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TELEVISION’S IMPACT ON YOUNG CHILDREN

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
TELEVISION’S IMPACT ON YOUNG CHILDREN
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. What are your opinions of how TV watching affects young children? I can control what shows they watch but I’m more concerned about TV’s impact on a child’s development.

A. TV content isn’t the only concern for parents. Too much TV is a major problem, too.

The American Academy of Pediatrics discourages TV for children under age 2. For children over 2, the recommendation is to limit “total media time” to 1 to 2 hours of quality programming per day.

Studies have demonstrated a range of risks associated with TV. For example, excessive amounts of TV watching have been linked to restlessness and hyperactivity in preschool children, especially boys.

The American Academy of Pediatrics advises that TVs not be placed in children’s bedrooms. Both the number of hours of daily TV viewing and the presence of a TV in the child’s room are associated with a greater risk of obesity.

Before age 2 1/2, children learn little from TV. Its stimuli are overwhelming: too much noise, rapidly shifting visuals and the content is beyond small children’s comprehension.

Children may be able to tune out the barrage, but the energy would be better used for activities that actually help them learn – like reading or playing.

In many households, TVs are left on all day even when nobody is watching. Yet in the presence of “background TV,” young children have more difficulty paying attention and participating in interactive play.

Many small children are “parked” in front of the TV when their parents need to do something around the house. TV seems to have taken the place of extended family – of having grandparents, aunts, uncles and siblings nearby who can lend a hand – but it is no substitute.

In any family, raising a child is a challenge. Still, when a parent must briefly resort to TV to keep a child occupied, I’d limit the amount as much possible and choose soothing, low-key, commercial-free content.

After age 2, I recommend restricting TV viewing to no more than one hour per day. I would always choose TV shows appropriate to your child’s age and temperament. When a child watches TV, parents should watch, too. You can talk over what you’ve seen.

Your questions will help your children learn to ask their own questions, think for themselves and begin to separate your family’s values from the ones on commercial TV that are meant to sell things. “Did you like that show? Why do you think that man was trying to hurt that lady? How did they make it look like that kid could fly? Do you think skateboards can suddenly appear under your feet when you open that can of soda?”

You can discuss the content with them in order to help them detoxify it and understand it. Such discussions will help children become media literate – an increasingly important skill.

Some parents feel they must expose their children to everything that other people’s children might see on TV. They fear that tuning out and unplugging might somehow deprive their children. Yet parents can rest assured that plenty of children turn out just fine with less TV – or none.

Sure, children may protest at first when the TV goes off. They may not tell you until they’re adults, but they’ll be grateful to see their parents behaving like parents and asserting control over their family’s values.

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.

NURTURING A CHILD’S MIND

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
NURTURING A CHILD’S MIND
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My sister has a bright 3-year-old son. She is determined to nurture and develop his mind and brain to the best of her ability. How can she expand his horizons?

A. At 3, a child is curious about everything and brimming over with questions: “Why, why, why?”

Valuing children’s curiosity encourages their drive to explore, investigate and understand.

But parents needn’t have all the answers or respond right away: “That’s an interesting question. Can you remember it so we can talk about it tonight at supper when I have more time?”

For children to learn, they must develop their ability to be patient; pay attention; persist even when they fear they may not overcome a challenge; face their mistakes; and focus even when frustrated.

Thus children take the measure of their abilities and potential. This self-confidence, along with a sense of optimism, helps children see problems as opportunities to find solutions.

Patience, focus and tenacity may not be the first skills that come to mind when considering how to expand a child’s horizons. Instead, we think of teaching him about colors; numbers; the alphabet; names of animals, trees and flowers; and the world’s countries.

A child who develops the character of a learner can take on these challenges and many more, and he will always seek new horizons on his own.

Of course it helps to expose an eager child to the world’s sights and sounds – music, or a second or third language.

But watch for his signals about how he learns – with his eyes, his ears, when he is in motion, or all of these.

Also look for clues to when he has had enough. If you overload a child, pressure him or present him with tasks he can’t yet handle, you may make him feel unsure of himself as a learner, or worse, like a failure. The risk of too much teaching is to turn him off learning. Challenges should be just a small step beyond – and within his reach.

One sure way to expand a child’s horizons is to talk together, ask questions and listen – about everything, even life’s small details. This helps extend a child’s language skills, which are critical for learning.

Children’s strongest motivation comes from the adults who care about them. For example, children will want to read if they see adults reading.

It inspires children when they interact with adults who are excited to learn and who encourage them to do likewise, without pressure or judgment.

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.

TODDLER’S BEDTIME RESISTANCE

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
TODDLER’S BEDTIME RESISTANCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. We have never let our 33-month-old son cry himself to sleep. He couldn’t adjust to a crib, so we put a mattress on the floor and lay down with him until he fell asleep.

This approach worked for all of us until recently. Now it can take upward of two hours for him to fall asleep. If we tuck him in and leave, he screams and comes running for us. I am left with skipping his nap. He is so tired by bedtime he goes right to bed, but I can’t give up two hours every night until he falls asleep.

A. Between age 3 and 5, most children stop napping. At first the transition can be confusing. A child is too tired without a nap but not tired enough for bedtime without one.

A two-hour nightly struggle is tough on everybody. Taking care of yourself as a parent is important, too – for all of you.

As naps fade, most children still need a rest break in early afternoon. Take him to his room, dim the lights and help him quiet down by quieting yourself.

At first he may want you to stay. Once he understands he needn’t sleep, he’ll learn to take a break on his own. You might put on soft music and give him storybooks or a few stuffed animals for daydreaming.

End his rest period by 3 p.m. Otherwise he’ll never be ready for bed at 8 or 9.

The mattress on the floor sounds fine – as long as his room and your entire home are childproof. Be sure he knows that his room is the limit.

Your child is still learning to settle himself for sleep. To help, you will need to help less. When you lie beside him he is comforted by your warmth, your heartbeat, your smell and your touch. Eventually he must feel comfortable on his own, wrapping himself in pillow and blankets or nuzzling a favorite stuffed animal.

One of my children would always go to sleep with her hands together, palm-to-palm, against her face – as if she were praying herself through the darkness.

Gradually you can shift to simply being present. Rather than lying in the bed, you can sit beside him, sing a lullaby or rub his back. Quietly encourage him to find his own thumb or a stuffed animal. Compliment him on his progress.

Over time you can pull back more, even if he still needs you to sit within sight as he falls asleep. By then he’ll be doing far more of the work of settling on his own.

The goal is for him to learn that he can control his own patterns of sleeping and waking and that he can find ways of self-comforting.

Learning to sleep alone is an adaptation that our society has made to the way we live. For most of human history, and today in most places in the world, families sleep in close quarters and children may never need to learn to sleep alone.

If dropping the afternoon nap doesn’t help, we suggest you discuss your child’s sleep problem with his pediatrician, who can check for other, less common causes.

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.

A THREE YEAR OLD’S POTTY PROGRESS

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
A THREE YEAR OLD’S POTTY PROGRESS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 3-year-old daughter is fully potty-trained for urination – no diaper at night or for naps. But she refuses to use the toilet for a bowel movement and asks for a diaper instead (she will sit on the potty and pretend to go but always wants a diaper). She doesn’t seem to be afraid of the toilet and gives nonsense answers when we ask why she won’t go. What would help?

A. By nature, 3-year-olds need to assert themselves. They have strong reasons for not wanting to use the toilet but they can’t understand them, much less explain them. Making a big issue of the process can become a power struggle where your daughter’s healthy self-assertion goes astray – resisting your instructions rather than learning to control her body.

She has made great progress – potty-trained during the day and even at night. She’s shown you she knows what the toilet is for and how to use it.

But bowel movements are special. To small children they seem like some hidden part of their bodies that they are learning to master. Questions may make your daughter fear she’s failed or done something wrong – not the best feelings about bodily functions.

It’s hard for adults to remember how perplexing and disconcerting this process once seemed to be. Watch a child flush the toilet over and over. Is it to be annoying? Or to get attention?

No. Children have to be scientists and conduct experiments to figure out the world we take for granted.

Your daughter knows what you want if she’s pretending to try, but she’s not ready – which is why she wants the diaper. If a parent struggles with a child this age, the result may just be constipation.

You can avoid the turmoil. Just apologize to her. (Imagine that!) Say you’re sorry you’ve focused on this issue and you will leave her bowel movements up to her.

Don’t convey a sense of shame or failure. Let her know she can use a diaper until she decides, on her own, that she is ready for the potty. If you’re patient, you’ll end up using far fewer diapers.

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.

WHEN MEALTIME BECOMES A POWER STRUGGLE

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
WHEN MEALTIME BECOMES A POWER STRUGGLE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 9-month-old is resisting solid foods, and mealtimes are turning into a power struggle. We introduced solids at six months, and she has been breast-fed, with an occasional bottle of breast milk.

She is not interested in bottles anymore. We are trying not to push her too hard but she ends up eating only 1-2 ounces per day. Do you have any tips to help her take more interest in solid foods without a struggle?

A. Between 7 and 9 months, babies learn to touch forefinger to thumb – the pincer grasp that gives them new power over their world.

They now can pick up tiny objects, look at them and explore them with their fingers before putting them in their mouth to learn all about everything within reach.

Now that they can deploy their fingers and thumbs, they want to use them as often as possible. They would much rather feed themselves than be fed.

As soon as a baby learns the pincer grasp, you must let her use it – or she will resist being fed by you. When you need to spoon-feed her, give her two spoons – one for each hand. With both hands occupied, she may let you use a third spoon to feed her yourself.

It will still be more exciting for her to pick up soft foods to put in her mouth – all by herself. She wants to try out her new abilities on her own – a big adjustment for her, and for her parents who may long for the cuddly, compliant baby they once had.

But there is no turning back. Instead, take advantage of her drive to practice fine motor skills. Offer her a soft bit of cooked meat, bread, cheese or scrambled egg, and let her have fun feeding herself.

Just give her one or two bits of food at a time, since most of it will end up on the floor anyway. And stop as soon as she loses interest.

Be prepared to start over at every meal. The theory is that many young children will not try a new food or flavor until it has been presented to them 15 times.

When your child turns away from food, she is not rejecting you. She is reminding you that children learn through patient repetition. If you are ready for this process, you’ll feel less frustrated.

You’re right not too push too hard. Eating is a behavior that – like breathing – can’t be forced. It must build on the child’s own drives.

Battles over food always backfire. The child inevitably gets her way, but nobody wins. If you can keep mealtimes relaxed and pressure-free, your baby is likelier to connect food and eating with enjoyable times of being together.

As she learns how much fun it is to feed herself fingerfood, she will begin to imitate you. Later on, she will learn to eat with fork, knife and spoon – and manners.

Meanwhile you may share your concerns with your child’s pediatrician, who can measure her height and weight and let you know whether her growth is on track. Ask about vitamin supplements, including Vitamin D and iron. At this age, limited interest in eating is very common, but if a child’s growth is not continuing apace, the pediatrician will consider other causes that will require other solutions.

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.

AN 8 YEAR OLD WHO SUCKS HER THUMB

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
AN 8 YEAR OLD WHO SUCKS HER THUMB
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My daughter is 8 years old and she has a problem with thumb sucking. How can I help her?

A. Your daughter is much likelier to stop sucking her thumb if she decides on her own. Only when thumb sucking becomes her problem – not yours – will she give it up.

When parents try to stop a child’s thumb sucking, or even comment on it, they reinforce her need for it. Thumb sucking is one way a child comforts herself when she is scared, lonely, bored or anxious. Her worry that parents will try to interfere with her favorite form of soothing is yet another trigger for thumb sucking.

If you must do anything, just look for the things she does that she can be proud of, and compliment her on them. Help her to feel sure of herself. A parent is a child’s most reliable source of soothing until she learns she can count on herself for comfort.

Reduce the stresses and pressures on her that you can control so she’ll have less need for this kind of self-soothing. Point up other things she does that help her relax: “You look so comfy like that, all curled up with your book.”

Suggest other small pleasures she might try – going for a walk or a bike ride, humming a song, lying in the grass and looking at the clouds, sipping a cup of milk, or playing cat’s cradle or some other game that occupies her hands – without ever suggesting that these will replace her thumb.

Most children eventually stop on their own out of embarrassment and the wish to be like peers and older children – if nobody makes an issue of it.

My oldest child sucked her thumb until she was about 8 (as did I). At that age, children whom she admired began to comment on it, so she quit. Leave it to your daughter. If you don’t, her struggle with you will matter more to her than her peers’ disapproval.

Of course this change is easier said than done. Every time you see her sneak her thumb into her mouth you are bound to think, “What is the matter? What did I do wrong?” Or perhaps, if you sucked your thumb too, “Does she have to turn out like me?”

When thumb sucking becomes a constant reminder of parents’ doubts about themselves and fears about their child, it is no longer simply the child’s soother. Instead it has become a vicious cycle between them. Then thumb sucking is everyone’s problem – and the only solution is for parents to pull out of the argument.

Of course parents wonder, “Will she ever stop?” Many parents take comfort in being reminded that thumb sucking isn’t likely to be an issue when the 8-year-old is 18. However, several years ago I wrote a column about thumb sucking. In it, I suggested that deciding when to stop should be left up to each individual.

A 23-year-old woman then wrote to me, “Dear Dr. B., I still suck my thumb when I am going to bed every night and I can’t seem to stop myself. I am about to get married and I’ll be so embarrassed if my new spouse catches me at it. What can I do?”

I replied, “Don’t worry. You won’t need your thumb to help you go to sleep now. You’ll have a much better replacement to comfort you.”

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.

RAISING YOUR ONE AND ONLY

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
RAISING YOUR ONE AND ONLY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I have an only child. What’s your best advice for raising one?

A. Raising an only child brings special challenges and rewards.

An only child is always a “first child.” Parents may feel that no other child can compare. But they may also be at a loss because they don’t have the experience with other children to help them understand this one.

In a larger family, a child must learn to share – and fight to hold on to what is his, right from the start. An only child needn’t share his parents.

So don’t shower him with excessive praise, rewards and attention. He doesn’t benefit from having too much of everything just because he’s the focus.

Siblings also help to spread out a parent’s protective instincts. Go easy on hovering. Like all children, “onlies” need to try things out for themselves, fail (temporarily), get upset, pick themselves up and try again. Otherwise they may become overly dependent on their parents and lack the self-reliance to separate from them.

If your child is upset, wait a few moments before rushing in to soothe her. See if she can settle herself. Thus she learns to handle her strong feelings. Then she’ll know she can count on herself rather than her parents.

Siblings teach, inspire and entertain one another. Research has shown that babies as young as 7 months of age study each other carefully and respond to each other’s facial expressions, gestures, coos and cries.

Therefore, put extra effort into introducing your only child to other children. Close friends are especially important. Make regular play dates. Whenever possible, let your child get to know her cousins, or the children of your closest friends, to give her the feeling of belonging to a family or community.

Some parents of only children express the concern that their kids miss out on “just being kids” and “grow up too soon” because they are surrounded by adults.

But if parents balance adult-like conversations and expectations by paying close attention to their only child’s cues, they will reinforce the child’s playful side – and rediscover, enjoy and share their own.

Parents of only children find deep satisfaction in the close relationships they share. And only children tell us that they “turned out just fine” and that they treasure the families and childhood memories they have. They speak of connecting with plenty of other children in their extended families, neighborhoods and schools.

Whatever the challenges of being an only child (or raising one), that child will feel like No. 1 from the start, and forever.

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.

CHILD RAISING IN A TIME OF MULTITASKING

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
CHILD RAISING IN A TIME OF MULTITASKING
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

In these challenging times, we risk losing our sense of balance. Technology and global competition have changed how we work. Multitasking has been glorified while new stresses on working parents sap more energy. Yet the most important jobs – like child raising – can’t be done without our full attention.

Working parents are less productive when they worry about their child care arrangements or about their co-workers’ resentment of parental time off when a child is ill.

Families suffer when parents – tethered to smart phones and laptops – bring work home. They may be home, but their jobs are their focus. They may be less engaged with their families, less available to them emotionally.

Yet that availability is critical for child development and strong family relationships.

Children and parents need protected time together to focus on each other, to watch, listen and respond with a minimum of intrusions.

From the start, babies and parents are learning to understand each other and themselves.

Since newborns have been listening to their parents’ voices for several months before birth, I like to help parents discover how much they and their babies already matter to each other.

I hold a newborn with his head in one hand and his bottom in the other. I ask the mother to stand on one side and to talk to her baby in one ear while I talk in the other.

Of course, most every newborn turns his head to his mother. And every mother grabs her baby, kisses him and says, “You know me already!” Then I do the same thing for the fathers. Eight in 10 babies turn their heads to their father’s voice instead of mine. With the other two, I tip their heads toward their fathers – to establish the “conversation.” The fathers react just like the mothers.

In our research, we found that 2-month-olds are already “conversing” with their parents. Sometimes a baby leads; sometimes he follows. He is learning that he can act on his world, and that he will be heard.

Babies and parents are working hard to get to know each other. They are already sharing emotions.

In another experiment, researcher Ed Tronick and I ask mothers to interact normally with their 2-month-olds – and then to turn away. When the mother turns back, we ask her to be unresponsive, expressionless: the “still face.”

Within 11 seconds the baby realizes that something is not right. Then he’ll try 15 different behaviors – smiling, crinkling his eyelids and cooing – to try to win back his mother’s attention.

The baby’s response changes if the mother is depressed. In the “still face” experiment, the baby gives up after only three tries.

Since we can detect maternal depression early and know how to treat it, we have an opportunity to protect children and families.

We used this research on Capitol Hill to advocate for the Family and Medical Leave Act (passed in 1993), which mandates job-protected leave for up to 12 weeks a year, although it is unpaid.

Parents need time with their new babies before returning to work. But these crucial interactions do not end after the first three months.

Workplaces can encourage strong families (and boost productivity, too) when job and family life are in balance.

Families also depend on strong communities where parents can find and share emotional support, practical advice and resources.

For many families, the workplace is their community. Workplaces must learn from strong communities about how to support healthy families. We must all put families first to keep our nation strong.

For more information on family and workplace:

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.

A BACK-AND-FORTH ON BITING (follow up)

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

In a recent column a grandmother recommended her solution to the problem of children biting: Bite back. We demurred. Now another mother lobbies for the fight-fire-with-fire approach.

Q. This is in support of the politically incorrect biting mother and grandmother. There is nothing like experience to teach us, and I’m talking about biting toddlers. We can talk a blue streak, and it’s all abstract to a toddler; they need to learn that if they cause pain, it comes back at them.

These are my biting stories from the trenches. I was nursing my baby and his teeth were starting to come in. After having toyed with the idea for some time, he finally bit me while nursing. I let out a very loud bellow out of proportion to the pain, because I was not going to have that happen again. The poor baby got quite traumatized by my loud scream, but he never bit me again.

When he was a toddler, I took him to a day care where there was a hyperactive boy who was a frequent biter. Nothing the parents or day-care provider tried changed anything. Finally the day-care provider’s toddler took matters into his own hands and bit him back. End of biting.

When my boy was a toddler, he kicked my leg. Like the politically incorrect grandma, I very carefully placed a kick on his leg (I was so scared of hurting him that the first attempts were air kicks). He never kicked anybody again. I must add that this boy is now 14 and a joy (besides the fact that, being a teenager, he counters everything his parents say).

A. Small children’s biting certainly creates a red flag for everyone. Yet it is such a universal response in late infancy and toddlerhood that it deserves all its eminence.

Starting out as an exploratory and often loving response when a nursing baby bites the breast of his mother, it gathers drama from the surprised, angry and even frightened response, “Have I lost my baby? Do I deserve this negative hurtful response when I’m giving him everything I can? Will he turn out to be a monster?”

For him, it is likely to mean that when he suddenly raised such a dramatic response, “Should I try it again when I need to get her attention?” Then, he may begin to fall back on it when he is tired or overwhelmed or doesn’t know any other way to get the attention of someone he craves. He tries it out on a peer toddler. The world blows up. Everyone overreacts. “Wow! This is more important than I thought. I’d better shove this behavior way down underneath. I’ve learned there are certain behaviors that I don’t dare to express. They mean something terrible to other people, even though that’s not what I meant when I tried them. I’d better be more inhibited than I was.”

Inhibitions can be expensive in the long run. Your method of retaliation has surely worked. But what has it meant to the baby or toddler? “I’m bad, or she wouldn’t have hurt me, and I’m not sure why. But I guess I’m just a bad kid.” Is that what you meant to teach him by your response?

Meanwhile, seeing it from the standpoint of the baby’s development, it has been a missed opportunity. Each behavior which becomes an intrusive or painful one presents the child the chance for him to learn about how to control himself.

A child who learns self-control is already way ahead of a child who must rely on an adult’s presence to be controlled by force or by retaliation. Learning self-control is a major goal for childhood in our present out-of-control society. Discipline (teaching) is the second most important gift we as parents can give a child. Love first, but discipline that says, “I shall have to stop you until you can stop yourself.” That’s a much longer goal in time than just teaching him to suppress his responses and his feelings.

Everything we know from research in child development demonstrates that suppressing angry, hurt feelings just postpones them. For a parent or a teacher or any caring adult, each episode needs to be understood from the child’s standpoint. We can use his hurtful behavior, share the idea of self-control rather than just shutting it off. “I can’t let you bite. It hurts and no one likes to be hurt. Let’s find another way for you to say what you’re trying to say.”

The story you tell of the child’s learning from another child how biting hurts and how necessary it was to control himself was on a different level. Children learn so much more from each other than they do from an adult. It’s fascinating to watch two toddlers as they reproduce by imitation hunks of behavior from each other.

I have recommended putting two 2-year-old biters together. One would bite the other. They’d look at each other with a startled look. “That hurt.” And they wouldn’t bite again. This is an almost sure cure, but maybe one to be used sparingly, in case it could get out of hand. When it works, one can see on the biter’s face that he recognizes the fact that he’d hurt him. “I never knew what I was doing could hurt someone. I can’t do that again.” He will have learned (at 2) how to experience what another is feeling – a major step toward empathy for others.

When an adult bites him back, his reactions are hurt and anger. He may not have meant to be aggressive in the first place. Now, biting could become loaded with angry feelings. Certainly, it has not been a learning experience except to stop the biting – but not the anger that being bitten has generated.

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

by

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.