BIRTH ORDER’S IMPACT

NEW YORK TIMES COLUMN: FAMILIES TODAY:
BIRTH ORDER’S IMPACT
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

This article is adapted from “Understanding Sibling Rivalry,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.

Birth order is often used – both by children and by parents – to explain siblings’ different personalities. Of course, being the first, last or in the middle will influence each child’s behavior.

But it is harder to use birth order to predict who a child will become than some may think. So many other factors determine personality, too – the years between siblings, gender, each child’s temperament and the whole range of life experiences. No wonder different birth order researchers seem to come up with different results.

OLDEST CHILD

Everyone expects the oldest to grow up quickly. The other children treat her with respect but also expect her to be more generous, more helpful than she may want to be.

When she grows tired of her “oldest child role,” she may turn on them. “Leave me alone. Stop bugging me.” This may feel like a desertion if the younger sibling is used to being nurtured and cared for by her.

An oldest child may be expected to be an athlete or a “brain.” “Help me with my homework. You’ve already learned how to do it.” She may feel flattered by this kind of adoration, and she’ll do her best – for a while.

But she may also feel the pressure of this role, and rebel. She may turn on a younger sibling and treat him mercilessly. She may even take out on him the anger she feels about her parents’ pressure for her to be the “oldest and most responsible.” For example, when she’s asked to baby-sit, she may find a way to dodge the role. Or she may make a sibling’s life so miserable that she isn’t asked again.

No matter how the oldest child behaves, she is likely to be a role model for younger siblings. Watch a toddler become hooked on an older child’s ball throwing. He’ll shape his hands in imitation, even if he must still throw with both hands. His eyes and his adoration show how much he values the older child as a teacher.

A younger sibling follows the oldest one around like a puppy dog. Often, this behavior is carried to extremes, and it is not appreciated. “Mom, don’t let that little squirt come out of the house when my friends come over.”

And yet, an oldest girl is expected to be a second mother, a boy a second father and teacher. That’s a mixed blessing and a mixed role for the eldest, and a lot of responsibility, whether she likes it or not.

HELPING THE OLDEST CHILD HANDLE RESPONSIBILITY

  • Try not to expect the oldest to be “too” responsible. Watch for signs of needing relief from the role. Praise the older child for the responsibility she demonstrates at times when you have not requested it. But be aware that too much praise represents pressure.
  • Let the oldest be a baby, too, when she needs to. Pushing an older child too soon to give up sucking her thumb, or carrying her blanket everywhere, or other “babyish” behaviors is bound to backfire. Expect her to fall back on these under pressure, and let her know that such temporary backsliding is okay.
  • Try to free the older child up from her siblings enough to have friends of her own, outside the family.

MIDDLE CHILD

A middle child starts out as the youngest sibling, and was the oldest child’s “baby.” He has worked hard to find his niche in the family, both wooing and competing with the older child. Suddenly, another baby comes along. Everyone is ecstatic. Everyone except him.

All of them concentrate on this new baby – including the older child. The middle child is deserted by everyone, including his rival, whom he can no longer even provoke into a squabble.

The second child is now a “middle child.” To him, being in the middle feels like being forgotten. He may try to provoke, to show off, to cry out for someone – anyone. Unless a parent hears this cry, he continues to be without a sounding board, without a reliable advocate. Some middle children learn to turn their wish to be cared for into caring for others – later.

A middle child may try to make up for his loneliness with friends. But he may seem irritable, and depressed. Parents will ask, “Why are you so upset? Isn’t she a cute baby? Look at her watch you, adoring you.” Of course, she looks at everybody that way because they all adore her. The eyes and the winning smile everyone saves for the baby makes the middle child “want to puke.” How could he ever like her?

In time, the middle child may start to mother the baby. But when the baby screeches, he wants to swat her over the head. But he doesn’t, and soon he may find that he can woo the baby from his older sister. Not often, but just enough to make it worth the effort. When he fails, he’ll battle with the little one.

The myth of the “middle child,” and parents’ worries about it, may be more powerful than its reality. My middle daughter can always get at me when she says, “You treat me like a middle child!” Do I? I don’t think so, until she accuses me of it.

The “book end” children do have special places, but maybe the middle is a special place as well. A middle child isn’t as likely to be as overwhelmed as the first child, nor as overprotected as the baby. It may be a freer spot to be in. One can always just disappear in a crisis. Some middle children even figure out how to use this position in the family to ensure that no one expects as much of them.

Some middle children find they have unique creative gifts that allow them to distinguish themselves from the firstborn in their families. Others will learn to be the peacemakers; they will mediate conflicts and feel responsible for everyone’s well-being. They feel the pressure, but also the rewards of being in the middle.

HELPING THE MIDDLE CHILD FEEL VALUED

  • Remind a middle child of his talents. Praise him for his resilience, in adjusting to the baby and finding his own role.
  • Let the middle child groan and complain, even blow up about how hard he works to be a contributing member of the family. As he feels heard, he will learn a lot about himself.
  • Face whatever bias you may have about a middle child.
  • Don’t feel sorry for him. Pity will only push a child to focus on the negative aspects of his situation. Every position in the family has its rewards and burdens. The give-and-take demanded of each child is the cement that makes the family strong.

THE LAST CHILD -THE “BABY”

Everyone loves the baby – as long as he is the baby. He gets used to being adored. He knows when to dodge the sibling just above. The rest of the family makes allowances for the youngest child.

Then, all of a sudden, he begins to grow up. No longer do his babyish wiles help. When he battles over something he wants, suddenly everyone labels him as “spoiled.” His older siblings desert him. (They’ve waited patiently.)

Being cute doesn’t cut it any more. The pressure to leave the “baby” role behind often weighs more heavily on boys than on girls; in girls, appeals of being “fragile” and “helpless” are still more likely to be tolerated.

In search of a niche, the youngest child may become a rebel, or an unexpected performer. He may not fit in with the rest of the family’s patterns. He can be unique and surprising. But if less has always been expected of him, he may learn to expect less of himself.

If the youngest regresses to baby-like behavior at home, it is still likely to draw his parents in. But he will pay the price of being the butt of his siblings’ disapproval. He may then resort to bravado or rebellion. But when his siblings accept him, he blossoms. He will have learned a great deal about adapting to his more grown-up role, and about giving up his babyish one for new rewards.

HOW TO HELP THE YOUNGEST CHILD GROW UP

  • Value his struggle to keep up with older siblings.
  • Comfort him when he needs it. But remember that the role of a baby cannot last. He needs to value the new abilities he can develop.
  • Remind yourself how much you love having a baby and how you may be prolonging his baby role.
  • Be ready for his accusation: “You always treat me like a baby.” You probably do. Apologize, and let him know that you’ll try to stop, though you may not always succeed.

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.

MENTAL ILLNESS AND ITS CONSEQUENCES FOR A FAMILY

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
MENTAL ILLNESS AND ITS CONSEQUENCES FOR A FAMILY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Four years ago my son had a nervous breakdown. He has since been diagnosed with bipolar disorder. His wife divorced him because he became physically abusive during an argument. They have a 5-year-old son, who has not been allowed to see his dad for the last three years, due to a restraining order by the mother, which included my grandson (although he has never been abused). My former daughter-in-law is financially stable and has a good lawyer, while my son is still barely able to support himself and cannot afford a lawyer.

My grandson is restless, angry and is already having problems in kindergarten. He can’t sit still and pay attention. He yells at his mother and does exactly what he wants to do, like going to bed at 9:30 on a school night. She loves him very much and wants him to have everything he wants in life. I feel her behavior is causing him to be insecure, and his actions are a call for help.

I tried to continue to be involved in his life, but have not seen him as much as I did (my husband as well) because his mother always makes it difficult by making excuses not to schedule visits — not enough notice, he’s going to a friend’s party, etc. I have told her how important it is to keep our relationship. She always says she understands and wants him to have a relationship with us, but does nothing to help us.

We have told her that we feel it’s vital to our grandson’s mental health that he see his father, and have offered to supervise any and all visits so our grandson would feel safe and be in a familiar setting. Nothing we say or do is working. We are sick about this and honestly feel the stress and heartache is wearing us down to the point that maybe we would all be better off if we gave in to her and stopped seeing him and stopped trying to reunite him and his father.

She says she doesn’t feel her son is safe with us (although when they were married he was with us at least once a week) and she says our son is too unstable and hasn’t changed enough that she wants him to see their son. I have told her he can’t change — this is a mental health problem that’s not going away (although he is getting help). I have told her all we want is for their son to have the best life possible, to be included as part of our family and to have a relationship with his father. She can’t see that her son is suffering silently and now overtly. What more can we do?

A. You are all suffering, and you’d all like it to stop. So you try to understand what is causing the pain and the problems. Inevitably, you end up blaming yourselves, and each other. But finding fault just leads to bitterness, misunderstanding and more pain. Deep down you all know that if anything is to blame, it is your son’s serious mental illness. That, of course, is no one’s fault.

If you could all forgive yourselves and each other, you might have a better chance of developing the kind of communication and teamwork that you know you all need. (When there are tough decisions to make that threaten to pit you against each other, a neutral third party such as a court appointed guardian ad litem for the child who would independently represent the child’s best interest might also help settle down the understandable tensions.)

Of course it would be best for your grandson for family ties to be preserved and strengthened, even while squarely facing whatever limits there must be to your son’s interactions with his son when he is unstable. Repairing your relationship with your ex-daughter-in-law will have to come first, before any hope of influencing your grandson’s life more directly.

You have been so strong and brave to face the realities of your son’s illness. No wonder you may need your own time to heal before you can understand his ex-wife’s reactions. Until then, see if you can hold off on attributing the child’s “bad” behavior to her parenting. She’s unlikely to feel that he’ll be safe with you as long as she has to worry that you are judging her critically, which may subtly undermine the authority she needs as a parent.

Of course the boy needs limits, and he may need more limits than he is getting. But the sadness and fear that sets in when a marriage ends often drains parents’ ability to tune into their children’s needs until they’ve had a chance to heal. Can you help her to heal as a critical first step to helping your grandson? She might feel that you could understand her side better if you could consider the possibility that her boy might be hard to handle for a number of reasons beyond late bedtimes and lack of limits.

How could he not be thrown off by his father’s violent behavior (even if it was never directed at him), the divorce and all of the family’s stormy feelings that have resulted? Or he might be showing early signs of threats to his own mental health, especially since these are sometimes transmitted genetically.

You sound big-hearted and generous, as if you can acknowledge his mother’s challenges. Can you take it a step further to let her know you can see and appreciate what she is doing right by her boy? She’s been violated and traumatized. So have you — by your son’s terrible illness. She’s lost her love, marriage and dreams for her future with her life’s partner.

You may feel that you’ve lost your son — at least temporarily — to the delusions and distortions of acute manic episodes. Are your feelings about this something you can share with her? Only once she believes that you understand what she’s been through, that you know she has the child’s best interests at heart, that you will support her as a parent rather than blame her, will she begin to feel safe enough with you herself to entrust your grandson to you.

We understand how close you feel to giving up, but we hope you won’t. We hope you have others in your family you can turn to so that you won’t have to turn away, and so that this little boy can have all the family he needs too. You sound like you have been such a critical support for your son — facing adversity together is the true test of family.


This article is not intended as a substitute for medical or psychiatric evaluation, diagnosis and treatment. Because of the rapid pace of research and new clinical findings, the information it contains is subject to change. If you are concerned about your child, consult your pediatrician, who can refer you to a mental health professional.

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.

HOW CAN WE IMPROVE OUR KIDS’ NUTRITION

NEW YORK TIMES COLUMN: FAMILIES TODAY:
HOW CAN WE IMPROVE OUR KIDS’ NUTRITION?
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Please comment about how much vitamin D children need as they are growing up. Also, does the location of where a child lives make it necessary to supplement vitamin D? My husband and I, in our early 60s, take supplemental vitamin D per the advice of our rheumatologist.

A. Last month the American Academy of Pediatrics (www.aap.org) doubled its recommended amount of vitamin D – necessary for bone absorption of calcium – to 400 International Units, for infants, children and adolescents:

“Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life.”

“All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day.”

“Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.”

“Children with increased risk of vitamin D deficiency, such as those taking certain medications, may need higher doses of vitamin D.”

“Given the growing evidence that adequate vitamin D status during pregnancy is important for fetal development, the AAP also recommends that providers who care for pregnant women consider measuring vitamin D levels in this population.” For babies, formula should be fortified with vitamin D, but breast milk may not contain enough, even though it contains all kinds of important ingredients for health that are not in formula: antibodies, digestive enzymes, and just the right kinds and amounts of fats. Parents should ask their pediatrician to advise them about vitamin D drops for their breast-fed infants.”

As your question suggests, vitamin D requirements vary with exposure to sunlight, since sunlight is required to convert vitamin D to its active form. Children living in northern regions, who are dark skinned, or who spend every daylight hour swaddled from head to toe are more likely to need supplements.

Good dietary sources of vitamin D include fortified milk, eggs and fish. Vitamin D is sometimes added to orange juice, but dairy products other than milk are usually not fortified with vitamin D.

Vitamin D supplementation has reduced the incidence of rickets – weak, bowed bones due to poor calcium absorption that can occur with a Vitamin D deficiency – a great example of the power of prevention.

Q. Is it really at all healthy to limit fats and other caloric nutrients in otherwise healthy and growing young children?

A. Children under the age of 2 years (or 3, according to some experts) actually need the fats contained in whole milk for the rapid brain development that occurs in the first years of life. Some pediatricians are adjusting this recommendation to switch to 2 percent milk after 1 year of age when a child is already overweight or if there are risk factors for obesity, for example, overweight parents.

Calories are not bad, but necessary, in the right amounts. Children have specific caloric needs that depend on their age, size and activity level. The word “calories” is just a measure of the energy a food contains. However, foods that offer only calories and have no other nutritional value are best avoided since they run the risk of filling a child up with “empty” calories before all of her nutritional needs have been met.

Q. Are young children (age 10 and below) at risk from a high cholesterol diet – for example, from eating lots of egg and cheese sandwiches and similar foods?

A. Cholesterol and triglycerides can be a problem for children, especially if their diet is high in saturated fats, if they are obese, or if there is a family history of coronary artery disease or high triglycerides.

Eating habits and preferences do not begin in adulthood. Why start and reinforce unhealthy eating in childhood and then struggle to undo it later?


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 PARENTS DIVORCE

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN PARENTS DIVORCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

From TOUCHPOINTS: BIRTH TO THREE: YOUR CHILD’S EMOTIONAL AND BEHAVIORAL DEVELOPMENT, by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.

Parents whose marriages seem to be failing have a major obligation to protect their children as much as they can, whether this means trying to work things out or deciding to divorce. This is a lot to ask of parents who are already overwhelmed with their own feelings.

In the aftermath of divorce, it is very hard for parents who may not only be angry, but also frightened, anxious and grieving the loss of their relationship, to focus on the needs of their children.

But there is no other choice. In the first years after a divorce, a child blames himself for his parents’ breakup and dreams of having his two parents to himself again, even though the original family may have been stressed and stressful. While everyone in the family suffers during a divorce, and during the first year or so that follows, the long-term effects of divorce vary depending on a wide range of protective and risk factors, including how parents handle the divorce and how well they recover from its immediate effects to become effective parents again. Over time, it turns out, many other individual characteristics of the child and parents, as well as life events, play a bigger role than a past divorce in a child’s well-being and healthy development.

As a result, there is no need to label the children of divorce with a self-fulfilling prophecy or to burden their parents with more guilt and anxiety than they may already feel.

The most serious harm to children is done by placing them in the middle of parents’ animosity – using them as a football. Angry parents all too readily take out their feelings on each other by using the child. That is sure to hurt the child. Her capacity to make solid relationships with other adults in the future is likely to be impaired by this insensitivity on the part of divorcing parents.

At first, children may continue to wish for the “old family.” They will feel deserted by the nonresident parent and will fear desertion by the resident parent, reasoning, “If one can leave me, why won’t the other?” Short-term separations become magnified in the child’s mind. Every time a parent leaves, the child must wonder, “Will she be gone for good? Will she remember to come back? Who will take care of me?” Or she may wonder, “Why does he leave me? Am I bad, and no one will want me?

Before every separation, parents must prepare a child as carefully as possible. After they return, they must say, “I missed you. Did you miss me? Remember I told you I’d be back at (such and such a time), and here I am. You worry, don’t you?” Then, the parent needs to be ready for the child’s feelings about being deserted. Every time the child has a chance to air them, the adult has a chance to demonstrate that desertion is not in the nature of all relationships.

The nonresident parent has a parallel responsibility. Visitation should be clear, dependable and on time. Even a 15-minute wait is an eternity for a small child. Visits from the absent parent offer reassurance about what he fears most – desertion.

A child takes everything personally. No matter how often she is told that a separation or a divorce is not her fault, she will continue to blame herself.

A child will fear that the reason the absent parent has gone is because he or she doesn’t love her, because she’s been “bad.” Later, children dare to put their fears into words: “I knew if I’d been a better kid, they’d never have split up.

Small children are less able to express it, but they also feel responsible for the split. Both parents must be ready to reiterate over and over and over: “We love you and we never wanted to leave you. We grown-ups couldn’t live together, but we both want to be with you. Nothing you do could ever change that for us.

A divorced parent must remember that demonstrating any animosity to the ex-spouse in the child’s presence will frighten her. She will take it personally. “If Dad and Mom can fight with each other, they can hate me, too. I must be a perfect child, or I’ll be in for it.”

Parents can help reassure a child that she needn’t try to be perfect. She may need constant reassurance about this, for she is likely to regress with the trauma of the divorce.

Most children regress in the area of the last achievement. If she has just become dry at night, she may begin to wet all over again. If she has been talking well before, she may begin to stutter. Her behavior may be either too good or too provocative. A sensitive parent will accept this and discuss it with the child so that she, too, understands it as normal and expectable. The usual limits should apply, however, and are more important than ever. Limits reassure the child that someone is still in control.

The presence of a sibling can lessen the fear of separation. Sibling relationships can become closer than they were before. Although rivalry will still surface, taking it too seriously can make relationships in the split-up family seem more fragile than they really are.

Grandparents, aunts, uncles and cousins can become important supports for children during and after a divorce. Not only can they give the child help in understanding the split-up, but they also fill her need for reliable, caring people who remain constant in her life.

Resident parents need to reconcile their own feelings about their in-laws in order to respect the child’s need for family. During a divorce, grandparents are likely to “spoil” the children in the family. They may let down all discipline. The resident parent may feel threatened by the lack of rules at Grandma’s. The child will use this: “Grandma gives me what I want. You’re mean and you don’t realize what I’m going through.

Since you are feeling pretty raw and deprived yourself, this criticism hits below the belt. You bristle. If these are your in-laws, you will feel even angrier at this undermining of your household rules.

If you can, discuss this with your in-laws. Ask them to back you up in your effort to support the child with firm rules and discipline. If relations are too tense for such discussions, simply tell the child, “Grandma does things her way at her house, we do them our way here.” Respectful discipline becomes a source of security.

Try not to overprotect the child. Let her make her own adjustment, and from time to time, point out how well she is doing. When a child can master the stress and change, she can take pride in this demonstration of her competence. Your continued love, respect and discipline can be shown without hovering.

AFTER THE DIVORCE, IF YOU BEGIN DATING

  • If you begin dating, be careful about introducing new people of the opposite sex to your children. Wait until you are pretty sure the child can rely on the relationship. A child of divorce will make new relationships with adults of the same gender as the missing parent all too easily, and she will be deeply disappointed if it doesn’t work.
  • When you do form a lasting relationship, point out that “friends” and stepparents are different from parents, but having two of each can be great.
  • Talk about the child’s fears of your desertion of her. Tell her that you aren’t going to leave her under any circumstance.
  • Find BOOKS about divorced families, or introduce your child to other children whose parents have gone through a divorce. These days, children of divorce are not a small minority, but it still helps a child going through one to know other children who are adjusting to divorce.

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.

WHERE DO PRESCHOOLERS LEARN MOST?

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHERE DO PRESCHOOLERS LEARN MOST?
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. What are your thoughts on preschool? Are very young children better off constantly interacting with a dedicated adult parent to stimulate their brain growth, or is there a benefit to socializing them with their peers at an early age? What’s the optimum balance of this for raising an intelligent yet independent and socially adept child?

A. How fortunate you are if you have a choice! And yet what a sense of responsibility!
Most parents in the United States today have no choice, and must work in order to be able to provide for their families. Because of the decline in real wages over the past decade, most single and two-parent families need all adults to bring in paychecks. While quality child care is hard to find and harder to pay for, it may be harder still to do without a parent’s salary. Some families find, though, that with two or more children under age 4, there’s no choice but for a parent to stay home. For others, friends and relatives are the only solution.

Early Head Start (for infants and children to age 3) and Head Start have been the salvation of many families, although for decades there have been no openings for the vast majority of eligible families. Finally new funding is on its way to make room for more children in these high-quality and proven programs.

To our knowledge, there are no actual studies that compare the brain development of children in preschool to children who spend their days at home with a dedicated adult parent. Such a study would be difficult to conduct both because the specific experiences in individual homes and preschools can vary so much and because there are so many other variables that influence brain development, including pregnancy, health, nutrition, air and water quality, and genetics.

What we do know is that high-quality early childhood education has been proven to save up to $17 for every dollar it costs because it leads to better academic success, fewer special education expenditures, greater chances for employment and productivity, and less risk of ending up in jail.

Quality criteria include a low child-teacher ratio, a high level of formal training in child development and education for teachers, positive relationships between teachers and parents, and meaningful parent involvement.

There is no evidence that such high-quality experiences can’t also be provided by dedicated and caring parents for children at home. Positive learning and growing may occur in either setting.

Since most parents don’t have a choice, and are either at home or at work because they must be, we’d hate to make them feel guilty about either option. What matters most is the quality of the child’s experience. Whether the child is at home or at preschool, parents and children need enough time together to continue to grow closer and to deepen their understanding and appreciation of one another. And children at home will still need abundant opportunities to be with peers to learn from them, with them and through their interactions.

Parents may feel overwhelmed by the responsibility that the “new brain science” may seem to impose on them to stimulate their children’s brain development – quick, in a hurry – before it is too late. The reality is that while the human brain never grows and develops more rapidly and dramatically than in the first three years of life, children’s most important learning experience will not come from videos or computer programs but from interactions with those who care about them most – parents, teachers, siblings and peers.

Parents are children’s first and most important teachers not because they teach the alphabet, shapes and colors but because they encourage and motivate children’s curiosity and enthusiasm to learn. Parents help children to take in as much as they can learn from their environment by gently buffering them from more stimulation than they can handle. Early on, children teach their parents how to read their cues so that together they can work toward this balance.

The foundations for learning are laid down before kindergarten in the context of children’s interactions with adults and with each other. We have known for decades that the key to school readiness and becoming a lifelong learner lies in the early experiences that help develop important qualities such as persistence, perseverance, curiosity, the capacity to tolerate frustration and the self-esteem to keep on trying even after making a mistake.


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 A TODDLER SUDDENLY DEVELOPS SLEEP PROBLEMS

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A TODDLER SUDDENLY DEVELOPS SLEEP PROBLEMS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. We have read “Touchoints” cover to cover. We keep our tattered and torn copy on the coffee table for easy access, but we are at a loss.

Up until a week ago, our 25-month-old daughter was the “perfect child” – our pediatrician often asks to adopt her if we tire of her! She has always has been able to self-soothe and go to sleep on her own. She is not having any problems at nap time (noon-2 p.m.) She eats fairly well, is active and well ahead of the curve in her language skills.

Last week, she started a pattern of not being able to/wanting to go to sleep in the evening (7:45-8 p.m.). We keep a very regular schedule and bedtime routine (bath, brush teeth, books in the rocking chair and then bed).

Now, we are having to actually get her into a sound sleep and when we finally get her to sleep, she experiences long spells of night waking – anywhere from one to four hours of screaming, crying, pleading with us to rock her, hold her, take her to our bed, stay in her room, rub her back, etc.

She’s not waking regularly at 10 p.m., 2 a.m. and 6 a.m., but rather wakes once and can not/will not go back to sleep. She repeatedly is crawling out of her crib. It is almost more than we can take to allow her to be in such a state.

A. At what time of night do these awakenings occur? Night terrors usually occur during the first few hours of sleep, while nightmares tend to occur in the last hours of sleep, in the early morning.

During night terrors, children are not really awake or conscious. They’ll suddenly sit bolt upright in bed and let out blood-curdling shrieks. Inconsolable, they often become more agitated when parents try to talk to them or comfort them. The best bet is to stay out of their way, if they are safe, and let them fall back to sleep on their own. They’ll have no memory for the event, since they never really were awake, even though it seems as if they are.

Nightmares, on the other hand, really are dreams, and children usually can remember them, and when they’re old enough to speak, talk about them.

Does your child really keep screaming for 4 hours even if you do hold her, stay with her, or bring her into your bed? It does sound as if she is conscious – not having night terrors – if she is pleading with you to stay with her and comfort her.

At 25 months, she is a little young to be having the kinds of nightmares that 3- and 4-year olds have when they begin to become aware of their own aggressive feelings and begin to scare themselves.

It sounds as if this has only been going on for about a week, but if it has persisted, we would suggest you consult with your pediatrician, who might refer you to a pediatric sleep expert.

Have there been any recent changes or stressors for your family? Her new resistance to going to bed, and her new demands for you to stay close during the night, raise the possibility that something has happened that has frightened her and makes her more hesitant to separate from 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.