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Daily Dose

Early Talkers

1.15 to read

Is your child a precocious talker?  Most children start to acquire words around 12-15 months, but that means 5-10 words and building. By the time a child is 18 months old they are often mimicking when you ask them to say a word, and some are putting 2 words together. This is all very normal development. But there are few children who are just “early talkers” who are speaking in full sentences by the time they are 18-24 months! 

I think having such a verbal child during the early toddler years is both a “blessing and a curse”. I know that from raising my own children, where my oldest was quite verbal by 20 months, and was “bossing us around” before age 2!!  I also see this same dilemma in my little patients.  While some parents are worried that their 2 year old does not put 3-4 words together, others want to know how you can stop the chatter.  Parents.....we always have issues. 

Example:  When I come into the exam room for a 2 year old check up, the precocious talker looks up and says, “Hi Dr. Sue...what took you so long?”.  Or they may tell their parent that they “don’t need any help” as I ask them to climb on the exam table. Recently a little boy looked right at his mother and said, “I’ve got this”, when I asked him to take off his shoes.  

On another day a little girl was impatient to leave and kept asking her mother if they could go to the park after they left my office.  The mother kept telling the little girl, “maybe” . Finally, exasperated, the 2 year old said, “what’s the answer, yes or no?””  How do you keep a straight face? 

A verbal child can bring you to your knees, both laughing and sometimes wanting to cry.  How can a 2 year old know just what to say to make a parent feel inadequate?  Is it inborn? This seems to be especially true if you have had another child and the 2 year old is instructing you on how to parent “their baby”.   

So, if your child is a talker write down all of those clever sentences they blurt out......one day you will look back and laugh.  I often saw myself in my 2 year old as he told complete strangers , “my mommy says my baby brother cries all of the time, and he has colic!”  Out of the mouth of babes, and I still remember it.  Bittersweet.

Daily Dose

Toddler Behavior

1.30 to read

Do you have a toddler? If so you are in the throes of some difficult, albeit sometimes funny, yet inappropriate behavior. It happens to every parent...suddenly their precious child turns into Dr. Jekyll and Mr. Hyde.  Somewhere around 15-18 months, you will most likely see this change in behavior. Although most books refer to the “terrible twos” I really think it is the “me no wanna” 18-30 month old. 

“Me no wanna” is the phrase we often used around our house, and it was coined when the boys were toddlers. It just seemed like the best line when our sweet toddler would rather have a tantrum than do the simple task that we wanted him to do. Example: please put your toy back in the box. “Me no wanna”, I would prefer to fall to the floor and scream.   

How is it that your typically sweet 20 month old child can be in middle of playing nicely and then suddenly seems possessed as they fling themselves to the floor kicking and screaming?  What is the matter?  Are they having a seizure? Or is it that “something” just didn’t seem right to them and they are angry and frustrated???  How can they change behavior so quickly.?   (hint, foreshadowing for those teen years). 

You never know with a toddler what kind of answer you will get when you say something as easy as “let’s get on your shoes to go outside”. Sometimes they happily run get the shoes, bring them to you, sit down and the shoes go on licitly split.  The next time they get the shoes, throw them across the room, lay on the floor and look at you like “me no wanna”. 

Trust me, you are not a “bad” parent, you are just living through some really challenging parenting. It is exhausting at times, but while this age is typically difficult it is some of your most important parenting. This is really the beginning of behavior modification.  Your brilliant toddler is testing you, this may be the first time you the parents understand why everyone talks about boundaries and consequences. 

Some children also express their “me no wanna” by acting out with hitting, biting and kicking. Again, very inappropriate behavior. Your job is to change that behavior by using time out, or taking away a toy or even putting the child to bed early.. There are so many ways to start letting your toddler know that there are consequences for misbehaving, and that tantrums don’t work. 

I am in throes of “me no wanna” again, only this time it is with a puppy! Seems very similar to me.

Daily Dose

Holiday Pictures: When Your Child Is Afraid Of Santa

1.30 to read

Over the past several weeks, I have been talking with all of my patients about what they want from Santa Claus, and asking them if they have been to sit on Santa’s lap. It is such fun to hear all of their responses, and it also keeps me abreast of the newest toy choices.

This is the best time of year to chat with the 2–5 year old set. They have those wonderful wide eyes and they are so cute when they start listing the things they want from Santa. It is such a wonderful age. But the toddler set is a different story as they are just beginning to understand the concept of Santa, and are still a little unsure of that “jolly old man” with the long beard and white hair.

How many parents have stood in long lines with their toddler who “has to sit on Santa’s lap” only to finally get to the front of the line and guess what, the cute, precious toddler suddenly does not want to sit on Santa’s lap!!  You must be kidding right?

It is a common occurrence, and looking back I have to laugh!  Me, (mom/pediatrician) knew that it was at this age a child's imagination begins to take shape and some concepts like Santa, sound great in books and stories, but in person…..no way!  Even armed with that knowledge, I dressed all of my boys in the cutest matching outfits and headed to the mall for that magical Christmas card picture with all three of them on Santa’s lap.

I know we stood in line for over 30 minutes, trying to entertain everyone, but at the same time trying to keep their outfits pristine.  That meant no food or drinks in line, just a mother and father entertaining and distracting the boys while we inched our way toward Santa.  It was going to be perfect; a “Kodak Moment”. Well, you probably guessed what happened next.

We finally get to the front of the line and head for Santa’s lap.  The 6 year old and 4 year old  just hop right up  but the 1 year old starts to let out horrific cries as I try to put him in Santa’s lap with his brothers.  The perfect Christmas card photo is actually a picture of the older two boys, holding the 1 year old brother down while he screams and Santa looks like he is not sure what to do.

At the time, I couldn’t believe that this was happening. We had been in line forever!  But the picture hanging on the wall is priceless, and will actually be a “Kodak Moment” forever.  It makes me smile to just look at those precious faces, with the perplexed Santa in the background.  Just like their first day of school pictures, the toddler screaming while sitting on Santa’s lap is priceless. Remember, this is a common event. Santa is a stranger with a big beard, a red suit and a deep voice.

If your child doesn’t want to sit on Santa’s lap, even after telling you how excited they are, do not despair. The “crying with Santa picture” may become one of the family favorites.  Within a couple more years, a toddler’s imagination matures, and they realize that Santa’s lap is actually a great place to sit and discuss all of their many wishes, without any tears!

I would love to hear your holiday photo horrors! Please share (comments below) and we'll all have a good laugh together!

Daily Dose

Toddlers & Tantrums

1.15 to read

I see toddlers for check ups nearly every day and for both the 15 month and 18 month visit, there are many challenges for parents and the pediatrician (and of course the child). Toddlers are not at what I would call an EASY age.

As you know if you have a toddler, they are quite moody (just wait for teenagers) and they can “stop, drop and roll” into a tantrum in the blink of an eye.  So while I was examining an 18 month old this week ( she is one of three adorable girls), she suddenly became infuriated (her mother and I were really clueless as to what triggered this) and she jumped off of her mother’s lap and fell to the floor kicking and screaming. 

Now, for a first time parent this might be alarming behavior, but for a seasoned mother of three it was really no big deal. Appropriately, we all just ignored her as she laid on the floor and screamed (no, the mother was not worried about germs on the floor either) and we continued our conversation about her child’s less than stellar sleep habits.

After a few minutes her daughter calmed down, the older sisters got her a sticker and she left without a fuss. Her mother had already learned, like we all do, that the best way to stop tantrums is by ignoring them and letting your toddler have some time to “express her emotions” with age appropriate (although inappropriate for older children) behavior.  

Several days later, her mother sent me an email with another picture attached of the same child having yet another tantrum after she found her in her diaper with a sharpie pen happily marking all over herself (the photo above). Of course, the minute she took the marker away her daughter fell to the floor again to express her outrage! So funny that her mom thought to document it and send me another picture.

By the way, she also told me that she had taken practical advice and was working on having her daughter cry herself to sleep and it was working well!  Both the tantrums and sleep were improving by just ignoring her behavior. Back to those laws of natural consequences.  

Daily Dose

Play It Safe While Playing on the Slide

Do you remember the first time your child went down a sliding board? Or do you have a toddler who is about ready to make their first trip down the slide?

I remember watching my child climb the ladder up a sliding board, and then looking back and saying, “Mommy, you come with me.” So, up the ladder you go, putting your child in your lap for that first sliding board experience. Isn’t that the safest and easiest way to teach your child about a sliding board? What a sense of accomplishment, for both parent and child. Such a fun day at the park!! Well, I was reading a study by Dr. John Gaffney in an issue of the Journal of Pediatric Orthopedics. Dr. Gaffney noted that he was seeing fractures of the tibia (shin bone) in toddlers, many of whom had a history of being on a slide. I must admit, I haven’t ever seen a fractured tibia from a sliding board accident, but he looked at medical records for all tibia fractures he treated over an 11- month period. Of the 58 tibia fractures he studied, eight (13.8%) were sustained while playing on a playground slide. The age range of these patients was 14 – 32 months, and the average age of the eight patients in the study was 20.7 months. All of the tibia fractures associated with playing on a slide were sustained while going down the slide on the lap of an adult or an older sibling. None of the eight children studied had been on the slide alone. Dr. Gaffney states, “if a toddler is riding by himself and gets his leg stuck against the side of the slide, he can stop himself fairly easily, but with a parent’s weight added in you have greater velocity and momentum and it is harder to stop and the leg may get wedged and subsequently break.” He advises that if a child cannot use a sliding board independently, you should look for another age appropriate piece of playground equipment. I guess that would mean the sandbox. Thank goodness that I was lucky enough that all of my children made it safely down the slide with their parents, as I know both my husband and I were on the slide numerous times. I am sure I have pictures of that event, but I will be telling my patients about this interesting study. Like many things, there are risks involved, so find a smaller slide that your child can handle alone, or just wait until they are bigger. It ironic that something that we think will make our children safer might actually cause more injury. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue right now!

Daily Dose

Toddler Constipation

1:30 to read

I get so many questions about toddlers and constipation.  Constipation relates to stool frequency and consistency.  It is important to understand that everyone has different bowel habits and not all children will have a stool every day.  While some children will have several stools a day another may have a stool every 2 -3 days. Both of these scenarios may be normal and not an indicator of problem.  At the same time, stool consistency is important. If your child has  hard, dry, pebble like stools ( rocks rather than softer snakes or blobs ) this may be an indicator of constipation. Everyone will occasionally have a hard stool, but this should not occur consistently. Lastly, it should not be painful to pass the stool. While toddlers may grunt or push, or even start to “hide” to poop, it should not cause real pain.

With all of that being said, it is not uncommon for toddlers to become constipated as they often are also becoming picky eaters. Due to this “phase”,  some young children will drink too much milk in place of eating meals and this may lead to constipation. Your toddler should be drinking somewhere between 12 -18 ounces of milk per day.  Many children also load up on other dairy products like cheese, yogurt and cottage cheese, which while healthy, may also lead to too much dairy intake and contribute to constipation.

Water intake is also important to help prevent constipation. If your child is drinking too much milk, substitute some water as well.  It is a balancing act to make sure your child is getting both milk and water. If necessary I will also put the smallest amount of apple or prune juice in the water. By the age of 1 year, your child should no longer have a bottle as their main source of nutrition is no longer in the liquid form!

Fiber is also important so offer plenty of whole grains and limit the “white foods” that toddlers love (yes, the bread, cereal, pasta). If you always buy whole wheat pasta and whole grain breads your children will never know the difference. Stay away from processed white foods whenever possible.  It is also easy to throw flax seed or bran into muffins or smoothies (disguising fiber). I also sometimes use Metamucil cookies (they are pre made) and may even resort to dot of icing smeared on it and offer it as a cookie for snack, along with a big glass of water.

Fruits and veggies are a must…even if you think your child won’t eat them! Your toddler needs 2 servings of fruits and veggies every day and rotate what you offer them.  You will be surprised at how one day they may refuse something and they next they will eat it. Don’t give up on fruits and veggies,  it may literally take years for your child to eat peas…but if they aren’t offered a food repetitively they will probably never it eat. I know a lot may get thrown to the floor but just clean it up and persevere.  Not only will this help their stools but their long term healthy eating habits as well.

Movement is also important to help keep the bowels healthy and “moving”.  Making sure that your toddler is moving seems crazy, as they are on the go all of the time.  But with an older child make sure they are getting plenty of time for play and exercise outside or in…and not just sitting in front of a screen.

Lastly, for short term issues with constipation it is also okay to try using milk of magnesia (MOM) or even Miralax….but ask your doctor about dosing in toddlers.   

Your Toddler

High Chair Recall Due to Fall Danger

1:30

Nuna Baby Essentials has recalled eight models of their baby high chairs because the arm bar can bend or detach during use, posing a fall hazard to children.

Nuna has received 50 reports of the arm bar detaching, including six reports of children falling from the high chair. Four incidents resulted in injuries, including bruising and a cut on the forehead.

This recall includes ZAAZTM high chairs in eight models: HC-07-004 (pewter), HC-07-005 (carbon), HC-07-006 (plum), HC-07-009 (almond), HC-08-004 (pewter), HC-08-005 (carbon), HC-08-006 (plum) and HC-08-009 (almond). ZAAZ and the model number are printed under the high chair seat on a white sticker. These high chairs look like a regular kitchen table chair and have removable trays, arm bars footrests, seat pads and harnesses so that they can convert into toddler chairs. “Nuna” is printed above the footrest of the unit.

The high chairs were sold at Albee Baby, Giggle, Magic Bean, Nordstrom and other specialty stores nationwide and online at www.nuna.eu and www.wayfair.com and other online retailers from February 2013 through November 2015 for about between $250 and $300. 

Consumers should immediately stop using these recalled high chairs and contact the firm to receive a free new arm bar and instructions on how to replace it.

For more information, Nuna Baby Essentials has a toll-free number at 855-686-2872 from 8:30 a.m. to 4:30 p.m. ET Monday through Friday. Or consumers can go online at www.nuna.eu/usa/ and click on “Product Recall” under the “Support” section on the sidebar of the homepage for more information.

Source; http://www.cpsc.gov/en/Recalls/2016/Nuna-Baby-Essentials-Recalls-High-Chairs/

Your Toddler

Noisy Homes May Influence Toddler’s Vocabulary

1:00

Have you ever had a hard time understanding someone speak in a noisy restaurant? Imagine if you were trying to learn a new language. That’s just what toddlers are trying to do, learn a language. According to a new study, toddlers learn new words quicker when their environment has less background noise.

"Modern homes are filled with noisy distractions such as TV, radio and people talking that could affect how children learn words at early ages," said study leader Brianna McMillan.

"Our study suggests that adults should be aware of the amount of background speech in the environment when they're interacting with young children," said McMillan, a doctoral student in psychology at the University of Wisconsin at Madison.

Researchers from the university assessed the ability of 106 children, aged 22 to 30 months, to learn new words. They found they were more successful when their surroundings were quiet than when there was background noise.

However, researchers noted that providing the children with additional language cues helped them overcome the detrimental effects of a noisy location.

"Hearing new words in fluent speech without a lot of background noise before trying to learn what objects the new words corresponded to, may help very young children master new vocabulary," said study co-author Jenny Saffran, a professor of psychology.

Sometimes, you simply can’t avoid a noisy environment- especially if there are other children around. Saffron says there is a way to overcome that.

“… When the environment is noisy, drawing young children's attention to the sounds of the new word may help them compensate," she added.

Story source: Robert Preidt, https://consumer.healthday.com/kids-health-information-23/child-development-news-124/noisy-homes-slow-toddler-s-vocabulary-713013.html

 

 

Your Toddler

Seven Tips For Toddler Discipline

2.15 to read

Toddler-hood is a particularly vexing time for parents because this is the age at which children start to become more independent and discover themselves as individuals. Yet they still have a limited ability to communicate and reason. "They understand that their actions matter -- they can make things happen," says Claire Lerner, LCSW-C, child development specialist and director of parenting resources for the organization Zero to Three. "This leads them to want to make their imprint on the world and assert themselves in a way they didn't when they were a baby. The problem is they have very little self-control and they're not rational thinkers. It's a very challenging combination." So how do you deal with a child who screams every time you try to give him or her a bath, and whose vocabulary seems to consist of just one word -- "no"? Here are a few simple toddler discipline strategies to help make life easier for both you and your child. Toddler Discipline Secret No. 1: Be Consistent Order and routine give young children a safe haven from what they view as an overwhelming and unpredictable world, says Lerner. "When there's some predictability and routine, it makes children feel much more safe and secure, and they tend to be much more behaved and calm because they know what to expect." Try to keep to the same schedule every day. That means having consistent nap times, mealtimes, and bedtimes, as well as times when your toddler is free to just run around and have fun. When you do have to make a change, it helps to warn your child in advance. Telling your child, "Aunt Jean is going to watch you tonight while Mommy and Daddy go out for a little bit" will prepare her for a slightly different routine, and will hopefully prevent a scene at bedtime. Consistency is also important when it comes to discipline. When you say "no hitting" the first time your child smacks another child on the playground, you also need to say "no hitting" the second, third, and fourth times your child does it. Toddler Discipline Secret No. 2: Avoid Stressful Situations By the time children reach the toddler stage, you've spent enough time with them to know their triggers. The most common ones are hunger, sleepiness, and quick changes of venue. With a little advance planning, you can avoid these potential meltdown scenarios and keep things relatively calm. "You have to anticipate, which means you don't go to the grocery store when your child needs a nap," says Lisa Asta, MD, a pediatrician in Walnut Creek, Calif., and associate clinical professor of pediatrics at the University of California, San Francisco. Try to make sure your child is home at naptimes, bedtimes, and mealtimes. If you are out, always keep food on hand in case of a sudden hunger attack. Keep excursions short (that means finding another restaurant if the one you've chosen has an hour-long wait, or doing your grocery shopping at times when the lines are shortest). Finally, plan ahead so you don't have to rush (particularly when you need to get your child to preschool and yourself to work in the mornings). You can ease transitions by involving your child in the process. That can be as simple as setting an egg timer for five minutes, and saying that when it rings it's time to take a bath or get dressed, or giving your child a choice of whether to wear the red shirt or the blue shirt to school. Toddler Discipline Secret No. 3: Think Like a Toddler Toddlers aren't mini-adults. They have trouble understanding many of the things we take for granted, like how to follow directions and behave appropriately. Seeing the scenario from a toddler's perspective can help prevent a tantrum. "You might say, 'I know, Derek, you don't like getting into the car seat ... but it's what we have to do,'" Lerner explains. "So you're not coddling, but you're validating their feelings. You have to set the limit, but you do it in a way that respects the child and you use it as an opportunity to help them learn to cope with life's frustrations and rules and regulations." Giving choices also shows that you respect your toddler and recognize the child's feelings. Asking your child if he or she wants to bring a favorite book in the car, or take along a snack, can make the child feel as though he or she has some control over the situation while you remain in charge, Lerner says. Toddler Discipline Secret No. 4: Practice the Art of Distraction Make your toddler's short attention span work for you. When your child throws the ball against the dining room wall for the 10th time after you've said to stop, it's pretty easy to redirect your child to a more productive activity, like trading the ball for a favorite book or moving the game outside. "Parents need to create an environment that is most conducive to good toddler behavior," advises Rex Forehand, PhD, the Heinz and Rowena Ansbacher Professor of Psychology at the University of Vermont and author of Parenting the Strong-Willed Child. "If they're into something they're not supposed to do, the idea is not to punish them but to get another activity going or pick them up and put them in another room." Toddler Discipline Secret No. 5: Give Your Child a Break Time-outs are one of the foundations of child discipline, but they may not be the best approach for the toddler stage. The negative implication of being sent away can teach kids that they're bad, rather than promote good behavior. If you do give your child a time-out, limit it to just a minute or two at this age. Instead of calling it a time-out, which can be confusing to children under 3, refer to it as something more positive. Lerner suggests creating a "cozy corner," a safe place, free from distractions and stimulation, where your child can just chill out for a few minutes until he or she can get back in control. That time away can help you regroup, as well. Correct bad behaviors, but also take the time to praise good behaviors. "If you don't tell your child when they're doing the right thing, sometimes they'll do the wrong thing just to get attention," Asta says. When you tell your toddler he or she has done something good, there's a good chance your child will want to do it again. Toddler Discipline Secret No. 6: Stay Calm When you're standing in the middle of the mall, looking down at your child who's screaming on the floor, and trying to ignore the stares of the shoppers around you, it's easy for your blood pressure to reach the boiling point. It's hard to stay calm, but losing control will quickly escalate an already stressful situation. Give yourself some time to cool off, advises Forehand. "Otherwise, you're venting your own anger. In the end that's going to make you as a parent feel worse and guilty, and it's not going to do your child any good." "I call it the "Stepford Wife" approach," Lerner says. As your child screams, say, 'I know, I know,' but stay completely calm as you pick him up. Don't show any emotion. Sometimes the best tactic is to ignore the behavior entirely. "You just literally act like they're not doing what they're doing. You ignore the behavior you want to stop," Lerner says. When your child realizes that his screaming fit is not going to get him a second lollipop or your attention, eventually he'll get tired of yelling. Your child may drive you so close to the breaking point that you're tempted to spank him, but most experts warn against the practice. "When we spank, kids learn that physical punishment is acceptable. And so we are modeling exactly what we don't want our kids to do," says Forehand. At the toddler stage, redirection and brief breaks are far more effective discipline tactics, Forehand says. Toddler Discipline Secret No. 7: Know When to Give In Certain things in a toddler's life are nonnegotiable. She has to eat, brush her teeth, and ride in a car seat. She also has to take baths once in a while. Hitting and biting are never OK. But many other issues aren't worth the headache of an argument. Pick your battles. "You have to decide whether it's worth fighting about, and about half the time it's not worth fighting about," Asta says. That means it's OK to let your son wear his superhero costume to the grocery store, or read The Giving Tree 10 times in a row. Once he gets what he wants, you can gradually get him to shift in another direction -- like wearing another outfit or picking out a different book to read. Finally, know that it's OK to feel stressed out by your toddler sometimes. "Realize that none of us as parents is perfect -- we do the best we can. There are going to be days that we're better at this than other days," Forehand says. "But if we parent consistently and have consistent rules, then we're going to see more good days than bad days."

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DR SUE'S DAILY DOSE

A few life lessons & fun with Elf on the Shelf!

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