A national survey conducted in 2000 by the Josephson Institute of Ethics showed that at least 70 percent of all high school students cheat at least once each year. About half admit to cheating repetitively.
Stealing likewise seems rampant. According to the survey, at least 40 percent of the males and 30 percent of the females admitted that they stole something from a store in the past 12 months.
And about one in four high schoolers said they stole something from a parent or relative in the same period.
It’s hard to believe that your kids would cheat or steal, but it is wise to accept the real possibility that culture puts great pressures on teens to sacrifice principles of honesty for personal gain and peer group approval.
Talk to your teens about the pressures they face. Let your son or daughter know that all people, including you, are in a constant struggle to live up to high standards of ethics and honor, and that the real measure of character is the ongoing commitment to self-improvement.
Creating Family Traditions
One of the most important things you can do to maintain a healthy family life is to have family traditions. If you don’t have traditions already, this holiday season is the perfect time to start a ritual, celebration or habit of your own.
Your family can celebrate the holidays in many ways. Here are a few examples of traditions that may work for you:
Prepare special foods that honor your family’s ethnic, religious or cultural heritage
Create at-home activities that everyone gets involved in: decorating the house, making dinner, eating together, watching a favorite video, playing games or cards, singing carols
Take a family outing; they can be as elaborate as ski vacations or as simple as trips to a local museum or attraction
Volunteer some time for a charitable cause: serving food at a soup kitchen or shelter, visiting residents of a nursing home
Attend worship services as a family
As your family marks holidays or special events, be sure to talk to your children about the specifics of your family celebration. Make sure your children help plan the celebration and assist with preparations, such as helping set the table or greeting guests.
As your children grow older, you can provide more details about how your family traditions got started and why they’re important. These details will help your children understand the traditions so they can carry them on when they are adults or adapt them to their own lives as they get older. Traditions provide each generation with links to the past.
For some, memories of holidays and special events may not be pleasant. If that is true in your family, try to establish different traditions that give new meaning to these special days.
Whether it’s with special foods or one-of-a-kind activities, traditions create fond childhood memories and bring everyone in the family closer together.
Your family can celebrate the holidays in many ways. Here are a few examples of traditions that may work for you:
Prepare special foods that honor your family’s ethnic, religious or cultural heritage
Create at-home activities that everyone gets involved in: decorating the house, making dinner, eating together, watching a favorite video, playing games or cards, singing carols
Take a family outing; they can be as elaborate as ski vacations or as simple as trips to a local museum or attraction
Volunteer some time for a charitable cause: serving food at a soup kitchen or shelter, visiting residents of a nursing home
Attend worship services as a family
As your family marks holidays or special events, be sure to talk to your children about the specifics of your family celebration. Make sure your children help plan the celebration and assist with preparations, such as helping set the table or greeting guests.
As your children grow older, you can provide more details about how your family traditions got started and why they’re important. These details will help your children understand the traditions so they can carry them on when they are adults or adapt them to their own lives as they get older. Traditions provide each generation with links to the past.
For some, memories of holidays and special events may not be pleasant. If that is true in your family, try to establish different traditions that give new meaning to these special days.
Whether it’s with special foods or one-of-a-kind activities, traditions create fond childhood memories and bring everyone in the family closer together.
Sanity Tips for Eating Out With the Kids
Believe me when I tell you that the young gentlemen of my household, ages 12 and 9, are not cosmopolitan or gourmands. The best thing you could ever pack in their lunch boxes is a nice cold package of Lunchables, and they love beef jerky, french fries, and pizza. But - here's the surprise - they also sometimes get a yen for sushi, tofu, fried calamari, artichokes, Mexican food, or dim sum. They love to eat out, and they love to eat well.
I'm afraid I can't attribute their tastes to any exceptional quality of their attitudes or palates. I guess it's simply a result of continued exposure to these foods and environments. According to Isobel Contento, a professor of nutrition education at Columbia University's Teachers College in New York City, "Continued exposure to new foods is extremely important. Research suggests that children sometimes need to be exposed to food ten to fifteen times before they develop a liking to the food."
Research by Contento and many of her colleagues supports my hunch: Any kid can learn to dine out and enjoy a broader range of foods, if given the chance. Unfortunately, resisting the temptation to feed kids only "kid food" ordered from "kid menus" at "kid-friendly" restaurants is no piece of Tastycake. But if you don't, you wind up with kids whose narrow palates and general cluelessness about restaurant behavior are the self-fulfilling prophecies of Ronald, Wendy, and the Colonel.
I love going out to eat, but I don't love anything that comes in a nugget or is served in molded plastic. My solution is this: While we do consume our share of burgers and pizza, our family also patronizes real restaurants. If you're ready to try something a little more civilized and adventurous than another trip to KFC, here are a few tips to keep in mind.
Tasting Tips for Kids
The journey of a thousand meals begins with a single bite - or something like that. Here are some clues to guiding that first morsel safely into the hangar.
Don't make a huge deal out of the new food in question. Start simply - just let your kids see the grown-ups eating and enjoying it.
While you don't want to flat-out lie, remember the old "tastes like chicken" ploy. You might say in your most casual tone, "Want a bite?" Then, when you're asked what it is, say, "It's like steak" (in other words, it's venison). Or try, "Taste a bite and see if you can guess."
Never eschew bribes: "A quarter for the first person who can guess what it is." "Taste it and you can pick the dessert."
If they absolutely hate it, do not make them eat it. If they're not sure, you might suggest a second taste, perhaps with soy sauce, pepper, or lemon to personalize the flavor.
Rules for Restaurants
Want to get your kids through an eating-out experience without a meltdown? Here are a few guidelines to make it more fun for everyone.
Do keep paper and crayons or pens in your purse at all times. This way, the gimmick of kid-friendly restaurants is yours anywhere. Older kids can play hangman and "dots."
Don't make a federal case about dressing up. Most restaurants these days don't mind casual clothes, and by choosing one with a relaxed dress code, you'll eliminate one area of dissent.
Don't let kids have too much sugary soda before the food arrives.
Don't let the waitperson serve meals to the kids first. If you do, the timing will get screwed up: They'll lose patience before you've finished your main course.
Don't bring other kids who have more limited palates than your own do. You don't want to get an "ew" thing going.
Do allow a field trip or two to the bathroom or the lobby. Accompany your kids the first time to demonstrate acceptable behavior.
Don't let your child order some expensive item she's never had before without having her first try an appetizer or tasting portion.
I'm afraid I can't attribute their tastes to any exceptional quality of their attitudes or palates. I guess it's simply a result of continued exposure to these foods and environments. According to Isobel Contento, a professor of nutrition education at Columbia University's Teachers College in New York City, "Continued exposure to new foods is extremely important. Research suggests that children sometimes need to be exposed to food ten to fifteen times before they develop a liking to the food."
Research by Contento and many of her colleagues supports my hunch: Any kid can learn to dine out and enjoy a broader range of foods, if given the chance. Unfortunately, resisting the temptation to feed kids only "kid food" ordered from "kid menus" at "kid-friendly" restaurants is no piece of Tastycake. But if you don't, you wind up with kids whose narrow palates and general cluelessness about restaurant behavior are the self-fulfilling prophecies of Ronald, Wendy, and the Colonel.
I love going out to eat, but I don't love anything that comes in a nugget or is served in molded plastic. My solution is this: While we do consume our share of burgers and pizza, our family also patronizes real restaurants. If you're ready to try something a little more civilized and adventurous than another trip to KFC, here are a few tips to keep in mind.
Tasting Tips for Kids
The journey of a thousand meals begins with a single bite - or something like that. Here are some clues to guiding that first morsel safely into the hangar.
Don't make a huge deal out of the new food in question. Start simply - just let your kids see the grown-ups eating and enjoying it.
While you don't want to flat-out lie, remember the old "tastes like chicken" ploy. You might say in your most casual tone, "Want a bite?" Then, when you're asked what it is, say, "It's like steak" (in other words, it's venison). Or try, "Taste a bite and see if you can guess."
Never eschew bribes: "A quarter for the first person who can guess what it is." "Taste it and you can pick the dessert."
If they absolutely hate it, do not make them eat it. If they're not sure, you might suggest a second taste, perhaps with soy sauce, pepper, or lemon to personalize the flavor.
Rules for Restaurants
Want to get your kids through an eating-out experience without a meltdown? Here are a few guidelines to make it more fun for everyone.
Do keep paper and crayons or pens in your purse at all times. This way, the gimmick of kid-friendly restaurants is yours anywhere. Older kids can play hangman and "dots."
Don't make a federal case about dressing up. Most restaurants these days don't mind casual clothes, and by choosing one with a relaxed dress code, you'll eliminate one area of dissent.
Don't let kids have too much sugary soda before the food arrives.
Don't let the waitperson serve meals to the kids first. If you do, the timing will get screwed up: They'll lose patience before you've finished your main course.
Don't bring other kids who have more limited palates than your own do. You don't want to get an "ew" thing going.
Do allow a field trip or two to the bathroom or the lobby. Accompany your kids the first time to demonstrate acceptable behavior.
Don't let your child order some expensive item she's never had before without having her first try an appetizer or tasting portion.
Separation Anxiety
You’re a stay-at-home mom who recently decided to reenter the workforce. While your world is turning upside down with change, your child’s reality is changing, too - quite dramatically! You may find that your son or daughter experiences separation anxiety upon facing your new schedule. But there is help. There are several things you can do to make the transition easier for your child, as well as your own state of mind:
Focus on the positive. Your child is having difficulty because he or she has bonded with you. There are many serious problems that can occur later in life if your child does not have a close connection with you – know that your influence is, and will continue to be, important to your child’s development.
Know that children are often sensitive to their parents’ moods. Often, when children are stressing out, they want to near their parents, but when parents are feeling stressed, they want to have some space from their children – hence the conflict of trying to leave when your child wants you to stay. If mom’s response is made in a reassuring, unexaggerated and matter-of-fact way when leaving, such as acting like she is going into another room, then her mood won't signal to her child, "Hey! Something big is happening!"
Do less talking and more walking. Often, parents drag-out the leaving process, turning it into an event with talking, extra hugging and coming back and forth to see to their crying child. This attention usually makes thing worse. The hardest, but perhaps best, thing to do when leaving your child is to leave quickly.
Put yourself in your child’s shoes. Remember that if you had someone hold you all day, and suddenly that person was gone, you would be stressed, too. In the interest of making “leaving time” easier, do more brief coming and going activities when you aren’t really leaving the house. As your child becomes satisfied that you always return, he or she may become less anxious when you leave. Play peek-a-boo or hide and seek to make coming and going more spontaneous. Leave quickly, but when you return, hug and nurture your child.
Help with a soothing scent. Get one of your sweaters or a throw blanket and wrap your child in your belongings. Rock and gently massage your child before you leave. The comfort might help lessen the anxiety.
If a caregiver is taking over for you during the day, make sure he or she does not hold the crying baby and wave goodbye – activities such as these reinforce both parental and child anxiety. Instead, ask your caregiver to start with fun activities for the three of you, then slowly lessen your own involvement in those activities so that your leave is less noticeable.
Redirect. When your child notices that you are gone and becomes upset, quickly start a new and engaging activity to redirect their attention.
While the transition from stay-at-home mom to leaving-home mom will still be difficult, these tips may help the process become one of closeness, caring and growth.
Focus on the positive. Your child is having difficulty because he or she has bonded with you. There are many serious problems that can occur later in life if your child does not have a close connection with you – know that your influence is, and will continue to be, important to your child’s development.
Know that children are often sensitive to their parents’ moods. Often, when children are stressing out, they want to near their parents, but when parents are feeling stressed, they want to have some space from their children – hence the conflict of trying to leave when your child wants you to stay. If mom’s response is made in a reassuring, unexaggerated and matter-of-fact way when leaving, such as acting like she is going into another room, then her mood won't signal to her child, "Hey! Something big is happening!"
Do less talking and more walking. Often, parents drag-out the leaving process, turning it into an event with talking, extra hugging and coming back and forth to see to their crying child. This attention usually makes thing worse. The hardest, but perhaps best, thing to do when leaving your child is to leave quickly.
Put yourself in your child’s shoes. Remember that if you had someone hold you all day, and suddenly that person was gone, you would be stressed, too. In the interest of making “leaving time” easier, do more brief coming and going activities when you aren’t really leaving the house. As your child becomes satisfied that you always return, he or she may become less anxious when you leave. Play peek-a-boo or hide and seek to make coming and going more spontaneous. Leave quickly, but when you return, hug and nurture your child.
Help with a soothing scent. Get one of your sweaters or a throw blanket and wrap your child in your belongings. Rock and gently massage your child before you leave. The comfort might help lessen the anxiety.
If a caregiver is taking over for you during the day, make sure he or she does not hold the crying baby and wave goodbye – activities such as these reinforce both parental and child anxiety. Instead, ask your caregiver to start with fun activities for the three of you, then slowly lessen your own involvement in those activities so that your leave is less noticeable.
Redirect. When your child notices that you are gone and becomes upset, quickly start a new and engaging activity to redirect their attention.
While the transition from stay-at-home mom to leaving-home mom will still be difficult, these tips may help the process become one of closeness, caring and growth.
ADHD Medications
The FDA has approved Strattera (atomoxetine), a nonstimulant, and the first new drug in three decades for treatment of symptoms of attention deficit hyperactivity disorder, or ADHD.
Deciding which medicine to use to treat your child with Attention Deficit Hyperactivity Disorder used to be easy. The big choice was whether to use generic or brand name Ritalin.
There are now a much larger choice among stimulants that can be used to treat ADHD. Many of the newer medications have the advantage that they only need to be given once a day and can last for up to 12 hours. Although there has been a sustained release version of Ritalin, called Ritalin SR, available in the past, most people found that it worked inconsistently.
In addition to not having to take a lunch time dose, the sustained release forms of these medications have the benefit that the medication is often still working after school, as your child is trying to do his homework.
Fortunately, according to the American Academy of Pediatrics, 'at least 80% of children will respond to one of the stimulants,' so if 1 or 2 medications don't work or have unwanted side effects, then a third might be tried. But how do you decide which medicine is best to try first? In general, there is no one 'best' medicine and the AAP states that 'each stimulant improved core symptoms equally.'
It can help if you are aware of the different medications that are available. Stimulants, are considered to be first line treatments, and antidepressants, are second line treatments and might be considered if 2 or 3 stimulant medications don't work for your child.
Stimulants include different formulations of methylphenidate and amphetamine available in short, intermediate and long acting forms.
The decision on which medicine to start is a little easier to make if your child can't swallow pills. While there are no liquid preparations of any of the stimulants, the short acting ones, such as Ritalin and Adderall can usually be crushed or chewed if necessary. The sustained release pills must be swallowed whole (except for Adderall XR).
In general, whichever medication is started, you begin at a low dose and work your way up. Unlike most other medications, stimulants are not 'weight dependent,' so a 6 year old and 12 year old might be one the same dosage, or the younger child might need a higher dosage. Because there are no standard dosages based on a child's weight, stimulants are usually started at a low dosage and gradually increased to find a child's best dose, which 'is the one that leads to optimal effects with minimal side effects.'
Deciding which medicine to use to treat your child with Attention Deficit Hyperactivity Disorder used to be easy. The big choice was whether to use generic or brand name Ritalin.
There are now a much larger choice among stimulants that can be used to treat ADHD. Many of the newer medications have the advantage that they only need to be given once a day and can last for up to 12 hours. Although there has been a sustained release version of Ritalin, called Ritalin SR, available in the past, most people found that it worked inconsistently.
In addition to not having to take a lunch time dose, the sustained release forms of these medications have the benefit that the medication is often still working after school, as your child is trying to do his homework.
Fortunately, according to the American Academy of Pediatrics, 'at least 80% of children will respond to one of the stimulants,' so if 1 or 2 medications don't work or have unwanted side effects, then a third might be tried. But how do you decide which medicine is best to try first? In general, there is no one 'best' medicine and the AAP states that 'each stimulant improved core symptoms equally.'
It can help if you are aware of the different medications that are available. Stimulants, are considered to be first line treatments, and antidepressants, are second line treatments and might be considered if 2 or 3 stimulant medications don't work for your child.
Stimulants include different formulations of methylphenidate and amphetamine available in short, intermediate and long acting forms.
The decision on which medicine to start is a little easier to make if your child can't swallow pills. While there are no liquid preparations of any of the stimulants, the short acting ones, such as Ritalin and Adderall can usually be crushed or chewed if necessary. The sustained release pills must be swallowed whole (except for Adderall XR).
In general, whichever medication is started, you begin at a low dose and work your way up. Unlike most other medications, stimulants are not 'weight dependent,' so a 6 year old and 12 year old might be one the same dosage, or the younger child might need a higher dosage. Because there are no standard dosages based on a child's weight, stimulants are usually started at a low dosage and gradually increased to find a child's best dose, which 'is the one that leads to optimal effects with minimal side effects.'
I'm Not Going to Take Anymore
When your child is angry and throws a tantrum, do you feel as though you have no control? Thoughts of helplessness can creep into the mind of even the most motivated parent.
A common reaction from parents whose child has just thrown a fit is to quickly return to life as usual. However, if little Johnnie or Suzy isn't taken aside and taught that tantrums won't be tolerated, the behavior is sure to repeat itself.
The next time your child has a meltdown, remember: You need to control your own emotions, and you need to correct your child's behavior.
Here are a few strategies to help you and your child stay in control.
Training days
Take time each day to practice your own personal staying-calm plan. The plan can be as simple as taking several deep breaths or as involved as reciting a positive message in your head.
Have a game plan for dealing with your child's tantrums. You and your spouse should agree on what to say and do when a child acts out. It's important for children to have parents who encourage and enforce the same behavior expectations.
Devise signals or choose "clue words" that will alert you or your spouse when your emotions are starting to run high or when your child's behavior is spiraling out of control.
If you're a single parent, always be consistent. Say what you mean, and mean what you say.
Never surrender
Avoid arguing or debating with your toddler.
You're the parent. The more rational you are, the quicker your child is likely to respond to your request. Parents who surrender are parents who exhibit the very behaviors they're trying to stop (yelling, arguing, threatening, etc.).
Don't sacrifice your adult role to act out your child's naughty behavior.
Return to the crime
Your first reaction after stopping a tantrum may be to escape from the scene and get back to something more pleasant. However, your child should have the opportunity to undo whatever he or she did.
Children are never too young to start taking responsibility for their actions.
If your child acted out by making a mess, saying naughty words, hitting others or destroying objects, make him or her correct the situation. That means cleaning up the mess, apologizing, doing something nice for others or replacing what was broken.
Children who must deal with their negative actions learn a valuable lesson.
Effective consequences
For example, if your child acts out in a store, don't threaten never to visit that store again - that's unrealistic. More effective consequences include going to the car for a time-out or taking away a snack, a possession, playtime or some other privilege.
If you go to the car for time-out, give your child a few minutes to calm down. Then, clearly describe the appropriate behavior you expect when he or she is in the store. You may even want to practice how to follow instructions and accept "No" for an answer. The latter may require several practices.
After you've explained your expectations and practiced with your child, return to the store. Let your child demonstrate what you taught during time-out. Give simple instructions, and praise your child for following your directions.
A common reaction from parents whose child has just thrown a fit is to quickly return to life as usual. However, if little Johnnie or Suzy isn't taken aside and taught that tantrums won't be tolerated, the behavior is sure to repeat itself.
The next time your child has a meltdown, remember: You need to control your own emotions, and you need to correct your child's behavior.
Here are a few strategies to help you and your child stay in control.
Training days
Take time each day to practice your own personal staying-calm plan. The plan can be as simple as taking several deep breaths or as involved as reciting a positive message in your head.
Have a game plan for dealing with your child's tantrums. You and your spouse should agree on what to say and do when a child acts out. It's important for children to have parents who encourage and enforce the same behavior expectations.
Devise signals or choose "clue words" that will alert you or your spouse when your emotions are starting to run high or when your child's behavior is spiraling out of control.
If you're a single parent, always be consistent. Say what you mean, and mean what you say.
Never surrender
Avoid arguing or debating with your toddler.
You're the parent. The more rational you are, the quicker your child is likely to respond to your request. Parents who surrender are parents who exhibit the very behaviors they're trying to stop (yelling, arguing, threatening, etc.).
Don't sacrifice your adult role to act out your child's naughty behavior.
Return to the crime
Your first reaction after stopping a tantrum may be to escape from the scene and get back to something more pleasant. However, your child should have the opportunity to undo whatever he or she did.
Children are never too young to start taking responsibility for their actions.
If your child acted out by making a mess, saying naughty words, hitting others or destroying objects, make him or her correct the situation. That means cleaning up the mess, apologizing, doing something nice for others or replacing what was broken.
Children who must deal with their negative actions learn a valuable lesson.
Effective consequences
For example, if your child acts out in a store, don't threaten never to visit that store again - that's unrealistic. More effective consequences include going to the car for a time-out or taking away a snack, a possession, playtime or some other privilege.
If you go to the car for time-out, give your child a few minutes to calm down. Then, clearly describe the appropriate behavior you expect when he or she is in the store. You may even want to practice how to follow instructions and accept "No" for an answer. The latter may require several practices.
After you've explained your expectations and practiced with your child, return to the store. Let your child demonstrate what you taught during time-out. Give simple instructions, and praise your child for following your directions.
Child Development From 6 Months to 1 Year
How much growing and learning can you expect from a typical baby who is between 6 months and 1 year old? Here are a few of the developmental “highlights” for children that age:
Physical – Sits alone, crawls, stands holding on to furniture, may walk; ability to grasp items between thumb and fingers improves; gives and takes objects; may favor using left hand or right hand
Cognitive – Recognizes name; enjoys listening to music; repeats chance behaviors that lead to fun or interesting results, such as a new noise; responds joyfully to image in mirror; can tell the difference between children and adults; engages in intentional or goal-directed behavior
Language – Loves to make noise; babbling expands to include sounds of spoken language; may repeat simple phrases; may say “dada” or “mama”; uses pointing or showing to communicate; understands a few words and may respond to short, simple requests; understands the meaning of “no”
Emotional/Social – May insist on feeding self; shows independence by not always being cooperative; begins trying to imitate parent behaviors; shows some fear of strangers; shows attachment to familiar caregivers; uses caregiver as a secure base for exploration; shows more frequent displays of anger and fear; smiles and laughs socially; shows very strong attachment to mother and develops attachment to father, siblings and other familiar people
Physical – Sits alone, crawls, stands holding on to furniture, may walk; ability to grasp items between thumb and fingers improves; gives and takes objects; may favor using left hand or right hand
Cognitive – Recognizes name; enjoys listening to music; repeats chance behaviors that lead to fun or interesting results, such as a new noise; responds joyfully to image in mirror; can tell the difference between children and adults; engages in intentional or goal-directed behavior
Language – Loves to make noise; babbling expands to include sounds of spoken language; may repeat simple phrases; may say “dada” or “mama”; uses pointing or showing to communicate; understands a few words and may respond to short, simple requests; understands the meaning of “no”
Emotional/Social – May insist on feeding self; shows independence by not always being cooperative; begins trying to imitate parent behaviors; shows some fear of strangers; shows attachment to familiar caregivers; uses caregiver as a secure base for exploration; shows more frequent displays of anger and fear; smiles and laughs socially; shows very strong attachment to mother and develops attachment to father, siblings and other familiar people
Sleepless in Parentville!
Sleep deprivation. It’s something I’m sure you’ve experienced more than once since your baby came home. Losing sleep is part of your job description as a parent. And it doesn’t matter if you have a toddler or a teen.
Feeding a hungry infant in the wee hours of the morning, rocking a sick child to sleep in the middle of the night – these are the moments that keep you awake at night.
According to most sleep specialists, if you try to take a catnap here and there to makeup for sleepless nights, you won’t get the real rest you need. As a result, you may start experiencing memory loss, diminished alertness or illness.
So what is a busy parent to do? Here are a few strategies to help you get that much-needed shuteye:
If you have a spouse, take turns being the on-call parent at night. While one gets a night of uninterrupted sleep, the other has a bonding experience with baby.
If Mom is breast-feeding baby, she can use a breast pump to prepare extra bottles. Having extra bottles ready means Dad can handle overnight feedings a few times a week.
If you’re a single parent, ask a grandparent, sibling or close friend for some relief. Their help, even one or two nights a week, can give you some rest. If possible, you might consider restructuring your job. Maybe you can work from home part of the week or take advantage of flex time.
Your life has changed, and your schedule will have to revolve around your new priority – your child. That doesn’t mean you have to be sleep-deprived the rest of your life. Manage the changes to your lifestyle. Ask for help. Delegate responsibilities.
You might just find you have the time to get the sleep you need.
Feeding a hungry infant in the wee hours of the morning, rocking a sick child to sleep in the middle of the night – these are the moments that keep you awake at night.
According to most sleep specialists, if you try to take a catnap here and there to makeup for sleepless nights, you won’t get the real rest you need. As a result, you may start experiencing memory loss, diminished alertness or illness.
So what is a busy parent to do? Here are a few strategies to help you get that much-needed shuteye:
If you have a spouse, take turns being the on-call parent at night. While one gets a night of uninterrupted sleep, the other has a bonding experience with baby.
If Mom is breast-feeding baby, she can use a breast pump to prepare extra bottles. Having extra bottles ready means Dad can handle overnight feedings a few times a week.
If you’re a single parent, ask a grandparent, sibling or close friend for some relief. Their help, even one or two nights a week, can give you some rest. If possible, you might consider restructuring your job. Maybe you can work from home part of the week or take advantage of flex time.
Your life has changed, and your schedule will have to revolve around your new priority – your child. That doesn’t mean you have to be sleep-deprived the rest of your life. Manage the changes to your lifestyle. Ask for help. Delegate responsibilities.
You might just find you have the time to get the sleep you need.
Stop Poking the Baby
"If you hit your little sister one more time, I will slap you!"
Okay. You said it. Now what? If you follow through on the threat, you engage in exactly the same behavior you're trying to stop, and you will hurt your child.
What can you do if your toddler can't seem to stop hitting, jabbing, pushing or poking a younger sibling?
Monitoring whereabouts
A baby should never be left alone in any area where other young children - or pets - have unrestricted access to him or her.
Many parents choose to wear a sling that holds the baby close to them. The sling gives parents the freedom to move their arms and perform multiple tasks while still holding the baby. It also makes it difficult for a toddler to reach up and poke or prod.
Teaching appropriate touch
Help your child understand that babies need to be handled with care. You can teach your toddler gentle touch using a "pretend baby," such as a doll.
Teaching your toddler how to act around the baby may take several weeks. It is not a "one-and-done" learning experience. Use the doll to demonstrate good touching and playing behaviors. Practice with your toddler. When he or she consistently displays good behavior with the doll, reward your toddler with more supervised time with the baby.
Catch 'em being good
"Baby bucks" can be a reward system for your toddler's good behavior. Each buck a child earns for good behavior can be turned in for a reward or treat, such as watching a video, getting a special snack, reading an extra bedtime story or spending more time with you and the baby.
The rewards should be directly linked to your toddler's behavior with the baby. Rewards and consequences (for bad behavior) should be significant and important to your child. As your toddler's behavior improves, you can reduce the rewards and focus on other behaviors he or she struggles with.
Okay. You said it. Now what? If you follow through on the threat, you engage in exactly the same behavior you're trying to stop, and you will hurt your child.
What can you do if your toddler can't seem to stop hitting, jabbing, pushing or poking a younger sibling?
Monitoring whereabouts
A baby should never be left alone in any area where other young children - or pets - have unrestricted access to him or her.
Many parents choose to wear a sling that holds the baby close to them. The sling gives parents the freedom to move their arms and perform multiple tasks while still holding the baby. It also makes it difficult for a toddler to reach up and poke or prod.
Teaching appropriate touch
Help your child understand that babies need to be handled with care. You can teach your toddler gentle touch using a "pretend baby," such as a doll.
Teaching your toddler how to act around the baby may take several weeks. It is not a "one-and-done" learning experience. Use the doll to demonstrate good touching and playing behaviors. Practice with your toddler. When he or she consistently displays good behavior with the doll, reward your toddler with more supervised time with the baby.
Catch 'em being good
"Baby bucks" can be a reward system for your toddler's good behavior. Each buck a child earns for good behavior can be turned in for a reward or treat, such as watching a video, getting a special snack, reading an extra bedtime story or spending more time with you and the baby.
The rewards should be directly linked to your toddler's behavior with the baby. Rewards and consequences (for bad behavior) should be significant and important to your child. As your toddler's behavior improves, you can reduce the rewards and focus on other behaviors he or she struggles with.
Intensive Toilet Training
Sometimes the 7 P plan is not enough. This often happens when continence is needed now or at least in the next week or two. Reasons for this range from parents simply being fed up with poopy pants and icky Pampers to ultimatums from day cares or preschools. Here’s an example of what I mean. Years ago when I left the University of Nebraska, I turned my incontinence clinic over to another professor. He then became Dr. Poop and Pee instead of me. One day, he received a call from his 3-year-old daughter’s preschool informing him that she was being expelled because she was having too many toileting accidents. This would be bad news for any parent, but it was particularly bad for Dr. Poop and Pee, if you catch my drift. He swiftly followed guidelines similar to those below and she was fully trained in four days. So if you are willing to spend a lot of your time toilet training and be consistent about following the guidelines, your child can be toilet trained in a few days.
A good time to begin intensive toilet training is a weekend when you are free from work and other chores. Okay, I know you are never free from work and chores. Just pick a time when all the things you have to do can be set aside for a while without too much of a penalty.
1. Increase fluids. Toilet training is really a form of plumbing, and to do it well, we need something to plumb. Said differently, good training requires multiple toileting opportunities, and the best way to achieve this goal is to have your child drink a lot. So let them drink as much of their favorite beverages as they want; you can even encourage them to drink more. And before I forget, stay home. Filling them full of fluid creates multiple urinations, and thus, multiple training opportunities – if you are home. If you are out and about, it creates either a big mess and large headache, or a lot of little messes and small headaches. Neither option is fun for Mommy and Daddy.
2. Give frequent prompts. Watch them carefully. When they begin to show signs of having to go, tell (don’t ask) them to go to the bathroom and then take them there. When they really have to go, the signs are obvious (e.g., they grab themselves, cross their legs, and wince). If they have their shirt off, you will be able to see more subtle signs (e.g., minor to major movements of their lower abdomen). In a sense, this is like bombardier training – you need to get them over the target before they release their payload. Keeping a close eye on them reveals when the payload is near the bomb bay doors. A more structured way to do this is to merely tell your child to use the potty every 30 to 45 minutes.
3. Do dry pants checks. Every 15 minutes or so, check your child's pants to see if they are dry. If they are, praise your little trainee (see P #6 from earlier). Because this is intensive training, I recommend having a system for rewarding your child for dry pants. For example, you could make a chart where you record each pants check and give a star each time you find dry pants. Then, you can reward your child for, say, every 10 stars he or she earns. Or, you can arrange to spend “Special Time” with your child in the evening after a day of dry pants. Special Time means one parent spends 15 to 20 minutes with the child doing an activity the child particularly enjoys. Always follow through on promised rewards (“Give it up!”).
4. Praise. You should abundantly praise and appreciate all toileting successes (once again see P #6). And if your child happens to go to the toilet unprompted, something big should happen. Have the glitter dome descend, the mayor call, and confetti spill from the ceiling. Or, if you are on a budget, a big hug will probably do.
5. Use positive practice for wetting accidents. Positive practice is an intensive practice of what should have been done instead of the accident. It can take various forms, but it generally involves multiple practice trips to the bathroom after an accident. (Because this practice can generate opposition from the child, I will cover it in another article. In the meantime, you can ask your health care provider to give you the guidelines on toileting accidents that explain positive practice.)
6. The cleaning bill. There will be accidents in the house – which is a nice way of saying there’s a good chance your child will poop or pee on your floors and carpets. So set aside about $60 for the cleaning bill when you are all done.
A good time to begin intensive toilet training is a weekend when you are free from work and other chores. Okay, I know you are never free from work and chores. Just pick a time when all the things you have to do can be set aside for a while without too much of a penalty.
1. Increase fluids. Toilet training is really a form of plumbing, and to do it well, we need something to plumb. Said differently, good training requires multiple toileting opportunities, and the best way to achieve this goal is to have your child drink a lot. So let them drink as much of their favorite beverages as they want; you can even encourage them to drink more. And before I forget, stay home. Filling them full of fluid creates multiple urinations, and thus, multiple training opportunities – if you are home. If you are out and about, it creates either a big mess and large headache, or a lot of little messes and small headaches. Neither option is fun for Mommy and Daddy.
2. Give frequent prompts. Watch them carefully. When they begin to show signs of having to go, tell (don’t ask) them to go to the bathroom and then take them there. When they really have to go, the signs are obvious (e.g., they grab themselves, cross their legs, and wince). If they have their shirt off, you will be able to see more subtle signs (e.g., minor to major movements of their lower abdomen). In a sense, this is like bombardier training – you need to get them over the target before they release their payload. Keeping a close eye on them reveals when the payload is near the bomb bay doors. A more structured way to do this is to merely tell your child to use the potty every 30 to 45 minutes.
3. Do dry pants checks. Every 15 minutes or so, check your child's pants to see if they are dry. If they are, praise your little trainee (see P #6 from earlier). Because this is intensive training, I recommend having a system for rewarding your child for dry pants. For example, you could make a chart where you record each pants check and give a star each time you find dry pants. Then, you can reward your child for, say, every 10 stars he or she earns. Or, you can arrange to spend “Special Time” with your child in the evening after a day of dry pants. Special Time means one parent spends 15 to 20 minutes with the child doing an activity the child particularly enjoys. Always follow through on promised rewards (“Give it up!”).
4. Praise. You should abundantly praise and appreciate all toileting successes (once again see P #6). And if your child happens to go to the toilet unprompted, something big should happen. Have the glitter dome descend, the mayor call, and confetti spill from the ceiling. Or, if you are on a budget, a big hug will probably do.
5. Use positive practice for wetting accidents. Positive practice is an intensive practice of what should have been done instead of the accident. It can take various forms, but it generally involves multiple practice trips to the bathroom after an accident. (Because this practice can generate opposition from the child, I will cover it in another article. In the meantime, you can ask your health care provider to give you the guidelines on toileting accidents that explain positive practice.)
6. The cleaning bill. There will be accidents in the house – which is a nice way of saying there’s a good chance your child will poop or pee on your floors and carpets. So set aside about $60 for the cleaning bill when you are all done.
Acne Treatment Guide
Pimples are a common problem that affects most teenagers at one time or another. It is caused by oil clogging the pores in your skin. The buildup of more oil and bacteria can then cause your skin to become red and inflamed. It commonly begins during puberty, because this is a time when many hormones increase and it is these hormones that cause your skin to produce more oil.
Pimples are not caused by the foods that you eat (such as chocolate, soft drinks or greasy foods) or by dirt (blackheads are caused by a pigment, not dirt), and you can't catch it from someone else. It can be made worse by pinching pimples, harsh scrubbing which irritates the skin, certain cosmetics which can further block oil ducts, and emotional stress.
Acne can also be commonly found in young infants in the first one to two months of life. This form of acne, called neonatal acne, is thought to be caused by a temporary increase in hormone levels just before and after birth. Neonatal acne usually goes away on its own without treatment. Infantile acne occurs in older infants after the firs two to three months of life and may last until they are 2-3 years old. Drug induced acne occurs in children taking certain medications, including oral and topical steroids, methotrexate and some anti-seizure medications.
The two main types of acne are comedonal acne, consisting of whiteheads and blackheads, and inflammatory acne, with red and sometimes tender papules, pustules and cysts. Also, many children have a combination of both comedonal and inflammatory acne.
Pimples usually improve by the time you are twenty – twenty five years old, but can be brought under control sooner with the proper treatments.
Preventing Pimples
Wash (but don't scrub) your skin twice a day with a mild soap. Avoid harsh cleansers or scrubs, as they can irritate your skin, and lead to more pimples.
Don't pop or pinch pimples, as this can lead to scarring.
Use noncomedogenic cosmetics and moisturizers and don't put oily or greasy substances on your face or hair.
Avoid 'stripping' of blackheads, as this can also lead to scarring.
Avoid touching your face a lot, as your hands have oil on them and this can make acne worse.
Avoid wearing hats or headbands that rub on your forehead, since this can also make acne worse.
Acne Medications
The medications most commonly used to treat acne contain benzoyl peroxide. Other medications include antibiotics (such as minocycline), retinoid creams , combinations of these products, and Accutane, which is usually only prescribed by a dermatologist for more severe or hard to treat cases.
Benzoyl Peroxide 2.5% 5% 10%
The different forms of benzoyl peroxide are the most effective medications available OTC (such as PersaGel or Clearasel) and helps to kill bacteria, unplug oil ducts and heal pimples. You should start with a low strength once a day and work up to 10% twice a day. Apply it to all areas where pimples occur, and not just on your current pimples.
Benzoyl Peroxide is also available in a number of prescription strength forms, including topical washes and cleansers (like Triaz and Brevoxyl).
If you do not see improvement in 4-6 weeks using OTC medications with benzoyl peroxide or if your child just has comedonal acne (whiteheads and blackheads), then you should see your Pediatrician about using a prescription medication used to treat acne, or see a dermatologist if your Pediatrician is not comfortable treating kids with acne:
Benzamycin Topical Gel
This is a combination of 5% Benzoyl Peroxide and Erythromycin (an antibiotic) and is very effective for treatment of inflammatory acne. It must be kept in the refrigerator and may bleach clothing. Apply a thin layer of it to affected areas after washing once or twice a day. Use it in the morning only if you are also using Retin A or other medications at night.
New! Benzaclin Topical Gel
Another combination of 5% Benzoyl Peroxide and an antibiotic, this time Clindamycin and it should also be effective for inflammatory acne. It has the added benefit that it doesn't need to be kept in the refrigerator. It should be applied to skin that has been washed, rinsed and patted dry.
New! Duac Gel
Another combination of 5% Benzoyl Peroxide and Clindamycin that is used to treat acne. Like Benzaclin, it doesn't need to be kept in the refrigerator. It should be applied to skin that has been washed, rinsed and patted dry.
Retin A 0.025% 0.05% 0.1% cream
Retin A cream helps unplug oil ducts and should be applied to the affected areas at least 20-30 minutes after washing (applying it to wet skin may cause irritation). Use a small amount (one pea-sized dose is enough for your entire face) every third night, and if tolerated, increase to every other night and then every night. It is especially effective for comedonal acne (whiteheads and blackheads) and is often used with Benzoyl Peroxide or a topical antibiotic cream for inflammatory acne.
If your skin can't tolerate Retin A cream, there is a Retin A Microsphere gel that is less irritating, or you can try some of the newer medicines, including Azelex, Tazorac or Differin gel.
Oral antibiotics such as Tetracycline or Minocin (minocycline) are sometimes used if topical therapy with a combination of benzoyl peroxide with a topical antibiotic and Retin A doesn't clear up your skin. They are used twice a day until your pimples have cleared up (usually 4-5 months), and then are slowly weaned off.
Irritated Skin
It is not uncommon for the skin to become red, dry and irritated when beginning to use new acne medications. This usually improves with time, but here are some suggestions to minimize irritation:
Use noncomedogenic moisturizers if your skin is becoming dry.
If starting more than one new medicine, consider starting with just one and then waiting two or three weeks before beginning the other one.
You can also begin a new medicine by applying it every third night, and then gradually increasing it to every other night and then every night.
Another alternative is washing the medicine off after about five minutes. Each night, you can then leave it on for longer periods of time before washing it off.
In general liquid and solution forms of medications are less irritating than creams and gels, so you can try using a different form of the medication if you can't tolerate it well.
Seeing a Dermatologist
While most primary care physicians can treat mild and moderate skin problems, you should consider seeing a specialist if you have severe cystic acne that may lead to scarring, if you are not improving with your current regimen (especially if you are already on a combination of medicines, including benzoyl peroxide with a topical antibiotic, RetinA, and minocycline (or other oral antibiotic), if you have very sensitive skin and can't tolerate topical medicines, or if your doctor is not comfortable treating children with pimples. A Dermatologist may be able to use different combinations of the above medicines or may put you on Accutane, an oral retinoic acid that you take daily for three to four months.
You may also need to see a Dermatologist if you already have scarring. Treatments for scarring include using chemical peels, dermabrasion and laser therapy.
Important Reminders
Be patient. It can take 3-6 weeks to see improvement and your skin may get worse before it starts getting better.
Use your medicines every day. If your skin is getting too irritated, red or dry, then start using them every other day. It takes time for your skin to adapt to your new medicines.
Accutane can cause severe birth defects, and should never be taken by someone who may become pregnant.
Don't overdo it! Scrubbing your skin or using too much of these medicines can irritate and dry out your skin and won't make your pimples go away any quicker.
Protect your skin from the sun. These medicines will make your skin more sensitive to the effects of the sun.
Call your physician if you haven't improved in 4-6 weeks with your current regimen.
Pimples are not caused by the foods that you eat (such as chocolate, soft drinks or greasy foods) or by dirt (blackheads are caused by a pigment, not dirt), and you can't catch it from someone else. It can be made worse by pinching pimples, harsh scrubbing which irritates the skin, certain cosmetics which can further block oil ducts, and emotional stress.
Acne can also be commonly found in young infants in the first one to two months of life. This form of acne, called neonatal acne, is thought to be caused by a temporary increase in hormone levels just before and after birth. Neonatal acne usually goes away on its own without treatment. Infantile acne occurs in older infants after the firs two to three months of life and may last until they are 2-3 years old. Drug induced acne occurs in children taking certain medications, including oral and topical steroids, methotrexate and some anti-seizure medications.
The two main types of acne are comedonal acne, consisting of whiteheads and blackheads, and inflammatory acne, with red and sometimes tender papules, pustules and cysts. Also, many children have a combination of both comedonal and inflammatory acne.
Pimples usually improve by the time you are twenty – twenty five years old, but can be brought under control sooner with the proper treatments.
Preventing Pimples
Wash (but don't scrub) your skin twice a day with a mild soap. Avoid harsh cleansers or scrubs, as they can irritate your skin, and lead to more pimples.
Don't pop or pinch pimples, as this can lead to scarring.
Use noncomedogenic cosmetics and moisturizers and don't put oily or greasy substances on your face or hair.
Avoid 'stripping' of blackheads, as this can also lead to scarring.
Avoid touching your face a lot, as your hands have oil on them and this can make acne worse.
Avoid wearing hats or headbands that rub on your forehead, since this can also make acne worse.
Acne Medications
The medications most commonly used to treat acne contain benzoyl peroxide. Other medications include antibiotics (such as minocycline), retinoid creams , combinations of these products, and Accutane, which is usually only prescribed by a dermatologist for more severe or hard to treat cases.
Benzoyl Peroxide 2.5% 5% 10%
The different forms of benzoyl peroxide are the most effective medications available OTC (such as PersaGel or Clearasel) and helps to kill bacteria, unplug oil ducts and heal pimples. You should start with a low strength once a day and work up to 10% twice a day. Apply it to all areas where pimples occur, and not just on your current pimples.
Benzoyl Peroxide is also available in a number of prescription strength forms, including topical washes and cleansers (like Triaz and Brevoxyl).
If you do not see improvement in 4-6 weeks using OTC medications with benzoyl peroxide or if your child just has comedonal acne (whiteheads and blackheads), then you should see your Pediatrician about using a prescription medication used to treat acne, or see a dermatologist if your Pediatrician is not comfortable treating kids with acne:
Benzamycin Topical Gel
This is a combination of 5% Benzoyl Peroxide and Erythromycin (an antibiotic) and is very effective for treatment of inflammatory acne. It must be kept in the refrigerator and may bleach clothing. Apply a thin layer of it to affected areas after washing once or twice a day. Use it in the morning only if you are also using Retin A or other medications at night.
New! Benzaclin Topical Gel
Another combination of 5% Benzoyl Peroxide and an antibiotic, this time Clindamycin and it should also be effective for inflammatory acne. It has the added benefit that it doesn't need to be kept in the refrigerator. It should be applied to skin that has been washed, rinsed and patted dry.
New! Duac Gel
Another combination of 5% Benzoyl Peroxide and Clindamycin that is used to treat acne. Like Benzaclin, it doesn't need to be kept in the refrigerator. It should be applied to skin that has been washed, rinsed and patted dry.
Retin A 0.025% 0.05% 0.1% cream
Retin A cream helps unplug oil ducts and should be applied to the affected areas at least 20-30 minutes after washing (applying it to wet skin may cause irritation). Use a small amount (one pea-sized dose is enough for your entire face) every third night, and if tolerated, increase to every other night and then every night. It is especially effective for comedonal acne (whiteheads and blackheads) and is often used with Benzoyl Peroxide or a topical antibiotic cream for inflammatory acne.
If your skin can't tolerate Retin A cream, there is a Retin A Microsphere gel that is less irritating, or you can try some of the newer medicines, including Azelex, Tazorac or Differin gel.
Oral antibiotics such as Tetracycline or Minocin (minocycline) are sometimes used if topical therapy with a combination of benzoyl peroxide with a topical antibiotic and Retin A doesn't clear up your skin. They are used twice a day until your pimples have cleared up (usually 4-5 months), and then are slowly weaned off.
Irritated Skin
It is not uncommon for the skin to become red, dry and irritated when beginning to use new acne medications. This usually improves with time, but here are some suggestions to minimize irritation:
Use noncomedogenic moisturizers if your skin is becoming dry.
If starting more than one new medicine, consider starting with just one and then waiting two or three weeks before beginning the other one.
You can also begin a new medicine by applying it every third night, and then gradually increasing it to every other night and then every night.
Another alternative is washing the medicine off after about five minutes. Each night, you can then leave it on for longer periods of time before washing it off.
In general liquid and solution forms of medications are less irritating than creams and gels, so you can try using a different form of the medication if you can't tolerate it well.
Seeing a Dermatologist
While most primary care physicians can treat mild and moderate skin problems, you should consider seeing a specialist if you have severe cystic acne that may lead to scarring, if you are not improving with your current regimen (especially if you are already on a combination of medicines, including benzoyl peroxide with a topical antibiotic, RetinA, and minocycline (or other oral antibiotic), if you have very sensitive skin and can't tolerate topical medicines, or if your doctor is not comfortable treating children with pimples. A Dermatologist may be able to use different combinations of the above medicines or may put you on Accutane, an oral retinoic acid that you take daily for three to four months.
You may also need to see a Dermatologist if you already have scarring. Treatments for scarring include using chemical peels, dermabrasion and laser therapy.
Important Reminders
Be patient. It can take 3-6 weeks to see improvement and your skin may get worse before it starts getting better.
Use your medicines every day. If your skin is getting too irritated, red or dry, then start using them every other day. It takes time for your skin to adapt to your new medicines.
Accutane can cause severe birth defects, and should never be taken by someone who may become pregnant.
Don't overdo it! Scrubbing your skin or using too much of these medicines can irritate and dry out your skin and won't make your pimples go away any quicker.
Protect your skin from the sun. These medicines will make your skin more sensitive to the effects of the sun.
Call your physician if you haven't improved in 4-6 weeks with your current regimen.
Starting Toilet Training: The 7 P Plan
The first step in toilet training is to make sure both you and your child are ready. Okay, I realize no one is ever really totally ready for toilet training. But your child should be at least developmentally and behaviorally ready. That means your heretofore untrained child should be at least 2 years old and be able to do such things as walk from room to room, raise and lower his or her own pants, sit independently, and follow a few one-step commands without raising a big fuss.
Children also should have some awareness of the need to urinate. So if they’re acting like they have ants in their pants but don’t, that’s usually a good sign they know, on some level, that they need to go. They should show the need only about five or six times a day. Your home life also should be fairly stable at this time (e.g., no home construction going on, in-laws who stay more than three days, major marital disputes, or other distractions).
Next, get a potty chair. Or, if you choose not to use a potty chair, get a stool your child can use while on the toilet. If you want to know why this is necessary, I suggest you try having a bowel movement while your feet are dangling above the bathroom floor. Much will be made clear to you. Comfort is a commodity that is hard to overrate when the task at hand involves having a bowel movement (regardless of the age of the bowel mover), and it’s hard to be comfortable when the person engaging in that task does not have good support for his or her feet. You also might consider purchasing an adaptor for the toilet seat that makes the seat child‑sized. One new adaptor on the market even has a stepladder attached. It is a relatively easy way for children to move up in the world.
Parents often are worried that their child will be afraid of falling in the toilet. There are no factual accounts of children (or adults) falling in. No one has ever admitted falling in. No one knows of someone who has fallen in. But the fear survives, resistant to history, facts, and outright logic. Let’s deal with it this way: It’s a parent fear, not a child fear (at least until it spreads from the parent to the child; it’s a very catchy fear). So it’s good to suppress this fear and remember that children are actually naturally curious about the toilet. They also usually enjoy flushing it over and over, which can lead to a different and more realistic fear for parents.
Also, be aware that long after your child is toilet trained, daytime wetting and soiling accidents will happen from time to time – and that’s the good news. The bad news is that bedwetting accidents are common all the way up to age 7, especially in boys. These continued accidents are merely God’s way of reminding you that procreative activity (i.e., sex) was supposed to be about having children and not having fun. They also can provide just the right amount of humility for your child. It’s hard to be too full of yourself when your pants are full of poop. If accidents do become a frequent problem, you should probably ask your child’s doctor about them. In general, try and remember that a child who is learning to use the toilet has to master many different skills and success does not come all at once. So give your child time and expect some accidents. After all, wouldn’t you rather be surprised than disappointed? Finally, try to remain calm and patient.
Now let’s get down to business. The letter P will figure powerfully in our plan. In fact, let’s call it:
The Seven P Potty Problem Prevention Plan
1. Parent modeling. Frequently allow your child to go with either you or your spouse to the bathroom. It’s like anything else; a smart kid can learn a lot by watching an expert. If you have some modesty about this, please park it for a while. After all, its just you and your child, and both of you have seen all there is to see, so to speak.
2. Potty chair. Give your child a chance to get used to and comfortable with the potty chair. Set it out and let your child sit on it, name it, put stickers on it, and pound his or her brother or sister for trying to sit on it.
3. Practice. Let your child practice using the potty chair. This practice should be "play" practice, with clothes on. Just remember to be prepared for what you might call “method acting.” In theatre, method acting involves actors actually experiencing the emotion they are trying to portray in the performance. In potty training, method acting involves actually eliminating during practice. True, there will be a mess, but hey, you’ve seen hundreds just like it and this one is a sign of good things to come. The next part may be difficult for some dads, but it’s only temporary, trust me. In the beginning, boys should be trained to sit on the potty chair or the toilet, for two reasons. First, sitting encourages bowel movements and so you might get a “twofer,” which is a bowel movement and urination during the same sitting. Second, sitting will help avoid what one might call the “garden hose” effect. Untrained boys have not yet had to stand, urinate, and aim all at the same time and may (will) accidentally spray the room (missing the potty or the toilet). So, if you can stand it, so to speak, boys should sit. Later, when toilet training is well established, they can stand.
4. Pampers and Pull-ups. Unfortunately for your child (but fortunately for your budget), to make the program work, your child must go “cold turkey” on Pampers and Pull-ups, except at bedtime. (Daytime and nighttime training programs should be separate, and while you are working on daytime training, it is fine to keep kids in Pampers or Pull-ups at night.) The reason for the cold-turkey approach is simple: Pampers and Pull-ups are actually wearable toilets, and your child is unlikely to see much need for using the one in your home when he or she can much more easily use the one he or she is wearing.
5. Prompting (Tell, don’t ask). As discussed in P #3, practice is important. Unfortunately, its importance will be much more apparent to you than to your child. In fact, let’s tell it like it is – he or she could probably care less. So you will need to prompt your child to go to the bathroom and sit for a few minutes multiple times a day. Tell, don’t ask. Asking very young children if they have to go to the bathroom is sort of like enrolling them in lying school. They will routinely say no, even if they are about to burst. But look at it from their point of view. When we ask, what children actually hear is something like, “Would you like to go and sit on a large, cold porcelain receptacle that is full of potty water and into which mommy and daddy are afraid you might fall?” You can see how the logical answer to this question is “no.” So instead of asking, just tell them it is time to go and then take them and have them sit. Then refer to P #6.
6. Praise. MCs at concerts often say something like, “Ladies and gentlemen, give it up for (name of the star, band, or act)” when urging a crowd to show its approval and excitement. Well, in a sense, I am the MC for toilet training, and I want to urge you to give it up for your little trainee. In the early stages of a training program, toileting behaviors are like little sprouts in a spring garden: Both need something to help them grow. For little sprouts, its water and fertilizer (so to speak). For toileting behaviors, praise and approval are the water and fertilizer that help them grow and blossom. So come on and give it up for the little poopers and pee-ers. Said differently, every time your child does any toileting behavior correctly – pulls down his or her pants, sits on the potty, whatever – be sure to praise him or her. Do this even when your child is having more accidents than successes. Remember, as children enter into the training phase, the training is likely to be way more important to you than it is to them. But if they get the idea that pooping and peeing into the potty is a way for them to get their names in lights, the importance of training will quickly increase for them, along with their cooperation. You can take this a step further and use rewards. One method I often use is to wrap little items – stickers, tiny toys, beads, gum, etc. – in tin foil and put them in jar near the bathroom. When the child achieves a success at any level, he or she gets to grab one prize (not one handful) from the jar. Praise and rewards make the training experience fulfilling, and make it more likely that children will repeat the positive toilet behaviors.
7. Postpone. Here in P #7 we have some really good news. You can always postpone. You can always put them back in Pampers or Pull-ups, declare a moratorium on any discussion about toileting for a few weeks or even months, and then start again. They will ultimately be motivated to be trained, possibly by something other than your prompting. For example, the rules of social life in childhood weigh heavily against toileting accidents in school-aged kids. In fact, research shows that having an accident in school is the third greatest child fear, behind the death of a parent and going blind. (And I know that high school kids frown on their peers who wear Pampers or Pull-ups.) So the point of P #7 is that if training is going badly, for whatever reason, you can use the time-honored method for winning a war that is being lost – declare victory and retreat.
Summary
Wait until your child is at least 2 years old.
Frequently allow your child to watch you go to the bathroom.
Make sure both you and your child are ready.
Let your child practice on a potty chair, with clothes on.
Prompt your child – tell, don’t ask
Postpone toilet training for a few weeks if it isn't going well or if you are getting tense about it.
Expect accidents.
If your child has a lot of accidents or if you must use intensive toilet training, ask your health care provider for the guidelines on positive practice.
Praise your child every time he or she does any part of toileting behavior correctly.
Children also should have some awareness of the need to urinate. So if they’re acting like they have ants in their pants but don’t, that’s usually a good sign they know, on some level, that they need to go. They should show the need only about five or six times a day. Your home life also should be fairly stable at this time (e.g., no home construction going on, in-laws who stay more than three days, major marital disputes, or other distractions).
Next, get a potty chair. Or, if you choose not to use a potty chair, get a stool your child can use while on the toilet. If you want to know why this is necessary, I suggest you try having a bowel movement while your feet are dangling above the bathroom floor. Much will be made clear to you. Comfort is a commodity that is hard to overrate when the task at hand involves having a bowel movement (regardless of the age of the bowel mover), and it’s hard to be comfortable when the person engaging in that task does not have good support for his or her feet. You also might consider purchasing an adaptor for the toilet seat that makes the seat child‑sized. One new adaptor on the market even has a stepladder attached. It is a relatively easy way for children to move up in the world.
Parents often are worried that their child will be afraid of falling in the toilet. There are no factual accounts of children (or adults) falling in. No one has ever admitted falling in. No one knows of someone who has fallen in. But the fear survives, resistant to history, facts, and outright logic. Let’s deal with it this way: It’s a parent fear, not a child fear (at least until it spreads from the parent to the child; it’s a very catchy fear). So it’s good to suppress this fear and remember that children are actually naturally curious about the toilet. They also usually enjoy flushing it over and over, which can lead to a different and more realistic fear for parents.
Also, be aware that long after your child is toilet trained, daytime wetting and soiling accidents will happen from time to time – and that’s the good news. The bad news is that bedwetting accidents are common all the way up to age 7, especially in boys. These continued accidents are merely God’s way of reminding you that procreative activity (i.e., sex) was supposed to be about having children and not having fun. They also can provide just the right amount of humility for your child. It’s hard to be too full of yourself when your pants are full of poop. If accidents do become a frequent problem, you should probably ask your child’s doctor about them. In general, try and remember that a child who is learning to use the toilet has to master many different skills and success does not come all at once. So give your child time and expect some accidents. After all, wouldn’t you rather be surprised than disappointed? Finally, try to remain calm and patient.
Now let’s get down to business. The letter P will figure powerfully in our plan. In fact, let’s call it:
The Seven P Potty Problem Prevention Plan
1. Parent modeling. Frequently allow your child to go with either you or your spouse to the bathroom. It’s like anything else; a smart kid can learn a lot by watching an expert. If you have some modesty about this, please park it for a while. After all, its just you and your child, and both of you have seen all there is to see, so to speak.
2. Potty chair. Give your child a chance to get used to and comfortable with the potty chair. Set it out and let your child sit on it, name it, put stickers on it, and pound his or her brother or sister for trying to sit on it.
3. Practice. Let your child practice using the potty chair. This practice should be "play" practice, with clothes on. Just remember to be prepared for what you might call “method acting.” In theatre, method acting involves actors actually experiencing the emotion they are trying to portray in the performance. In potty training, method acting involves actually eliminating during practice. True, there will be a mess, but hey, you’ve seen hundreds just like it and this one is a sign of good things to come. The next part may be difficult for some dads, but it’s only temporary, trust me. In the beginning, boys should be trained to sit on the potty chair or the toilet, for two reasons. First, sitting encourages bowel movements and so you might get a “twofer,” which is a bowel movement and urination during the same sitting. Second, sitting will help avoid what one might call the “garden hose” effect. Untrained boys have not yet had to stand, urinate, and aim all at the same time and may (will) accidentally spray the room (missing the potty or the toilet). So, if you can stand it, so to speak, boys should sit. Later, when toilet training is well established, they can stand.
4. Pampers and Pull-ups. Unfortunately for your child (but fortunately for your budget), to make the program work, your child must go “cold turkey” on Pampers and Pull-ups, except at bedtime. (Daytime and nighttime training programs should be separate, and while you are working on daytime training, it is fine to keep kids in Pampers or Pull-ups at night.) The reason for the cold-turkey approach is simple: Pampers and Pull-ups are actually wearable toilets, and your child is unlikely to see much need for using the one in your home when he or she can much more easily use the one he or she is wearing.
5. Prompting (Tell, don’t ask). As discussed in P #3, practice is important. Unfortunately, its importance will be much more apparent to you than to your child. In fact, let’s tell it like it is – he or she could probably care less. So you will need to prompt your child to go to the bathroom and sit for a few minutes multiple times a day. Tell, don’t ask. Asking very young children if they have to go to the bathroom is sort of like enrolling them in lying school. They will routinely say no, even if they are about to burst. But look at it from their point of view. When we ask, what children actually hear is something like, “Would you like to go and sit on a large, cold porcelain receptacle that is full of potty water and into which mommy and daddy are afraid you might fall?” You can see how the logical answer to this question is “no.” So instead of asking, just tell them it is time to go and then take them and have them sit. Then refer to P #6.
6. Praise. MCs at concerts often say something like, “Ladies and gentlemen, give it up for (name of the star, band, or act)” when urging a crowd to show its approval and excitement. Well, in a sense, I am the MC for toilet training, and I want to urge you to give it up for your little trainee. In the early stages of a training program, toileting behaviors are like little sprouts in a spring garden: Both need something to help them grow. For little sprouts, its water and fertilizer (so to speak). For toileting behaviors, praise and approval are the water and fertilizer that help them grow and blossom. So come on and give it up for the little poopers and pee-ers. Said differently, every time your child does any toileting behavior correctly – pulls down his or her pants, sits on the potty, whatever – be sure to praise him or her. Do this even when your child is having more accidents than successes. Remember, as children enter into the training phase, the training is likely to be way more important to you than it is to them. But if they get the idea that pooping and peeing into the potty is a way for them to get their names in lights, the importance of training will quickly increase for them, along with their cooperation. You can take this a step further and use rewards. One method I often use is to wrap little items – stickers, tiny toys, beads, gum, etc. – in tin foil and put them in jar near the bathroom. When the child achieves a success at any level, he or she gets to grab one prize (not one handful) from the jar. Praise and rewards make the training experience fulfilling, and make it more likely that children will repeat the positive toilet behaviors.
7. Postpone. Here in P #7 we have some really good news. You can always postpone. You can always put them back in Pampers or Pull-ups, declare a moratorium on any discussion about toileting for a few weeks or even months, and then start again. They will ultimately be motivated to be trained, possibly by something other than your prompting. For example, the rules of social life in childhood weigh heavily against toileting accidents in school-aged kids. In fact, research shows that having an accident in school is the third greatest child fear, behind the death of a parent and going blind. (And I know that high school kids frown on their peers who wear Pampers or Pull-ups.) So the point of P #7 is that if training is going badly, for whatever reason, you can use the time-honored method for winning a war that is being lost – declare victory and retreat.
Summary
Wait until your child is at least 2 years old.
Frequently allow your child to watch you go to the bathroom.
Make sure both you and your child are ready.
Let your child practice on a potty chair, with clothes on.
Prompt your child – tell, don’t ask
Postpone toilet training for a few weeks if it isn't going well or if you are getting tense about it.
Expect accidents.
If your child has a lot of accidents or if you must use intensive toilet training, ask your health care provider for the guidelines on positive practice.
Praise your child every time he or she does any part of toileting behavior correctly.
Wait! Before You Begin Toilet Training...
Many parents get nervous when they think about toilet training their young child. The folklore about toilet training may have a lot to do with their anxiety. For example, parents hear stories about children being toilet trained at six months of age. Those kinds of stories are ridiculous; a child who can't walk cannot possibly go to the toilet without help, which is what being toilet trained means. Or, a mother hears from relatives that as a child, she was easily trained and then never had an accident – day or night. Such folklore makes parents think there is some simple way – if only they knew it – to toilet train a child once and for all. No wonder parents question whether they or their child is up to the task of toilet training.
We’d like to help you get past these myths and misconceptions and give you some practical, common sense information that can help make potty training your child a more pleasant and satisfying experience.
Forget the Folklore
You can toilet train your child effectively and efficiently if you keep in mind some basic guidelines. Do these four things before you get started with potty training:
Relax. Toilet training is often the first task that parents take a strong stand on. Sure, it is important to you, but adding tension and pressure to the process will not make it any easier for you or your child. Remember, unlike eating, sleeping, and playing, there is no natural, immediate payoff for your child when he or she uses the toilet. Your child may not always cooperate with you during toilet training, but your tension will just make things worse. You know your child eventually will learn to use the toilet, so don't make it a contest of wills. Be calm and patient, and allow your child some time to get the idea.
Wait. Most children are toilet trained when they are 2, 3, or 4 years old. A few children are ready earlier, but just to be on the safe side, wait until your child is at least 2 years old.
Make sure you are ready. Do you really want to find out where the bathroom is in every store and restaurant you go to and on every highway and street you drive? Are you ready for potty interruptions all day long? Have the grandparents let up on their pressure about toilet training? (Remember, toilet training need not be a community affair. If you don't want to, you don't have to mention your child's efforts to anyone else, even grandparents.) Has the crisis at work passed? Is the household relatively stable now, and will it continue to be so for a few weeks? (Having other parts of your life running smoothly will help ease the chore of toilet training.)
Make sure your child is ready. If you are really ready to toilet train, see if your child is ready. Parents and others (grandma, aunt, friends) sometimes push toilet training before there are clear signs that the child is ready. Your child is not ready:
Just because he’s told you he wants to wear “big boy” pants.
Just because she wants the Big Wheel you promised as a reward.
Just because he or she has had some dry days playing on the potty chair. (Many children do this around 18 months of age.)
What Is Readiness?
Age: Your child should be at least 20 months old and preferably 2 years old or older.
Physical readiness: Your child should be able to pick up objects, lower and raise his or her pants, and walk from room to room easily.
Bladder readiness: Your child should already be staying dry for several hours at a time, urinating about four to six times a day, and completely emptying his or her bladder. If your child is still wetting a small amount frequently (7 to 10 times a day), you should wait.
Language readiness: Your child should understand your toileting words, words like "wet," "dry," "pants," and "bathroom." If your child does not understand what you are talking about, you should wait.
Instructional readiness: Your child should be able to understand simple instructions, such as "Come here, please" and "Sit down." Just as important, your child should be following the reasonable instructions you give. If your child opposes you much of the time and has frequent temper tantrums, you will probably have problems with toilet training.
Bladder and bowel awareness: Your child may indicate that he or she is aware of the need to void or eliminate. Children usually indicate this awareness not through words but through actions – making a face, assuming a special posture like squatting, or going to a certain location when they feel the urge to urinate or defecate. This may be a positive sign that your child is ready to begin toilet training.
Getting Your Child Ready
You can take some steps now that will help your child when, at some time in the future, you begin toilet training.
Let your child watch you. Your child can learn a lot about how to use the toilet correctly by watching a parent. Frequently let your child come with you when you go to the bathroom. Use simple words to explain what you are doing (for example, "Mommy is going peepee in the potty.").
Teach your child to raise and lower his or her pants. You can do this gradually when you are dressing or undressing your child. With your daughter, for example, you can first pull down her pants with little or no help from her. Then, do less pulling and let her do more. This process may take many weeks, but it is worthwhile. Later, when you begin toilet training, you will be glad that your child already knows how to pull down his or her pants and that you don’t have to tackle that learning task in addition to toilet training.
Help your child learn to follow your instructions. Make sure you have your child's attention when you give an instruction. Immediately praise your child if he or she does what you ask. If your child does not follow your instruction right away, gently guide him or her through what should be done, and do not give another instruction until the first one has been followed. If your child starts to cry, ignore the crying. When your child has calmed down, repeat your instruction. If you often have trouble getting your child to follow your instructions, ask your health care provider for guidelines on managing your child's behavior, or search the Girls and Boys Town Web site parenting.org for valuable help.
Set out a potty chair. A few weeks, or even months, before you think you will start toilet training, make a potty chair available to your child so that he or she can get used to it. Put it in the bathroom or in another room so your child has a chance to investigate it. Let your child get used to sitting on it, with clothes on. Encourage your son to sit on the potty (instead of standing in front of it) so that he will be used to sitting when you start toilet training. (Later on, when he is well past being toilet trained, he can stand.)
Praise your child. Every time your child does something the right way, be sure to let him or her know. Praise your child with words that are brief and to the point, such as "You did a good job pulling down your pants." Or, give your child a smile, a hug, or a kiss. This attention is how you teach your child what behavior pleases you.
Summary
By forgetting the folklore, following a few guidelines, getting yourself and your child ready, and preparing, toilet training should be easier for everyone involved. Just remember the things you can do before beginning to potty train:
Frequently let your child watch you go to the bathroom.
Teach your child to raise and lower his or her pants.
Teach your child to follow your instructions.
Make sure you are ready before you try to toilet train your child.
Make sure your child is ready.
Wait until your child is at least 2 years old.
Set out a potty chair so your child can get used to it.
Relax.
Praise your child every time he or she does any part of toileting behavior correctly.
We’d like to help you get past these myths and misconceptions and give you some practical, common sense information that can help make potty training your child a more pleasant and satisfying experience.
Forget the Folklore
You can toilet train your child effectively and efficiently if you keep in mind some basic guidelines. Do these four things before you get started with potty training:
Relax. Toilet training is often the first task that parents take a strong stand on. Sure, it is important to you, but adding tension and pressure to the process will not make it any easier for you or your child. Remember, unlike eating, sleeping, and playing, there is no natural, immediate payoff for your child when he or she uses the toilet. Your child may not always cooperate with you during toilet training, but your tension will just make things worse. You know your child eventually will learn to use the toilet, so don't make it a contest of wills. Be calm and patient, and allow your child some time to get the idea.
Wait. Most children are toilet trained when they are 2, 3, or 4 years old. A few children are ready earlier, but just to be on the safe side, wait until your child is at least 2 years old.
Make sure you are ready. Do you really want to find out where the bathroom is in every store and restaurant you go to and on every highway and street you drive? Are you ready for potty interruptions all day long? Have the grandparents let up on their pressure about toilet training? (Remember, toilet training need not be a community affair. If you don't want to, you don't have to mention your child's efforts to anyone else, even grandparents.) Has the crisis at work passed? Is the household relatively stable now, and will it continue to be so for a few weeks? (Having other parts of your life running smoothly will help ease the chore of toilet training.)
Make sure your child is ready. If you are really ready to toilet train, see if your child is ready. Parents and others (grandma, aunt, friends) sometimes push toilet training before there are clear signs that the child is ready. Your child is not ready:
Just because he’s told you he wants to wear “big boy” pants.
Just because she wants the Big Wheel you promised as a reward.
Just because he or she has had some dry days playing on the potty chair. (Many children do this around 18 months of age.)
What Is Readiness?
Age: Your child should be at least 20 months old and preferably 2 years old or older.
Physical readiness: Your child should be able to pick up objects, lower and raise his or her pants, and walk from room to room easily.
Bladder readiness: Your child should already be staying dry for several hours at a time, urinating about four to six times a day, and completely emptying his or her bladder. If your child is still wetting a small amount frequently (7 to 10 times a day), you should wait.
Language readiness: Your child should understand your toileting words, words like "wet," "dry," "pants," and "bathroom." If your child does not understand what you are talking about, you should wait.
Instructional readiness: Your child should be able to understand simple instructions, such as "Come here, please" and "Sit down." Just as important, your child should be following the reasonable instructions you give. If your child opposes you much of the time and has frequent temper tantrums, you will probably have problems with toilet training.
Bladder and bowel awareness: Your child may indicate that he or she is aware of the need to void or eliminate. Children usually indicate this awareness not through words but through actions – making a face, assuming a special posture like squatting, or going to a certain location when they feel the urge to urinate or defecate. This may be a positive sign that your child is ready to begin toilet training.
Getting Your Child Ready
You can take some steps now that will help your child when, at some time in the future, you begin toilet training.
Let your child watch you. Your child can learn a lot about how to use the toilet correctly by watching a parent. Frequently let your child come with you when you go to the bathroom. Use simple words to explain what you are doing (for example, "Mommy is going peepee in the potty.").
Teach your child to raise and lower his or her pants. You can do this gradually when you are dressing or undressing your child. With your daughter, for example, you can first pull down her pants with little or no help from her. Then, do less pulling and let her do more. This process may take many weeks, but it is worthwhile. Later, when you begin toilet training, you will be glad that your child already knows how to pull down his or her pants and that you don’t have to tackle that learning task in addition to toilet training.
Help your child learn to follow your instructions. Make sure you have your child's attention when you give an instruction. Immediately praise your child if he or she does what you ask. If your child does not follow your instruction right away, gently guide him or her through what should be done, and do not give another instruction until the first one has been followed. If your child starts to cry, ignore the crying. When your child has calmed down, repeat your instruction. If you often have trouble getting your child to follow your instructions, ask your health care provider for guidelines on managing your child's behavior, or search the Girls and Boys Town Web site parenting.org for valuable help.
Set out a potty chair. A few weeks, or even months, before you think you will start toilet training, make a potty chair available to your child so that he or she can get used to it. Put it in the bathroom or in another room so your child has a chance to investigate it. Let your child get used to sitting on it, with clothes on. Encourage your son to sit on the potty (instead of standing in front of it) so that he will be used to sitting when you start toilet training. (Later on, when he is well past being toilet trained, he can stand.)
Praise your child. Every time your child does something the right way, be sure to let him or her know. Praise your child with words that are brief and to the point, such as "You did a good job pulling down your pants." Or, give your child a smile, a hug, or a kiss. This attention is how you teach your child what behavior pleases you.
Summary
By forgetting the folklore, following a few guidelines, getting yourself and your child ready, and preparing, toilet training should be easier for everyone involved. Just remember the things you can do before beginning to potty train:
Frequently let your child watch you go to the bathroom.
Teach your child to raise and lower his or her pants.
Teach your child to follow your instructions.
Make sure you are ready before you try to toilet train your child.
Make sure your child is ready.
Wait until your child is at least 2 years old.
Set out a potty chair so your child can get used to it.
Relax.
Praise your child every time he or she does any part of toileting behavior correctly.
Abdominal Pain
Abdominal pain is very common in children, and it can be acute pain, meaning it happened all of a sudden, or it can be chronic or long term. You should not force a child with abdominal pain to eat, but you may encourage him to drink plenty of clear fluids. You should call your physician if pain lasts longer than three hours and is not improving or if you suspect that he may have appendicitis, an intestinal obstruction, strangulated hernia, or urinary tract infection.
Among the associated factors that can help determine the cause of abdominal pain include the presence of diarrhea, constipation, fever, and weight loss. The exact location of the pain can also be helpful, as well as how long the pain lasts, what makes it better (especially if you have been using over the counter medications) and what makes it worse.
Although often not necessary for most children with abdominal pain, testing may include plain xray (KUB), abdominal (and/or pelvic) ultrasound or CT scan, stool cultures (for parasites and bacteria), stool test for blood.
gastroenteritis: pain usually also accompanied by diarrhea and or vomiting.
appendicitis: continuous abdominal pain that moves to the lower right side and is followed by vomiting.
constipation: cramping lower abdominal pain, usually in a child with a history of having infrequent bowel movements
intestinal obstruction: a blockage of the intestines can cause severe pain and vomiting. Your child's vomiting may be bilious (dark green or yellow) and he will probably not be having bowel movements or passing gas. This is a medical emergency.
nonspecific or functional abdominal pain: chronic or recurrent abdominal pain in children without diarrhea, vomiting, constipation or weight loss. Pain is usually mild and centered around the belly button. It is usually not know what causes this type of pain, but it may be secondary to stress.
reflux: children with reflux may have a sour taste in their mouth and a burning substernal chest pain. The pain may be worse at night and after meals.
irritable bowel syndrome: Children with IBS have crampy abdominal pain and bowel movements that alternate between normal, constipation and diarrhea.
inguinal hernia: severe pain accompanied by a bulging in your child's groin or scrotum.
urinary tract infection: lower abdominal pain with fever and pain with urination.
food allergy (lactose intolerance): usually chronic pain that follows eating or drinking certain foods and is accompanied by bloating, gas and diarrhea.
ulcers: burning epigastric pain, usually worse before meals, at night and in the early morning. Children with ulcers usually also have vomiting and a family history of ulcers. They may also have blood in their stool. The pain may be relieved by antacids and by eating.
hepatitis: usually caused by viruses that cause inflammation in the liver. There are many viruses that can cause hepatitis, but the most common are Hepatitis A, B, and C. Symptoms include fatigue, pain in the right upper side of the abdomen, vomiting and jaundice.
celiac disease: with gas, chronic diarrhea, bloating, poor weight gain and recurrent abdominal pain
inflammatory bowel disease: Children with ulcerative colitis and Crohn disease diarrhea, usually with bleeding, cramping abdominal pain, obstruction (a blockage of the intestine), malabsorption (failure of the intestines to absorb minerals and nutrients), and weight loss or poor weight gain.
Other causes of abdominal pain can include a lower lobe pneumonia,
Gynecological causes of abdominal or pelvic pain can includ ovarian cysts, torision, ectopic pregnancy, and pelvic inflammatory disease. Also Mittelschmerz is a dull or cramping lower abdominal pain that occurs with ovulation (midcycle) and may last a few minutes to 6-8 hours
Among the associated factors that can help determine the cause of abdominal pain include the presence of diarrhea, constipation, fever, and weight loss. The exact location of the pain can also be helpful, as well as how long the pain lasts, what makes it better (especially if you have been using over the counter medications) and what makes it worse.
Although often not necessary for most children with abdominal pain, testing may include plain xray (KUB), abdominal (and/or pelvic) ultrasound or CT scan, stool cultures (for parasites and bacteria), stool test for blood.
gastroenteritis: pain usually also accompanied by diarrhea and or vomiting.
appendicitis: continuous abdominal pain that moves to the lower right side and is followed by vomiting.
constipation: cramping lower abdominal pain, usually in a child with a history of having infrequent bowel movements
intestinal obstruction: a blockage of the intestines can cause severe pain and vomiting. Your child's vomiting may be bilious (dark green or yellow) and he will probably not be having bowel movements or passing gas. This is a medical emergency.
nonspecific or functional abdominal pain: chronic or recurrent abdominal pain in children without diarrhea, vomiting, constipation or weight loss. Pain is usually mild and centered around the belly button. It is usually not know what causes this type of pain, but it may be secondary to stress.
reflux: children with reflux may have a sour taste in their mouth and a burning substernal chest pain. The pain may be worse at night and after meals.
irritable bowel syndrome: Children with IBS have crampy abdominal pain and bowel movements that alternate between normal, constipation and diarrhea.
inguinal hernia: severe pain accompanied by a bulging in your child's groin or scrotum.
urinary tract infection: lower abdominal pain with fever and pain with urination.
food allergy (lactose intolerance): usually chronic pain that follows eating or drinking certain foods and is accompanied by bloating, gas and diarrhea.
ulcers: burning epigastric pain, usually worse before meals, at night and in the early morning. Children with ulcers usually also have vomiting and a family history of ulcers. They may also have blood in their stool. The pain may be relieved by antacids and by eating.
hepatitis: usually caused by viruses that cause inflammation in the liver. There are many viruses that can cause hepatitis, but the most common are Hepatitis A, B, and C. Symptoms include fatigue, pain in the right upper side of the abdomen, vomiting and jaundice.
celiac disease: with gas, chronic diarrhea, bloating, poor weight gain and recurrent abdominal pain
inflammatory bowel disease: Children with ulcerative colitis and Crohn disease diarrhea, usually with bleeding, cramping abdominal pain, obstruction (a blockage of the intestine), malabsorption (failure of the intestines to absorb minerals and nutrients), and weight loss or poor weight gain.
Other causes of abdominal pain can include a lower lobe pneumonia,
Gynecological causes of abdominal or pelvic pain can includ ovarian cysts, torision, ectopic pregnancy, and pelvic inflammatory disease. Also Mittelschmerz is a dull or cramping lower abdominal pain that occurs with ovulation (midcycle) and may last a few minutes to 6-8 hours
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