people who will eventually become heterosexual.

It's normal for people who might eventually become homosexual.

It's normal or bisexual.

As we're going through puberty and hormones are raging and we tend to

develop crushes.

And crushes could be on people because of how they look or who they are or what

they do.

And we may develop crushes on people who are the opposite sex and the same sex.

So I think it's normal. Don't belittle it because to your child,

I'm sure it's a massive, massive deal,

but just that there's no rush and it will all come out in the wash.

They will likely under understand more as they get older as

to what their sexuality is and what their preferences are.

I'm confused by gender identity how can I be more understanding?

I think firstly well done for being curious,

identifying that there's a gap in your knowledge and wanting to fill that gap

because it's the right thing to do, as you say,

so that you can be more understanding.

There's a difference between the words sex and gender.

So when a baby's born, depending upon their sexual characteristics,

in other words, what genitals they have,

they're identified as a boy or a girl. That's sex. Gender is different.

So gender is what somebody identifies as.

So in most cases, throughout a person's life,

their sex and their gender will be their same.

So somebody who is born a girl will continue to be a girl

and then eventually a woman. But in some circumstances, as a person grows up,

they feel that their gender is different to their sex.

So maybe they were born a girl, but as they grow up,

they feel more like they're a boy,

and some people choose to therefore live their life as a boy and a man,

and that's transgender. Now there's a lot, it's a very interesting topic,

and there's much more to say, and it goes beyond my area of expertise as well.

So a really great resource to learn more about this is JAAQ.org,

where you can ask these questions to people who have lived experience or who've

researched it, or probably can give much more eloquent answers than me.

Is my daughter transgender because she likes 'boy' things?

The fact that your daughter likes boy things doesn't necessarily mean that she's

transgender. I think that boys can like girls things,

girls can like boys things and it's completely normal.

I think we do tend to think that boys,

young boys are more interested in things like trucks and cars

and footballs and girls are more interested in things like dolls and prams and

what have you.

And I think part of that is probably that society's constructed that,

and part of it is probably real.

I know I have a two year old son and typically the friends that he

plays with that are boys do behave slightly differently to girls.

But you'll always have people who are outliers. So you can think of it as,

I guess the majority of girls might be more likely to enjoy girl things,

but some girls will enjoy boy things that doesn't necessarily mean anything

about their sexuality or whether or not they've been

assigned the wrong gender.

It might just mean they're a girl who likes boy things.

Where can I find good resources on mental health help?

There are luckily lots of great resources out there when it comes to mental

health. The NHS website has some information,

but also has a long list of all the available resources that are out there.

A few that I'd recommend Young Minds is great for young people.

BEAT is really great for people who are suffering from eating disorders

or for relatives or family members who are worried about somebody with an eating

disorder.

JAAQ.org is a really great resource to kind of, I guess,

take on that information in a different way because you can just ask any

question, which is what JAAQ stands for,

and they've got a range of various different experts on there that can answer

it. Bupa has got a load of resources on their website as well,

so depending on what it is that you are looking for or looking to direct

your young person to lots of resources,

Samaritans is an incredible resource,

a great helpline that anyone can call if they're struggling 24/7.

And remember,

I think if you have a child who's having difficulties with their mental health,

make sure that you utilise some of these resources to take care of your own

mental health as well.

How can I help my daughters mental health?

I think the most important thing we can do to help anybody

who is experiencing a mental health issue

is to let them know that we are completely there for them

unconditionally, no matter what,

and let them know that they can always talk to you about anything

that's going on. They may not always want to talk to you,

but making sure that they never feel on their own.

I think depending on what the mental health issue is, also,

it's important to support them to access additional help if they need

it. So if this is something like anxiety or depression,

which sadly is becoming more and more common in young people,

then accessing support that's available through school,

through the GP, online.

There are lots of online resources that can do things like self-guided CBT,

which can be particularly helpful because sadly,

there are often very long wait times for young people to get professional

support for mental health on the NHS.

So I think letting them know you're there, talking to them about it often,

make sure they never feel that they're on their own.

There's always somewhere for them to go, someone to talk to,

and helping them access additional support is really important.

Physical activity

is one of the best things that we can do for our mental health.

So if that's something you can support your young person with,

whether it's going for a walk together once a day,

I'm not necessarily recommending that everybody rushes out and getting dogs,

but sometimes it is something like that.

Building something into that person's life like a dog,

which means they have to walk every day. Inviting their friends around.

Other people who you may know who've had similar experiences with their

mental health.

Inviting that person to talk to your child if your child's willing.

I think we have to bring up something here that people don't always feel

comfortable talking about, and that is the word,

suicidality. Whilst your child,

that might not be something you're concerned about at all.

I think one thing I always like to make clear is that you will never put your

child at increased risk of suicide by having a conversation with them

about suicide. So asking how bad have you felt?

Have you ever felt like harming yourself or even taking your own life?

You will not harm somebody by asking that question. In fact,

it just means that either they can completely reassure you or it means that

if they ever did a reach point where they were feeling that way,

they know that that is something they can talk to you about.

That's not off the table.

That's not too shocking for them to have a conversation with you about.

What mental health issues affect girls most commonly?

The most common mental health diagnosis amongst girls is anxiety

disorder,

and there are a number of different anxiety disorders that make up that group.

The most common one is generalised anxiety disorder,

which we tend to call anxiety,

followed by depression. Following that,

then it's behaviour disorders and ADHD will be the next one in line.

Does exercise really help mental health?

So exercise really,

really can help support good mental health. And not only that,

it can actually be used as treatment for things like mild to

moderate depression.

Just simply getting out and going for a brisk walk every day

can really protect our mental health. In fact,

there were studies done that showed that for mild to moderate depression

exercise,

if done in a group with other people because of the added benefits of that is as

effective as antidepressant medication and is as effective

as cognitive behaviour therapy talking therapy.

So I think if somebody is suffering from depression,

then antidepressants can be helpful as can talking therapy,

but doing exercise alongside that can help even more,

and there's tons of evidence to back that up.

So my advice always to people is whatever's going on with your mental health,

whether it's perfect, exercise

will help to protect it or whether you're really struggling,

then it can help to make you feel better.

I think it's important to acknowledge however,

that when people are struggling with their mental health,

especially something like depression,

it can be really challenging to find the motivation to go and do

exercise. So that's when a reminder,

something like just walking around the block can be enough to give

you a benefit,

but can often be enough to sort of give you the motivation to then go that bit

further and do a little bit more.

So make it achievable something like a 10 minute walk or a 10 minute

yoga session or even a stretch.

Anything that gets you started might help break that motivation so that you can

do more.

How can I tell the difference between normal teenage mood swings and mental health issues?

So mood swings in teenagers, as you've said, are completely,

completely normal.

There's lots of reasons why mood swings are happening. Due to hormones.

The brain is still developing the way in which different parts of the brain

interact with each other.

The fact that teenagers are made to get up early in the morning when actually

their circadian rhythm through those years wants them to lie in the morning.

So lots of different reasons. The question around when do you know,

actually it's a mental health issue.

So I think the difference between something that is normal

because things like low mood, feeling, anxious, all these things are normal.

When does that become a clinical issue?

And I think the issue is when it's happening most of the time

for a persistent amount of time. So for several weeks,

somebody is in a very, very low mood.

And also if there's changes to their behavior,

which could be types of behaviors, like they're eating more or eating less,

or sleeping more or sleeping less,

or it could be behaviors like they're not seeing their friends or doing

the activities that they normally enjoy and spending much more time on their

own. Or

you actually as a parent and your gut instinct, it must not be ignored.

Your gut instinct as a parent is a very powerful and usually

very on point thing. That's when it becomes more concerning.

But teenagers got in and out of all sorts of moods and funks,

that's less to be worried about.

It's when it's persistent and it lasts for more than a few weeks.

Why is my daughter so moody?

Well, this is a very, very,

very common thing amongst preteens and teenagers,

people going through puberty, in particular, this moodiness.

And there are a lot of reasons.

Hormones are obviously a big reason. The brain is still developing.

The brain is not fully developed until we're into our late twenties,

and actually the decision making part of our brain

is not yet developed. I think often teenagers have a very short fuse.

They might lose their rag or blow their top,

and that's completely normal as well.

Because of the way in which different parts of the brain interact with each

other,

sometimes they'll blow their lids and maybe don't have quite as much

resilience as older adults have at containing emotion.

And sometimes there's fluctuations in mood.

You might notice a pattern with your young person.

Sometimes teenagers are very, very tired early in the morning,

and that's normal because they have a slightly different sleep

structure, circadian rhythm,

and they tend to want to go to bed really late and stay in bed late in the

morning, but they have to get up for school.

So you might find that your teenagers very tired in the mornings,

might have an energy burst in the middle of the day around lunchtime and then

get moody later in the day. All of this is normal.

And I think if you think back to actually when you were that age,

you probably remember that feeling of just being a little bit less

in control of your emotions, feeling emotions very,

very strongly,

and often feeling just like things really annoy you,

perhaps more than they do other people. It's all normal.

What is a good way to manage emotions?

There are lots of good ways to manage emotions.

I think the first thing to say is that emotions are normal and we all have them

and they don't always need to be managed.

We will always feel sad at certain times.

We will feel anxious at certain times. We'll feel happy at certain times.

So having emotions is really important that we have them.

But sometimes if our emotions are

causing us difficulty,

whether that is something like we are very low in mood all the time,

we think we might be at risk of depression.

Whether our anxiousness we think is maybe actually anxiety because

it's really negatively impacting

or any other sort of emotion is being significantly detrimental to

our lives, then there are lots of different ways in which we can help.

Firstly, we can help ourselves,

so whatever helps calm our emotions.

Sometimes stress is something that a lot of us suffer with a lot.

There are lots of different practices that we can do to reduce our stress.

Even though we might not always be able to change the things that are making us

feel stressed, we can lower our stress levels.

Things like breathing exercises, meditation, mindfulness,

spending time with the people that we love or our friends or being in nature or

even stroking an animal like having a pet. All of these things,

there's evidence to say that they can alleviate stress.

So putting stress for leaving practices in exercise is one of the

best things that we can all do for regulating our emotions and sleep

is incredibly important as well for regulating our emotions.

Having said that, if your emotions, whatever that might be,

are at a point where you feel things are out of control and these things are

actually just not going to make a difference and you need help,

then you can speak to your GP,

who can signpost you to various different resources. You can refer yourself.

If you're an adult for talking therapy or for a child,

then you'd need to speak to your GP or the school.

But there are lots of online therapies as well. So online,

CBT, cognitive behaviour therapy, there are lots of things out there.

So some really good resources to look into this further is the

MIND website, and there's also a MIND website for children as well.

So check those out.

Are anti-depressants okay for my teenager?

Sometimes antidepressants are prescribed for teenagers,

and it is a somewhat controversial topic.

They're certainly not prescribed as often or as readily for teenagers as

they are for adults.

One of the main reasons for that is that there isn't as much data or research

that tells us that they're effective and tells us that they're safe,

and antidepressants aren't recommended as first line treatment.

For teenagers, that would usually be a talking therapy,

something like CBT or counselling. Also,

if a teenager has more severe depression,

whilst antidepressants may be considered,

they should really only be prescribed alongside another form of therapy.

Something like CBT, a talking therapy, and usually that

decision to prescribe should be made by a psychiatrist or somebody who

has the right clinical expertise. Like everything in medicine,

medications like antidepressants will potentially have benefits and

potentially have risks. So if the professional,

the doctor and the child involved,

and their parent or caregiver believe that the likely benefits

significantly outweigh any risks in that case,

then an antidepressant may be prescribed.

Is low mood the same as depression?

Low mood is something that we will all experience from time to

time. It's a normal emotion,

but it's the time to time. That's what's normal about it.

If somebody is experiencing low mood all of the time,

or nearly all of the time, and that persists for more than a few weeks,

then that could be depression.

So depression is a medical health problem,

which is associated with persistent, longer term, low mood,

but low mood on its own is normal.

How can I help my daughter to open up about how she's feeling?

I think it can be really challenging for parents to

approach this subject because there's the fear of

offending. There's sometimes the fear of making it worse,

which you absolutely won't do, by the way, by raising the topic

sometimes, maybe even the fear of what you'll uncover.

But I think the most important thing is if you have that gut feeling that

there's something going on with your child that they may benefit from

sharing with you so that you can give them support, you must act upon it.

It's really important that you open up that conversation.

Some of the tips around doing that, trying to take the intensity out of it,

so doing it in a car, having a chat whilst you're having a drive in the car,

because then it's much less intense than doing it over the dinner table,

for example, where you're directly making eye contact,

doing it if you're out for a walk, or sometimes just giving a warning shot,

just saying to your child, letting them know how you are feeling. Saying,

I've been feeling a little bit worried about you.

I'd love if it's okay to just have a chat about how you're feeling emotionally.

It doesn't have to be right here and now.

Maybe at the weekend we'll go for a little drive to this place.

We'll go shopping and in the car we'll have a chat,

because that means they know it's coming. They can prepare for it.

But what you've done, which is really important,

is you've given them permission to talk about their feelings.

You have opened up that direct route of conversation just by

saying that, and that's the first and most important step.

How can I spot anxiety in my teenager?

So anxiety disorders are the commonest mental health

disorders in teenagers and young people.

And I think what can be tricky is differentiating between

anxiousness, which is an emotion,

a feeling that we all experience to different extents from time to time,

and that's normal, especially sort of situational,

anxious feelings around giving a presentation or maybe

being in large groups.

But anxiety and anxiety disorder is when those

feelings of anxiousness and the symptoms that are associated with it are

negatively impacting on a person's quality of life. So usually when it's severe,

it's persistent, and it's lasting more than a few weeks.

I think the best thing you can do is have a conversation with your child

and see what they're thinking, what they're feeling.

I think young people now more than ever,

are quite clued up when it comes to mental health.

It might be that your young person is able to completely reassure you and say,

actually, yeah, I know why you're thinking that mum or dad,

but actually this is what's going on.

Or it may be that they're relieved that you've started the conversation because

they've been wanting to talk to you about it.

Or it may be that actually you don't really get anywhere with that conversation,

but it's opened the line of conversation that needs to be revisited at a later

time. I think what I always say to parents is,

your gut instinct as a parent must not be ignored. It's really,

really important.

So if you're feeling concerned and you want to raise the topic,

it's much better to do that and find out it wasn't necessary than it is

to quietly keep that to yourself and not give your

teenager the opportunity to share what's going on.

What are the signs of a panic attack?

There are many, many different signs and symptoms of panic attacks,

and one person's panic attack might present completely differently to another

person's.

So you can almost think of starting at the top of your head down to the tips of

your toes. So it could be that you get a dry mouth.

It could be that your brain doesn't work properly, you feel very confused.

It could be that you feel dizzy. It could be that you feel short of breath,

or you feel your heart racing. You could get sweaty palms.

Some people describe it as an impending sense of doom,

just like feeling like something really, really bad is about to happen.

Some people faint, some people hyperventilate.

So it really is different for different people.

I think the hallmarks of a panic attack are that it tends to come on very,

very quickly, and it also tends to go away,

usually within a few minutes, sort of up to half an hour.

And some people might have one panic attack in their whole life.

Another people who suffer more significantly might have several panic attacks a

week. But yes, many, many different symptoms. Some people get one symptoms,

some people get three, some people get 10. So it is worth having a little look.

Have a little look online.

The mind website is a really good resource to get more information or ask some

more questions to people who've been on JAAQ.org as well,

because there's lots of people there who will have experienced panic attacks and

will be able to talk you through what they've experienced.

I think my daughter has an eating disorder. How can I be sure?

I think it's really important when we talk about eating

disorders

that we define that it is a mental health condition.

And I think what's helpful is if you're talking to your daughter

or any young person who you think might have an eating disorder,

is to remember that this is predominantly a mental health issue based

on how somebody is feeling,

rather than talking and opening the conversation based on what they are

or aren't eating.

So whilst you may have noticed changes to their eating behaviors,

those changes, if this is an eating disorder,

are caused by emotions.

So I think it's important to raise the topic if this is something you're

concerned about.

I would lead in by asking your daughter permission to have a conversation about

how she's feeling and what's going on with her emotions.

I think later down the line,

obviously it is important to discuss what you are

witnessing, but when you get to that point,

make sure that you are nonjudgmental non accusational.

And in an ideal world,

she'd be the one who'd start explaining to you about how her eating behaviors

have changed. And if she does have an eating disorder,

it's really important then to support her in getting some help.

Why does my daughter suddenly hate the way she looks?

I think it's so common that girls and women,

but also boys and men,

but to more of an extent girls and women are self-critical of their

appearance.

There are lots and lots of reasons why, we often have this negative self-talk

that we use to ourselves that we would never use to other people

that we care about.

I often say that if we all spoke to ourselves with the same love, care,

and respect that we speak to our best friend,

then that could do such a lot for our confidence.

And that could even be an example that you could share with her when she's

looking in the mirror. You could say,

imagine it was your best friend's face on your body,

or would you say that to her? What words would you use to say to her?

And then she can practice using those words to herself.

But I think there were lots of other reasons as well.

Social media and the way in which young people are

exposed to the highlights

and reels of other people's lives.

And it may be that she's sort of choosing to follow people who have a

particular type of appearance on social media. So in her brain,

she's starting to think that that's the norm, whereas any body type,

any body shape, any look, we're all human beings,

and the beauty of diversity is that we are all different.

So I guess to answer your question, it is not an easy answer,

but I think as a parent, what you can do is to have a really open,

honest conversation with her about why she feels this way.

If it's social media,

then maybe that would take you on a path of looking at a social media with her.

Can she start to curate her feed?

So something I write about in my book is that if you are

following somebody and on three separate occasions their feed

makes you feel bad about yourself, three strikes and you're out,

stop following them because we are in control of that. Likewise,

if somebody else's feed makes you laugh or makes you feel happy or good about

yourself, always give them a like,

because that means you'll get sent more of that.

So social media can be damaging,

but it can also be helpful if used well.

But when you have that conversation with her,

it might not be to do with social media.

It might be that somebody's said something harmful to her.

It could be that somebody's made a comment. I think as parents as well,

we have to be so careful, especially as mothers to daughters,

because there was something I saw on social media the other day that really

resonated with me where it was,

your daughter will probably be told many times throughout her life, oh,

don't you look like your mom?

So if you as a mother are being self-critical of your appearance,

she's going to take that on as well. So I'm sorry I don't have a simple answer.

It is not a simple

conversation. It's not a simple topic,

but I think the first step is really to have a conversation with her,

try and figure out where this has come from,

and maybe there are some tips there in ways that you can approach tackling that

moving forwards.

My daughter is having suicidal thoughts, what do I do?

I think the first thing to say is

I'm really relieved that you know about it and that she's not completely on

her own suicidal thoughts or what we call suicidality

is perhaps more common than a lot of us realise. In fact,

I would say we all know somebody who has experienced

suicidality, and in most people,

that doesn't lead to actual attempts to take their own life.

But of course, in some people it does.

And one of the biggest protective factors against suicidality

leading to suicide attempts is somebody else knowing about it and

being there and making sure that that person never feels on their own.

Of course, it's important to try to get some professional support,

so depending on the age of your child, that could be through the school,

it could be through the GP. There are lots of resources online as well.

So Young Minds is a really great website, as is the mix.

But I know that there are lots of pressures on the system,

and sadly there can be long wait times for people to get the

support that they need.

One sort of practical tip that I would give is for you and

your child to put together an SOS box.

Suicidal thoughts can be very, very distressing,

but an SOS box can be a box of things that your child can go to

when they're having these thoughts or they're feeling very distressed.

And in that box it might be some affirmations that they've written for

themselves previously. Some words such as 'you are enough',

'things will get better'.

It could be a telephone number in there for their best friend.

A reminder to not just send a message saying that you're okay,

but to actually pick up the phone. Let your best friend know, oh,

now's this time that I want to call you.

And have the chat and make sure your best friend knows that that's in there and

how important you are to them. It could be anything.

It could be a candle because you remember that lighting a candle and

doing some meditation helps.

It could be a few leaves because you remember that a walk outside in nature,

so your SOS box is exactly that.

If you're feeling really distressed and struggling,

it's a reminder of those things that can help you in that moment.

And I think being a parent to somebody going through that is really,

really difficult and distressing.

So it's important to make sure that you are reaching out and getting support

from your support network as well.

You might not want to share this with certain people,

and there might be other people you are comfortable sharing it with,

but those people that you trust,

it's really important that you are supported too.

My teenager is self harming, how can I help?

I think the fact that you've obviously noticed that your teenager is

self-harming either because you've observed something or because they've told

you.

I think the most important thing is that you do act upon the fact that you know

about it and speak to them about it.

Find a way to let them know that it is going on,

but in a nonjudgmental way, in a really relaxed and calm way.

And there are some ways you can take the intensity out of those conversations,

such as having the conversation in a car or whilst you're out for a walk,

rather than doing it across the dinner table with direct eye contact.

How best to do it?

I think often a good way of starting these more difficult

conversations is by letting the other person

know how you are feeling.

What you absolutely don't want to do is be accusing them and saying,

you've done this or you did that, or you are this.

But what you always have the right to do is tell somebody how you are feeling.

So if you were to say, for example, to your child, oh,

I've been a little bit upset and a little bit worried lately because I noticed

those marks on your arms, or whatever else it might be,

I think the other person can't really get too upset that you are sharing

your feelings. So that might be quite a nice way of leading into it.

Sometimes given a warning shot as well.

So if you are thinking you'd like to raise this conversation and have a

detailed conversation, maybe saying a few days before or at the weekend,

shall we go shopping and buy that thing you've been talking about,

but in the car on the way,

I wanted to talk to you about something that might be a slightly awkward

conversation and then just say,

I've been a little bit worried about you lately because I noticed that mark on

your arm, but let's not get into it now. We'll have a chat on Saturday.

So giving a warning shot,

it lets them know that it gives them time to sort of have a little think and

prepare. We all know that teenagers,

their emotions can go quite off the handle really quickly.

They don't necessarily, and this is all, teenagers,

don't necessarily have the ability to contain their emotions and hold onto them.

So I think that way, knowing it's coming,

you're more likely to have a more useful and helpful

conversation. It also gives them the opportunity to say, absolutely not,

I don't want to talk to you about this.

But then maybe there is somebody else that they feel more comfortable talking to

about it.

Maybe it's another relative or a friend or an older sibling.

And then you can support them with identifying that person and doing that if

that suits them better.

What is body dysmorphia?

Body dysmorphia or body dysmorphic disorder is a mental health

condition where people worry and are concerned excessively

about their appearance to the point that they can't live their lives normally,

or it causes them extreme amounts of distress or it impacts negatively on their

quality of life.

What is Anorexia?

Anorexia or anorexia nervosa is a very severe mental health

condition where people have low body weight and often have lots

of rules around how they eat and what they eat.

It is a really severe mental health condition that definitely needs

professional support.

What is Bulimia?

Bulimia or bulimia

nervosa is a serious mental health condition where people

get caught in a cycle of eating, overeating,

large volumes of food, which is often called binging,

followed by what's called purging, and that can be vomiting.

Taking laxatives or diuretics,

excessively exercising.

It's a really severe mental health condition that needs support and help.

How much sleep should a teenager get?

So teenagers actually need more sleep than adults do.

Most teenagers will need somewhere between eight and 10 hours sleep,

but sadly,

most teenagers get on approximately seven to seven and a half hours

sleep. So often teenagers are running at a sleep debt,

which is not great because sleep is so important for

everything from forming memories,

which of course they're trying to do because learn, to having a healthy,

functioning immune system to regulating our emotions,

to growing and healing and repairing. So yeah,

most teenagers are not getting quite as much sleep as they need.

Is it normal for my teenager to sleep all the time?

So it sometimes feels like all teenagers want to do is sleep,

and they do need a little bit more sleep than adults.

So most adults need between seven and nine hours,

and most teenagers need between eight and ten hours.

But I think the thing that really messes teenagers up is

that throughout adolescence, the body clock,

the circadian rhythm is set differently,

and actually they start producing melatonin,

which is a hormone that helps the sleep later in the day than

adults do.

So therefore teenagers feel tired and want to go to bed very, very late,

maybe around midnight, 1:00 AM and that's biologically,

their body is more in line with doing that,

and therefore they want to sleep in the morning till ten, eleven, twelve

o'clock, but they can't. They've got to get up and go to school.

So there have been conversations, lots of conversations around actually,

should the school day change,

would it suit young people better if they started school later in the day?

And I think most sleep experts would say the answer to that question

is yes.

And this is why certainly at the weekends when teenagers get the opportunity to

sleep,

they want to spend time in bed because they've got what's called a sleep debt.

They've had less hours sleep over the week than they need.

So this is the first opportunity that they've had to catch up on that.

So therefore,

I don't think you should be necessarily giving your teenager a rough time if

they want to stay in bed till lunchtime at a weekend.

It's not that they're lazy,

it's that their biology is not consistent with the way in the world,

the way that the world is set up. So yeah, maybe go easy on them.

What's a healthy diet for teenagers?

I think the topic of diet and nutrition is so big.

So the Mediterranean diet is what's usually classed as a healthy diet.

That's a diet that is predominantly plant-based with loads of fruit and veg and

nuts and seeds and whole grains. Oils from olive oil, vegetable oils,

fish at least twice a week.

Ideally one portion of oily fish and small amounts of lean protein,

so things like chicken and pork and dairy products.

Calcium is particularly important for children and teenagers who

are still growing and developing to lay down strong bones for the future.

A couple of things that often come up talking about diet is there's a trend

towards a vegan lifestyle. Of course,

you can live a very healthy vegan lifestyle,

but the diet does need careful consideration to make sure you're getting all the

nutrients that you need,

and often we'll need some supplements as well to top up on things

like iron and vitamin B12 and iodine.

Other things that come up. I always talk about hydration.

It's really important that teenagers are getting enough fluid on board.

Often our brain tells us that we're hungry when in fact we're thirsty

and thinking about processed foods and ultra processed foods.

Sadly, nowadays, children and young people, about two thirds of what

they consume is considered to be highly processed.

So thinking about ways to reduce that, and fibre getting more fibre

in the diet. It's a real challenge, I think, to get more fibre,

but just making some simple switches in your shopping trolley, for example,

if you're a family who eat rice most days or every day,

switching white rice to brown rice can make a really big difference

over a lifetime as to how much fibre you consume and therefore

your health. Word of warning, children and teenagers may not like it initially.

They might say they don't like the brown rice, they want to switch back,

but if you persevere and stick with it,

they'll get used to it and probably end up preferring it.

I think brown rice has got a nice nutty flavour to it,

and it's actually become my preference, even though it wasn't at the start.

Is eating five a day really important?

So we should all be trying our best to eat five a day portions of fruit and

vegetables. And yes, it is really important. In fact,

I'll let you into a little secret.

The research tells us that we should actually be aiming for at least eight

portions of fruit and veg a day. But the guideline,

the government guideline is five a day.

Now the reason it's five and not eight is because these guidelines are developed

to influence the people who have the poorest diets and the poorest

health to improve their health.

So what we're really trying to do there is encourage people

who may be eating zero or one or two portions of fruit and veg day

to work towards five,

rather than trying to get people who are consuming five portions of fruit and

veggie day to increase to eight. And if you make the guideline eight,

then the people that are not consuming any fruit and veg fill that that's

unachievable and are less likely to give it a go. So yes,

five a day is important, and eight a day is even better.

Does diet affect mental health?

So the link between diet and mental health is something that

we are currently in the scientific world understanding more and more about.

It's relatively recent that there's been research that has shown us that there

is definitely a direct link between the quality of our diet

and mental health.

So eating colourful fruits and vegetables,

eating plenty of fibre and good hydration are all things that

support our gut microbiome,

which is the community of bacteria and other organisms that live in our

intestines.

Our gut and our brain are connected by a nerve called the vagus nerve,

and also they send chemical messages to each other.

So a healthy gut helps us have a healthy brain and vice

versa. In fact, the hormone serotonin, which is the happy hormone,

we produce the majority of that in our gut.

So what we eat can absolutely influence and impact

our mental health.

What are the risks of smoking and vaping?

So the good news here is that smoking rates are lower than they've ever been

and that actually most young people are smart enough and knowledgeable enough

to never even try it,

which is great because smoking is just about the riskiest thing you can do

in your lifestyle. It increases your risk of heart disease,

of lung cancer more than anything else. But luckily,

most people who are young don't even entertain it. Vaping however,

whilst it is considered to be significantly safer than smoking

tobacco, it's not safe. And we,

to this day, because it's quite new,

don't actually entirely know what all of the risks are.

Vaping is something that if somebody smokes tobacco and they're using

vaping to get off cigarettes,

it's deemed to be okay for that because it's safer than smoking.

But for people who don't smoke, taking up vaping is definitely a risky behavior,

especially if there's nicotine in the vape as well.

Because nicotine is a highly addictive substance,

it can increase anxiety and we really don't know what the long-term effects of vaping

are. So it's something,

sadly that is more popular amongst young people and it's definitely something

that's of significant concern to the health community.

Is it okay for teenagers to drink alcohol?

There are lots of reasons why it's not a good idea for teenagers to drink

alcohol,

and one of them is that the brain is still developing and drinking

significant amounts of alcohol whilst the brain is still developing

can actually alter brain development,

so it can be damaging in that way.

One of the other major concerns about it is that alcohol can

lower inhibitions and it can affect high judgement to make sensible

decisions, which can be an issue for older people as well.

But teenagers are in a phase of their life whilst the brain

is still developing,

where actually that is something that they're already affected by.

As a teenager, your brain is developing really, really quickly,

but the decision-making part of the brain isn't fully formed,

and therefore teenagers can be more likely already

to make, let's say, perhaps not the most sensible decision.

There's lots of things like peer pressure as well,

so when you throw alcohol into the mix,

it does increase the likelihood of teenagers doing things that they might regret

later on.

What effects can alcohol have on the teenage body?

So we know that alcohol,

or certainly excessive amounts of alcohol can have devastating effects on

the adult body. It can affect the brain, it can affect the liver,

it can affect the heart. That's if people are having excessive amounts of,

not to mention the mental health implications. It can affect sleep,

it can increase the risk of depression and anxiety,

but with teenagers it's even more important,

largely because the brain is still developing and drinking

alcohol, especially significant amounts of alcohol can affect that brain

development.

So really important that teenagers ideally don't drink any

alcohol, or if they do, it's minimal amounts. Also,

whilst the teenage brain is still developing, teenagers already

have, let's say, a little bit less control over their decision making.

We know that teenagers are perhaps a little bit more likely to be impulsive

and make decisions and do things that had they had a bit more time to think

about it, they wouldn't have done. When you add alcohol into the mix there,

then that can be quite devastating and teenagers are more likely to do things

that they might regret the next day.

How can I help my teenager see the dangers of drug use?

I think the best way to help your teenager understand the

dangers of drug use is simply to talk about it,

have a conversation with them.

It's one thing if you are concerned about them using drugs,

that's one conversation.

But even if you are not talking openly about all subjects with your

family, with your children,

is the best way of making sure that when there may be a reason to have

a more in-depth conversation, you've almost already practised it.

I think talking about drugs and the use of drugs,

using examples that they might be familiar with, whether that's TV,

whether if there's anybody that you know that's had problems with

addiction and drugs and alcohol,

I think the more you can talk about it openly, honestly,

and freely throughout their life, the better.

But if you are concerned that they may be using drugs,

I think the best way to do it is respectfully

and calmly and non accusationally,

but perhaps by letting them know that you are worried,

saying to your child,

I'm feeling a bit upset and I'm feeling a bit worried because I've seen this or

because I've noticed that.

And I think allowing there to be a little bit of silence in the conversation.

Having the chat in the car or whilst you're having a walk rather than across the

dinner table because it's a bit intense.

But if you feel that there's a need to raise that conversation,

if that's what your gut instinct as a parent is telling you,

then there probably is a need to have that conversation and it's better to do so

and it not have been necessary, than the opposite.

My daughter is reluctant to socialise with the rest of the family - is this normal?

Yes it is.

So this is one of the really common and normal social changes

that is a part of puberty.

So puberty is changing from a child to an adult.

So there are physical changes of the body,

there are emotional changes and there are also social changes.

And one of the common social changes is that young people tend to want to spend

less time with their family, with their parents, with their siblings,

and more time with their friends. It's all a part of growing up,

it's a part of becoming more independent. It's a part of also,

whilst up until that point,

they've probably followed whatever the values of the family

are, but they're starting to develop their own values,

which will be largely based on the family values they've been brought up with.

But figuring out who they are and what their place is in the world.

And in order to get that independence,

they do need to spend more time away from their parents in particular.

So it's completely normal that young people throughout various different

stages of puberty growing up tend to not want to engage in family

activities as much as they previously did, which is really sad,

I think sometimes for parents. But it is normal.

Is it normal for my teenager to stop talking to me?

It's really common and really normal for the relationship

between a child and a parent to change as they are going through

puberty, as they're growing up. And it can be really difficult for parents,

I think,

to experience that because you may have had this

perfect bond throughout their life.

Now all of a sudden it may seem that they're putting their friends before you

that they don't seem to have as much interest in you,

not want to spend as much time with you,

but it is all part of them becoming more independent.

So puberty is developing from a child to an adult, physically,

mentally, emotionally, and socially.

In order to one day be able to look after themselves in the big

wide world, they've got to start learning to do that without you by their side.

So it is normal, even though it might feel sad, it is normal.

I think my daughter is being a bully, how do I stop this?

I think this can be really, really difficult. As a parent,

you can feel so many emotions. You might feel sadness,

you might feel guilt.

First thing to do is to open up a really honest conversation with your

child and get them talking about it. Usually,

often bullying is a symptom of something else

underlying in the bully.

Often the person doing the bullying is experiencing something

themselves somewhere else.

That is perhaps making them feel vulnerable or making

them feel like they're not enough. And sometimes bullying can be a symptom.

So I think first and foremost,

it is being really open with your child and trying to understand what

potentially that might be.

And then the next step in terms of trying to stop the bullying,

rectify the bullying.

If you can help the child by supporting them with perhaps whatever the cause of

that is in the first place would be helpful.

But then to rectify it longer term and there needs to be an apology.

If they recognise that what they've been doing is wrong and is harmful to

another person, then

enabling them and supporting them and empowering them to apologise to that

person for what they've done will not only help with the healing of the person

who they've been bullying, but will help with their own healing as well.

So that's kind of the bit that's further down the road.

My daughter is being bullied, how can I help?

I think being the parent of somebody who's being bullied can be

absolutely heartbreaking, and you can sometimes feel really disempowered

as to what to do. First and foremost

it's really important that all parties involved are aware of what is going on.

So that would be the school. If it's happening at school, ideally,

the person who is being the bully, their parents as well,

because it's kind of everybody's responsibility really to be aware of it and to

play their part in putting a stop to it.

Bullying come about in many different forms.

It could be physical things, it could be verbal things,

it could be online,

which is even more challenging to rectify in terms of being a parent

to your child.

I think the most important thing is let them know that they can tell you

everything that's going on.

There's absolutely no shame on their part. It's not their fault.

And usually the person who is being the bully has things going on in their

own life that they're suffering from,

and the bullying is a symptom of that.

So trying to understand that can sometimes help.

But the most important thing is making sure that your child feels supported,

loved, reassured, and that they have somebody that they can talk to.

My daughter is really shy, is there anything I can do?

Well, believe it or not, I was really shy when I was a little girl,

extremely shy,

and one of the things that helped me come out of my shell was getting involved

in dance classes.

So I think if your daughter is shy trying to find something that she's

interested in, ideally something that involves physical activity as well,

and trying to get her involved in a group or a team or

doing an activity with other children that have a similar interest.

It is normal to be shy and normal to be clingy to our parents,

but I know I certainly benefited a lot,

such a lot through having that experience of going to dance classes and

making friends and starting to spend a little bit of time away from my mum,

even if it was for an hour here or there.

Should I let my teenager have a phone?

I think this is a really tricky one that if I'm completely honest,

I don't have the answer to.

I think your teenager will probably want to have a phone,

and it sounds like you might not want them to have a phone.

I think perhaps the best way to weigh this up is to literally

make a list of the pros and the cons. They can make their list.

You can make your list, and then you can compare lists.

But in your particular individual set of circumstances,

what are the benefits? What are the things you're afraid of?

And then also think about what are some of the measures that you might be able

to put in place to make a compromise.

Could it be that there are certain blocks on the phone,

or that they only have the phone at certain times of the day?

But yeah, it's not really something I can say you should or shouldn't do.

My teenager has been watching porn, what should I do about it?

I think the reality is sadly,

that nowadays it is so easy

for children and young people to access things like pornography

online,

and it's a tricky one to know what to do in terms of stopping

them doing that. But I think what you can do is you can have a really open,

honest conversation with them about exactly what porn is,

because as a teenager, they may not realise that this is watching a movie.

This has a director and lights and camera people,

and that the people that they're seeing are actors.

And those actors tend to have, if they're female,

a very specific type of vulva, which is not a typical vulva.

It's just one type of vulva.

And the men tend to have larger than normal penises and they wear ridiculous

underwear,

and they have sex in positions and in ways that actually mostly people

don't.

So I think perhaps having a conversation with them and explaining that's what

pornography is, it's a form of

made up entertainment and that's not what real sex is like,

can maybe help undo some of the potential damage that observing porn

at a young age can do. There are great resources out there.

I wrote a book called You Grow Girl,

which demonstrates that vulvas come in all different shapes and sizes.

They all appear different and they're all normal. As a doctor,

I've seen hundreds, so I know that to be absolutely true.

Yet when you see pornography, they're all one type.

So I think that's probably the best thing you can do as a parent is just be

really honest and explain that it's not real and

therefore it should never influence the way that they think they

should look,

the way that they think they should be or the way that they think, when the time

comes, they should have sex.

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