THE PURPOSE OF TIME-OUT

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
THE PURPOSE OF TIME-OUT
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Could you please send me guidelines for time-outs?

My son-in-law put my grandson, who is almost 5, in time-out for a couple of hours and when he ran an errand my daughter let him play and his daddy made him go back and sit.

He’s a sweet boy, and after we spank him or give him a time-out, he always apologizes.

Even the next day when we’re playing or watching a movie, out of the blue he says, “Mamaw, I’m sorry I upset you or threw a fit, etc.” He’s a very good boy. My sister and I and his grandmother tell him we love him even when he messes up. And that we have to correct him but that doesn’t mean he’s not a good kid.

A. Guidelines for time-outs? First, time-outs are not punishments, and should not be used as punishments. If they are, then of course the child will try to avoid them. This is one reason why some parents find they don’t work.

Time-outs require that a child actively cooperate to come to a quiet place to sit, calm down, think, get ready to apologize and come up with some better ways of handling himself or approaching a problem. This is an awful lot to ask a child to do if at the same time he is being made to feel that a time-out is bad, scary, uncomfortable and shameful.

Time-outs should not be presented as if the child were being banished forever to outer space. What child would ever go along with that? Instead, the child needs to be reassured that a time-out does not mean a rupture in the relationships with parents, just a quiet time to settle down and think things over before coming together again. If time-outs have come to mean punishment in your household, them it may be time to call them something different and to do them differently.

One family we know says “time to sit on the calming-down couch.” Stuffed animals and books are welcome there too.

Second, time-outs are for learning. Time-outs can be used when a child becomes overwhelmed by strong feelings – frustration, disappointment, anger, which have been expressed in misbehavior, for example yelling, hitting, talking back, being rude and disrespectful, and breaking things.

Children are not born knowing how to handle these feelings, and it is our job to help them learn. Once parents understand that time-outs are a special time in a quiet place for a child to learn to settle down and regain control, then they can help children understand their purpose.

At first, parents may need to help children calm themselves, offering them a cool washcloth to wet their faces, or their favorite stuffed animal to squeeze. These are not rewards for misbehavior. They are examples of strategies for learning how to get back in control. It can also help to remind the child of the ways he has successfully settled himself down in the past. “You might need to make a mad face and not talk to anybody for a little while. Let me know when you’re calmed down, and then we can talk.”

Once a child is calm, the next step is for him to work on recognizing his role in what went wrong. This doesn’t mean everything is always his fault. But he might be helped to see that he did have trouble controlling his strong feelings, and then did something he knows he shouldn’t have. Or that he did something he didn’t know there is a rule about – but now he does.

Now he’ll be ready to apologize, and then be forgiven, a critical step to protect self-esteem that is important to include. Forgiving does not mean that his misbehavior is acceptable, but that parents recognize his potential to learn and grow.

There seem to be a number of questions within your question.

First, about the different ways your son-in-law and daughter discipline your grandson: Time-outs don’t work when they are too long because they can’t be enforced. How can any adult get a 5-year-old to sit quietly in one place for an hour or more? (How many adults can do that themselves?)

Discipline strategies that don’t work are bound to lead to conflict between parents, which in turn undermine whatever other discipline they may try. Parents’ agreement on when to discipline and how to discipline is at least as important, if not more so, than on the specifics of what they decide. Children need parents to discipline together, although it often seems that they actively make this even more difficult than it is to do so.

Second, what, if anything, can you do, as the grandmother? Taking sides certainly won’t help. Understanding that parents usually have strong feelings about discipline, and that it is expectable for them to discipline differently – even though this causes problems – may be the key.

Then your role is not to give specific advice but simply to encourage that they share their ideas and listen to each other so that they can arrive at a shared understanding. But your children aren’t likely to listen to your advice as a grandparent. So mostly what you can do is to love and cuddle your grandchild – while trying as hard as you can to avoid turning him against either parent.

Finally, what effects is this having on the child’s image of himself, and what can be done about it? It does sound like he may be struggling with the feeling that he is a bad boy. When children feel this way, they often misbehave more and more, as if they’ve come to believe the worst about themselves.

Discipline that focuses on teaching, not punishment, and that gives a child a chance to apologize, make reparations and be forgiven, can help. Spanking won’t, since it can feel to a child like it is an attack on his “badness.” Instead, effective discipline makes the child feel that he has the potential to learn and grow and improve his behavior.

See our book “Discipline: The Brazelton Way.” Da Capo Press 2003.

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 2-YEAR OLD WON’T STAY IN BED

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A 2-YEAR OLD WON’T STAY IN BED
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How can we keep our 2-and-a-half-year-old daughter in bed? Two weeks ago she climbed out of her crib and never looked back. However, I don’t feel that she is developmentally ready to stay in bed.

We are patting her back until she falls asleep, but this goes against all the parenting I’ve done with my other kids. I would like her to rest and sleep in her own bed, by herself.

A. We’d love to know what else happened two weeks ago. Has an important change or event affected the family – a move, illness or death, a pregnancy, a parent’s job loss? When children this age experience a new stress, the first sign may be a change in sleep patterns.

Parents sometimes assume that a child is “too young” to realize that something’s up, which is appealing when a change is hard to face and parents wish they could protect a child from knowing. At such moments, though, young children need parents’ help to understand what is happening, and how the family will manage. What young children can’t put into words they may translate into actions, like refusing to stay in bed.

Another potential cause may be allergies, asthma or even a cold. Check with your pediatrician.

If your child had been sleeping through the night, she’s mastered how to settle herself down at bedtime. But going to bed means she must temporarily separate from parents and surrender to being alone – unless she is sharing a room.

Separation can be tougher when a child’s world seems less predictable. She needs to believe you will still be there, and respond as always, in the morning.

Another sleep-disrupting event can occur within the child – a developmental threshold we call a touchpoint. At age 3 or 4, children become newly aware of their emotions and of the moral judgments that go with them. They realize they can feel angry or vengeful or jealous. Such emotions may frighten them or make them feel guilty. Often this awareness surfaces as fear about monsters and witches, and in nightmares of angry, vengeful, hurtful creatures.

Parents can help to ease this stress by talking gently about the full range of emotions (their own and their children’s) and by reading children’s books that deal with them – for example, “Where the Wild Things Are” by Maurice Sendak, or “There’s a Nightmare in My Closet” by Mercer Mayer.

When children know their parents can help them handle emotions so they won’t act in scary ways, the fears and nightmares will subside.
(See our book, “Touchpoints: 3 to 6: Your Child’s Emotional and Behavioral Development.” Da Capo, 2006)

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.

DEVELOPING A SENSE OF SELF ESTEEM

NEW YORK TIMES COLUMN: FAMILIES TODAY:
DEVELOPING A SENSE OF SELF ESTEEM
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D

Q. I would like to hear your thoughts on how to raise a child to have a strong sense of self-esteem.

A. The word “self-esteem” has been so overused that its meaning has been lost and sometimes confused with “selfishness.” But these are entirely different. Thank you for your question and this opportunity to clear up the confusion.

Self-esteem does not refer to an inflated view of one’s self. Instead, it is the capacity to hold onto a basically hopeful view of one’s self while facing and integrating experiences that challenge this view.

The development of healthy self-esteem in a child allows her to confront her mistakes without taking apart her positive feelings about herself, so that she can mobilize these positive feelings (confidence, faith in her potential, etc.) to find the courage to learn from and overcome her mistakes. The result is not a skewed view of one’s self, but a realistic one in which both strengths and weaknesses can be acknowledged and accepted.

How to help a young child develop healthy self-esteem? Here, too, there’s been a great deal of misunderstanding.

Overpraising a child (“Yay!” for every least little utterance or gesture) can interfere with a child’s learning to motivate herself, to praise herself when she deserves it, and to face her failures so that she can work to overcome them. I have seen 5-year-olds in Kenya care competently for younger siblings without anybody cheering them on, yet radiating a quiet confidence in their own abilities.

In some upper-middle-class communities in this country, I have seen some children who seem to lack the inner motivation to challenge themselves, and who have become dependent on external sources of praise – over which they have a different kind of control.

Abundant opportunities for small successes and an environment rich with developmentally calibrated challenges are important, but total protection from small failures deprives a child of the experience of facing mistakes, feeling the feelings that go with this, getting these feelings under control, and then developing the resolve to try again.

Perhaps most important of all for the development of healthy self-esteem in a child is a parent’s unconditional acceptance – entirely independent of performance – of a child not for what she does, but for who she is. Feeling loved no matter what does not fill us with illusions about how wonderful we are, but helps us to tolerate our imperfections. When we can do this, we are more likely to learn to live with the imperfections of others. This is why self-esteem is such an important first step in learning to get along with others.

Q. I am writing to appreciate you for being such a fine pediatrician who cares as much about the parents as you do about our children … I felt you were like a friendly grandfatherly type of doctor sitting by my side as I faced each developmental phase. I’ve always felt my daughter is my teacher, and with your guidance, I learned to listen and observe her better so I could support her to develop her potential.

A. It is good to hear that I was able to get across to you what I truly believe, that parents need support at least as much as they need advice, and that their best teachers are not the “experts” but their children, if only parents can really watch and listen, as you have been able to.

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.

STRATEGIES FOR LIBERATION FROM THE PACIFIER

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

Q. We have a very bright, active and affectionate 3-and-1/2-year-old boy, who is wonderful in every way.

My question concerns the use of a pacifier. Our child still sleeps with one, and occasionally (rarely) asks for it “to calm down.” It is something he uses only at home. The dilemma is that our pediatrician, who is a wonderful child advocate, says it is fine and that we should let him give it up when he is ready.

My dentist (who has not yet examined the child), however, says in no uncertain terms that will deform his palate and we should take it away.

We’ve decided not to nag him about it, but think we should make a decision about it soon. I myself sucked my thumb until I started school.

A. Does your child use the pacifier just to soothe himself to sleep at bedtime, or does he suck on it all night long? If he only uses it briefly as he falls asleep and occasionally “to calm down”: for short periods, then trying to take it away may not be worth the struggle. If he uses it more often than this, he’s even less likely to give into nagging.

Either way, attempts to stop thumb sucking or pacifier use are bound to backfire unless the child is offered and successfully learns alternative strategies for self-calming. Without other ways to relax and calm down, a child will cling to a pacifier even harder when a parent tries to interfere with its use, since this struggle creates a new source of stress while threatening to take away a major way of handling it.

Instead, without ever mentioning the long-term goal of replacing the pacifier, watch your child for other things he does to calm himself down. Does he talk or sing to himself, squeeze a teddy bear, curl up under the covers, or come to you for a hug, a lullaby, or reassurance?

Whenever he does use his pacifier, encourage him to fall back on one of his other ways of soothing himself too. You can also introduce new ones. If he has a favorite (small) stuffed animal, doll, or toy, offer it to him when he is upset, and ask him to stroke and hug it until he’s feeling better again. Take it with you wherever you go as you do the pacifier, so that you can offer both.

Little by little he’ll learn to feel nearly the same comfort from his specially treasured toy or doll as he has from the pacifier, and will begin to let go of the latter – when he is ready.

The key is to keep any sense of urgency to yourself, for this will only make him anxious, and more in need of his pacifier. Let him lose interest in the pacifier, at his own pace. Sooner or later he will. As may have been true for you when you stopped sucking your thumb as you began school, many children make up their minds to give these soothers up when being accepted by their peers becomes even more important.

Strategies that simply stop pacifier use or thumb sucking in the short term may come at some cost. For example, simply taking away something this important to a child may lead some children to feel less secure, and some to become more focused on seeking comfort by putting things in their mouths, fingers, thumbs, other objects, or more food than is healthy.

Turning the pacifier into a negative experience, for example, by scolding or mocking the child when he uses it, or punishing him when he does, may stop the behavior in the short term, but there may also be a price later to pay for it.

Unfortunately, too many sources of information for parents try to reduce child rearing into a few quick tips and simple steps. Although some of these may “just work” in the here and now, they may not be good for a child’s future development. To raise a child is not always simple or easy. It wouldn’t be as rewarding as it usually is if it were. Often parents are caught between conflicting recommendations from professionals. Perhaps you might ask your pediatrician and dentist to talk with each other. If they do decide together to recommend stopping the pacifier, it is reasonable to expect that they would also help you figure out how to do it. Just ordering parents to make a child change a hard-to-change behavior without any other help won’t do.

Perhaps our readers can help too.

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 AND POLITICS; BABIES AND MUSIC

NEW YORK TIMES COLUMN: FAMILIES TODAY:
PARENTS AND POLITICS; BABIES AND MUSIC
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

A reader adds a contribution to a column about adults’ political responsibility for children.

Q. People can be so self-centered that they forget that we are all in this boat together. Sometimes people without children or with grown children, for example, act to undermine the educational system or publicly complain about contributing to it.

A. We agree with you that we will all pay the price of shortsightedness and selfishness. We do, though, want to be clear that personal responsibility for such irresponsible attitudes is broader than you suggest: Some people without children or with grown ones may not see themselves as having a broader contribution to make to the greater good, but of course there are many who absolutely do.

The mere fact of bearing children doesn’t seem to be quite enough to help people accept the interdependence that goes along with being human. (Isn’t our need to communicate with and understand one another the reason why we humans have such elaborate languages, even if we are still stumbling in the Tower of Babel’s rubble?)

Some parents seem to be so over-focused on their own offspring that they teach them only to fend for themselves. We all know at least one parent who has taught their child that it is not how you play the game that counts, but whether you win. What happens then to the rules of good sportsmanship that will keep their child and everyone else’s safe?

We appreciate especially your comment that “we are all in this boat together.” Perhaps some of us are uncomfortable with the closeness and responsibility that your metaphor implies, and adhere instead to the notion that “each man is an island.” Yet a stranded man on an island isn’t likely to do much for perpetuating the human race until he reaches broader shores. Until then, his only hope is a message in a bottle – not much good if it never makes it way to someone who can understand it and respond.

When times are tough, and the flood waters are rising, it may not be a boat we need, but an Ark. Can’t we aspire to one in which all can be welcomed, including those without children or with grown ones? Can any of us mere mortals presume to determine who the sinners are to be left to drown? (In recent years, we’ve seen too many examples of such presumption on the part of high-handed humans with more than their fare share of human foibles.)

Tolerance and the most inclusive generosity are the best ways we know to leave that job to a higher power.

Our answer to a question about a 1-year-old who cries during brief car trips prompts another solution.

Q. The 1-year-old sounds just like the situation we had as grandparents. Once a week we had the little girls and the 40-minute trip to our home was almost constant crying from the younger one – until we discovered a set of 100 favorite children’s songs recorded on a CD. They loved the “kids”’ music, there was no more crying and they learned the classic old children’s songs. Good luck to the parents.

A. For thousands of years, long before car rides and CDs, humans have turned to music for comfort, and sung lullabies to soothe their young. Most soothing of all to infants are the songs sung by familiar voices.

Of course modern technology offers us wonderful opportunities for introducing young children a rich and wide range of musical sounds and textures – from the very simplest ones, those that make them feel ready to try out their own singing too, to more complex ones, that astonish, and prompt them to dream. But we sure hope that you all sang along too.

Recorded music will never replace the human act of singing, of listening to each other sing, of according the voices of a family and singing together.

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.

BABIES WHO WANT TO WALK; AND BEDWETTING

NEW YORK TIMES COLUMN: FAMILIES TODAY:
BABIES WHO WANT TO WALK; AND BEDWETTING
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Are there any studies about babies who develop learning disabilities if they never crawl? Or, is this an old wives’ tale? A friend’s baby is almost 11 months old and he will not crawl. He is trying to walk but will not crawl.

A. I am not aware of any studies on the long-term development of children who don’t learn to crawl before walking, but I have known many children who skipped crawling entirely, went straight on to walking and never developed any learning disabilities that anyone was ever aware of.

I don’t think it helps parents to scare them about unknown or improbable risks that they can’t do anything about. On the other hand, if there is already other evidence that this 11-month-old is not developing on target in any way (leaving out crawling on the way to walking as an isolated finding is not evidence), then early identification and intervention can make an enormous difference in optimizing the child’s ultimate progress.

If your friend is worried, she should start with her pediatrician, who should be able to provide an initial developmental assessment. See our newly revised “Touchpoints Birth to 3: Your Child’s Emotional and Behavioral Development” (Da Capo 2006) for information on the range of behaviors a healthily developing 11-month-old can be expected to display: They are so much fun!

Q. I have a daughter who outgrew bedwetting years ago. This year she started sixth grade and has now resumed wetting the bed every night.

My daughter and I agree that the bedwetting must be due to stress. But she is doing well in school, with good grades and new friends. There are no big negative stress factors — just the newness of sixth grade.

What can I do to help her stop this problem?

A. Bedwetting in a child who has been dry for six months or more is altogether different from bedwetting that has never ceased. When a child this age who has been dry for years starts bedwetting, it is concerning. I would look for possible causes for this sudden change, for example, a urinary tract infection, or diabetes and other less common medical or neurological causes. Check on it with her pediatrician.

In this situation, stress can only be settled upon as a cause after medical ones have been ruled out. After you have determined that there is no medical reason for her bedwetting, then you and she can face together any new stress that she may feel about entering sixth grade.

Sixth grade can be a time of great change and great anticipation. If they didn’t start in fourth or fifth grade, boys and girls are likely to start showing new nervousness and excitement about each other now. Some girls have already had their first period and the others ought to know their time is coming.

Sixth or seventh grade may be the start of middle school– what a terrible time to lump together so many children undergoing such drastic upheaval, without the pressure to act grown up from older students (9 -12 high schools), or the opportunities to feel grown up provided by younger ones (K-8 elementary schools)! No longer nurtured by a single teacher, students may already be moving from class to class, teacher to teacher, and feeling much more like they must fend for themselves.

For many children this age, it seems like time to say goodbye to childhood, and to prepare for the unknown. As much as they may act as if they were eager to forge ahead, many sixth graders struggle with mixed feelings about the end of this somewhat more carefree period of their lives.

I am impressed that your daughter is so open and eager to work on her problem with you Rather than feeling so ashamed that she wants to hide it. Her close relationship with you is the single most important protective factor against whatever you and she may fear about the adolescent years ahead!

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.

TODDLERS AND VEGETABLES

NEW YORK TIMES COLUMN: FAMILIES TODAY:
TODDLERS AND VEGETABLES
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 3-and-1/2-year-old son will not eat vegetables at all, except (very occasionally) a couple of baby carrots. He has thus far defeated every one of the strategies I’ve used to sneak in veggies. He will eat certain kinds of fresh fruit, so I give him those whenever possible.

We also avoid sweets and use whole grains rather than refined flour. But I worry that he’s getting poor nutrition – his diet is so heavy on meat, cheese, pasta and bread (in addition to whatever fruit he will eat, the current favorites being cantaloupe and red grapes).

For his age, he’s only in the 25th percentile for height, while 50th for weight. Our pediatrician said he didn’t need a multivitamin and she didn’t see any cause for worry about weight. What do you think?

A. Vegetables! I hated them as a child – and I still hate them. My younger brother hated them more. As I watched my mother hover over him for hours trying to shovel vegetables into him, while completely ignoring me, I began to hate my brother even more than vegetables. Now you know why I became a pediatrician – to stamp out vegetables, and to overcome my guilt at wanting to kill my brother!

When I turned 50, I began to get along with my brother – of course we both had to wait for this moment until our mother had died. But I’ve never forgiven her for vegetables. So every time I am asked about young children and vegetables (and in the course of 50 years of practice, I have discovered that my mother was not the only mother who cared so deeply about vegetables), I tell mothers, and grandmothers, “Forget about vegetables.”

They turn pale. Open their eyes wide. Feel faint. I offer them a seat, and repeat, “Forget about vegetables.”

As they gasp for breath, I continue, “When a young child struggles with you over food, you won’t win. The more you struggle, the more he’ll hate whatever you’re trying to shovel into him. Back off. Apologize. Let him know that you know that only he can swallow the stuff you prepare for him.”

As they begin to recover, they stammer, “Really? No vegetables? No green vegetables? No yellow vegetables?”

“Really,” I say. “You can cover them with a multivitamin during this temporary period – usually between 2 and 3 years old – when any battle over food will backfire into even worse nutrition. They’ll make it through this with enough milk, meat, eggs, grains and fruit.”

As a pediatrician, I would carefully monitor for growth and general health. Height and weight need to be considered not only separately, but together, and not just at one single moment in time, but over time. The context of a child’s overall health, eating habits and activity level, and his parents’ height and weight, also need to be factored in. Any parent who is concerned about a child’s weight, height or eating certainly deserves to have this taken seriously by the child’s pediatrician.

Of course, the truth is that science is still working to identify all the active ingredients of vegetables, and how they promote health – and not all of these are contained in multivitamins. Yet even once this has all been fully worked out, there still will be certain basic bodily functions – such as eating and breathing – that we can’t take over or control for children.

Jessica Seinfeld has written an intriguingly entitled book, “Deceptively Delicious,” in which she whips up a number of child-friendly disguises for vegetables. If you try this kind of maneuver, try not to make an issue of it, or to take your stealthy nutritional missions too seriously.

Instead, keep mealtimes relaxing and enjoyable, and focus talk on fun things, but not on food.

Many children take time to acquire tastes for new foods, and their taste-sensing equipment actually matures with age. So in the meantime, you can introduce a vegetable over and over, in very small amounts, so that there is no pressure to try it. The tiny bit of new and different food should just repeatedly appear – without commentary, without pressure, without monitoring of or reaction to whether or not it is consumed. On the sixteenth time, you may be surprised to see the child give it a try, and you may be disappointed as you watch him spit it out. In the meantime, if you avoid processed sweets, and salty and fried foods, your child’s palate will not become overwhelmed with and addicted to these easy-reach taste blasts, and will be more likely to welcome the more subtle tastes of – vegetables.

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.
www.touchpoints.org.

Reprinted with permission from the authors.

HOW MUCH SHOULD TODDLERS SLEEP – AND NAP?

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
HOW MUCH SHOULD TODDLERS SLEEP — AND NAP?
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How much sleep does an 18-month-old really need? My son sleeps 10 hours at night (waking several times) and takes a 1 hour nap during the day – well below what the books (and common sense!) say he needs. However, he seems rested and energetic and is developing normally. What do you think?

A. What the books say about the amount of sleep children need at different ages is usually limited to averages. Individual children, though, may fall at one end of the range or the other. (The average at this age would be about 12 hours at night plus 1 to 3 hours of napping.) We think that your observations that he is rested, energetic and developing normally are reassuring.

However, you also mention that he wakes up several times at night. Does he just briefly rouse, never becoming fully awake, and quickly settle down to sleep? Or does he become fully awake, and if so for how long, and what does it take for him to get back to sleep?

Has this only begun to occur recently? If so, and if it rapidly resolves itself, it may mean that he is responding to some minor stress, or even to the stress of development – the temporary backslide in one area of development just as a new developmental skill is coming together – a touchpoint.

But if this has been going on for some time, or persists, then we would suggest that you bring this to the attention of your child’s pediatrician. There are a wide range of readily treatable causes of sleep disturbances that you wouldn’t want to miss. If the waking at night is a regular bother for you or for him, then it is a sleep problem worth addressing. (See our book “Sleep: The Brazelton Way,” DaCapo Press, 2003, for more information.)

Q. I have a 3-year-old son who is becoming terribly resistant to taking naps until late in the afternoon, which of course impacts on his behavior (and we have a 5-month-old baby boy in the family now as well, which is a part of this as well).

If he does eventually put himself down for a nap in the late afternoon, bedtime is a nightmare as well. How hard should we try to get him to take a nap? I really do not think he is ready to completely drop his nap, based on his mood on days he doesn’t get one. I just don’t know how much of an issue I should make it. Any advice would be much appreciated.

A. It does sound as if he may be beginning the transition away from the afternoon nap – not a struggle you want to fight, nor one you’re going to win. We’d bet that he wants to be up and around as much as possible so as not to miss out on all the fun his baby brother is having.

Why not put him down for a “rest” early enough to prevent the bedtime “nightmares?” If he sleeps, fine; but if he doesn’t, don’t bother with a nap too late to help. Instead, when he doesn’t nap in the afternoon, try moving up his bedtime a little earlier. Some children who aren’t getting enough sleep actually start sleeping less and less, or sleep less restfully. If he really isn’t ready to give up his afternoon nap, he may show you this by sleeping more at night – if given the opportunity. (Three-year-olds average about 11 hours of sleep each night and an hour’s nap each day, but the range varies from one child to another).

If you can break away from the 5-month-old briefly in the early afternoon, this could be your special time to cuddle and relax together with your older child. Maybe this will help with his moods. As you say, sharing you with his new brother is bound to affect his moods and his sleep.

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.

ANNUAL CONFERENCE 2018

Event Phone: 207-375-8184


  • MeAIMH Annual Conference 2018
    May 18, 2018
    8:15 am - 4:00 pm

MeAIMH Annual Training Conference REGISTRATION IS NOW OPEN For our 31st Annual Conference May 18, 2018 8:15 AM – 4:00 PM Hilton Garden Inn Freeport Downtown 5 Park St., Freeport, Maine Finding the Hope and Strengths In Substance-Exposed Young Families Featuring: Jayne Singer, PhD Developmental Medicine Center, Boston Children’s Hospital Faculty & Founder Early Care Read moreANNUAL CONFERENCE 2018