A 5-YEAR-OLD WHO NEEDS TO LEARN SOME LIMITS

NEW YORK TIMES COLUMN: FAMILIES TODAY:
A 5-YEAR-OLD WHO NEEDS TO LEARN SOME LIMITS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My son is almost 5 years old and an only child. He loves to talk and interrupts quite often. My husband and I have brought it to his attention numerous times and talked with him about taking turns when speaking, but we have yet to see much improvement. Is it just the age or is there more we should be doing?

Our other concern involves the relationship between our son and another child at school. The two of them have been in preschool together and friends for a couple of years. The other child has begun acting out in negative ways and sometimes tries soliciting others to join in the behavior. When our son has been the target, we have suggested he tell the other child that he does not like the action(s) and then walk away. He is comfortable with walking away (although the other child often persists) but doesn’t want to say anything that might hurt the other child’s feelings. I don’t want to discourage his compassion for others but don’t want him to feel unable to stand up for himself either.

We would like to know how to speak with our son better about both issues.

A. Five years old is indeed an age when children want to intrude, partly to test their new found power over others — adults and peers. The other, more subtle reason for the irresistible urge to break into parents’ conversation arises from what Freud called the “Oedipal” struggle. Children this age want to possess each of you as their own, and may have trouble putting up with the intimacy of your speaking together.

Of course, parents must insist on their need to be in close touch, and a child this age shouldn’t be allowed to interfere, for his sake as well as yours. As much as he wants to interrupt and have you all to himself, he’d feel terrified and out of control if he succeeded! An only child may have an even more difficult time learning that he doesn’t need to be the center of everyone’s attention. He can be adored but not arrogant.

You are right to want to help him, but I sense from your language that you and your husband may feel torn because you find his interruptions hard to resist — maybe even precocious? No matter how compelling he makes himself, if you can consistently insist each time that he wait his turn, you will be teaching him to value other people’s significance.

This kind of sensitivity is priceless, and sometimes seems almost like a lost art. And it sounds as if you are afraid an only child may not have the opportunities to learn to value the rights of others as one would in a larger family, but there isn’t any reason why he can’t. You can start helping him develop this valuable social asset by labeling each interruption: “You are interrupting now. It’s Daddy’s turn. After he’s finished, we will be ready to hear your idea. Meanwhile, Daddy’s idea came first.”

Don’t let a single interruption slip by without doing this, or you’ll be giving him a mixed message — sometimes it’s OK to interrupt, and sometimes it isn’t. It may seem like discipline, but it is in an important cause — learning how to value others, and to listen as well as just to talk. He does sound exciting and it must be intriguing to hear all his ideas. You can reassure him that if he waits his turn you’ll be sure to listen to what he has to say.

Second question: I am not sure what “negative ways” you refer to, but most children at this age begin to “try their wings.” It’s a way of both testing the system and of learning an important goal, how to stop themselves when their wishes are getting out of hand. They may be used to hearing parents say, “I have to stop you until you can stop yourself.”

But at this age they must find out for themselves whether or not you still will, whether or not you still can. For your boy, living vicariously through his friend’s troublemaking may be a safe and appealing way to try this out. Of course, he’s both attracted and repelled. All the other 5-year-olds are, too.

Although you may prefer to say it as all the other child’s fault, if you can face his role in the “negative ways,” you’ll stand a better chance of helping him understand what he’s up to. Let him know that all children are bound to be curious about “getting into trouble,” even though they know they shouldn’t.

You might ask him “How do you feel when you do  “bad stuff’?” With this question, you are not condoning the behavior, but helping him to realize that he feels both excited and guilty if he would go too far. Becoming aware of these guilty feelings is not unhealthy, but instead, a powerful motivation to keep himself under control. His friend may be silently asking the others to help him take this kind of perspective on his mischievous urges and to learn to stop himself.

Walking away, as you suggest, is one way to handle these situations. But as a close friend, he may be able to find other ways to help his friend that will allow him to stand up for himself. “I don’t want to get into trouble. And I don’t want you to either. Because we’re friends.” Warn him that his friend may thump his chest in response, “Scaredy cat! No one’s gonna catch me!” Your son can still stick up for himself and say, “That’s no reason to do bad stuff!”

At this age children should know that breaking rules will lead to punishment. But recognizing the reasons for obeying for rules for their own sake is a whole new world. They will both be learning together, the good and the bad. Then your son can be proud of himself — as a friend, not as a victim.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

CARTOONS; AND ROCKABYE, BABY

NEW YORK TIMES COLUMN: FAMILIES TODAY:
CARTOONS; AND ROCKABYE, BABY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. A fond recollection I have from around the age of 5 was of my mother coming down the street, returning from work, and my calling out to her, loudly but lovingly, “Mammy Yoakum, Mammy Yoakum,” whom you might recall (age permitting) was the pipe-smoking mother to Al Capp’s “Little Abner.”

Cannot tell you how long that had gone on, nor how long it continued nor why. Someone smarter than I might use the word transference in a long sentence. All I know is that for several years she was my Mammy Yoakum.

A. And of course every little boy wanted to be her L’il Abner! I did. What a delightful memory! Why ruin it by psychoanalyzing it? Your mother sounds great, that she could accept the teasing of being called “Mammy Yoakum,” and that you remember her and your boisterous welcome the way you do.

I surely remember L’il Abner and the Al Capp comic strip, as will some of our readers. It is fun to have you respond to our other reader’s question with your own wonderful childhood memories. Sometimes comic strips seemed to carry so much meaning, and other times they didn’t seem to mean much — except that one could picture the whole country sharing the same experience every Sunday morning.

My grandchildren have replaced them with video games, and they aren’t the same. Their video games seem to be reflecting the ominous, dangerous world we have created for them. It makes me sad, and I’d like to return to Mammy Yoakum and Lil Abner and Daisy Mae! Wouldn’t you?

A recent column recommended a rocking chair as a parents’ helper at a child’s bedtime. Here a mother also endorses good rocking tonight.

Q. My younger daughter never had to be told to go to bed when very young: When tired, she would voluntarily go to their bedroom and fall asleep. The older was so tightly wound that she could not fall asleep unless held. Even by grade school she was still having difficulty falling asleep, and would keep her sister awake chatting.

It was at that point that I brought the rocker into their bedroom and began reading to myself while they fell asleep. I read quite a few books that way that otherwise I would never have gotten around to. Eventually they got the knack of relaxing and didn’t need help anymore. This worked very well for us.

A. It always amazes me that two children in the same family — same genetics and same environment — can be so different. I admire your restraint, and your ingenuity.

Instead of blowing up at the older, more tightly strung girl, you found a way to set quiet limits on her difficulty in falling asleep. Your quiet, unreactive presence was more impressive than words would have been. It said to her, “I’m here and I will stay with you until you can learn how to calm yourself down.’

Your measured response physical presence, without holding or rocking — signaled to her: “I can’t do it for you but I can keep you company.” Your quiet presence was just enough to encourage her to keep on trying as she struggled to find her own ways of calming herself.

Learning how to calm herself down is a difficult problem for such a high-geared little person. And yet, it is necessary, as an adjunct to learning how to sleep through the night. We all come up from deep sleep to light sleep every three to four hours through the night.

A child who is temperamentally so reactive is likely to come to full awakening every four hours. Unless she can learn how to help herself relax and find her own way back to sleep, she may grow up unable to sleep through the night. But your ability to leave it to her to find her own pattern of relaxing, will equip her to handle every rousing with her own way — rocking, hugging herself, shifting positions, sucking a thumb — of getting herself back down into deep sleep. Your rocking chair and books were a therapeutic way of letting her solve her own problems in getting to sleep.

One of the biggest challenges of parenthood is this delicate balance between doing just enough for the child and leaving the child just enough room for her to learn and reach new heights. What makes this even more complicated is that the balance is different from one child to the next, and within the same child it is always changing as the child develops. Bravo!


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

 

 

WHEN A 3-YEAR-OLD BITES HER TWIN

NEW YORK TIMES COLUMN: FAMILIES TODAY:
WHEN A 3-YEAR-OLD BITES HER TWIN
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I am a stay-at-home mom of twin girls, age 3 and 1/2; a son, almost 2, and am expecting another little boy in March.

When my girls were around 2, one of them would bite the other. The roles were consistent: One was always the biter; the other was always the victim. I initially reacted the way most parents probably do, with scolding, time outs, etc. None of these responses was effective in stopping the behavior. It was especially distressing to me because of the unique, special relationship of our twins. They love each other so much and clearly demonstrate it all the time — I had a hard time seeing one hurt the other.

All of this biting began when I was trying to give them a little more independence. By age 2, I thought they needed to begin to learn to play and do some activities without me always right there. I set up a play area near the kitchen where they were close by me when I was doing other things. When I really determined to figure out what was going on, I spied on them and realized what was causing the biting.

My little victim is a big tease! She could quietly do something to pick on her sister (which I, in the next room, would be unaware of). Sister would object and try and get her to stop – but the pestering would continue.

With limited communication skills, the only way she could get it to stop was with a bite! Then I would come running when I heard the crying. I was able to explain, “You love your sister and don’t want her to be hurt. Look at the owie you gave her. When she does something naughty, you yell for mommy and I’ll help you. Be as loud as you want! That way mommy will know and I can come help you.”

This worked beautifully for our family. I was concerned it would turn the biter into a “tattletale.” But it didn’t. She only used her “yelling for mommy'” weapon when she really needed it. Soon their communication skills with each other advanced to the point where they only need my intervention on rare occasions. They remain best of friends, yet still have a healthy independence and enjoy playing with other kids, too.

A. Your letter shows how much you have learned about sibling relationships from your careful observation of your twins. First of all you’ve discovered that when, as a parent, you try to figure out who’s to blame, you’re usually wrong! Second, you saw how each twin was taking a different role in their relationship, yet how each had their turn at being victim and victimizer. Third, you saw how siblings handle their ambivalence about their own growing independence.

As you gave them more room to play on their own, they managed to draw you back in by attacking each other. And finally, you learned from your mistakes as a parent– the best way for any of us to learn. You saw that time outs and scolding weren’t working, and questioned your approach and what was really going on. Then you went back to really look again — observing children’s behavior is the only way to really understand them as individuals, and of course you couldn’t really figure out what to do until you did.

To your great credit, you avoided taking sides, and focused on strengthening their relationship. Your strategy of inviting the twin who bit when teased to come to you for help may actually have prevented either of the children from becoming tattletales. After all, a tattletale is not a child who innocently goes to an adult for help when she can’t defend herself against another child. A tattletale is a child who uses this situation in order to win special favors or a preferred role from an adult.

The way you treasured your children’s special closeness — so unique and precious in twins — was bound to keep you from reinforcing this child’s cries for help with unhealthy favoritism. You gave the biter know two very important messages: (1) that you trusted she could give her biting up and that you knew she wasn’t “bad” and (2) that she didn’t have to go on being a victim to her sister’s teasing. And by giving that child an alternative to biting, there was little incentive left for the teaser to tease her. Bravo!


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

WHEN A MOTHER BATHES WITH HER 3-YEAR OLD SON

NEW YORK TIMES COLUMN: FAMILIES TODAY:
WHEN A MOTHER BATHES WITH HER 3-YEAR OLD SON
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I like to think I am not a prude yet it bothers me that my daughter-in-law bathes with her 3-year-old son. She started this practice when he was born and it has continued. She is in the bathtub with him and of course they are naked. My son states she did this with her older son (not by this marriage) until age 5 until my son put a stop to it.

If sex roles were reversed and it was my son in the bathtub with a 3-year-old daughter I feel this would be considered taboo.

A. Your daughter-in-law bathes with her 3-year-old son and it bothers you. But you don’t say exactly why. You say that it would be “taboo” for a father to do the same with his 3-year-old daughter. Is it the double standard that bothers you? Or that what your daughter-in-law is doing might be taboo, too? You may be worried about what bathing together means – about the mother, for the child and for their relationship. It is not unnatural for parents to bathe with their infants, and it may be easier to hold them and wash them when there are no worries about getting wet too. Getting out of the tub with a slippery baby in your arms is a challenge, and a hazard, unless there is a dry adult with a dry towel to whom the baby can be carefully handed. Splashing together, playing with rubber ducks and plastic tugboats, or just watching the water as it sloshes and gurgles down the drain are innocent ways to be together. What really matters is what is going on in the bathtub between the mother and child, and for each of them.

By the time a child is 3 or 4, he may be more interested in exploring the differences between his body and others. At that point, an adult’s nudity can be too much, too stimulating, and daunting to the child who is just becoming aware not only of gender differences and related anatomical ones, but also of how small and dependent he really is.

Bathing with a sibling who is no more than a few years older (with a parent nearby) allows a young child to learn about differences without the over-stimulation that adult nudity might entail. But stopping the bathing with the parent can be harder to do and harder for the child to understand once it has become important and compelling to him. This may be the case by 3.

For the mother, this might just be an innocent way of relaxing and being close. But it may be, as you seem to be suggesting, that she is driven by some deeper need that would interfere with her being able to watch her child’s cues, and respect them if this were too much for him.

What can you do? As a mother-in-law, not much – unless you have strong reason to believe that the mother is clearly causing the child harm. Then, it would be your duty to talk about this with your son. If he were unwilling to take action (as he did with the older child) then you could present your concerns to the child’s pediatrician for further investigation, and reporting to child protective authorities if warranted.

But if all you really know is that they are bathing together, then all you can do is gently test out your son’s position on this. More than that might make him think that you are trying to interfere with his relationship with his wife. This could easily backfire and push him away from you, without helping the child – if the child needs help. We doubt your daughter-in-law would be ready to hear you address this intimate issue directly. You might, though, have a general and sympathetic conversation about the challenges of letting a child grow up, and of keeping up as a parent with a child’s changing needs.

If you are asking us to decide if you are a “prude” or not, we can’t. We’re not sure what that word means to you, but think that you are entitled to decide for yourself about your level of comfort with family.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

PARENTS: DOING WHAT COMES NATURALLY

NEW YORK TIMES COLUMN: FAMILIES TODAY:
PARENTS: DOING WHAT COMES NATURALLY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I live overseas and looked into all the parenting books, French and English. Yours were the only ones that showed deep faith in the mother and the child. Can you tell me where you got this confidence? Your guidance helped us through those youngest years and played a large role in helping me raise two wonderful, outgoing and sweet kids.

A. Where did my faith in mothers – and in fathers and children – come from? During my 50 years in practice, I saw more than 25,000 families. They taught me most of what I know. From them I learned that parents are the experts on their children, and that we pediatricians and other professionals had better listen to them.

Except in the rarest of cases, parents want to do well by their children. We professionals may not always recognize the positive intent behind parents’ actions – and if not, we need to look again. Sometimes, for example, we may think parents are harsh with their children. Instead, we may be witnessing parents who live in a tough world and are doing their best to prepare their children to be tough enough to handle it.

For humans to survive, nature had to set things up so that parents would make all kinds of sacrifices – ones they never dreamed possible – to keep their fragile new babies alive. Attachment is a powerful biological process. Even a baby’s gaze or cry stimulates changes in certain hormone levels in both parents that help ensure their nurturing responses.

Parents also must innately know pretty much everything they need to, if they’re going to protect their young. If parents needed books, TV shows or the Internet to raise children, we’d never have made it this far.

Fortunately, new parents are naturally primed to take in everything they can about the vulnerable new beings for whom they are responsible, and babies are designed to draw parents in and give them all kinds of information about how they’re doing.

Parents learn how to become parents by trial and error. They are guided by their babies’ behavior, which actually shapes theirs – right from the start. Some people still think that babies are lumps of clay that parents just shape. But babies guide their parents through their own responses, showing them when they get something right or wrong.

I wouldn’t have much confidence in parents and children if biology hadn’t set them up to be so skilled at caring about and learning about each other.

Sometimes when humans try to improve upon nature, we make things worse. During the 1950s, medical science thought that women would do better giving birth while under general anesthesia. Then we learned that babies were anesthetized for days afterward, interfering with their job of teaching their parents what they needed and when – and sometimes even interfering with their breathing.

Next, medical science teamed up with industry to recommend that breast milk be replaced with formula. But breast milk’s special properties could not be reproduced – the antibodies it contains to fight infection, or the way it varies the kinds and quantities of fats within it as the baby grows. Breast milk adjusts to the baby’s changing nutritional needs.

More recently, infant “brain-stimulating” toys have been marketed to parents. Yet nothing is more stimulating for babies than their parents’ ever-changing voices and faces.

Then there are the rigid baby carriers that interfere with the development of babies’ muscles and balance that takes place when their parents carry them against their own bodies.

Perhaps most concerning right now are the smart phones – and the new behaviors and beliefs that go with them about the feasibility and even importance of multitasking. When parents are talking or texting or checking their e-mail, they may not take in the subtle, ongoing messages that their babies’ nonverbal behavior is sending – about what parents need to know to keep growing in their parenting role.

I still have as much confidence in parents and children as ever, but they must not be misled to think that anything can replace what they do naturally to grow together as a family.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

6 YEAR-OLD WHO WON’T EAT MEAT

NEW YORK TIMES COLUMN: FAMILIES TODAY:
6 YEAR-OLD WHO WON’T EAT MEAT
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 6-year-old son will not eat meat, chicken or cheese. Is half a peanut-butter sandwich, one yogurt and one glass of milk enough protein for a day? He eats plenty of fruits and several vegetables.

A. A few simple rules apply to nutrition and growth.

A child whose height and weight stay on his growth curve at each checkup is consuming enough calories.

For example, a child who has always been at the 25th percentile for weight on the standard growth chart should continue on that percentile over time. If he drops below it, he may not be eating enough calories, or may have a medical problem interfering with growth. A child’s height is determined not only by nutrition but also by his parents’ height.

Children are naturally programmed to seek the foods they need for healthy growth and nutrition. Processed foods that are unnaturally sweet, salty or fatty undermine that ability.

Around the world, a robust variety of healthy diets balance human needs with local foods. These diets typically include different kinds of foods. Many cultures have developed diets with small amounts of meats (the most costly protein source) and larger amounts of vegetables and grains.

Children’s taste preferences mature and broaden with time. A child who rejects a food early on may learn to like it later. Many children need to be presented with the same food up to 15 times before they’ll even try it.

Children’s interactions with the adults who feed them also drive what and how much they eat. Parents’ sense of urgency about feeding their child can backfire. A child is bound to react to pressure by becoming even pickier.

The menu can turn the kitchen into a battlefield. But healthy eating is more likely when mealtimes are relaxed occasions, with no pressure about food.

If the otherwise healthy child doesn’t like a particular food, he’ll just have to eat what’s on his plate or wait until the next meal.

A child’s nutritional requirements vary by age, gender, height, weight, metabolism and activity level. Protein requirements also depend on total daily calories.

Eating enough calories every day allows a child’s body to use proteins for growth instead of breaking them down to provide energy.

Milk, yogurt and peanut butter all contain proteins, as do eggs. Alternative sources include soy foods (soy milk, tofu, tempeh and ice cream). Children who don’t eat meat, fish, poultry, eggs and dairy products may need 1 to 9 grams more of protein per day than those who do.

Check with your pediatrician about your child’s protein requirements.

Children’s daily nutrition guidelines:

“The Pediatric Nutrition Handbook,” edited by Ronald E. Kleinman, M.D., offers these daily nutritional guidelines for 7- to 12-year-olds:

  • 24 to 32 ounces per day of milk or other dairy products. 1/2 cup of milk can be replaced with 1/2 to 3/4 ounces of cheese, or 1/2 cup of yogurt, or 2 1/2 tablespoons of nonfat dry milk stirred into other foods the child likes.
  • 6 to 8 ounces per day of meat, fish or poultry are recommended. 1 ounce of meat, fish or poultry may be replaced with 1 egg, 2 tablespoons of peanut butter, or 4 to 5 tablespoons of cooked legumes such as peas, beans or lentils.
  • 3 to 4 servings of vegetables (each one about 1/4 to 1/2 cup) per day should include a green leafy or yellow or orange vegetable.
  • 1 medium-size portion of fruit or 4 ounces of fruit juice (avoid added sugar, corn syrup or high-fructose sweeteners).
  • 4 to 5 portions of grain (especially whole grain) products such as bread (1 slice equals 1 portion), cereal (1 cup equals 1 portion), pasta, macaroni or rice (1/2 cup equals 1 portion), crackers (5 pieces equals 1 portion), English muffins or bagels (1/2 equal 1 portion), corn grits and the like.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

IN TOILET TRAINING, A PREMIUM ON PATIENCE

NEW YORK TIMES COLUMN: FAMILIES TODAY:
IN TOILET TRAINING, A PREMIUM ON PATIENCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Problems in toilet training nearly always arise because of an imbalance in the parent-child relationship. Children usually show signs of readiness between age 2 and 3. When parents can’t wait until then, and impose toilet training as their idea, the child will feel the pressure as an invasion.

All parents, of course, want their child to grow up and cross this threshold. Preschools often insist that a child be “trained” before he comes to school.

Other parents may offer advice and condescending comfort when their children are already trained. Grandparents may imply that toilet training is a measure of effective parenting and of a child’s overall competence. Some families may see the child’s entire second year as preparation for success in this area.

A toddler for whom independence is a passionate issue anyway will have his own struggles. He may stand in front of a potty, screaming with indecision. Or, he may crawl into a corner to hide as he performs a bowel movement, watching his parents out of the corner of his eye.

It’s a rare parent who won’t feel that such a child needs help to get his priorities straight.

When a parent steps in to sort out the guilt and confusion, the child’s yearning for autonomy becomes a power struggle between them. Then the scene is set for failure.

In bedwetting, as in many of the problems encountered with toilet training, a child’s need to become independent at his own speed is at stake. When a child’s need for control is neglected, he may see himself as a failure: immature, guilty and hopeless. The effect of this damaged self-image on his future will be greater than the symptoms themselves.

Given that toilet training is a developmental process that the child will ultimately master at his own speed, why do parents feel they must control it? My experience has led me to the conclusion that it’s very hard for parents to be objective about toilet training.

The child becomes a pawn – to be “trained.” It may take us another generation before we can see toilet training as the child’s own learning process – to be achieved by him in accord with the maturation of his own bladder and central nervous system.

When Problems Exist:

A.) Discuss the problem openly with your child. Apologize and admit you’ve been too involved.

B.) Remember your own struggles, and your eventual successes, so that you can let the child see that there is hope ahead.

C.) State clearly that toilet training is up to the child. “We’ll stay out of it. You’re just great, and you’ll do it when you’re ready.”

D.) Let the child know that many children are late in gaining control, for good reasons. Then, let him alone. Don’t mention it again.

E.) Keep the child in diapers or protective clothing, not as a punishment, but to take away the fuss and anxiety.

F.) Don’t have a child under age 5 tested unless the pediatrician sees signs of a physical problem. A urinalysis can be done harmlessly, but invasive tests and procedures – enemas, catheters, X-rays and so on – should be reserved for children who clearly need them.

G.) Make clear to the child that when he achieves control, it will be his own success and not yours.

(This article is adapted from “Touchpoints: Birth to Three,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

THE PACIFIER PROBLEM

NEW YORK TIMES COLUMN: FAMILIES TODAY:
THE PACIFIER PROBLEM
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My almost 4-year-old refuses to give up her pacifier and I am concerned about her teeth. Since her sister was born 10 months ago, she seems to be using it much more. Do you recommend we get rid of it cold-turkey as some pediatricians have recommended? Will the pacifier cause long-term damage to her palate and/or teeth?

A. Some studies associate pacifier use with orthodontic problems, especially as children get older. Such findings don’t mean that any child who uses a pacifier will need orthodontic treatment, but treatment appears to be necessary more often with pacifier use.

We know of no studies that link cold-turkey termination of the pacifier with significant psychological problems later. Concerns arise from the notion that interfering with a young child’s need for oral soothing may lead to overeating and other problems.

The practical challenge in stopping pacifier use is that there’s no sure way to do it. Often, when a parent tries, the child just clings harder to the pacifier.

You mention that a baby sister came along 10 months ago.

Children often suck their thumbs, fingers or pacifiers to reduce stress. They’re bound to feel more anxious when the whole family is.

When a new baby is brought home, parents are understandably preoccupied, worn out and less available to the older child. She may wonder why her parents had to go to all that trouble for this crying, demanding, inert little creature who won’t be much fun for a long time. The question may vaguely cross her mind, “Is the new baby here because I wasn’t enough to satisfy them?”

As she tries to adapt to her new role of older sister, and learns to wait until her parents have time for her, she’s likely to feel upset. As the baby grows, there will be new challenges for the older child – when the baby says her first words, or begins to crawl or walk and get into all of the older child’s toys. A thumb, finger or pacifier can be a welcome refuge.

It may help to offer this child other strategies for soothing herself – a “lovey” such as a soft blanket to stroke and cuddle, or a stuffed animal to squeeze tight. There’s no need for lots of dolls and animals – too many will just distract her. Instead, she’ll need to become attached to a single special one. Hand it to her when she’s distressed, tired or has scraped an elbow or knee, and tell her to hug it hard to help her feel better.

After a new baby is born, the older child feels the need to be a baby, too. The baby just seems to suck up all the time and get all the parents’ attention – so why wouldn’t an older child try the same thing?

Parents often think they can help the older child adjust by praising her for being such a “good big sister.” But the older child also needs reassurance that she can be a baby again when she needs to. The more her need to regress is openly expressed and accepted, the less she’s likely to do so.

Family life is especially busy with a 10-month-old, but the older child might need some extra time to cuddle with you. Don’t say a word about it, and don’t make it an issue, but try to give her some gentle one-on-one time when she doesn’t have her pacifier. Thus she’ll learn – through actions rather than words – that there are even more rewarding places for her to find the comfort she seeks.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.