Families Today Articles

A resource for parents and professionals, written by T. Berry Brazelton MD and Joshua Sparrow, MD.

Who better to answer some of our most pressing questions about developmental challenges (such as eating, sleeping, weaning, and realationships) than noted pediatrician Dr. T. Berry Brazelton and psychiatrist Dr. Joshua Sparrow? They take thoughtful consideration of both the physical and emotional stages of a child, and how you can respond with sensitivity to the baby’s experience in difficult situations.

We invite you to read, download and share Families Today with others in your community.

FAMILIES TODAY: Feeding A Quiet Child & An Active One

FAMILIES TODAY: Feeding a Quiet Child — and One Who is Active
By: T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

(This article is adapted from “Feeding: The Brazelton Way,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

As a child grows out of babyhood, a family’s goal is for her to feed herself independently and to enjoy eating enough of the right kind of foods to help her grow and be healthy. Parents will of course want to take into account her temperament.

Feeding a Quiet Child

A quiet, sensitive child may be on a different track from her peers. She may comply with being fed and continue to be compliant even during the usual times of conflict. For example, unlike other children her age, she may allow herself to be fed into the second year, apparently content to be a passive recipient.

Then, all of a sudden, refusal! No longer will she put up with being fed. Passive resistance may be her response. Her refusal to be fed is a warning to her parents to pull back and let her try feeding herself. Since she has not had experience with finger feeding or with utensils, her first attempts to feed herself may be clumsy. A big mess at every meal – food on her face, her clothes, the table, the floor, everywhere – will be the inescapable price for her earlier compliance.

Parents may even be thankful for the slobbery mess when it comes – a welcome relief from the initial food refusal of this phase of self-assertion! Patience with such a child will be the saving grace. Let her learn how to take over the job of feeding.

Offer her only two bits at a time of an attractive finger food for each meal. Then ignore her struggle and leave it to her. Keep her company, but don’t cajole during meals. If and when she downs the two bits, offer her two more at a time, until she starts smooshing them or launching them over the edge of her high chair. This means it’s time to stop – until the next meal. Don’t let her “graze” between meals. And for now, don’t worry about a well-rounded diet.  Remember that this previously compliant child is quickly learning the skills of self-feeding.  It might have taken her several months longer to learn had she been less passive and started in with her attempts to take over her own feeding earlier. Be patient and follow her lead.

Feeding an Active Child

At the other end of the temperament spectrum is the active, constantly moving, curious-about-everything child. She is far more interested in sights, sounds, and rushing around than in food. A parent whose motive is to see that the child is well fed is bound to feel frustrated, even desperate.  “Sit down in your seat,” a worried parent will beg as the child climbs out of her high chair to hang teetering on the edge. The child looks up coyly, holding out one hand for a “cookie.” Anything she can eat will do as long as at the same time she can clamber around the house, up and over furniture and into drawers to pull out clean clothes with grubby fingers.

Many parents of active children have asked me: “Should I feed her on the run? She’ll never eat enough sitting down. She barely sits before she’s gone. I wait until she’s hungry, but she never is. I feel like I need to give her bits of food all through the day so that she’ll get enough. What should I do?”

Mealtime Advice

  1. Keep mealtimes a sacred time for the family to be together. Don’t let the phone or other interruptions interfere.
  2. When your child loses interest in sitting at the table – that’s it. Put her down and let her know her meal is over. No grazing between meals. No more food until the next meal.
  3. Make meals a fun time to be together – at least as much as is possible with a squirming, food-throwing toddler. Make meals as companionable as possible – you eat when she does.  But if she doesn’t, eat your own meal and let her know that you can chat and be together if she stays at the table. If she squirms to leave, put her down. But she’ll have to wait for your attention until you’re done. Eventually she’ll learn to model on you.
  4. No television at the table or promises of special sweet desserts to get her to sit and eat.
  5. Be sure you let her feed herself. Never say, “Just one more bite.” If you do, you’ll be setting yourself up for testing.
  6. Don’t go to special trouble to cook her a special or exciting meal – your disappointment is likely to outweigh the benefits. Instead, let your child know that “this is what we’re having for dinner tonight.” If she doesn’t want it, she’ll have to see if she likes the next meal any better.
  7. Let her help with meals as soon as she is old enough to do even the smallest task, such as setting the table (start with the napkins only!), cleaning it with a sponge, and so on.
  8. Have your child’s pediatrician check her weight and growth, and ask her for supplements if necessary.
  9. Above all, don’t set meals up as a struggle or her high chair as a prison to keep her in.

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Distributed originally by The New York Times Syndicate with permission to circulate, copy and redistribute through MI-AIMH.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: Community-Building Among Families

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FAMILIES TODAY: Community-Building Among Families
By: T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

Q: I’ve seen parents benefit from the exchange of advice on the sidelines at a soccer game, and by volunteering together for a parent-teach association.  But not every parent can participate.

How can we help restore and strengthen social networks that nourish parents?  Networking reduces not only parents’ anxieties but also overuse of the medical system.

Being a parent can be a lonely job.  More than half of all children in the U.S. spend part of their time being raised by a single parent.

A: Single or not, working parents are often so busy juggling jobs and family that it’s hard for them to connect with relatives, friends and other parents. Yet when parents compare notes, they are often relieved to discover that they are not alone, that they share mutual concerns about bedtime battles, homework overload, fears about how their children will fare in a world of vanishing resources, to name a few.  They realize they aren’t the only ones who sometimes feel like they don’t know how to help their child – that they’ve tried everything and nothing seems to work.

Exchanges with other parents provide more solutions and resources, along with confidence and hope.  When parents speak their fears out loud and know that they have been understood by others who care, they are likelier to find a fresh perspective.

Parents often feel that they must be perfect, that they should instinctively know what to do with their children.  Of course that’s not realistic.  Parenting is a process of trial and error where mistakes themselves can be teachers.  But parents will only learn from their mistakes if they can face them, and that takes an underlying sense of security.  It helps to have a safety net of reassuring relationships with other parents who share their challenges and cheer them on.  The sidelines of their children’s soccer games are a fine setting for that back and forth.  Perhaps every generation has to learn that it takes a village to raise a child.  When communities strengthen themselves, children get supported not only by their own parents but also by all the other parents and adults in their universe.

Pediatricians, teachers and other professionals can help develop opportunities for parents to connect – formal ones such as parent-teacher associations and parent groups, and informal ones, too.  I used to schedule pediatric appointments during the same block of time for children of the same age so that their parents could compare notes in the waiting room.

Public libraries and children’s museums also have become interested in helping parents get to know each other.  But the job of strengthening communities cannot be accomplished by child-oriented professionals and institutions alone.

Internet social-networking sites can be helpful tools to share community information.  Communities become places where children and families thrive when a critical mass of people and institutions share their commitment to everyone’s well-being.

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Distributed originally by The New York Times Syndicate with permission to circulate, copy and redistribute through MI-AIMH.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

Copyright © 2014 Michigan Association for Infant Mental Health, All rights reserved.

FAMILIES TODAY: Preschoolers' Habits: Handle with Care

FAMILIES TODAY: “Preschoolers’ Habits: Handle with Care”
By: T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

(This article is adapted from “Touchpoints: Three to Six,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Preseus Books Group.)

Many preschool children go through a period of various self-comforting habits such as hair-pulling, rocking, or biting their nails and skin around them.  As if they were exploring the behavior that bothers their parents, they seem to run the gamut of habits.

Habit patterns have deep roots.  My first child sucked her middle two fingers as a newborn to comfort herself, an unusual pattern – and I found myself taking them out of her mouth.  My wife said, “You’d never recommend trying to stop this to your patients.  Why do you try to interfere with her sucking?”  I couldn’t answer her.

A week later, my mother came up from Texas to see her new grandchild.  “Isn’t that amazing?  She sucks the same two fingers you used to suck!  In those days, finger sucking was considered a bad habit.  We tried to stop you, but we never could.  You were determined.”

I realized then why I’d tried so hard to stop my daughter.  Attention to habit pattern is more likely to set it as a problem than to eradicate it.  Thumb bandages, terrible-tasting ointments, or other ingenious measures have the opposite effect from that intended.

An older child can be helped to see that she resorts to self-comforting habits when she’s stressed and needs to calm down.  Those are signs of tension.  Parents can evaluate the pressures on a child who is resorting often to such habits.  The pressure isn’t always from the outside.  An over-charged, hard-driving child may need such a habit pattern to help her manage her temperamental intensity.

One child, on being reprimanded for her nail-biting, pleaded, “Mummy, can you take my head off?  My mouth just bites my fingers.  I don’t like it and I don’t know what to do.”

This shows the depth of feeling in a child who is trying to control such a symptom.  Do we want to add our own pressure to it?  Why not say, “Most people bit their nails.  Sooner or later you will stop.  In the meanwhile, worrying about it won’t help.  I’ve made you feel guilty about it, and I’m sorry.”

Better to reassure her that the habit is likely to go away.  This is more likely to happen if everyone (including the child) can ignore it.  The various habits common at these ages – thumb sucking, pulling out hair, nail-biting, stuttering, and the many others that parents encounter – can show a common pattern.  (See below for guidelines to identify habits.)

Criticizing the child for a habit makes her feel inadequate, unable to “break” the habit.  For these reasons, a parent would best be advised to ignore the behavior from the first.  Because all parents are loaded with their own past experiences, this is not easy.  Nail-biting was a habit to be “broken” for the last generation.  A parent today who was broken of this habit during his own childhood will find it extra hard to “ignore” such behavior today.

HABITS TO GROW OUT OF:

Many 3- and 4-year old children run the gamut of habits.  They last only a few weeks or months.  Many of these habits may be imitative of a parent, a sibling, or a peer.

Habits may serve a self-calming purpose at a peak of frustration or excitement.  A child turns to his behavior as she might have to her thumb earlier.  A special doll or other treasured object to hold and touch might help to redirect the child’s need for self-comfort.

When a parent sets up a prohibition, this surrounds a habit with heightened interest or excitement and tends to reinforce it.  Either the added attention or the use of it as a kind of rebellion makes it satisfying.  All this is unconscious on the part of the child.  In this way, what might have been transient behavior becomes more fixed – a habit.

Much less commonly, more unusual kinds of involuntary behavior (for example, repetitive hand washing or staring spells, among others) may seem to take on a life of their own and seriously interfere with a child’s daily life.  If they have a more bizarre quality, are more repetitive or disruptive throughout the range of a child’s activities, they require professional attention.

A health professional is needed to determine whether these are habits or something more serious (such as obsessive compulsive disorder, Tourette’s syndrome, or certain seizure disorders) for which treatment is needed.  Your pediatrician can refer you to a pediatric neurologist or child psychiatrist.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: Coping with Loss

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Coping with Loss
By: T. Berry Brazelton, MD and Joshua Sparrow, MD

Q. Since her great-grandfather died a few weeks ago, my 4-year-old daughter asks constantly about death.  She asks why and how my mother died (which happened before my daughter was born). She wants to know if we parents will die at the same time, and who will look after her. It’s hard to be honest without scaring her.  We aren’t religious, so a lot of my answers are, “I don’t know.”  What is best to say? Or not to say?  My mother died from smoking. Is it too early for that information?

A. Clear, simple information is the key to helping your daughter cope with frightening things that are hard for any of us to understand.  You needn’t explain more than what’s required for her age – just tell her enough so she can trust you to guide her through these challenges.

Sometimes language that is meant to be reassuring confuses and worries children. “He died in his sleep,” for example, makes many children scared to go to bed.  A little reliable information makes the world seems less frightening to a child.

Maria Trozzi, author of “Talking with Children about Loss,” suggests saying, “Most people do not die until they are very, very, very old.”  If your daughter asks why, you might reply, “After living for a very, very, very long time, great-grandpa’s body wore out. When people grow very, very, very old, their bodies just stop working.”

You can add, convincingly, that you and you parents are not very, very, very old, and that your bodies are working fine.  It’s not critical for your daughter to know now about your mother’s smoking.  Since people are likelier to die younger if they smoke, your child might wonder why anybody would ever do such a thing.  It’s not dishonest to save this explanation for later.  Most important is that your daughter knows you are always ready to listen and that you will do your best to answer her questions.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.

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 is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: A 14-month old, Early to Bed and Early to Rise

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A 14-month old, Early to Bed and Early to Rise
By T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

Q. My 14-month-old is an excellent sleeper – she has slept through the night since she was 2 months old. However, she goes to bed early and wakes up early (typically 7:15 p.m. to 5 a.m.).  I have tried shifting bedtime a little later but it hasn’t affected wake-up time; instead she is cranky and tired until her morning nap, which shifts earlier.

I don’t want to mess with a full night’s sleep, even if it’s not on my preferred schedule. But I find it hard to make evening plans with the rest of the family.

Do you have suggestions for (a) shifting to a later bedtime and/or (b) explaining to relatives and friends why it’s so important either to turn down invitations or to leave early to keep her sleep schedule?

A. At 14 months, 10 hours of nighttime sleep is about average. A child this age would also need another hour or two of sleep during the day. (Of course, many children are not average, so sleep requirements vary.)

An early-to-bed early riser’s sleep schedule is healthy so long as the child gets the sleep she needs. If you want to try to change her sleep schedule, you will need to shift every sleep-related event – naps, bedtime and mealtimes – in each 24-hour cycle. And you must maintain the pattern consistently, advancing by 10 to 15 minutes each day. The process is like adjusting to a new time zone.

At first, your child probably won’t wake up later and may be tired and cranky. But if you continue this schedule for a few weeks, chances are she eventually will start waking up later in the morning.  At that point you would not advance her bedtimes, naptimes and mealtimes any further. She should still obtain the same amount of sleep at night and during naps. If not, you may need to go back by 15 minutes or so, settling on a new schedule that works best for him.

None of this is necessary unless her current schedule bothers the family enough to make the effort. You may indeed prefer not to “mess” with a good night’s sleep.

You don’t tell us whether your child appears well rested and wide-awake when she is up: important signs of a healthy sleep pattern.

As for the pressure to make your baby conform to others’ schedules, you are her parent. Decisions like these are up to you. You may deflect criticism by making it clear that this is a matter of the child’s biology, not a lack of parental backbone. Assert your authority: “She’s an early bird. Some people just are, and we intend to respect that.”

Others’ opinions will bother you less once you feel confident about your stance on your child’s sleep.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.

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 is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: Tough Times, Resilient Families

Tough Times, Resilient Families
By T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

These times of economic insecurity challenge parents who already feel strapped to find enough time, any time, for their young children.  Parents everywhere may take comfort from knowing that they are hardly alone in this period of foreclosures, layoffs, dislocations and worries about today and tomorrow.

Many parents cling desperately to the jobs they have, no matter how much time is now demanded, and bring home even more stress than ever – doing double time to make up for staff cuts and worried about looming layoffs.  Children feel the impact.  But parents and children may also find that facing adversity together can strengthen the family – and the community, too, when families share what they have.  During this holiday season especially, giving and sharing take on a new meaning.

In most U.S. families today, both parents are in the workforce; 63 percent of mothers (of children under 18) work outside the home.  Despite massive layoffs, the demands of the workplace on the families aren’t likely to change all that much.  We still need to find ways to adjust to them that will put children’s best interests first.

Today, parents are asked to split themselves in two – for the workplace and for nurturing at home.  Increasingly, parents also are “on call” at home via work-linked cell phones, computers and all manner of hand-held devices that can compete for a family’s time.  Children must adjust to the pressure on their parents and participate in all the efforts to “make it” in a working family.

More time is the universal need of working parents.  For most families, there simply is not enough time to just be together.  No time for just dreaming and thinking.  No time for oneself.  No time for one’s spouse.  No time for the children.  Children feel the stress their parents are under.  Some turn away, as if to prevent themselves from causing their parents further stress.  They seem to have given up on moments when they might have their parents to themselves.  Others lobby hard to keep their parents turned in to them, even if it means behavior that wrecks the little time they have together.

Children benefit, though, when parents can strike a reasonable balance between work and family.  Ellen Galinsky, director of Work Family Directions in New York, asked children what they thought about their mother’s working outside of the home.  Most children quickly stood up for their mothers: “Even if she hates her job, we need the money and we all know it.”  These children felt that their mothers were “the most important person for me.  She’s always there when I’m sick or I need her.”  Their mother’s working or not was not their issue.  They wanted “focus time” with their mothers, time in which they were uppermost in their thoughts.  The most satisfied children valued the “hanging out” time they had with their mothers.  Rather than so-called quality time spent on planned excursions or planned togetherness, these children preferred just hanging out with their parents.

For the many parents who must spend the bulk of their time at work, there are ways to turn the priority of work into a positive for the children.  It became apparent from Galinsky’s study that children want to be a part of the family’s efforts; they want to understand their parent’s jobs, to be included in the family’s efforts to “make it.”  If the family is working together, children do not feel shortchanged.  “School is kids’ workplace.  My mom and dad have theirs.  But we have each other to help us.”

In planning solutions for families in which both parents must work, each parent needs to share in decisions about family priorities.  If their children are old enough, they may be included in the decision-making, too.  Then, when the questions arise, “Did you see Joey’s flashy new car?  Are we ever going to get rid of our old junk heap?” or “She gets an allowance to buy her own toys.  Why can’t I have one?  You don’t ever buy me anything,” the parent can point to the family’s decisions, trade-offs and the values behind them.

The current economic downturn is a time to re-examine values, and to model more altruistic and less materialistic ones for children.  Many parents will now need to be ready to make extra efforts just to try to hold onto their jobs – and their children will again need to adapt.  A shift of values toward pulling together, looking out for each other, making sacrifices for each other, and having fun just being together rather than buying together may help many families make the transition to having less.  Still, this can’t make up for basic necessities such as food and shelter that more and more families can no longer take for granted.  Some may find that they can stretch some of what they have a little farther by sharing their resources with neighbors – carpooling to school or for grocery shopping, or sharing childcare arrangements.

At the same time, they’ll be modeling the kind of values that have made this country strong and always pulled us through tough times.  This is a time to pull together, to help each other out, and it will last well beyond this holiday season.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH. 

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 is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: A Child's Big Emotions

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A Child’s “Big Emotions”
By T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

Q. How do I help an almost-6-year-old learn to handle disappointment and frustration?  This is a child with big emotions, both positive and negative. Nearly every time he doesn’t get his way, he instantly gives in to his impulse to stomp, throw something, cry, scream, and sometimes hit and push.  He is always apologetic and remorseful, and even berates himself, which I find disturbing (he says he is “stupid,” a word we don’t allow in our home).

A. At nearly 6, your son can learn to manage his strong feelings. The work may be hard now, but it will be much harder later.  It is good that his behavior bothers him, which may motivate him to change.  But if he is feeling hopeless, he will need your reassurance that he will someday learn to control himself.  He will need to know that physical aggression is unacceptable, and that you will do everything you can to keep him under control until he can manage on his own. He sounds like he is scared

of himself, and he needs to know that he can count on you until he can count on himself.  Help from you will be far more effective if he can keep reminding himself that he, most of all, is the one who wants to learn.

In calm times, help him make a list of the triggers for his tantrums.  Some triggers will be avoidable, others not. You can strategize together about how to handle both.  For example, when he can’t have what he wants right away, he could focus on when he can have it and what he can do while he is waiting.  Instead of pushing someone when he is mad, he can stop and think about what he is feeling, and why. Rather than getting physical, he can say, “I’m mad because I wanted to go first. If you won’t let me go first, then I’m not going to play with you.”

Of course he won’t be able to substitute these reasonable responses for the pushing and hitting right away. Tell him he’ll need to be patient with himself.  Look at the list and help him to identify any triggers that have warning signs. You can agree on a special code that you’ll both use, such as, “Looks like it’s time to cool down.”

But then he’ll need to know how. Ask him to think about what helps him relax when he’s feeling upset. Share with him what you’ve noticed, and give him some ideas to try.  For example, leaving the scene to go to his room, not as a punishment but just to cool down, can make a big difference. Does he have a teddy bear to squeeze really hard? Would it help him to wrap himself in his bed covers? Listen to music? Take a shower? Have a cold drink? Or scribble furiously (on paper) until eventually he feels like making drawings or writing about what bothers him?

If these strategies don’t work, you may need more help. Has your child always had “big emotions,” or is this a recent development?  Have there been major changes in his life or in your family’s situation that may have gotten under his skin? Have other family members had problems with “big emotions”?  If so, we suggest you consult your pediatrician, who can refer you to a mental health professional skilled in working with young children.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.

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 is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: A Child Who Bangs Her Head

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A Toddler Who Bangs Her Head
By T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

Q. My 21-month-old daughter head-butts. She has been doing this since about 13 months. She bangs her head on the wall or ceramic floor and doesn’t cry. When told no, she does it again. Sometimes she bangs her head so hard she bruises her forehead.  My pediatrician says this is normal. My mother thinks this is abnormal and she should be checked out.

A. Many children bang their heads in the second year when they begin to have temper tantrums or meltdowns. Some also rock themselves forcefully in their cribs or on the floor.  These actions seem to be a child’s way to handle uncomfortable feelings – frustration, disappointment, tension, anger, boredom. But of course such behavior frightens parents.

Even though toddlers bang their heads hard, I have never heard of one who hurt himself. As a precaution, though, I recommend putting carpet or other “shock absorbers” on concrete floors, cinder block walls and other unyielding surfaces – without making a big deal of it.

I don’t think that telling her no will help. If she could stop herself, she probably would. Struggling with her over the issue might give her another reason to bang her head: It not only helps her soothe herself but also gets your attention.  Look for opportunities to engage her before she bangs her head. When she is playing quietly by herself, you can help her learn how to prolong her play so she wards off boredom.

Try to protect this quiet time by avoiding interruptions and cutting down on distractions. When she starts to lose interest or to become bored or frustrated, you can move in briefly to help her with what she’s doing or to introduce a different activity.

When she’s ready for a break, cuddle her before she gets to the point of head-banging.  Look for sources of tension that you can control and try to minimize them. If you or other family members are under stress, take a break and let off steam.  Help your daughter focus on her other ways of calming herself, and teach her new ones. Does she like to cuddle with and talk to a stuffed animal? Look at a storybook? Scribble with crayons? Listen to calming music? Or suck his thumb?

At the first warning signs for head-banging, offer an alternative like cuddling or singing with you. If all else fails, you can’t do much more than sit nearby and say soothingly, “I am here and I would like to help but I can’t.”

If a child is otherwise healthy and developing on track, he’s likely to outgrow head-banging. If the behavior persists, there may be a more serious problem. If a parent is concerned that a child’s development is not on pace, it is important to alert the pediatrician as soon as possible. Early intervention can make a big difference for developmental delays and disabilities.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.

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 is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

FAMILIES TODAY: Parents and Children Learn from Each Other

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Children and Parents Learn from Each Other
By T. Berry Brazelton, M.D. and Joshua Sparrow, M.D.

Q. My husband and I have different opinions about how parents’ behavior affects a child. I believe that the child learns from your behavior and watches how you react to situations, in turn learning how to handle his emotions. If you are patient even when a child is fussy, that helps him learn to be more patient. If you are frustrated with him and speak to him in a negative tone, that has a negative effect.

A. A child’s behavior is both genetic and learned from modeling on parents. The genetic endowment with which children are born gives them limits within which they can develop. Each child is born with strong individual traits.

Our first child was quiet, shy and hypersensitive. I am very intense and active. I reacted quickly and loudly, often injudiciously. The baby would look at me, cowering, as if I were crazy. I found I couldn’t reach her. She drove me to write my first book, “Infants and Mothers: Differences in Development” (New York: Delacorte Press, 1969). Her behavior determined how I reacted. As I realized that her behavior was genetic and more powerful than anything I could change, I adapted to her and she adapted to me. We’ve managed together.

The second baby was more responsive – more like me. She was playful, laughed easily and talked all the time. She responded to my volatile behavior. Her genetic endowment fitted with mine and we’ve always gotten along. Our last two children have each been different from the others but easier for me and for them. I found I learned the most from adapting to the child who seemed most different from me.

I think our differences also contributed to her growth as a person – from a quiet, hypersensitive child to an avant-garde musician. Our efforts to understand each other have led us to realize that we have much more in common than first seemed apparent.

Your husband may not fully appreciate just how important he is to his children. Often fathers end up feeling left out and don’t recognize how they affect their baby from the beginning. If a father has been present during pregnancy, and he speaks just after the baby is born, she is likely to turn her head and look for him. After all, she’s been listening to his voice for the past several months. Or watch how a 2-year-old boy looks up at his father adoringly. He proudly puts on his father’s shoes and tries to swagger just like him.

Our children are always watching us and learning from us. Children are born to learn, and parents are children’s first teachers. Children do not come into the world fully programmed to become adults. Of course genes play a role but couldn’t possibly prepare children to adapt to all the circumstances – including their parents’ personalities – they must learn to live with. Both you and your husband are right. A child learns by modeling on the parent, but parents also learn by adapting to their children. If you are reading your child’s cues, she will read yours, and you will learn from each other.

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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.

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 is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at  www.brazeltontouchpoints.org.

Families Today is published with permission granted to MI-AIMH.