DAY CARE CONCERNS; AND A TEASING PROBLEM

NEW YORK TIMES COLUMN: FAMILIES TODAY:
DAY CARE CONCERNS; AND A TEASING PROBLEM
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

DAY CARE CONCERNS

Q. I am working in Dubai. My daughter is 15 months old and living with my family in India. Day care and kindergarten aren’t available near my family. Can you give me some idea about what is taught in day care and kindergarten? Are they really important? Will they really help my child’s education?

A. How tough for all of you to have to be apart! For so many families, scarce work opportunities force a parent to leave spouse and young children for employment in a foreign country. It would mean so much for your family to know that even at such a distance you are thinking about how to make the best life you can for your baby girl. We hope they read this too!

Day care is a solution for working families where there is no community or extended family to take up the slack with the child. Since she is in India and with your family, you may be able to comfort yourself with the oft-quoted but still true statement, “It takes a village to raise a child.”

She can learn a great deal from the adults around her: about herself, her emotions and those of others, and all the complexities of language and — even before she speaks — nonverbal communication. In her interactions with those who take care of her she is already learning to pay attention, calm herself down when she gets upset, try again when she fails, and so many other basic skills that any child needs to become a successful learner.

These will give her a firm base when she does get a chance to enter a school situation, hopefully by the time she is 4, if kindergarten is available where your family lives. (In the United States we often forget how many children around the world still don’t have access to primary education!)

Children 3 and 4 years old need to have an opportunity to learn how to get along with other children, how to share and take turns, to understand themselves and care about each other. These are also important early steps for children to be ready to learn. We have a term, “emotional learning,” that expresses how important the child’s social and emotional development is as a base for cognitive learning.

Can you trust your family and the community they live in to give her these? Then she won’t miss out on these important experiences if she can’t be in day care or in preschool.

A TEASING PROBLEM

Q. I have a 3-year-old son. We carpool to his preschool with a neighborhood boy the same age. One afternoon a week, the boys have an after-school play date. My son used to look forward to seeing the other boy. Recently, however, the other boy started telling my son he doesn’t like him. It doesn’t occur during a heated exchange, but rather just in ordinary situations, like while they are eating lunch. It has gotten to the point where my son will ask him, “Do you like me today?” The boy always says, “No”.

My son’s feelings are obviously hurt, but I think he handles it fairly well. Some mornings he doesn’t want to ride to school with the other boy. I tell him that he just needs to be himself and others will like him — and that what matters is that he likes himself.

Is this normal 3-year-old behavior? Or is it a situation I should remove my son from?

A. Some teasing can be destructive, but other teasing is normal, a child’s way to work on understanding language, behavior, feelings, other people, relationships — so much to learn! This does seem like pretty normal teasing for 3 year olds — figuring out themselves and each other.

At 3, a child is working very hard to figure out what “liking someone else” even means! You might just ask your child what he thinks, and what he thinks the other boy is thinking when he says those words. If you take the teasing too seriously it may make your child feel that the boy’s statements are more powerful than they are, and may make him more vulnerable and less able to handle them.

It seems as if the other child is trying to test out the possibility of dominating him. If your boy gets upset, he accepts the domination. Instead, you could encourage him to say, “I don’t care, I don’t like you either. I want friends who like me. I don’t need friends who don’t.”

The two boys may get over this rough patch in their relationship. If they don’t, they’ll still need to put up with each other in the car! In the meantime, you can try to find other children with whom he can feel liked.

If a child can learn to stand up for himself at this age, he is less likely to be vulnerable to the more serious teasing and bullying that may lie ahead in the school years to come. Bullies look for children who give the impression that they expect to be victimized. This is an early opportunity for you to help your child learn to make it clear that he does not.

You are absolutely right in wanting him to like himself. Congratulate him on not being upset by the other child’s attempt to dominate him. So far, so good! (See our book “Mastering Anger and Aggression: the Brazelton Way” (Da Capo 2005) for more suggestions on how to handle teasing.

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.

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.

A 1-YEAR-OLD WHO RESISTS HER CAR SEAT — AND HER MEALS

NEW YORK TIMES COLUMN: FAMILIES TODAY:
A 1-YEAR-OLD WHO RESISTS HER CAR SEAT — AND HER MEALS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I’m the proud father of a 1-year-old baby girl.

Every time we put her into her car seat for a drive (5 to 20 minutes long), she seems fine and playful for the first few minutes but within no time, she’s crying for attention. She’ll do the cry-stop-cry-stop for as long as 20 minutes.

She’ll reach a point where she’ll just burst into continuous tears. My wife and I have tried toys, Cheerios, cookies, singing and even ignoring her to see if she would stop. The toys, food and singing work just for a minute or two but that’s about it.

We’ve reached the point where we dread going for drives. We know that she’s OK because her diaper is dry, she’s well fed and she’s not tired (when she is tired, a pacifier puts her to sleep in no time).

There is another issue as well. Our daughter is a great eater when it comes to formula and Cheerios (sometimes some cookies). However, we’ve been working on trying to give her solids but with no success.

You’ve said that milk is fine until age 3 but you also recommend the child having bread, yogurt, orange juice, etc. Our daughter will have minimal to no solids – I mean like two to three pea-sized pieces of chicken/tomato/cucumber, etc., MAX!

It seems that all the other kids her age are eating quite well. As you’ve mentioned, we tried giving her solids before her regular feeds (when she’s hungry) but haven’t gotten anywhere.

Also, when she’s in the highchair, we’ll immediately take her out if she starts throwing the food onto the floor. I must mention that from 6 months of age till 9 months, she was eating oatmeal baby cereal once a day. She then reached a point where she didn’t even want to see the spoon coming toward her.

People tell us that she isn’t eating her solids because we started solid feeding too late. They all think we should have started at four months instead of us starting at six months.

A.    A two-fer!

First the car seat:

You are not alone. Nor is your 1-year-old. Babies were not designed to be in car seats, no matter how well car seats were designed to protect them. Many 1-year-olds hate them. Their energy is likely to be focused on getting up and getting going. Whether they’re already walking or not, at this age, children are intent on moving, practicing their moves, strengthening their muscles, learning to balance and to experience the world around them. So of course your baby is bound to protest until she can get going again.

You say she’s crying for attention, but it sounds like when you give it to her, it doesn’t help. So it may be that she’s just letting you know that she hates being restrained, and can’t wait to get out. Don’t let her until you’ve arrived at your destination. But don’t worry. When she’s older, and takes walking for granted, she won’t mind sitting still as much as she does now.

In the meantime, she might be more likely to settle if one of you can sit next to her and soothe her. You’ll miss out on being together as a couple on your drives during this period, but it doesn’t sound like you could be having much fun anyway with all that screaming. (And of course this won’t work when you’re all alone to drive her.)
The other possibility is that she may be motion sick – that could be why she seems fine for the first few minutes. Does it make a difference if you drive more gently, taking it easy on the accelerator and the brakes, and slowly around the curves? You might try a bottle for her to suck on to see if this helps to settle.

Next, the picky eating:

It sounds as if the advice and criticism from books and friends are making you doubt yourself. Yet what you describe can be right on track for many children, as long as their growth and health are. (And we don’t think you need to worry about having started solids at six months.)

You say you could spoon-feed her cereal from 6 to 9 months – and then, nothing doing. Nine months is the age when many infants seem to announce to their parents that they are ready to take over. They’ll start grabbing for the spoon, and now that they can, they’ll pick up food between finger and thumb and throw it on the floor. It is time to start involving them in their own feeding. At this age give them a spoon, and let them try to shovel in their food themselves. Or try one spoon for each hand, so that you can use a third one to feed her while her hands are busy.

But at 1, or a few months later, many children start making a fuss about feeding. If you try to force them, you’ll lose. You are right about the pea-sized pieces of food. Just put a few of these on her table at a time. That way, she won’t be overwhelmed, and when she hurls them overboard, you can just start again. Many children need to be introduced to the same new food over and over before they’ll give it a try and many more times before they can accept the taste and texture.

If your pediatrician can check her out, and offer vitamin and iron supplements, you’ll be able to relax, and avoid the struggles that tend to just make the picky eating worse. You and she are lucky that she still likes her milk! (See our book “Feeding Your Child: the Brazelton Way,” Da Capo 2003, for more suggestions, and information on children’s nutritional needs.)

The best part – that no matter what, you are a proud father! Congratulations.

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 heads 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 Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

A 3-YEAR-OLD’S DISTRACTION ON THE POTTY

NEW YORK TIMES COLUMN: FAMILIES TODAY:
A 3-YEAR-OLD’S DISTRACTION ON THE POTTY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I have a 3-year-old grandson who is pretty much potty trained. The problem is he likes to sit on the potty and play with his penis. When I tell him he should finish his business he tells me he is not finished. I have to distract him to get him off the potty. Will he outgrow this or what?

A. Children this age who are just getting out of diapers are always fascinated to discover what’s been hidden underneath them. Already their genitals are sensitive and physically responsive, and the fact that these have been so inaccessible heightens toddlers’ interest.

At these ages children are scientists and explorers, working hard to conquer the exciting new worlds opening up to them. So it is both common and natural to turn their curious investigations to their own bodies as well.

Three-year-olds are bound to inspect themselves with their eyes and hands as they work to understand themselves and how they’re put together. They’ll also be using their eyes to look with astonishment at parents’ and siblings’ private parts as they struggle to understand differences and figure out whether their own bodies are OK just they way they are.

When boys discover that girls don’t have penises they often think that they must have fallen off and worry that theirs will do the same!

Rarely, a child will become preoccupied with the sensations provoked by this kind of self-exploration so much that this begins to take over and drain the child’s energy and interest for other activities.

When a young child’s masturbation takes on a compulsive quality, persists even with efforts to distract and engage in other activities that ought to be appealing, and goes on for long enough most days to significantly cut into a child’s time from engaging in play and interactions with friends and family, there is cause for concern.

This may occur when a child has been sexually molested, although it sometimes arises in the absence of this kind of trauma. Sexual molestation often produces other changes in a child’s behavior too.

For example, the child may engage in more adult-like sexual behaviors rather than simply just touching his genitals. He may become irritable and angry, or frightened and withdrawn, and he may appear fearful whenever he undresses, use the toilet, or takes a bath, or must separate from a trusted caregiver.

Other causes for persistent, compulsive masturbation remain unclear, although some researchers have suggested that for some children this may be an attempt to make up for a lack of other kinds of stimulation (play, social interaction) or a lack of normal physical stimulation – hugging and cuddling, or for some abnormality in the way touch sensations are experienced and processed. Sometimes referred to as “infantile gratification disorder,” this remains a controversial and poorly understood area of child behavior.

As is often the case, the answer to the question about how much to worry about one behavior in a young child can be found by looking closely at whether other behaviors are thrown off. The child’s pediatrician should be able to help his parents sort through this kind of information.

A 3-year-old is just beginning to learn about other people, what they think, how they react, and the social conventions and expectations that must guide his behavior. Children who touch their genitalia in public can be gently told that their private parts are private. Usually their motivation to please, fit in and win over the important people in their world is even more powerful than the gratification of fondling their own genitals.

Any strong reaction or attempt to change this behavior runs the risk of setting it up as a more deeply engrained habit that is more likely to take on a life of its own. As long as the genital touching is restricted to a private place like the bathroom, the best approach is to try to relax, let it be, and trust that this, and the bowel movements, will eventually pass.

There’s no need to stop the touching or to comment on it. You could try distracting him with conversation or with a book to read or something else to fiddle with while sitting on the potty, but only because this might interfere less with focusing on moving his bowels.

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 heads 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 Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

BATH TIME FEARS AND TEARS FOR A 3-YEAR-OLD

NEW YORK TIMES COLUMN: FAMILIES TODAY:
BATH TIME FEARS AND TEARS FOR A 3-YEAR-OLD
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Our answer to a letter about bath time fears and tears has stirred up sympathy, salutary suggestions, and speculation in readers across the country.

Q. The 3-year-old who fears baths and showers might be willing to sit in a baby bath tub and get clean or to sit in a sink. Also, he might like to have a small inflatable swimming pool brought into the house or if the family lives in a warm climate have a bath outside in the small swimming pool.

Is the child afraid of taking off his clothes? Children are so exposed to mass media today it is almost impossible to isolate the source of fear but I find that asking a child to tell you what should be changed for him/her to like doing something sometimes works.

A. What great suggestions!

If the child slipped or swallowed water or had a traumatic shampoo in the “big” bath tub, simply switching bathing to another location might help. And a smaller place to bathe like the baby bathtub, sink or blow-up pool you suggest might also be less overwhelming to a small child to whom a “grown-up” tub might seem like a vast and gaping ocean.

Introducing water and the bath slowly, in small amounts, and on the child’s terms all make sense. Best of all, we like your idea of including the child in figuring out the solution and giving him some control. This way he might be more likely to tell you what the fear is all about, including whether it all started with some scary TV show.

We wondered what kind of media exposure you thought might prompt a child to fear taking his clothes off. When children are exposed to overstimulating adult sexual behavior, they are more likely to imitate it and act it out. When children are exposed to violence that makes them worry about the safety of their own bodies, they may spend more time inspecting themselves to be sure “everything is still there.” We certainly have seen children who have been sexually abused fear taking their clothes off. They do seem to see their clothes as a kind of protection, and staying dressed as a way of fending off unwanted memories of the trauma. (Often, though, other changes in behavior and mood are present too.)

Perhaps some of our readers have seen similar behavior in children who have been traumatized by media exposure without having actually been sexually abused.

Q. I read with interest your possible explanations for why a child would suddenly develop a fear of bathing. All of your possible reasons were valid. However, may I suggest a more ominous one?

Often children who have been sexually molested develop fears of being vulnerable as one is in the bathtub. Perhaps this child should be gently questioned regarding if anyone has frightened him in any way of was he touched by someone who made him feel uncomfortable.

Hope you find the cause of the problem and hopefully it is not as serious as I suggest.

A. We couldn’t agree with you more that this possibility is one to consider, although we would caution against scaring either the parents or the child in doing so. We appreciate your recommendation that the questions be gentle, and would underscore that they must not be leading, since the resulting replies would be harder to know how to interpret. Such questioning is best conducted by a professional trained to address such issues with young children.

We agree with your emphasis on the traumatized child’s fear of feeling vulnerable, and would add to this the fear of activities that contain some reminder of the traumatic event.

The original text of our answer to the “fear of bathing” question did close with the following paragraph which was eventually cut due to space limitations:

Children who have been sexually molested may also appear fearful at bath time. But this is not likely to appear as the only symptom. Instead, other activities involving their bodies — using the toilet, getting undressed — also often stir up fear and attempts to avoid them.

This is a possible but unlikely cause in a child who shows no other changes in behavior. There are so many more common reasons for a child this age to become afraid of the bath.

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 heads 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 Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.