ADHD Tips and More: KITV Live Segment

Thanks to Jill Kuramoto and the great team at KITV for having me on again yesterday. This time, we talked about how to know whether your child has ADHD -- or is just an active kid. We also talked about how to slow down and enjoy this wild adventure of parenting a bit more. Check it out!

Aloha,

Dr. Heather The BabyShrink

BabyGeek: Early Trauma Damages Babies' DNA

It took me over a year, but I finally started to understand the fabulousness that is Twitter. And no, it's not because I want you to know what I had for lunch (although I had some amazing Indian food today). It's because I meet a lot of interesting people on Twitter, and am directed to some fascinating info. The geek in me LOVES the immediate access I get via Twitter to all sorts of interesting infant research. But I do realize that most of you don't share my fascination with primary-source research -- you just want to get through your parenting day with your wits reasonably intact. And that's why I'm here -- to help sort through all the clutter, and show you what I think is TRULY interesting, relevant, and important to parents. So I'm starting a new category on BabyShrink -- BabyGeek. It will give me the opportunity to use more than 140 characters to help interpret the most current findings from the world of infant and child development, and the mind-boggling findings from brain and neuroscience. I hope I can make it all interesting for you, too.

And now, for my first moment of BabyGeek:

Early Trauma Damages Babies' DNA

This heartbreaking study confirms what shrinks like me have long suspected: The mind and body are closely linked, even from the first months of life. This study shows how deeply linked: Traumatic emotional experiences such as institutional care actually damage the child's DNA. Scientists have been investigating how the length of the telomere (the cap that protects the ends of the DNA strand) is related to health and longevity -- and the orphans in the study had significantly shorter telomeres. Here's the study report.

In college, we used to argue about "nature vs. nurture". Now, we know it's nature AND nurture -- down to our DNA.

I'm waiting for the research that shows longer telomeres in babies from "good enough" homes.  I wonder what other aspects of parental care will show impacts -- positive or negative -- on DNA?

What are your thoughts?

Aloha,

Dr. Heather The BabyShrink

And I hope to see you on Twitter! Follow me here.

Sleep, Toddlers, and Mental Health (Hopefully, Not Mutually Exclusive)

Mental Health Blog Party Badge I'm blogging for mental health today -- but not in way you might expect. Mental health isn't just some esoteric list of psychiatric diagnoses. It starts with simple -- but critically important -- things. These include the support of loved ones, meaningful work and relationships, and enough resources to have a little fun. On the top of that list, though, is getting adequate SLEEP. Having young children is the quickest way to ruin in the sleep department (and I speak from vast experience). Here's a quick tip on tackling the sleep issue for toddlers (and by extension, YOU):

Dear Dr. Heather,

 

My 2 year old started climbing out of the crib a few weeks ago. We transitioned her to a toddler bed and she continues to wake up around 2 am to play! And doesn't go back to bed until after 4 am. I've tried cutting her nap, which resulted in a miserable little girl in the afternoon and still waking in the middle night. I know allow her to nap for an hour and she's still up and playing at 2 am. Her bed time is around 8:30pm every night. Help!

Holly

Dear Holly,

It's very common for toddlers to start waking in the middle of the night after transitioning to a bed. That's why I always recommend WAITING to give up the crib as long as possible. But don't worry: Your late-night party-girl will remember how to sleep through the night -- with your help.

During the day, remind her that it's her job to sleep when it's dark outside -- plus, Mommy and Daddy get grouchy when she wakes them up at night. Everyone needs their sleep to be healthy.

Adopt the "broken record" approach -- she needs to stay in bed. Lights out. Time to sleep. If she gets up or makes a ruckus, calmly guide her back to bed and repeat the rules. Don't get emotional, don't turn on the lights, don't talk much, and certainly don't offer any food, drinks, or TV.

It may take a zillion or so reminders (or just a few, depending on her personality), but eventually her internal clock will win out and she'll start to sleep again -- as long as YOU'RE consistent in your approach. And when she DOES sleep through the night again, congratulate her for a job well done in the morning, and tell her how great YOU feel after having a good night's sleep!

Aloha,

Dr. Heather The BabyShrink

 

Child Development: Update On The Whole Vaccine/Autism Thing

Just a quickie to point you to an update about the "doctor" who started all the craziness about the SUPPOSED link between the MMR vaccine and autism. The most lifesaving discovery EVER -- the vaccine

(My friend Esther runs the site -- a smart cookie and a doctor to boot -- look around her site a little bit, too):

mainstreamparenting.com

Remember, there are no guarantees when it comes to weighing the healthcare options for your family. But the more informed you are, the better prepared you will be to balance the pros and cons. For my money, vaccines are an easy bet.

Aloha,

Dr. Heather The BabyShrink

Child Development: Is It Okay That My Baby Walks But Never Crawls?

Dear Dr. Heather, Our 8 month old son seems to be skipping the crawling phase altogether and learning to cruise and walk straightaway. Today someone told me that this means he’ll have learning disabilities later; is this true?Baby walking but never crawling, any learning disability worry?

Thanks!

A Concerned Dad

Dear "Concerned",

That's an old wives tale, but one that many people still believe. Here's the deal: if he's not working on locomotion -- in some form or another -- at this age, it could be reflective of some underlying issue. But ANY of the goofy forms of locomotion exhibited by babies at this age counts as "normal locomotion" -- the "Commando Crawl", the "Tushie-Scoot", the "One-Kneed Creep", and of course regular cruising and walking. Apparently the Back-To-Sleep campaign has resulted in an increase in babies who skip crawling, as they don't get as much practice on their tummies. But getting mobile is the important thing.

Look at it this way: crawling is a drag. Walking is a lot more fun --and a lot less gross -- for parents (Think: less opportunity to find and eat yucky stuff off the floor!). Plus you'll save tons on Spray 'n Wash since his knees won't be dragging through the dirt all the time. And for you parents of girls -- rejoice! You can finally bust out the pretty dresses! (There's nothing more frustrating to a crawling baby than having a dress get caught up underneath her over and over!)

We look for some form of mobility -- attempts to crawl, scoot or walk -- by about 10 months, but this isn't a hard and fast rule. Your pediatrician can do a quick review of your baby's developmental progress if you're worried.

Enjoy -- and double-check your baby-proofing. This phase begins the wild time of The Mobile Baby With No Self-Protection Mechanisms! You'll be running around after him very closely for the next year or so!

Aloha, Dr. Heather The BabyShrink Mom of Four, Parenting Expert

New Info on the Autism/Vaccine Issue

In an interesting development in the ongoing saga of the alleged link between vaccines and autism, the medical journal The Lancet is retracting the original study that proposed the idea that the MMR vaccine could cause the disorder. If you've been a BabyShrink reader for awhile, you know my stand on vaccines: They've saved millions of lives. It's just like any medical advance: There's a cost-benefit ratio to consider. And when you're talking about saving the number of lives that vaccines have saved, SIGN ME UP.

In terms of the supposed autism/vaccine link, I've always been skeptical. I want to know more about possible environmental and genetic causes, but I believe the reams of research done that show NO CAUSATION by vaccines. And I'm still wondering about the issue of autism recognition, diagnosis, and the increase of cases: Clinically, I see a lot of pressure to diagnose autism, and much greater willingness to give the diagnosis. If you're interested in more, here are a couple of links:

Here's a link to my other posts on autism and vaccines.

Here's a link to the CNN article on the retraction of the MMR/autism article by The Lancet.

Aloha, Dr. Heather The BabyShrink

Developmental Issues: Is Your Young Baby Showing Signs of Autism?

Hi Dr. Heather, I came across your website when doing a search for signs of autism in infants. Our 3-month-old doesn't look at us very much, doesn't track objects across the midline well, and doesn't often respond to our voice. He stares at the wall or just beyond us pretty much anytime we hold him in our lap looking up at us. He is very calm and mellow, and only cries when he is tired or hungry. He would sit in his bouncer or swing all day if we let him. We also have a 3-year-old very active boy with sensory processing problems so I know our baby doesn't get as much attention as i would like to give him. We know he is way too young for any of these signs to be a definitive answer, but I am having a hard time finding information on what we can do preventatively as we observe him over time. There is a program in our city, but other than that, everything I find is geared towards 18 months to 2 years, since that is the time that it is easier to see more clear signs. Can you help?

Jennifer

Dear Jennifer,

I'm so glad you are aware of this crucial aspect of your baby's cognitive development. I think most parents would be happy to have a "mellow and easy" baby who would happily sit in his bouncer all day. But you recognize that he might not be reaching out to you for the important "give and take" and communication that he needs to trigger important aspects of his development. He needs to engage with you and play "Baby Games" in order to solidify his relationship with you, which forms the foundation of his cognitive growth. What to do?

I understand that you want to be as proactive as possible, given your experience with your older son. And while there is a possibility that your baby may suffer some similar developmental issues, it's also quite possible that everything you describe is well within the norm for typical development. First of all, try not to over-worry, but maintain the watchful engagement that led you to research your concerns. Your baby can pick up your fears and anxieties, and this can push him to be even more distant. There is some interesting psychological discussion and observation going on about this very basic "give and take" in the parent/infant interaction, and in the ability of a baby to pick up on his parents' feelings. When a very anxious parent reaches out to a baby in a way that seems desperate or demanding, the infant can sometimes seem to feel pressured, and retreat even more. So, as with many aspects of parenting, containing and managing your own feelings is Job One.

That said, there are many things that ALL parents can -- and should -- be doing to maximize this incredibly important time in a baby's development:

Carefully watch your baby's sleep/wake/activity schedule for clues as to when he is most likely to be responsive to parent interaction. Sometimes he'll be fussy, or seem overstimulated by your efforts. Other times he may be more receptive. Often, these receptive times are shortly after waking from a nap and having a feed. But you are your baby's best expert; try to figure out when he's most approachable.

Then, make a conscious effort to play "Baby Games" during these times of approachability. Try to match his energy level and catch his gaze. Follow his lead; if he coos and looks away, try to respond in kind. You want to reinforce any efforts on his part, even brief eye contact that might be just 1 or 2 seconds long. Each baby is different; perhaps your baby is more auditory and responds well to your cooing back, other babies might be better reinforced by a brief touch to the face or hand, or from a big returned smile. Experiment, and see which response generates another round of interaction from your baby.

Don't give up if your baby continues to avert his gaze. Take a deep breath if you start to worry, and try to be as available as you can for "Baby Games". Give him time and keep trying.

Jennifer, I have a 3-month old too. Although she does engage in periodic eye contact, coos and smiles, she is much more reserved than her siblings were at this stage. At first I also worried about her relative lack of eye contact and her willingness to hang out in her crib for long periods of time. I can't help but think that the noise and chaos of our busy household causes her to be a bit more protective in her interactions; there's a lot for a little baby to absorb in this household! But her Daddy and I have been engaged in the exactly these exercises with our little one, and I can see the difference in just a couple of weeks of consciously trying to engage with her.

Dr. T. Berry Brazelton has some excellent suggestions for engaging a baby who might have sensory issues or sensitivities. Use your parents' detective skills to determine WHICH senses your baby tolerates -- and DOESN'T tolerate -- very easily. Use this information to "fine tune" your interactions with him. For instance, our baby seems to respond longer to us, and with more smiles, when I'm quiet. Responding both with my facial expressions AND my voice seems to be too much for her, and she turns away. But if I keep focused on giving her a big returned smile, maintain eye contact, and maybe even stroke her hand or her cheek, she's much more likely to stay engaged in our "Baby Game" than if I coo or talk back to her. Eventually, she'll develop the ability to tolerate my voice as well. But until then, I'll hold back a bit. Experiment with using different modes of communication with your baby and maximize what works.

I also double-checked on the expected timeframe of infant response to parents' voices, and most authorities agree that this isn't regularly observed in most infants until 4 months. Our baby is 14 weeks, and only in the past few days has she started responding to our voices on a somewhat-regular basis.

Now, I'm not able to evaluate your little one, but there are many things you can do to maximize this important aspect to your son's development. Over time, you can judge his progress and if you're not satisfied, have him evaluated by the program you mentioned in your city. If they're not yet able to enroll him due to his young age, perhaps their specialists can take a quick look at your son and make some further suggestions to you. I'm a firm believer in erring on the side of having a child evaluated early, not only for reassurance of an expert opinion, but for the often very helpful recommendations that the specialists can give you, even if there's nothing really atypical with your child.

And I can't stress this enough: At 3 months of age, you should be aiming for interactions measured in SECONDS, not minutes. Feel good if you generate a few "rounds" of interaction between you and your baby at this age. Over time, you'll both want to stretch these interactions to last longer and become more complex. But at 3 months of age, your baby is still very young and new to the world of interaction. A 3-month-old is only recently "hatched" -- our psychological term for the opening of awareness that marks the end of the "squirrelly newborn" phase. So manage your expectations accordingly.

Jennifer, thanks for the opportunity to write about this extremely important topic. I hope you'll write back to update us on your progress!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Developmental Issues: Why Your First Grader Probably Doesn't Have ADD or ADHD

One of my pet peeves is the tremendous pressure that schools have been putting on our young children to "perform". Over the past several years, schools have been ratcheting up their demands for the performance of academic tasks on younger and younger children. But the developmental realities of young children don't change just because No Child Left Behind wants "results". Young children aren't yet capable, cognitively or psychologically, to tackle heavy-duty academic work -- without paying a price. And I worry about those children, like Linda's daughter below, who may be unfairly flagged as having "problems with focus", or even labeled ADD/ADHD, at such a young age.

Read on for Linda's question, and my answer below:

Hi Dr Heather,

My six-year-old daughter is in first grade. Her teacher says she has "focus" issues, and is worried. While this is a small class in a private school, she is there for about 10 hours every day. That's a long day. I think she just gets tired in the afternoon…at that age the best thing would be for her to be at the house at 3p I think. However we both work full time so it's not an option.

I asked the principal about holding her back. However because she is so smart, there is a chance she would be bored and the principal says in her experience (30 years) holding back children due to focus issues rarely solves the issue at hand. She was tested at age three with a district program that checks for ADD and other issues, and the assessor saw no warning flags.

I think she is just a kinesthetic learner who is dreamy and in her head..and should probably be in school for a shorter day. Am I missing something? Can you really say "ADD" for sure at age six? I am worried that this could just be normal range of behavior for this age, and the requirements of schools these days are just the stress trigger, making her hard to work with.

Thanks,

Linda

Hi Linda,

In general, I do agree with you that our educators are expecting WAY too much of our children these days, when it comes to "performance" at an early age.

First grade is an interesting age. Teachers will tell you that they typically witness a huge change in children as the year progresses. Most kids will make the transition from what I see as more of a "preschool" sort of mentality, to more of a "grade school kid" sort of mentality. It's a big step that's made sometime during the year, and many issues of the kind you describe are sorted out in the process. That's why standardized tests are viewed (at least by testing specialists) as being NOT super-valid until SECOND grade. There are too many variables up through the first grade. That's also why we typically don't diagnose a child with ADD/ADHD until at least age 7.

Our own daughter was "flagged" in first grade for variable performance on standardized tests that year. It made me crazy that they made the first graders sit for standardized tests at all -- they're worthless at that age! By the time they had a specialist test her (at the END of the year), all the issues they were concerned about had "vanished". She is now doing beautifully in third grade.

Now of course I can't directly evaluate your daughter, but I do think the questions you are asking are valid, developmentally. Asking a 6-year-old to focus for 10 hours a day, 5 days a week, is pretty unrealistic. But of course you want to make sure to take any legitimate concerns seriously.

You might consider asking the teacher to reinforce "on task" behavior, instead of simply worry about "off-task" behavior. You and she can collaboratively set up a plan whereby your daughter is rewarded (with something simple, like stickers or checkmarks, to trade in for small prizes) on a chart for demonstrating a few minutes at a time of "on-task" behavior. You want to set it up so that the goals are ACHIEVABLE -- not something diffuse like "having a good day". You will get much farther with rewarding her for focusing, than by making a federal case out of her being "off-task". You also want to avoid giving her undue attention for NEGATIVE behavior, especially at this age. Kids have a way of absorbing the negative attention directed at them, and can internalize the idea that they "have a problem". You're much better off by reinforcing -- and praising her -- for doing what you'd like her to do more of. You can also tie her performance at school to things you want her to do at home -- listen, complete chores, etc. If reinforcement and praise are coordinated between home and school, you have a better chance of improving things in both places.

See where this gets you, and let us know how it goes.

Aloha, Dr. Heather The BabyShrink

Child Development: What to Do if a 2-Year-Old Isn't Talking

Hi Dr Heather, My 2 year old son isn't talking yet. He socializes at daycare, we read books, and try to encourage him by pointing at objects and saying their name. He will ramble on in his own language & expect us to understand it & sometimes gets frustrated when we don't. He communicates with us mainly with body language when he wants something, but he's also so laid back, and almost feels like he doesn't think he needs to speak. Every now & then he'll come out with a word here & there & we acknowledge it with praise, and other times when we try to get him to say a word, he gets really frustrated. He understands what we say & he follows directions very well. Do you have any tips? We're running out of ideas.

Thanks, Carrie

Hi Carrie,

I often get this referral question in the clinic where I consult. Parents and clinicians frequently worry about slow-to-develop speech; luckily, there is often nothing "wrong". In general, what we're most concerned about at this age is COMPREHENSION. If a 1 or 2-year-old has good comprehension, then overall language skills are usually fine. Kids DO talk at much more variable rates, and it often has nothing to do with later speech and language proficiency. Our third child was the latest to develop speech, yet now at nearly 4 he has, by far, the best diction and vocabulary of all our kids at that age.

With that said, however, 2 is quite late, overall, for speech to emerge. I suggest having him evaluated by your local Early Intervention team; your pediatrician can usually guide you to a group with a good recommendation. Even if there's nothing amiss, the evaluators often can give you some great suggestions on how to further encourage speech use by your little guy. If he does qualify for speech and language therapy, definitely go for it. These services are usually provided by very well-trained and dedicated professionals who can make the sessions fun and exciting for little ones. The good therapists closely involve parents in the sessions too.

Good luck and let us know how it turns out!

Aloha,

Dr. Heather The BabyShrink

Breastfeeding & Bottle Feeding: Being A Good Mom And NOT Breastfeeding

So I'm still huge, and not yet in labor. Luckily the doctor has caved and agreed to schedule an induction for 10/19, if I haven't delivered by then. But in the meantime I'm looking for anything to take my mind off the discomforts and anxieties of imminent labor. Reader Lisa made my day with this email: Dear Dr. Heather,

I was googling the meaning of the term "mainstream parenting" and ran across your site. I read a lot of articles on BabyShrink, including one by the name of:

The “Good-Enough Mother”: Are Breasts Required?

This particular article made me feel choked up and teary-eyed as the mother of three boys. I experienced so close to the original poster's experience, that it was emotional for me to read about. My second son ended up in the hospital with failure to thrive because I did not know I had under-developed breasts, and the pressure to breastfeed was tremendous. It was as though if I didn't breastfeed I was not a good mother -- end of story.

Now don't get me wrong - I think breastfeeding is the most natural and wonderful way to care for a child that there could possibly be, but I have struggled against huge odds to get people to understand that there are those of us out here who simply CANNOT breastfeed... it's not that we chose this option.

I have since had my third son two months ago and planned right off not to fully breastfeed and just give him whatever little bit I could make, and the rest of his meals would be formula. This was the best choice I could have made. Taking the pressure off myself allowed me to make a little bit more milk, and I have totally enjoyed the breastfeeding this time around without feeling like it was forced upon me. (When I say a little.. I mean that I made about 1/3-1/2 oz of milk between both breasts, which increased to 1/2-1 full oz now.)

My close friends and I have always felt that there is no completely right way to do this job of mothering. It's very dependent on the individual child and his or her needs as a person. Reading your site only backed us up on what we believe and I shared it with my closest friend tonight. I have nothing against the AP crowd except that there are those extremists that ruin it's reputation. The ridicule and nastiness they can dish out is in a whole category by itself. I'm just grateful that there are those out there with credentials like you who see that there is good in several parenting approaches, and your philosophies closely resemble my own.

So this is basically a kudos to you, Dr. Heather.

---- Lisa Utah Mother of 3

Here's my response to Lisa:

Hi Lisa,

There are so many moms like you out there who feel this way.

I keep reminding myself that the WHOLE process of pregnancy, labor, delivery, and indeed parenting itself is an ongoing process. Trying to decide what is best for you, your child, and your family, from day to day, is what it's all about -- not following some kind of idealistic dogma about what is "best". In that way, we model to our children that we create solutions that are best for all of us -- not just based on something that someone else said was supposedly correct for everyone. We can (and should be) flexible, for the good of the kids and our families.

I am so glad you are having a nice experience this time around and trusting yourself. Enjoy and thanks again!!

Aloha,

Dr. Heather The BabyShrink

Developmental Issues: Did Swine Flu Cause Autism In My Son?

There's a lot of confusion out there about illness, the flu, vaccines, medications, and autism. This poor Mom is terrified that her son may have contracted Autism from a bout of Swine Flu. Here's her email to me: Dear Dr. Heather,

Please help. I saw your article on autism, and I am very intrigued and impressed by your knowledge and insight.

I don’t know what to do. I have two beautiful, 91/2 month old identical twin boys who were always very social, smiley, interactive, looking directly into the face, etc. The one I am most concerned about would turn his head and smile at his brother in their crib, smile at everybody, I would play the ‘up’ game with him and he would gaze into my eyes, smile, and giggle… and they both almost always responded by looking when I said their names.

Then one of them got sick with Swine Flu on August 6th. His brother got sick on August 8th. I will never forgive myself as the last time I remember him (the baby who got sick on the 8th) acting distinctly like himself was the 6th when I went to pick up his sick brother at daycare… he looked right up into my eyes, threw up his arms, smiled, and said ‘Mommmmm’…. And I barely paid attention to him, I rushed to his sick brother… I should’ve thrown my arms around him and hugged him and praised him…. I have such guilt and keep worrying/wondering what if that is the last time he ever does that?

They were both put on Tamiflu due to being high-risk (they have asthma symptoms). The baby I am most concerned about didn’t get as high a fever, but the virus infected his eye, and we think he also got a bacterial infection, so he got eye-drops and Amoxycillin as well. He was miserable and cranky for days. I know he can hear (by testing by loud noises, etc.) and he doesn’t have an ear infection, as he’s seen a doctor.

Now he is not himself. I first noticed this as he got better. He is not responding when I say his name, hardly ever. If he does he just looks for a second. He will make eye contact, but only for a second or two. He looks away when I try to play the ‘up’ game with him. He is still babbling, but not as much. He did this weird whisper-babbling this morning and smacked his lips. He is still playing with his toys, but is also playing with non-toy objects like straps and blinds.

The doctor has an ear test set up for him, but I have to wait two weeks just for a call to make the appointment.

Can a virus or antibiotics trigger autism? Does a flu ever attack the ears, eyes, or brain which might cause sudden symptoms? What are the other possibilities might be going on if he doesn’t have an ear infection? This is a very, very abrupt change.

What tests should I push for to find out what is wrong as soon as possible? What are the possibilities?

So far his brother is acting normally, but I am terrified as I'm worried about it affecting both twins eventually.

Please, I would love a response. We have (mega-large HMO) and it is hard to get tests/things done. I am eagerly awaiting your response and guidance.

Very, very sincerely, Concerned Mom

Obviously, this mom is in a state of desperation, so I responded immediately:

Dear Concerned Mom,

Of course I cannot evaluate your son myself and as such, I can only provide some educational information for you. But I did want to respond right away because you sound so very upset and worried.

First of all, please know that autism is thought most likely to be a genetically-related developmental issue, and I have seen no convincing information that it can be caused by a simple flu or other virus in a child, nor by antibiotics or antivirals. Additionally, the timeframe you mention of the abrupt changes in your son do not sound like the onset of autism. After all, it's been barely 2 weeks since the onset of his flu symptoms.

A (temporary) step backwards in response to illness However, it is VERY common to see temporary developmental regression in response to illness. This means that your child can take several steps BACKWARD developmentally -- in response to illness and/or stress -- and then "bounce back" days or weeks later. It's all part of the normal developmental process,which is full of starts, stops, and reversals -- the old "one step forward, two steps back" thing. Young children don't understand that the course of illness is temporary; that they will get better. They simply know they feel lousy. They are not up to showing off all their "best" developmental skills. They commonly regress to earlier stages of development, temporarily, until they feel better. And often times, symptoms of illness can linger for WEEKS in children -- especially for something as yucky as a flu. If he is showing regression in response to illness, the regression itself can linger for weeks as well, past the time that he gets better. This may vary from child to child and from illness to illness, so his brother may be fine (at least this time). Personalities vary in response to illness and stress I don't know about your husband, but when mine gets sick, he just wants everyone to GO AWAY. (is this a guy thing?) He's crabby and won't talk to me and is just a completely different personality than when he's feeling well. Everyone is different, and your boys also will have different responses to stress and illness. The point is that there are very reasonable possible explanations as to why your son is acting so differently than his usual self, for this relatively short timeframe.

It's important that you respond in a positive and supportive way, and not convey to him that you're so worried. He's able to pick up your anxieties, and internalize the message that "something must be wrong with him". He needs reassurance that he WILL get better, and WILL feel better, but for now he still feels lousy and needs to be babied -- and that's OK.

As I said, however, I cannot evaluate your child from afar, so it's important you get your doctors' advice, as it sounds like you are doing. But since you have to wait for appointments, I would take this time to hang out with your boys in a relaxed way, giving them the chance to fully recover.

Please let us know how you're all doing in a few weeks' time.

Aloha,

Dr. Heather The BabyShrink