BabyGeek: Chronic Stress In Children

I recently wrote about amazing findings showing that stress in early life actually causes DNA damage. Researchers at Duke have taken the next step, finding the exact receptor that is disabled by chronic stress, resulting in genetic damage.

This adds strength to what I believe about making sure our kids are brought up in Good Enough environments: We already know that a LITTLE bit of stress is a good thing. It toughens us up and helps us learn new lessons. But too much stress, over a long period of time, is a bad thing.  That's why children brought up in chronically abusive or deprived environments fare so poorly. And these folks at Duke have found a glimpse into exactly how that works, on a molecular level. Cool stuff.

Their research is connected to how our cells are damaged in a variety of ways -- including by the aging process -- and I know I'm not the only 40-something parent out there hoping science will help us push the envelope of healthy life way out into the future, giving us more time with our children, grandchildren, and great-grandchildren.

Do you think science will offer us a cure for stress and aging -- in our lifetimes? I hope so!

 

Aloha,

Dr. Heather The BabyShrink

Toddler Behavior: When Children Are Stressed About A New House Or New Baby

Dear Dr. Heather, My 2-year-old granddaughter is stressed about her new house. Her parents moved a couple of weeks ago, and then her mother had a new baby. Emma seems to "love" her new brother, so I can't imagine that he is upsetting her. But I am concerned that her mother is not giving Emma new routines in the new house. Emma is overtired and cranky. She is a lovely, intelligent child and I am worried about her. Doesn't she need routines?

Sometimes it's all too much for a little kid!

Chris

Dear Chris,

It's tough being a grandma -- you can see that your kids (and grandkids) are suffering, but there's little you can do about it, since you're not the parent.

But yes, the changes that Emma has experienced are quite pronounced, and even a 2-year-old picks up on all the changes. The new baby is a big part of it, believe me. At times she is thrilled and entertained by the new baby, but deep down she suspects that the baby is the cause of all the problems in her life right now. That's why we always remind parents to NEVER leave a baby alone with a toddler -- no matter how much the toddler "loves" the new baby. Too many "accidents" happen to babies that way. But don't blame Emma -- she really can't help herself. It's her age.

And of course you are right that Emma needs routines, as close as possible to the old routines as possible. But right now, with the new baby, all bets are off. Her poor Mom is struggling with the new addition, PLUS a new house, AND being up all night, and so she gets special dispensation to be disorganized and "out of it". The name of the game now, with your family, is to GET THROUGH IT, in any reasonable way. Let the new routines emerge naturally and support Emma's parents as much as possible. The better they feel, and the more rest THEY get, the more their own natural instincts will kick in, and they'll naturally start to establish new routines.

But if there aren't many routines yet, and Emma is cranky and overtired for a few weeks -- it's OK. We assume that a few weeks' disruption will naturally return to normal after an adjustment period. If not, talk to Emma's parents about your concerns, but until then, I would suggest simply supporting the family and being understanding of a cranky toddler. (And after all, grandmas get special dispensation to spoil their granddaughters, especially when they're a little stressed out, right?)

If things don't improve in a few weeks, let me know.

Aloha, Dr. Heather The BabyShrink

Pregnancy Help: More Postpartum Depression/Postpartum Anxiety Support

Julie Malone of CoolMomGuide launched a support forum for moms with postpartum depression and anxiety. She's also hooked it up to play my podcast on PPD/PPA. If you haven't listened to it yet, hit my podcast button to the right, or listen to it over at Julie's place! A new mom has about a 10% chance of having postpartum depression or anxiety. This is the most common complication of childbirth. Postpartum illness impacts the entire family. Not only does it affect mom's mood, it impacts the development of the baby -- and the functioning of the entire family. Most of us are too ashamed to ask for help -- yet it is very treatable! If you or someone you care about might have PPD or PPA, please listen to the podcast and take the steps to get help.

Pregnancy Help: Hope for Postpartum Depression: A Podcast

Tune in to Dr. Heather on Postpartum Depression. Here at BabyShrink, I get emailed questions from all over the world. Many of these make it onto the site; questions about potty training, TV-watching, and poop-smearing (which is my most-read post, if you can believe it!)

But there are other questions; questions too pained and personal to be published. Questions from mothers desperate about the difficulty of having a new baby. Questions from grandmothers, worried about the dark circles under their daughter's eyes. Questions from husbands, worried that their wives (and marriages) might never be the same after the birth of their baby.

In our Lamaze class, we met several couples. You know how it is; you can't help bonding with other couples going through the same trial-by-fire. You stay in touch with some of them. Others fade away, but you always recognize each other, say "hi" at the grocery store, and ask about their child, who is the same age as yours.

There was one couple we met and really liked. But they never seemed to follow through on suggestions of get-togethers. When we ran into them, they seemed fine. But they weren't.

Quite by accident, I found out that the Mom had suffered a terrible, crushing postpartum depression after the birth of their baby. They never came to us -- knowing we were both psychologists -- and suffered alone.

I was stunned to have been so clueless about the pain they went through. Luckily, they eventually got help, and all is well now. But I never forgot about the terrible shame and hopelessness that must have driven them into silence.

I know there are many more of you out there, similarly suffering in silence. I hope that this, my first BabyShrink podcast, can help.

There are many people to thank in the launching of this podcast. Ilima Loomis, who helped me see that a podcast was the perfect vehicle for communicating with new mothers, who are alone and up with the baby at night. Heather Sanders, for my tech-support and visual flair extraordinaire, Glenn Sakamoto, my most tireless and knowledgeable supporter and designer, Danny Evans, who made BabyShrink happen, and his lovely Hot Wife, my BFF and straight-shooting reviewer. I also want to thank the women and families who have opened up the most frightening and painful chapters of their lives to me, to help me understand how best to help others.

I'm also collecting stories of recovery. If you've suffered from PPD and come through to the other side, please post a comment here to encourage others to get help....and send the message that you CAN feel better.

Note: This is a 16-minute podcast. It downloads to your player OR your computer in less than one minute, with a broadband connection.

[Click to Download Podcast Here]

Parenting Tips: Lessons Learned From A Baby's Surgery

Thanks to all of you who wrote your comments and emails of support over the past couple of weeks while I anxiously awaited our 2-year-old's hernia surgery. He's fine today; a little tender, walking around like an old man who put his back out. He's covered in the dirty, gummy remnants of surgical tape, and has two (yes, TWO) inch-long diagonal scars in his groin. But he is fine. So while the memories are still fresh, here are some important things I learned yesterday: Be Ready for Changes in the Surgery Schedule Not easy for a control freak like me, but important to know. The schedule can be changed for any number of reasons, so plan accordingly. For us, T was found to need more extensive surgery, requiring more time (2 hours, as opposed to the 30 minutes we had expected). That meant the doctor had to shuffle his schedule, which affected our arrangements. Stay light on your feet, and keep your options open on the day of surgery. If at all possible, arrange to have both parents present AND a support person (like a grandma -- Thanks Mom!) so you can juggle communication with the staff, care for your child, and other basics like parking, travel arrangements, and food.

Don't Be a Hero I'm a health-care professional, right? I grew up in a medical household; my Dad was a physician. The sight of blood doesn't bother me, I have more than a passing familiarity with medical practices, and I've been roaming around hospitals since I was 3.

But yesterday, I was just "Mommy". A shaky, scared Mom who was an idiot and asked to help carry her baby to the Operating Room, and assist with the baby until he was asleep. I thought that helping out as much as possible would be best for the baby. Big mistake! The sight of my baby struggling and screaming while he was being held down (by me) while the nitrous was administered -- that's an image I'll never forget. And it certainly didn't help T. Take my advice and don't be a hero. Treat yourself with some TLC as much as you can. And let the professionals do their job. I don't care if you're in the profession yourself; on Surgery Day, we're all Just Mom, or Just Dad.

Don't Be an Idiot -- EAT Something! I assumed my stomach would be too upset with worry to eat anything, so by the time 11 am rolled around, I was shaky, dehydrated, and bitchy. Not too helpful (nor very appreciated by Mr. Dr. BabyShrink). If you're used to caffeine in the morning, make sure you get some. And at least bring a banana and some trail mix to the hospital; I picked at it, and once T woke up, he devoured it (and the outpatient surgi-center usually doesn't provide food afterward to the kids; you need to bring something for them, since they may very well get hungry afterwards). And since the surgery took so long, I actually did go to the cafeteria for 20 minutes. I forced myself to read the paper, have a snack, and NOT picture my baby being strapped down to the operating table. Even though part of me didn't want to be farther away from the operating room, walking away from the surgi-center for a short break gave me some perspective and allowed me to decompress for a bit.

Thank You To The Doctors and Nurses We are all incredibly indebted to the doctors, nurses, and other health-care professionals who take care of our kids; those like Dr. Sid Johnson and post-op nurses Jessica and Mike who were among those who took care of TT yesterday at Kapiolani Women's and Children's Hospital. These people have the stamina, dedication, courage and expertise to take care of difficult, challenging, and often very sad cases every day. But mostly they love kids, and it shows in the work that they do.

A Hernia Is Just a Hernia; Nothing More. When TT was resting in the "wake-up room", Jessica shared stories with us about some of the very sick children who come in and out of Kapiolani every day. It gave me some healthy perspective: To them, TT is a healthy, strong child who just needs a little patch-up work. The child on one side of T was a 9-year-old who has had leukemia for 3 1/2 years. On the other side was an 18-month-old who has had multiple surgeries from birth defects, and had reconstructive work done on her pelvis. She was put into a full-body cast. And although our little guy will be sore for awhile, in comparison, this was small potatoes. So while the day was grueling, and we hit some tricky spots, we're home, and everyone is on the road to recovery. We're extremely grateful for the health of our family; even more so, after our experience yesterday.

BabyShrink's Feelings About Pet Loss

Rusty-Puppy was a sweet, happy dog who spent her life at Evans World Headquarters. She would rest her warm head on your knee as you sat at the table, peering up at you with those trusting brown eyes. She joyfully bounded around the yard with the kids. She was everything you could ever hope for in a family dog. But Rusty got old and sick. There were sparks of her old self, but her quality of life was miserable. Sharon and Danny agonized over when to end Rusty's suffering. They decided that yesterday was the day.

I spoke to Sharon yesterday after their appointment at the vet. "I bawled the whole time," she said. "She kept losing weight. She couldn't make it outside anymore on her own. Then I would see a little improvement. Was this the right time?"

Sharon also talked about the finality of death -- even with pets. "Somehow we take it for granted, if it's an animal. But it's just as final as if she was a person."

In the background, I could hear kids yelling and laughing. Sharon had taken the kids to their first soccer practice of the season. "We haven't told them yet. We told them it was coming; we tried to prepare them as best we could. But I couldn't imagine taking them home to tell them about Rusty, then having to sit there with them as they missed practice. Somehow, life has to go on. I think it may be harder on me than it will be on them."

Last night, I dreamt about Morey. Morey was a skinny red tabby; my first pet. After living through six cross-country moves in eight years, Morey gave me a sense of stability. She would sit in my lap, and I had a friend. I wasn't the "new kid in town" to Morey.toddler and cat

My Dad took her to get "fixed" one day. Late in the afternoon, we still hadn't heard back from the vet. I made him call. I was afraid, but I wasn't sure why. When my Dad hung up the phone, he threw his hands in the air and shrugged. "She died," he said. Then he went for a jog. I sat there and cried, trying to "pet" Morey's fur that was still stuck on my t-shirt.

I hate to tell those kinds of stories about my Dad, first of all because he died several years ago, and second, because he was one of the nicest guys you could ever meet. But he was a doctor's doctor. His sensitivity to the emotional life of his kids left a lot to be desired.

Apparently, Morey had a reaction to the anesthesia. (Those of you who read my last post are putting two and two together right about now. Aha. Maybe THAT'S why she's doubly worried about the anesthesia.)

We quickly got two new cats, but they got left in Texas after we moved back to Hawaii. Then the cat I had my whole adult life died when I was finally pregnant with our first child (which was immediately after my Dad was diagnosed with terminal cancer).

So, my reaction to pet loss is a little more complicated and neurotic, as a result. I wanted to have some pithy comments and suggestions to give Sharon yesterday. But the pit I felt in my stomach distracted me from rational thought.

Sharon and I talked about whether to introduce a new pet into the family, and when. Are there any ideal ages, in terms of the kids? And of course the burden of caring for an animal falls on the adults in the family. Do we really want that extra job, when we're running around after little kids? I told Sharon, "I can't do it again. It's too hard." But I understand that pets provide so much love to a family. I understand that important lessons about the cycle of life and death are beautifully demonstrated to children by owning and caring for pets.

So I'm sitting here, trying to put together some guidelines for how to cope with pet loss. And I can't come up with much, other than the fact that each kid is so different, and each developmental age is so different, that you have to individualize your reaction, based on those factors. Obviously, DON'T throw up your hands and go out for a jog. Let the kids set the pace, in terms of questions about the pet, and death in general. Lean on your family's spiritual tradition to help inform your answers about "what happens after death". When considering adding a new pet to the family, don't automatically jump in to that responsibility. You want to send the message to your kids that, although losing an animal is not the same as losing a person, we still must honor the place the pet held in our family, and that every life is unique.

In my last post, you had some incredible advice and suggestions. Now let me ask you: When IS the right time to add a new pet to the family, following the loss of a beloved animal?

Parenting Tips: Do I Have Childhood "Baggage" About Moving?

Hello Dr. Heather, My husband and I have a 6-year-old son, a 4-year-old daughter, and a baby due in early August. We are moving across the country about two weeks after I have the baby. My husband will be attending graduate school in our new city. We were settled here and I'm having a really hard time with this. The kids are, too, though not as much as me. My daughter threw a penny in the fountain the other day and said "I wish we didn't have to move." My son was really looking forward to starting first grade with his kindergarten friends, and he's quite upset from time to time, although not every day. Currently, we are still searching for a place to live there, and we have just sold our home here, which we all love, and so everything feels so unsettled.  I moved in the middle of second grade and still remember how traumatized I was by it, although my dad had lost his job, so there were some other difficulties going on in my family. I don't want to project my childhood onto them, in addition to the sadness I'm feeling now.

My question is, how do I make this transition go as smoothly as it can for them, and how much does my sadness about this situation transfer to them?

Thanks,

You can call me "Emily".

Dear "Emily",

Did you see my recent post about moving?  I'm getting lots of questions like that at this time of year.

I do understand your concerns; it's a big deal for me too; we moved several times in my childhood, and I am pretty sensitive about the issue. Uprooting your life is no small thing. The familiarity of your routine, the process of making new friends, adjusting to new jobs and schools; it's harder than most people realize. But for young kids, it's a lot easier.

It sounds to me like the challenge is going to be more for you, not the kids. Wow, Mama, you have your hands full! Moving 2 weeks post-baby? With 2 other little kids? Yowza! That's a huge job, physically and emotionally. And your past negative experience with moving is likely to haunt you, to some degree.

YES, your kids totally pick up on your emotional reaction to the move. You (and their Dad) are their main emotional signposts, at least until they get to about second grade. In order to get through this with as little stress as possible, you need to lean on your husband as well as anyone else you can; family? Friends? Clergy?  Don't hold back on asking for help.

Do you have any risk factors for postpartum depression? Please keep that in mind, especially in the 2-week-plus-postpartum period, when PPD is most likely to strike. That much change and stress -- moving and a new baby, with two little ones, a whole new city, as well as your own childhood history of the difficult move...it all raises your risk for depression. Ask your husband to help monitor your mood as well. Make sure you hook up with an OB/GYN as soon as you get to your new city -- and make sure you go in for a checkup. There are lots of resources available online to help you find a counselor if you need one.

Try to look at it all as an adventure. Help the kids see how to handle change in a positive way. Look at this as an opportunity to have a "re-do" on your own negative childhood experience of moving. This is not the same thing as when you were a kid; this is not an unfortunate turn of events that you all have to live with. This is you and your hubby making a decision for the ultimate good of the family. You have a chance to do it again...but different. Better.

Good luck with everything and keep us posted!

Aloha,

Dr. Heather

The BabyShrink

Parenting Tips: Will Moving To A New House Be Too Stressful For My Child?

Dear Dr. Heather, I'm a full time single dad of a 5 1/2 year-old girl.  I have a great career, and she is happy and doing very well in school. I've decided to move again; the 3rd place in 3 years, all within the same neighborhood. Each time has been for "upgrades". So we will have a yard to play in and not have to deal with the apartment living we are most used to here in LA. My question is, will all this moving create any problems for her, emotionally, at her age?

Thanks, Rich

Hi Rich,

First of all, GO DAD! I love to hear about Dads like you who are considering psychological issues in the development of their kids. The fact that you are asking the question tells me you're on the right track!

Now, the issue of moving: I’ve been getting this kind of question a lot lately, as lots of families move during the summer. At this age, your daughter is basically still tied to YOU, as her anchor in the world. The house is secondary, at best. What's best for YOU is best for HER. If you are happy, she will be, too.

Your attitude about moving is also important. Approach it like an adventure, and involve her in the process as much as you can. Let her make choices about anything reasonable, like paint colors, or how to set up her room. Ask her about any down sides; what does she miss about the last house? Let her talk about it. Just listen. Maybe there's nothing; maybe there's something. Let her know that her feelings do matter to you, regardless. You may not change anything, based on her feelings, but she WILL know you took her seriously.

Your best guide is to observe her behavior. A little regression following a move is normal. Sleep habits might go out the window, temporarily. She may be more clingy or temperamental. Talk to her about the feelings you suspect might be underneath the behavior. But it sounds like she's a PRO at moving, and I doubt it will be too difficult. She likely will bounce back very quickly.

But soon, her school and friends are going to become important...VERY important. And then, you will want to think twice about moving her around, especially if it affects her school placement. I would start thinking about her elementary school situation, and where you want her to be. Consider the neighborhood in terms of kids her age and other kid-friendly features like parks. Start thinking about a longer-term living situation, where she can feel settled, and try to stay, if you can. Moving when your daughter is older is bound to cause more stress for her. Good luck!

And for more on Dads, check out these BabyShrink posts.

Aloha,

Dr. Heather

The BabyShrink

Parenting Tips: When Your Parents and Kids Unite Against Their Common Enemy -- YOU

VickisphotoDear BabyShrink,

I have two children; a seven-year-old boy and a five-year-old girl.  We are lucky enough to live close to three sets of their grandparents who all want to spend time with them.  The problem is that the kids have picked favorites.  They only want to spend time with the "fun" ones (the ones that let them eat whatever they want, watch whatever they want and go to bed whenever they want).  This has resulted in tension with the grandparents who believe in rules and boundaries.  The kids have also told my husband and me that they don't want to live with us anymore.  I realize they're just being kids, but they're also hurting feelings.  How do I speak to them about this in a way that they can grasp? 

Sincerely, Vicki

Hi Vicki,

Thanks for the picture! Your kids are adorable, and you can't really blame them for responding like they do when they're showered with gifts and given no limits. At this age, they're just following the cookies and the Wii. Social skills are not really their strong suit, yet.

But it is important to set a standard for them in how they treat people, and family in particular. In every family, there are differences in the way one set of relatives relates to the kids, vs. the other set. Differing cultural traditions and values can play a role. Sometimes, one family has tons of grandkids (and therefore less time and money to spend) and the other side has few, so therefore more time and money. The general level of intensity of the relationships within the family often dictate things, too. For instance, my husband's family is more involved in general in the lives of their friends and family. My family, on the other hand, is more "live and let live".  Neither is better, just different. Kids have to get used to the fact that everyone is different; and that's OK.

Grandparents have the inalienable right to spoil their grandkids; nothing I can say will change that.

But your children will learn over time, with your help, that you can't "judge the book by it's cover". Treats and presents are great, but they're not everything.

The kids do have to learn that some things in life cannot be controlled; Grandma X gives cookies and candy, Grandma Y gives fruit and crackers. All you can do is talk to the kids gently (but frequently) about manners, being polite with everyone, and the fact that everyone is different. Perhaps the less-lenient grandparents have other attributes: Maybe they can teach the kids to fish, or go camping, or how to sew. The grandparents also have to come to terms with the fact that they will each have different standards with the kids.

You can talk to all the grandparents (probably separately) about your dilemma. Try to generate some empathy for the kids, for the other set of grandparents, and for YOU in the situation. Talk to the lenient grandparents about the bind they put you in. "I don't want to deny you your right to spoil the grandkids. I don't want to control your time with them. But when they come back home to rules and to be with us, they're impossible, since they've had so many goodies. They even told us they don't want to live with us anymore, or visit with the other grandparents. Can we talk about toning it down just a little bit?"

Also, talk with the other grandparents about your plans to address it. Show them you mean business when you insist that the kids are nice and polite. Really play up the cool things that they CAN do with these grandparents. Show your kids that their tantrums aren't going to get them anywhere; they still need to have a cordial relationship with all family members.

Good luck and keep us posted!

Aloha,

Dr. Heather The BabyShrink

 

Parenting Tips: How Much Time Should You Spend Playing With Your Baby?

Dear BabyShrink, I’m having trouble figuring out when to put my two-month-old daughter down, and when to pick her up and play with her. I've heard many ways of encouraging her development, but I feel guilty when I place her in her chair to get things done. She sleeps well at night, but I often spend a lot of time holding her and rocking her to sleep in the daytime. When I put her down in her bassinet she frequently wakes up crying, so I end up holding her while she naps. A big part of my problem is that I really don't want to be like my mom, who I feel was pretty neglectful. Sometimes when I put her down, I feel like I'm being like my mom. So, my question is, how much do I need to play and interact with my baby? How much is it okay to sit and let her play by herself?

Katie J.

Dear Katie J.,

Good questions: Is it OK to let a happy, alert baby sit alone in her baby seat while you get something done? And if so, how much, before there is “neglect” and developmental damage?

Trying to Improve our Parenting with Every Generation You say you want to change the pattern in your family of origin; and you want to pay more attention to your baby than what you experienced. Let me say this: The fact that you are conscious and aware of the issue tells me you are already most of the way there. It’s hard (but critically important) to be aware of the psychological baggage we bring to our parenting. If we’re not aware, we’re likely to do one of two things: Repeat the same negative patterns as the generations before us, OR overreact in the opposite direction in an attempt to “correct” the wrongs of our parents. So if you were neglected as a baby, you might find yourself either automatically leaving the baby alone too much…or being a “helicopter parent”; hovering every second, not allowing the baby any room to be alone. Conscious awareness of our ingrained tendencies makes it possible to move past them.

Once you’re aware of your tendencies, you can react less to your own inner demons, and respond more to the unique baby in front of you. What does she seem to need, today? What are the patterns you notice in her temperament? When is she most responsive to interaction and “play”? When is she content to be left on her own for a bit while you get something done around the house? There is no magical formula that tells us how many minutes per hour or day that will be optimal for her development. She will “tell” you, through her behavior. Babies are all different. You’re best off trying to “read” yours from moment to moment.

How Do I Know What My Baby Really Needs? When you observe your baby’s behavior over time, you will notice she has unique rhythms and patterns. Sometimes, she will have better control over her body, and be nice and alert. Other times, she will be disorganized in her movements, overwhelmed, irritable, tired or hungry. These patterns follow a fairly predictable cycle throughout the day. Your baby is most receptive to interaction and “play” when she is in the quiet, observant, alert phase of her sleep/wake/activity cycle. Other times, she will prefer to sit on her own, observing her environment, trying to make sense of it all. At two months, she is working so hard to try to focus her eyes, move her head (and feet and hands) purposefully, get used to her digestion and other internal sensations, and make sense of all that information. So giving her some time alone to “take it all in” while she’s in her bouncy seat (or crib, or bassinet) is perfectly fine. READ HER CUES. A well-developing baby will thrive on both her intimate, intense “play times” with you, and also be able to tolerate some time just watching the world go by.

A Mother’s Guilt: Never in Short Supply But it’s OK if you can’t play with her at each and every opportunity... I give you permission! Perhaps you have other things to do…Oh, I don’t know, like make dinner? Do laundry? Take care of other kids? Or, even lie down on the couch and relax for a bit (what a concept)? You need to balance her needs, and the needs of the family; that includes YOU too. You need to re-fuel yourself so that you can be your best with your baby. A tired, overwhelmed Mom doesn’t read anyone’s cues very well.

You can find practical solutions to some of the challenges in your baby’s early months, too. I hear you when you say your daughter is awake and fussy more in the daytime. You want to give her attention, but you also need to balance the needs of the rest of the household and the family. My second baby wanted to be held more than the others and didn’t nap well, but he slept well at night like your baby. So while we did play together during the day, when he was fussy and tired (but not willing to sleep) I schlepped him around in a front-carrier so that he could get the physical contact he craved, but I could still get something done around the house. Find solutions that are workable not only for your baby, but for you too.

Experiment with these ideas and let us know how it goes.

Aloha,

Dr. Heather The BabyShrink

Next time, I’ll tackle a related issue: How DO you “play” with a tiny baby, anyway?

Pregnancy Help: What NOT to Expect From "The Birth Plan"

There is a strain of pregnancy propaganda out there that sets new moms up for failure. It says that unless you “achieve” some particular kind of delivery perfection, well, then…you haven’t quite made the cut, as a Mom. And that makes me angry. It’s in all the standard pregnancy books. Something along the lines of, “Create your own birth plan. Be in charge of your delivery. Don’t let that mean, nasty doctor force you to deliver in some way that’s NOT in your plan. Decide in advance if you want to use pain medications for the delivery….or not.”

What they don’t say is that the birth process is usually so unpredictable that your carefully crafted “Birth Plan” gets left at the bottom of your carefully packed “Going To The Hospital Bag”…that got left at home, in a panic, as you rushed to the hospital.

Now, I’m a recovering control freak, so don’t get me wrong. Anything that’s called “a plan” looks fabulous to me. I did it myself, with our first baby. Here were my rules, when I was cluelessly buying into the notion that I could actually control the birth process by planning for it in advance: No induction. Lovely, inspirational music playing in the background. No pain meds. No pitocin. No c-section. (Oh yeah: no binkies or bottles for the baby either, but that was a different lesson for me to learn, for a different post!)

What happened, you ask? Oh, surely you must have guessed by now. I had it coming to me, big time. The control freak gets hammered. The doctor wanted to induce labor, since the baby was getting big, and she was overdue. But oh no, that was not in my Birth Plan. So we waited. And waited. When labor finally did begin, the early stages went well. But when it came time to push…not so well. I pushed and pushed and pushed…and nothing happened. I stood up to push. I squatted to push. I pushed and pushed for hours. The doctor wanted to add pitocin in order to add strength to the contractions, to help me along. No way. Not in the Birth Plan. She wanted to add an epidural, to relax me. No dice, doc. Finally the doctor had to go and do an emergency c-section on another lady. I had some time. The nurse convinced me to have the epidural and the pitocin, and then our baby was finally born. After four solid hours of pushing.

I was so sore after the delivery I had to sit on two huge pillows for weeks, and I still was miserable. Here are some other examples of “Birth Plans” that didn’t “pan” out:

The alternative-medicine-practitioner who swore she’d never use pain meds, who begged for (and got, with huge relief) an epidural after 12 hours of excruciating labor

The Maui-Hippie-type who arranged to have a birthing bath (with doula) brought to her home, only to need an emergency c-section at 34 weeks

My pain-fearing friend who hoped for every drug in the hospital, but delivered in the hallway of the ER while her husband was parking the car

Now, I’m all for planning, to the extent that planning is possible. But I’m really against the notion of feeding new mothers the idea that there is somehow an ideal birthing situation that they should be aiming for…other than the delivery of a healthy baby, with a healthy mother. Because that sets us up for comparisons, judging, and disappointment. The labor and delivery process is so unpredictable, and so individual and varied, that you really cannot plan for every possibility.

Many of you have expressed sadness, even a sense of failure, because you had to have a c-section. Or if you “caved”, and got an epidural. Unrealistic expectations can lead to big problems. For some, this disappointment can even lead to postpartum depression.

Lamaze Shlamaze; use whatever works.

The breathing techniques I learned in yoga and exercise classes helped me way more than anything I learned in the actual preparation to have a baby. That said, I still pushed for four hours! The only thing that is important in delivering your baby is that both you and baby are healthy. I don’t care if a Martian comes down and performs some kind of weird alien delivery for you, as long as you and your baby are healthy at the end of it.

Did you have any surprises in your delivery? Do tell!

Aloha,

Dr. Heather The BabyShrink

Toddler Behavior: My Kids Whine All Day

Dear BabyShrink, My husband and I have two really great little girls, ages four and 22 months. They are both really well behaved, good kids, but we have been having a lot of problems with our youngest whining constantly.

I expect a toddler her age to have plenty of temper tantrums and be willful. But the constant whining all day long is really getting to me. No matter what she is doing, she wants something different and is whining constantly. For instance, she whines for a certain toy she can't reach. When she gets it, she drops it and decides she wants something else. She gets that and she whines that she wants something her sister has. She whines when she wants her snack. I set her at the table and she whines because she wants down the whole time she is eating.

I have tried to treat it like a temper tantrum and not give in if it is something she really doesn't need. But she soon forgets whatever it is she is whining for and moves on to whine for the next thing she decides she wants. It is making my husband and me CRAZY! Is this just a stage that we need to ride out, or do we need to make some changes in how we deal with this? I try to get her to use words to tell me what she wants, but she is very stubborn and refuses even though I know she can say these words. She can talk very well when she wants to. Please help!! We will really appreciate any suggestions you might have, or suggestions for books that address this issue.

Thank you,

Jaime

Hi Jaime,

Ugh! I am so with you. Our youngest is 26 months old, and just getting to the end of that horrible "constant whining" stage. Whining is specially created by the baby gods to cut through the hustle and bustle of the household to get your immediate attention. It works, right?! Toddlers' whining is super irritating, party because at this age, we KNOW they CAN "use their words" when they feel like it. Why must they insist on whining, when all they have to do is USE THEIR WORDS?! Just like they did so nicely yesterday (for like 14 blissful seconds, but who's counting?).

Well, toddlers this age are really on the brink of a developmental shift. I HIGHLY recommend the DVD series, "The Baby Human". It's terrific at showing so much of what we're talking about here. (Please do yourselves a favor, everyone, and watch that series.) One of the episodes focuses on the time around 18-24 months, when a huge change starts to occur. Before that, they're really just walking babies. We don't expect much more from them. But after this change, they're more like "miniature preschoolers", capable of expressing themselves much more directly. Yeah, they're still toddlers, but an important shift has occurred. They can hold themselves together longer. They can communicate much better. They understand more of what you're telling them. They can wait for things (for a few seconds, anyway).

Have you read T. Berry Brazelton, MD, about how any new developmental shift is first accompanied by some serious regression? Your little girl wants to do all these new, "mini preschooler" things, but is overwhelmed a lot of the time with her inability to make the world work in all the new ways she's trying out. So she's frustrated and feels like freaking out. It's like when we, as adults, are learning a new skill (say on the computer, and writing a new blog!). Until you really understand your new skill, you feel like banging your head on this damn keyboard, and screaming at the screen!

The Best Thing About Whining But I digress. Whining, believe it or not, is a way your toddler has developed to avoid melting down into a total tantrum. This is good, right? What would you rather have: whining -- or a kicking, screaming tantrum? It's also a way your toddler is working on to establish some more power around this place. How can I be in control here? How come everyone decides everything for me?  "I do it! I do it!" These are early signs of the negotiating skills that are used so well by 5, 6 and 7-year-olds. And even though it's irritating as hell, it's also a sign that your baby is growing into a thinking, negotiating little person, striving towards independence and self-assertion. I've said it before, but I'll say it again: you really don't want a passive little toddler who never complains. I worry about those kids. Blustering, loud, irritating attempts at independence are the hallmark behaviors of this stage, and need to be struggled with in order to help your toddler feel a sense of competence and success in the world.

How To Cope But how do you cope with it? First of all, understand that it is a normal phase. Constant whining at this age is really common. If your toddler is whining constantly at a later age; something else is going on. Perhaps there's a speech delay, or you could be unintentionally reinforcing the behavior. Whining also increases a lot when kids are sick. So always check to see if that might be true.

Tell your toddler: "I hear whining. I don't like whining. Tell me in your words. You want juice? Here's your juice. No juice? OK, tell me, 'Mommy, no more juice'. Thank you for using your words. Now you want milk? OK, but no more changes. Milk, or juice. You choose. OK, no milk and no juice?" If whining starts, try again. "No more whining. Milk or juice. You pick." Often, this little exchange will help, at least a little. Your toddler wants to feel that you take her needs seriously, even if she changes her mind a million times.

Lather, rinse and repeat until you start to get irritated. Because there will be a limit to how much any living, breathing parent can do this. And she's checking to see exactly how much you can take it...today.  Testing is part of the whole routine. Exactly how much control do I have in this situation? When does Mommy take over and cut me off? How far can I push it? Now, notice I didn't say, "Continue to negotiate until you're about to lose your mind and give her the juice box, milk, water, AND the Diet Coke you were just drinking, plus open up the bottle of wine that YOU need now". Instead, set the limit before you're at your wit's end. "OK, no more drinks, all done with drinks. Let's go do something else."

Try to Ignore? If you're really strong, you can try ignoring the whining. Say you're about to do it. "No more whining.  I don't like it when you whine. Mommy is busy. I don't hear whining." And then go about your business with the whining toddler behind you, trying to get your attention. Breathe deeply, don't make eye contact, and repeat yourself. "I don't listen to whining." This may take several minutes, which seem like several hours, in toddler-time. Some will get the message, others will not.

Take a Time-Out You can also give time-outs for excessive whining. The amount of time necessary for each toddler will vary, but usually a short one (a minute or less) is sufficient to make your point. We have a little place in our kitchen for exactly such purposes; it's just a small corner of space between a wall and an armoire, about three square feet of space, which provides a sense of containment for our little guy. After going through the above routine, I will threaten one. "No more whining. More whining, and you go in time-out." When he was at his peak of whining, I would follow though on this once or twice a day. He felt the pain of the consequence, and  especially the pain of having to give up some power, and often (but not always) return in a better frame of mind.

A key part of all this is to make sure you give huge props for quitting the whining.  "Wow! You used your words! You are playing nicely now! Oh, that feels so much better!  Good job, honey! Gimme five for talking nicely! I love it when we play and talk nicely together like this!"

Also, make sure you can blow off some steam about the whining. Call a friend who understands and complain about your whiner. Exchange "horrible toddler whining" stories. Laugh about it, and get away regularly so you can re-gain your sense of perspective about all of this. Take turns with your partner when the whining is really getting on your nerves, even if you have to "trade off toddler duty" for just a 10 minute break. Ten minutes taking a quick walk around the block, or plowing through People magazine, in the quiet of your own bathroom, can be wonderfully restorative. (I know I'm not the only one who retreats to the bathroom for some peace and quiet! Where else can you go, sometimes?!)

Hope that helps. Let us know how it works out!

Aloha,

Dr. Heather The BabyShrink

Toddler Behavior: This Toddler is Driving Me Nuts!

Dear BabyShrink, I am going to make my question quick cause I am eight months pregnant and exhausted. I have a 2.5 year old son who is currently at home with me. He will be returning to "school" in July, which is a nice daycare that does a good job.

I am looking for a book to read to help me communicate effectively with my son. I want to do a better job than my parents, who did almost no job. I read Dr. Harvey Karp’s book on babies, The Happiest Baby on the Block, and it helped me survive a very happy babyhood with my son, and now hopefully my daughter too. But now that my son is 2.5, I feel like I am not doing a good job. I read a book my sister gave me, the name escapes me now, that said to give lots of choices blah blah blah. And I do that and it works.

But what do I do when he just won’t do what I ask of him? I do the whole "you need to follow directions", and sometimes he just ignores me. Recently he has started clicking his tongue at me or squeezing his eyes closed instead of listening to me. Now I feel like I am whining about a great kid cause most of the time he is really good, but I still feel like I am not saying the right things to him. So, are there any books that you suggest that can help me communicate with him better?

Thanks,

Ashley

Hi Ashley,

You've got your hands full, my friend! Managing a new baby and a toddler was one of the most difficult things I've ever done. Pace yourself, get as much help as possible, and keep up the good work. It sounds as though you've got a good head on your shoulders and good mommy's intuition. Keep following that, above everything any of us "experts" have to say.

That said, I can recommend some techniques and books for you.

I like anything by T. Berry Brazelton, MD. He has great empathy for the stormy, torrid, intense world in which our toddlers live. You've got to try to inhabit that mental place from time to time in order to "get" your toddler. Use his words, and reflect the intensity of his feelings, when you talk to him. Speak in short, simple "sound bites". Remember: the intensity of this moment can literally evaporate in a second for a toddler.

I also love Vicki Iovine's Girlfriend's Guide to Toddlers. She talks all about the weird, wacky ways of toddlers, and how you can try to manage it all without throwing your own tantrum (which by the way is unavoidable at times! Toddlers have a way of really pushing our buttons!) You can try to stay vigilant and unemotional about it, but sometimes we ALL need a time out.

Toddlers are really in a mini-adolescence. They are struggling mightily with how to act. Whom to be like. "How can I get some power around this place, anyway?" And otherwise asserting themselves in really important, developmentally appropriate ways. When I evaluate toddlers, the ones who worry me the most are those who are quiet, passive little things who don't cause a minute of struggle for anyone. Those children are either delayed in some form or really repressing themselves, which will cause BIG TROUBLE later on. You don't want to stamp out a toddler's powerful, striving little spirit -- but you don't want to give them the upper hand, either. That's even more destructive down the road.

Now, what to do when your little man flatly refuses to do what he needs to do?  First, make a choice: is this particular issue really worth the power struggle it will create with him? If not, let it go. But sometimes it will be absolutely YES, like staying away from the street or other safety issues, and the things that make you nuts. For me, it's screaming in the house.

In those cases, remember, YOU'RE THE BOSS. I am amazed at how often we as parents forget that simple fact. I was engaged in a power struggle with our then two-year-old daughter once, when my husband reminded me: "Just look at the size of her! She's a little shrimp! How can you let her get to you like that?" Getting that perspective back is crucial. Don't hesitate to pick your resistant toddler up like a football and put him in that car seat, move him away from the street, or place him in that stroller, if need be. And don't hesitate to use a short (one minute for each year of age) time-out for major defiant displays. And tell him how you feel in terms he can understand, using a "listen to me, I'm serious" tone of voice. "I don't like that. No hitting."

Good luck with the little guy and the new baby. And get some sleep, while you can! (AS IF, right?!)

Aloha,

Heather, The BabyShrink

Parenting Tips: Dealing With Sensitive Boys And Emotions

Dear Dr. Heather,

Danny talks about his son, who is only a year younger than mine, having a propensity for tears. Our son is very similar. He is a budding perfectionist (as his mom was) and gets stormy when he can't do things right on the first few tries. It really, really bothers his dad, who was teased unmercifully by other kids when he was young and did the same thing. Danny mentioned that he tries to work through those moments with the Champ, and I was kind of hoping you might get him to share some of those specifics or some of your own. (I believe he did blog at one point about trying to make the Champ laugh when he saw such a situation arising in baseball, but if you or he have any other hands-on solutions, I would love to hear them!)

In one sense we are lucky, because being somewhat overly concerned with success has not kept him from trying things, as it did me. But it took me 20 years to learn that I didn't have to do everything perfectly to enjoy it, and I am hoping we can significantly shorten the learning curve for my son.

Thanks!

Donna, Rossville, KS

 

Hi, Donna,

I have a five-year-old who's a real perfectionist too (he comes by it naturally, like your son). Sometimes he does give up trying when it's difficult -- that real danger your son has sidestepped, so that's a great start already. As long as they don't give up and keep trying, what you're really asking about, I guess, is the stormy emotional reaction.

Does his reaction get him into trouble, say at school, or with his friends, like what happened to his dad? Or is the real problem your worry about his future possible perfectionism -- and his Dad's worry about his tears? Because there are different approaches, depending on where the problem lies.

If his emotional reactions DO get him into trouble, talk with him about what to do with his feelings, instead of breaking down. Make sure he knows that his feelings are always OK, but it's how we handle them that matters. Make a plan ahead of time, when he's feeling good. Practice some things that he can do instead: take three deep breaths (practice with him and you can make it a silly game). Help him find words for his frustration. "I wish I could do it right! It makes me so mad! "  Et cetera.

If he's doing well and it's really more of your worries, remember, he's young. You might want to observe his classroom; I'll bet there are a couple of other kids in his class who are similar. You might even ask his teacher about it; they have lots of experience in dealing with all sorts of kids, and often have insights that we as parents don't.

His perfectionism can really be an asset -- I'll bet you have found a way to make it work for you. Help him channel his energies into being productive and successful at what he loves.

~~Heather

Parenting Tips: Dealing With Four-Year Olds, Tantrums, and a Death in the Family

Dear BabyShrink, I have a son who will be 4 in April.  Recently he has taken to laughing at us when we get mad at him. He despises doing anything he is asked to do and will cry and carry on until he gets his way. I know giving in is wrong but the tantrums become unbearable sometimes. In the last 2 weeks there has been the added stress of dealing with the death of my father. I'm willing to give my son space and time to grieve the way I imagine a 3 almost 4-year-old would, but it's taking a toll on my stress level and I don't want his behavior to escalate into something bigger that we have no chance of getting our arms around.

Please help!

Signed,

Karla, MN

Hi Karla,

I'm so sorry about your loss. I can certainly relate, having lost my own father a few years back, with little ones at home too. First, know that little kids really don't understand death until they're 7 or older. You can't do anything about that, it's just their level of cognitive development.  If your son and Dad were close, you can talk to him about " Grandpa has died and we won't see him for a long long time", but ONLY if your son brings it up.  Follow his lead.  Don't assume that he is suffering....or is not.

Most likely he is upset by the adult emotions that must be strong around the house nowadays. That's inescapable of course; but you can try to give yourself room and have supportive people around for YOU...away from your son, so he does not have to get upset by YOUR being upset.  When you feel OK, you can talk calmly to him about it, in very short, simple sentences; just a little sound-bite at a time.  But focus on reassuring him that you are ok, and he is ok, and the family and house have rules, and that they have to be followed by everyone.

In terms of his behavior, hold the line.  He is testing you partly because he sees that you're down.  He is wondering:  "What happens when Mommy is upset?  Can I get away with things now.....and will things fall apart?" He's pushing the limits to see if he's safe, and if you're OK.  I bet a few days of consistent expectations, and consequences, will set him on a better path.

Aloha,

Dr. Heather The BabyShrink

Pregnancy Help: Do I Have Postpartum Depression? Me?

Brooke Shields and Marie Osmond are celebrities who are helping the sufferers of postpartum depression by reminding us that it can happen to anybody. Like all new Moms, they were told that they are supposed to “fall in love” with their newborns the moment they are placed in their arms. But for up to 15% of new mothers, a combination of biochemical changes and other stresses can result in real problems. Women with previous histories of depression, poor social support, or other life stresses have an even higher rate of difficulties. Feeling unloving about the baby, feeling sad, overwhelmed, and irritable; having trouble with sleep and appetite, and feelings of worthlessness or guilt, can occur in up to 80% of new Moms and are commonly referred to as the “Baby Blues”, but when the symptoms last for more than two weeks, it could be Postpartum Depression (PPD), and it’s time to get help. But new Moms are ashamed of these feelings, and often don’t ask for help. They are told to “get a grip”, to “appreciate your beautiful family”, or that “in my day, we didn’t have time to be depressed”. All these reactions make the PPD sufferer feel worse, and less likely to seek help. We now know that babies of untreated PPD sufferers have a much higher risk of developmental delays and other social, emotional and other health problems. Depressed Moms are not able to provide the strong attentive, responsive, emotional comfort and eye-to-eye contact that newborns need for their little brains to grow. Infants really only feel that they exist in the light of their mother’s eyes. If she is distracted by emotional pain, fatigue, and depression, the baby suffers. And as the saying goes, “If Mom’s not happy, nobody’s happy”. The whole family suffers from PPD. So, treating Mom for PPD helps Mom, the baby, and the whole family as well.

Living in Hawaii, as I do, or in other rural areas, can present unique challenges to new Moms. Many families are recent immigrants from far-away countries or the mainland, and are disconnected from extended family and friends who can help in difficult times. New Moms often feel stuck at home with a crying baby, and no energy to leave the house to get support and help. Other Moms are afraid of what people may think if they admit their feelings, based on highly publicized media reports of mothers hurting or killing their babies. A very rare but severe form of postpartum disorder, called Postpartum Psychosis, occurs in about 1-2 out of 1,000 Moms and can include feeling out of touch with reality, rapid mood swings, and obsessive thoughts of hurting the baby. This is a rare form of the disorder, and women with a history of Bipolar Disorder or other more serious psychiatric conditions are at higher risk of developing this disorder. Living on an island or other rural area also means that resources are limited, and it may be difficult to find treatment providers out there who are trained to recognize and address the problems faced by new Moms.

But help is out there, and it works!

For most women, a combination of counseling and short-term antidepressant medication makes all the difference. If you don’t want to try medications, ask your therapist about starting with counseling first, to see if that is enough – often, it is. Also make sure to ask about the importance of getting adequate sleep, exercise, and good nutrition….many studies show that these factors can help a lot! New Moms can ask their OB/GYN, Family physician, clergy, or friends for a referral to a psychotherapist who can help Moms suffering from PPD.

Let’s keep talking about PPD, so that we can have happier Moms, happier babies, and happier families!

Click this link for a great resource:  Postpartum Support International has regular, free, confidential chats, tons of information, and resources for moms, their families, and professionals.

Toddler Behavior: Is My Child Becoming A Bully?

Dear BabyShrink, Our three-year-old son is a great kid, but lately he has been playing this annoying little game: he orders us around, telling us what to do and how to do it, with really specific orders like “Mommy has to sit on the orange rug! Put your feet here, not there!” He gets really mad if we don’t do it his way. I have nightmares about where this is going. Is he becoming a bully? How do we handle this?

Lisa

Dear Lisa,

Your little tyrant is showing you in no uncertain terms that his budding superego is in a fever-pitch of development.

At this age, toddlers are struggling to master their bodies and their environment. They feel a flush of power, since they can now use their words and bodies to control what people do. They really enjoy play-acting, and that’s a wonderful and important part of being three. A three-year-old gets lost in the imaginative process, and we want them to learn from and enjoy play-acting. And they don’t yet feel the pull of what is socially OK. But the tiny superego is blossoming; the internal sense of mommy and daddy, deciding what is right, what is wrong, what is allowed, and what isn’t. The superego is still very primitive at age three; very black-and-white, “my way or the highway”. It’s really common to see three-year-olds behaving like little tyrants, ordering people around, trying out their new dictatorial tendencies.

So what’s a parent to do? It’s our job to help the little dictator get a taste of democracy; or at least accept the role of Vice President. Help him learn the rules of give and take, taking turns, and asking nicely. These skills take years to develop, but this is a really important time to lay the foundation of how your little one will respond to, and create, rules and order in his life.

Next time Junior starts ordering you around, play with it a bit, but with the ultimate idea in mind that YOU are the boss. If you have time to play, go ahead and follow his rules and orders. But sneak in little requests, like, “oh, that works better when you say please”. Or, “Now that you made me dump out these blocks, let’s clean them up, let’s take turns seeing who can get the blocks into the bin!” If you don’t have time to play, or if he’s asking you to do things that aren’t nice, safe, or allowed, remember: you’re the parent, and he’s counting on you to know better. Say, “I know you want me to jump out the window, but that’s not allowed. We’d get hurt. Let’s jump up and down instead.” If he throws a tantrum, that’s OK. He’s upset that he’s not the boss — but deep down, he’s also relieved. And over time, with your help, that primitive, controlling little superego of his won’t be quite so tough.

Aloha,

Dr. Heather The BabyShrink

Pirates of the Crib-bian: How Can I Get My Child To Stop Having Temper Tantrums?

Turns out Johnny Depp is a lot more than a fantastic actor; he’s also an armchair psychologist. On a recent appearance with David Letterman, Depp said this about his kids: “Living with young children is like hanging around with miniature drunks. You have to hold on to them. They bump into things. They laugh. They cry. They urinate. They vomit…

Accurate comparison? Absolutely. In fact, Depp’s comment has striking relevance to an issue thousands of frustrated parents confront every day – “How can I get my child to stop having temper tantrums?

Your Toddler is a Drunk. Kind of. Think about Depp’s analogy. Alcoholics exhibit some distinct behavioral and physical signs – many of them quite similar to the actions of a toddler:

•    They are impaired in their ability to make decisions •    They have difficulty controlling their bodies, speech, behavior, and emotions •    They feel happy one minute and the next they are crying inconsolably •    They slur their words and often forget what they have heard, seen and done •    They fall down, get into accidents, hit people, break things and embarrass those around them

If that sounds familiar to you, you’re either a parent or a bartender.

You Knew The Job Was Dangerous When You Took It Toddlers’ brain development is such that their ability to control their behavior, control and understand their feelings, and use logic are barely starting to emerge. We might see our toddler acting patiently one day and screaming, hitting, and acting like Jack Daniels after an all-night whiskey bender the next.

Naturally, this behavior needs to be controlled – and the best way to get a handle on it is to understand your toddler’s frame of mind.

What If You Were a Toddler Too? Imagine yourself as a two-year-old. Remember how small and powerless and dependent it feels. Being a toddler is HARD, mostly because they are:

•    Unable to make their needs known most of the time •    Unable to make their body do things that others around them do easily •    Unable to make grown-ups understand what they need to say •    Needing help with almost everything. •    Being overpowered by their emotions several times a day

Why Your Child Is Acting Like That Girl From The Exorcist You certainly can’t prevent ALL tantrum triggers, all the time. But you can try to keep them in mind throughout your day with your toddler – and possibly prevent some tantrums as a result.

Here are some common situations that can trigger toddler meltdowns:

•    Not enough physical activity during the day •    Too many “forbidden” things or activities in the environment •    Frustration at inability to do something (e.g., speech, coordination, dexterity, size) •    Too many people and/or too much noise in the environment •    Unfamiliar/disliked people in the environment, especially if they want something from the toddler, like a kiss •    Major change in routine or environment •    Sleepiness •    Hunger/thirst •    Illness/teething pain/ear infection •    Potty conflicts and frustrations •    Parent “tuned out”/busy/not paying attention to what toddler needs •    Parents trying to accomplish too many “adult” tasks with toddler (e.g., adult conversations) •    Activity overload (e.g., too much TV) •    Environment is too active/chaotic (e.g., dinnertime, kids running around, TV on, neighbors coming and going)

A Personal Anecdote: Diffusing Dinnertime Meltdowns In our house, dinnertime is so noisy and chaotic that it used to lead to nightly meltdowns for our 20-month-old. Now, I try to eat with him, ahead of the rest of the family, so that we can all eat in peace.

Once my husband and "the big kids" are ready to eat, I take Tai into the bathroom for a nice long bubble bath, with the door CLOSED, so he is not distracted by all the noise from his older brother and sister. We work on “eating as a family” at other meals, and he will be far more capable of enjoying family dinners when he is a little older and a little less sensitive to the noise and activity of the house. Plus he gets tired at the end of a long day of trying to share with the “big kids”, trying to communicate with us; he’s exhausted and needs a little break to “mellow out” before bedtime. I know this forced family separation every night is just temporary, and it’s certainly worth everyone’s sanity. And since we have been doing this, we have NO nightly tantrums.

Decide What Works For YOU I’m not suggesting that all toddlers should be separated from their siblings at dinnertime, and I realize this is not practical advice for every family. But what is really important is that you develop routines for your family that work for you. Every family is different, and every toddler is different. KNOW YOUR CHILD. See how they respond in different situations. When are they feeling good? When do they behave well? When do YOU feel good, as a parent? These things are not random occurrences. There are patterns to your child’s behavior and feelings; there are patterns to YOUR behavior and feelings, and patterns to the rhythm of your family. What are those patterns? Become a detective. Observe. Take notes. Remember.  Put it all together. Here are some questions to keep in mind:

•    When does my toddler behave well?  What times of day?  What situations? With whom? •    What kinds of things seem to make my toddler angry or have a meltdown?  What changed in the situation just prior to the meltdown? •    What helps my toddler feel better when she is having a tantrum?  What has worked in the past?  Who is able to help her feel better? •    What was I doing just prior to my toddler’s meltdown?  How was I feeling?  Was I stressed/distracted/not “present”?

Start paying attention to these things.  Once you do, you will start to suspect certain patterns. You might not be sure if your hunches are correct. That’s OK; like any scientist, you will test your hypotheses. How? By being aware, in the moment, with your toddler; then when you see the pattern start to emerge again, do something to MAKE IT DIFFERENT.

If there is a certain time of day that makes him fussy and difficult, try to decrease the noise and stimulation at that time.  If there are certain places you go that make him crazy (WalMart, anyone?), don’t take him there! Change it up, and see what happens. Then, you start to have answers. Your detective work will lead to a much happier toddler. Good luck!

Aloha,

Dr. Heather The BabyShrink