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Your Toddler

Toddlers at High Risk for Chemical Eye Burns

1:45

You might think that most chemical eye burns occur at work places, but according to a new study, more toddlers than adults are treated at emergency rooms.

"Household cleaners are a huge culprit," said Dr. R. Sterling Haring, who led the study. Spray bottles frequently have been implicated in other research, he said.

"The rates among 1-year-olds are 1.5 times higher than the highest rate of [eye] injury for working-age adults," said Haring, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health in Baltimore.

Researchers analyzed data from 900 hospitals and found more than 144,000 ER visits related to chemical eye burns across all age groups.

When the researchers broke the data down by year of life, 24-year-olds had the highest rate among adults. Among children, 1- and 2-year-olds were injured most often, with this age group 1.5 times more likely to get an eye burn than a 24-year-old, the findings showed.

"We see chemical eye injuries in the little kids all the time," said Dr. Roberto Warman, a pediatric ophthalmologist at Nicklaus Children's Hospital in Miami, who wasn't involved in the study.

"It's always the same story. They got access to the cleaners in the house. These are some extremely serious injuries," Warman said.

The investigators discovered that when the chemical agent that caused the burn was known, alkaline injuries were more common than acid injuries. Alkaline agents are found in oven cleaners, drain cleaners, chlorine bleach and ammonia products, according to background notes in the study.

Alkaline chemicals can continue to burn into the eye even after contact with the compound, Haring explained. Damage can be blinding, he said.

Workplaces often have precautions set up to avoid eye accidents while home products are not always locked or secured in a place a child can’t reach. Warman and Haring agreed that parents and industry could do a better job protecting young children.

The toddlers' injuries occur at home most often and are more common among lower-income families. They also are more common in the South, according to the analysis of 2010-2013 data from the Nationwide Emergency Department Sample.

Haring's advice: Never keep household chemicals under the sink. "It's a terrible idea, even with a lock," he said.

Instead, store all cleaning supplies and other potentially harmful products "in a lockable cabinet out of reach," he said. Supervise their use if, for instance, older children are using them. Also, be sure to turn the spray bottle nozzles to the "off" position before storing them, Haring advised.

In addition, Warman said, "The industry can also help us more. They can make caps in a way that they are harder and harder to open."

Even with precautions, however, chemicals might sometimes get into the eye. If that happens, run tap water over the eye for a while, Haring said. Emergency room doctors usually rinse the child's eye with saline for 20 minutes or more, often after applying antiseptic eye drops to reduce the pain, according to information from Boston Children's Hospital.

The study was published online Aug. 4 in JAMA Ophthalmology.

Story Source:  Kathleen Doheny, https://consumer.healthday.com/eye-care-information-13/eye-and-vision-problem-news-295/toddlers-at-high-risk-of-chemical-eye-burns-study-713568.html

 

Your Toddler

Naps Help Preschoolers With Language Skills

2:00

Naptime for a toddler or preschooler is a welcomed respite for many parents and caretakers, but it may also provide an important benefit when it comes to a child’s ability to understand words and their meanings, according to a new study.

Researchers assessed 39 youngsters who were all 3 years old and found those who napped after learning new verbs had a better understanding of the words 24 hours later.

"There's a lot of evidence that different phases of sleep contribute to memory consolidation, and one of the really important phases is slow-wave sleep, which is one of the deepest forms of sleep," said study co-author Rebecca Gomez. She is principal investigator of the University of Arizona's Child Cognition Lab.

"What's really important about this phase is that essentially what the brain is doing is replaying memories during sleep, so those brain rhythms that occur during slow-wave sleep ... are actually reactivating those patterns -- those memories -- and replaying them and strengthening them," Gomez said in a university news release.

What if your child doesn’t have the opportunity to catch a few winks during the day? Researchers noted that parents shouldn’t worry about it. The most important thing is that children get the proper amount of overall sleep. Preschoolers should get 10 to 12 hours of sleep in a 24-hour period.

"We know that when children don't get enough sleep it can have long-term consequences," including poor performance on mental skill tests, Gomez said.

If you know that your child isn’t getting enough sleep at night, then naps become more significant.

"It's important to create opportunities for children to nap -- to have a regular time in their schedule that they could do that," Gomez said.

In the study, the investigators chose to test the children on how well they learned and understood verbs rather than nouns because action words are typically more difficult to grasp than names, such as "Mommy" or "doggie," which are often the first words kids learn.

In general, naps provide a variety of benefits for toddlers and preschoolers. They help children from becoming overtired, which not only takes a toll on their moods but may also make it harder for them to fall asleep at night.

Crucial physical and mental development is going on during this growth stage and naps help children with much-needed down time for rejuvenation.

For toddlers and preschoolers, sticking to a naptime schedule can be challenging. Though many do still love their nap, others don't want to miss out on a minute of the action and will fight sleep even as their eyes are closing. In this case, don't let naptime become a battle — you can't force your child to sleep, but you can insist on some quiet time. Let your child read books or play quietly in his or her room. Parents are often surprised by how quickly quiet time can lead to sleep time — but even if it doesn't, at least your child is getting some much-needed rest. If your child has given up daytime naps, consider adjusting to an earlier bedtime.

The study findings were published in the journal, Child Development.

Story sources: Robert Preidt, https://consumer.healthday.com/kids-health-information-23/child-development-news-124/naps-may-sharpen-a-preschooler-s-language-skills-719550.html

http://kidshealth.org/en/parents/naps.html#

Daily Dose

Breath-holding & Fainting

How common is breath-holding & faintng in the toddler years? More than you think. Have you ever fainted?  I bet you may have not realized how common fainting is in the pediatric age group?  I know this from my own children (yes, I had 2 “fainters” and boys no less) as well as from many of my patients.  The medical term for fainting is syncope, and it really is common among children.

It starts during the toddler years with breath-holding spells.  Many in this age group (up to 50%) will hold their breath when they are hurt or angry. When a child holds their breath while crying (you can just see it happening in front of you) they will often turn a bit clue and “pass out”. This is a type of fainting. This can be very scary for parents who have never seen their precious child have such an attitude and then hold their breath over not getting the cookie? Yes, this is a normal part of being a toddler! They are very emotional and labile at this age (foreshadowing for teen years?) and most toddlers don’t have a lot of language yet, so when they get mad or frustrated they just SCREAM! But, while screaming, the child forgets to take a breath, and then the brain and autonomic nervous system takes over and the breath holding leads to fainting. The breath holding spell, as scary as it is, is just a form of fainting. It will not hurt your child, but it may take your breath away! My advice? Try not to pay attention to your child if they begin having breath-holding spells. It may be hard to “ignore” the first two or three, but these “spells” usually last for months (maybe years) and you do not need to rush to your child when they hold their breath. By calling attention to the event you may inadvertently reinforce the behavior. As a child gets older, the breath holding will stop (but not the tantrums?) and there will be new behaviors to conquer. Do you have a breath-holder? How do you cope? Let us know! That's your daily dose for today. We'll chat again tomorrow.

Your Toddler

Making Time Outs Work for You and Your Child

2:00

It’s not going out on a limb to say that at eventually, mom or dad will resort to the “time out” rule when their little one is behaving badly. And that’s a good thing. 

Time-outs can be very effective in helping children learn how to change their behavior as long as they are not overused and handled correctly.

What is a time-out? Basically, a time-out is when a child is separated from others for behavior that is unacceptable such as throwing a full-out tantrum, continuingly refusing to obey a command, or biting, hitting or kicking someone. 

When used correctly, a time out can teach a child how to modify his or her behavior in a more acceptable way. However, problems can arise when parents don’t know how or when to use time outs effectively.

Time outs should be used as positive and consistent discipline, not as a form of punishment. Time outs separate a child from positive feedback when they are intentionally acting up. It gives them the space and time to settle down and associate the behavior with the consequence.

A time out should consist of a designated place in the home where the child is safe and can be seen. The place should be quiet and away from the activity that caused or included the behavior. Many parents have a stool, chair or step on standby for time outs. The area needs to be boring and not have “reward” objects such as TVs, toys, or computers present.

How long should time outs last? Many follow conventional wisdom that when a child demonstrates unacceptable behavior, he or she should be separated from the activity for a number of minutes equal to his or her age.

Time outs should be used to help a child calm down and think about the behavior that got them there.

The American Academy of Pediatrics (AAP) says it's okay to give children as young as 1 a time-out – but it's best only as a last resort. Until he's a little older, your child may not have the self-control and reasoning skills to make a traditional time-out effective. Instead, think of a time-out as the "quiet time" your toddler needs to calm down and get his or her emotions under control. It’s also a time when parents can get their own emotions under control as well.

If you’re child is capable of understanding that certain behaviors are not going to be tolerated, and yet they are right in the middle of acting out one of those behaviors, that’s when a time out should be implemented.

You want your child to associate the behavior with the consequence. Calmly tell your child in no more than 10 words why they are in time out. As soon as he or she calms down, reward them with positive attention.

Children whine, cry and sulk – those are not reasons to put them in time out. Time outs are for intentional behavior such as biting or continuing to break rules.

What's helpful about a time-out is that it can defuse and redirect an escalating situation in an unemotional way. It lets you teach your child without setting a negative example, the way yelling or hitting does.

Parents tend to over explain a situation to a child, that’s why it’s important to keep the wording simple and direct. Over-talking the problem also tends to make the parent more agitated when the behavior doesn’t change. Being calm when putting your child in time out not only de-escalates the situation but also helps your child relax and think about their behavior. If you’re screaming and jerking your child to the time out area, they are more likely to be frightened and / or defiant than contemplative.

When the time-out is over, give your child a hug. A sign of affection demonstrates that he or she is still worthy of your love even though the behavior is unacceptable.

What if your child won’t stay in the time out zone? Toddlers are going to give you a challenge- that’s their nature. Power struggles can easily get out of hand. Until your toddler can appreciate the need to follow rules, limit the use of time-outs. Otherwise he or she won't understand why she's being corrected, and you may get frustrated and abandon the strategy prematurely.

You might actually consider “practicing” time outs with your child. Say your little one is revved up and on the edge of losing it- this might be a good time to grab a favorite book and sit down together. This is more like a “time-in” that associates positive attention to calming down before the behavior gets out of control.

When your child can follow simple directions and has a slightly longer attention span, they’re ready for a more traditional time-out. Between ages 2 and 3, you'll probably notice that he or she is better able to understand cause and effect.

But don't spring the tactic on them in a burst of frustration – a time-out works best if it's explained ahead of time. Use simple terms: "When you get too wild or act in a way that Mommy and Daddy don't think is a good idea, I will call, 'Time-out.' That means you will sit in this chair for a little while until you can calm yourself down."

Some parents find it useful to act this out or to use a doll or teddy bear to demonstrate taking a time-out.

Time outs are not miracle cures for unacceptable childhood behaviors. They are one tool parents can use to help educate their children about cause and effect. Parenting is a balancing act between positive reinforcement and consistent discipline.

When a child is very young, redirecting their attention to something more appropriate or fun may be the best approach. The key is to always keep your expectations realistic.

Sources: Paula Spencer, http://www.babycenter.com/0_time-outs-how-to-make-them-work-12-to-24-mo_12252.bc?page=1

http://www.news-medical.net/news/20150320/Time-outs-can-train-children-to-behave-better.aspx

Your Toddler

More Small Children Poisoned by Detergent Pods

1:45

When detergent pods first became available, many families thought they were a convenient product for dishwashing and laundry. Grab a pod, pop it in and go. However, over time, warnings began to emerge that these colorful products proved too tempting to small children. The bright designs and little round shapes looked a lot like candy to toddlers and young children.

Even though the warnings have taken on a sense of urgency, a growing number of children are getting their hands and mouths on these products, with serious and sometimes fatal repercussions.

Among more than 62,000 calls made to emergency departments for poisoning from any kind of laundry or dishwashing detergent from 2013 to 2014, 17 children were in a coma, six stopped breathing, four had fluid in their lungs and difficulty breathing, and two died.

"Over 60 percent of these calls were due to laundry detergent packets," said lead researcher Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital, in Columbus, Ohio.

"That's about 30 children a day, or one child about every 45 minutes," he said. "Over the two years of the study, poisoning from detergent packets increased 17 percent, and in 2015 there was another 7 percent increase," Smith said.

Laundry detergent packets are more toxic than other forms of detergent and cause more hospitalizations and serious medical problems, Smith explained.

These packets look attractive to children, who could mistake them for food or candy, he said.

"All they have to do is put them in their mouth and bite down and the packet will burst, and once these toxic chemicals get down their throat the game's over," Smith added.

Given this growing problem, Smith said that parents of children under the age of 6 years should not have these products in the home. "They should use traditional detergents, which are far less toxic," he said.

Smith and colleagues analyzed data from calls made to U.S. poison control centers in 2013 and 2014 after unintentional exposures to laundry or dishwasher detergent involving children under the age of 6.

During those years, the number of poisonings increased for all types of detergents, but it was greatest for laundry detergent packets (17 percent), followed by dishwasher detergent packets (14 percent), the researchers found.

Smith noted that the liquid detergent were the most harmful to children.

Dr. Barbara Pena, research director in the emergency department at Nicklaus Children's Hospital in Miami, said companies have to do something to make these products safer.

People need to keep these products out of sight so children can't get into them, she said. "They should be treated just like medicine."

Ideally, parents of young children would not have them in the home, Pena said.

In response to the study, the American Cleaning Institute said Monday that manufacturers are working on a series of packaging and labeling steps that will be part of new international standards intended to reduce accidental exposure to the cleaning products.

The standards will include "secure package closures designed to challenge the typical strength, mental acuity and/or dexterity of a young child," the institute said in a news release.

There will also be first-aid instructions on the products' packages, the group said.

The report was published online in the journal Pediatrics.

It’s good that companies are researching safer packaging for their products, but ultimately, it’s up to the parents and caregivers of small children to make sure that their young child is safe from being poisoned by detergent pods.

Story source: Steve Reinberg, http://www.webmd.com/children/news/20160425/more-kids-being-poisoned-by-detergent-pods-study?print=true

Your Toddler

Is Your Child a Biter?

2.00 to read

At some time or another your sweet child is going to bite or wallop someone, most likely another kid. And yes, it's embarrassing to have to pull your child off another or to apologize to grandma because her grandchild just took a chunk out of her arm. 

Know that you’re not alone - all kids bite and /or hit. The key to stopping aggression in children is teaching them that there are alternative ways to handle frustration and biting is not acceptable behavior.

Not all biting stems from anger. The younger the child, the less chance that biting is an aggressive behavior. It can also be a simple case of exploration. Young children bite for many reasons, from painful gums because they are teething to seeing what kind of reaction they get. Children between the ages of one and three typically go through a biting phase they eventually outgrow.

While biting may be a normal phase kids go through, it’s something you want to discourage.

Let’s look at some of the reasons kids bite.

  • They're in pain. When babies bite, typically it's because they're teething. They're just doing it to relieve the pain of their swollen, tender gums.
  • They're exploring their world. Very young children use their mouths to explore, just as they use their hands. Just about everything infants or toddlers pick up eventually winds up in their mouths. Kids this age aren't yet able to prevent themselves from biting the object of their interest.
  • They're looking for a reaction. Part of exploration is curiosity. Toddlers experiment to see what kind of reaction their actions will provoke. They'll bite down on a friend or sibling to hear the surprised exclamation, not realizing how painful the experience is for that person.
  • They're craving attention. In older kids, biting is just one of several bad behaviors used to get attention. When a child feels ignored, discipline is at least one way of getting noticed -- even if the attention is negative rather than positive.
  • They're frustrated. Biting, like hitting, is a way for some children to assert themselves when they're still too young to express feelings effectively through words. To your child, biting is a way to get back a favorite toy, tell you that he or she is unhappy, or let another child know that he or she wants to be left alone.

So, how do you prevent or teach your child that they can’t go through life biting others?

You start with consistent prevention and move on to discipline if they are older.

  • If your baby is teething, make sure to always have a cool teething ring or washcloth on hand so he or she will be less likely to sink teeth into someone's arm.
  • Avoid situations in which your child can get irritable enough to bite. Make sure that all of your child's needs -- including eating and naptime -- are taken care of before you go out to play. Bring along a snack to soothe your child if he or she gets cranky from being hungry.
  • As soon as your child is old enough, encourage your child to use words such as “I'm angry with you" or "That's my toy" instead of biting. Other ways to express frustration or anger include hugging (not hitting) a stuffed animal or punching a pillow. Sometimes redirection is helpful; shortening activities or giving your child a break can help prevent the rising frustration that can lead to biting and other bad behaviors.
  • Give your child enough of your time throughout the day (for example, by reading or playing together), so he or she doesn't bite just to get attention. Extra attention is especially important when your child is going through a major life change, such as a move or welcoming a baby sibling. If your child is prone to biting, keep an eye on any playmates and step in when an altercation appears to be brewing.

You’ve done all that is possible to prevent another biting situation, and low and behold your child is biting another. What do you do then?

When your child bites, firmly let your child know that this behavior is not acceptable by saying, "No. We don't bite!" Explain that biting hurts the other person. Then remove your child from the situation and give the child time to calm down. It’s important that you remain calm.

Seeing your child bite another is naturally going to create an unpleasant reaction in you. As soon as you witness a biting episode, your body tenses, your heart races, and even if you don't actually scream, you really want to. The angrier you are, the tenser the situation becomes. You are much more likely to strike your child when you let your anger get the best of you. Take a deep breath, assess the situation and intervene calmly. Remove your child, let him or her calm down and explain (yes, once again) that biting is not going to be tolerated. If your child is old enough to understand time-out, this is a good time to use it. If not, remove the child from the temptation. Playtime is over.

One way some parents handle biting is to bite their own child to show them how painful it can be. Doing what you are telling your child not to do sends a mixed message. It’s similar to hitting your child and then saying “don’t hit others.” Most likely your child will experience how painful it is because another child will bite them someday.

The point is not so much that biting is painful, the action itself is unkind, unproductive and wrong.

When biting becomes a habit or continues past the age 4 or 5, it may stem from a more serious emotional problem. This is the time to ask for help from your pediatrician, family doctor or a child psychologist.

If your child is bitten, wash the area with soap and water. If the bite is bleeding and the wound appears to be deep, call your child’s doctor. The bite may need medical treatment, which could include antibiotics or a tetanus shot or both.

Biting is a horrible habit to get into and a difficult one to stop. Start teaching your child early that momma and daddy are not putting up with it and that there are better ways to explore the world and handle frustration.

Source: http://www.webmd.com/parenting/guide/stop-children-from-biting

Your Toddler

Detergent Pods Causing Severe Eye-Damage to Kids

1:45

Warnings have been out for a while on the dangers of small children getting their hands on laundry detergent pods that often look like packets of candy. The main threat has been poisoning, but another problem has surfaced; vision threatening burns, according to a new study.

Researchers analyzed data from the U.S. Consumer Product Safety Commission and looked at eye injuries caused by chemical burns or conjunctivitis among 3 to 4 year olds between 2010 and 2015.

They found that more than 1,200 preschoolers in the United States suffered eye burns from these single-use detergent pods. In 2012, only 12 such burns were reported. By 2015, that number was almost 500.

"These pods look like toys, they look like candy, and kids are finding them, playing with them, puncturing them, and the chemicals inside the pods are getting into their eyes," said lead researcher Dr. R. Sterling Haring, from the Johns Hopkins University Bloomberg School of Public Health in Baltimore.

The injuries often occur when children are playing with the pods and they break, squirting liquid into their eyes. Eye burns can also happen when the soap gets on children’s hands and they touch their eyes, Haring said.

"Laundry detergent pods are playing a large and growing role in chemical eye burns among small children," he said.

As a proportion of all chemical burns to the eye among kids, burns from these liquid laundry pods rose from less than 1 percent in 2012 to 26 percent in 2015, Haring said.

"I am expecting the number of burns in 2016 to be higher than 2015. These numbers have grown every year," he said.

The American Cleaning Institute (ACI), an industry trade group, has voluntarily introduced improved safety standards for many of these products. New guidelines call for pods that can withstand squeezing pressure from a child. The pods also have a bitter substance on their outer layer to keep children from swallowing their contents. And packaging of the pods is now opaque so the laundry pods can't be seen from outside the packaging, the group said. Many detergent manufacturers have already begun making some of these changes.

One reason the detergent pods can be so dangerous is because the chemicals used are alkaline instead of acidic. Alkaline chemicals are more likely to cause lasting damage than acidic chemicals, Haring said.

The effects of alkaline chemicals can be devastating to a young child’s vision.

"The detergent can burn the cornea, leaving a scar that can impair vision or potentially cause blindness," Haring said. "In the most severe cases, children may need a corneal transplant to restore vision."

If a child has a chemical burn, step one is to rinse the eye with cool water under a faucet for 20 minutes, Haring said.

"Call 911 or take the child to an emergency room, but do it after you rinse the eye for 20 minutes," he said. "That is the first step, and that's the most important step. The longer those chemicals sit on the eye, the higher the likelihood they are going to leave a lasting burn and threaten vision.”

Detergent pods have become very popular because they are convenient, but parents and caretakers sometimes forget that they are packed with dangerous chemicals. These pods need to be kept in an area where small children cannot see them or reach them.

The report was published online in the journal JAMA Ophthalmology.

Story source: Steven Reinberg, http://www.webmd.com/parenting/news/20170202/laundry-detergent-pods-linked-to-eye-burn-danger-in-kids#1

 

Your Toddler

Thumb Sucking

2.00 to read

I admit it – I was a thumb sucker for way too long. My thumb and mouth didn’t part company until I was in first grade. The fear of getting caught during a sleepover at a friend’s house was enough for me to finally call it quits.

It’s normal for babies and toddlers to suck their thumbs. Babies are born with the urge to suck as part of their survival. They also use it as a way to soothe themselves when they feel hungry, afraid, restless, sleepy or bored. Toddlers carry on that natural instinct as they find their way in the world.

By the time children are around four-years-old they’ve typically stopped sucking their thumb and found replacements for self-soothing. Occasionally, children (like myself) will continue to suck their thumb out of habit.

Some experts say that if a child is still sucking their thumb by the age of six, they may be doing so because of emotional distress such as anxiety.

Thumb sucking isn’t a problem under the age of four, but if a child continues- with great intensity- after five or six years old, they could be setting themselves up for dental or speech problems.

Prolonged thumb sucking may cause their teeth to become improperly aligned (malocclusion) or push their teeth outward. If the thumb sucking stops, the teeth most likely will align correctly, but the longer the sucking continues the more likely orthodontic treatment will be needed.

Extended thumb sucking may also cause speech issues such as lisping, inability to say Ts and Ds, and pushing the tongue out when talking. A speech therapist may be needed to help correct these problems.

How do you help your child stop sucking their thumb? It takes a lot of patience.

One place to begin is to pay attention to what triggers the thumb sucking. Does your little one start when they are bored, sleepy, or unsure about something? Redirecting can help. Busy hands help keep thumbs from going into the mouth. Give your child a large stuffed animal to wrap their arms around or have them help hold the book when you are reading to them. Offer a squeezable rubber ball or finger puppets to grasp when they are watching TV.  The key is to offer an alternative at the times you notice they are the most likely to want to suck their thumb.

Ask your child to not suck their thumb in public and gently remind them when you see them doing it. Let them suck their thumb at home, but start the process of being self-aware in public. Kids often unconsciously slip their thumb into their mouth. A reminder helps them notice what they are doing.

You can also start talking to your child about why it’s time to give some thought to stopping. In age-appropriate language explain how thumb sucking is okay for younger children, but as children get older they learn how to stop. Ask them questions like “Do you see (insert name of an older child or adult here) sucking his or her thumb?” They’ll think about it more and start to decide whether they want to continue. It’s a process that takes time.

Punishing or shaming your child is absolutely the wrong method to address thumb sucking. This approach not only doesn’t work, but also lowers a child self-value and can create an even stronger desire to thumb suck. It’s like quitting anything you’re doing that may not be good for you in the long run- the worse someone tries to make you feel about it- the more you want to do it (think overeating, smoking, drinking.)

You can also talk to your pediatrician or family doctor for his or her suggestions on how to help your child. For older children, behavioral therapy may be beneficial.

There are products that are nasty tasting that can be swabbed on your child’s thumb, but some experts think that approach is cruel and more like a punishment than a humane way to help a child outgrow a natural inclination.

Most kids will simply quit sucking their thumb when they are good and ready. Helping your child reach that point may require patience and creativity, but in time his or her thumb will cease to be a constant comfort companion.

Sources: http://children.webmd.com/tc/thumb-sucking-topic-overview

Daily Dose

Common Toddler Questions Answered

2.00 to read

It was "toddler week" in my office and I was just amazed that the questions from room to room and morning to afternoon were essentially all the same. Forget that these were all different kids with different parents; the concerns were echoed from room to room. He/she doesn't eat. Toddlers are notoriously picky eaters and they also are smart enough to self-regulate. In other words, they only eat when hungry (such a novel idea to us adults, as I sit here eating a four-day-old cupcake just because it was there). If you provide your toddler with a balanced meal three times a day, they may choose to eat it or not, but I promise you they will not starve. Toddlers seem to grow and gain weight on air alone, and they also really only eat once a day, and pick at the other meals. Who needs a trainer when you know when to stop? A parent's job is to provide the healthy, well-balanced meals and the child will learn to eat a wide variety of foods, over many years. No need to bribe, scream, beg or feel guilty. Toddlers hit/bite/spit/pinch/pull hair. You fill in the blank. This is what I call "age appropriate, in-appropriate behavior." We all go through this as parents, some more than others. But this is also the time to begin teaching your toddler appropriate expectations as to playing, sharing, and the social graces. Correct your child when they misbehave. Begin time-out and consequences. Learn to get on your child's level to redirect inappropriate behaviors. Use a firm voice when talking told a child about their behavior, no need to scream or yell, but voice inflection is important as your child learns to listen to you. Sleep is also a big concern, and most toddlers should be sleeping alone at night. Have a set bedtime and bedtime routine and begin a sticker chart for good bedtime behavior and for staying in their bed. The toddler years are some of the most important for a child's development and long term well being. Start young, if not it only gets harder. That's your daily dose, we'll chat again tomorrow.

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