Category: Meg Zweiback

First Year: Surviving Those First Shots

10/20/2015

A calm parent will help baby with stress of immunizations.

Question:

Our beautiful baby girl is 2-weeks old and we just had our first visit with her pediatrician. She spent lots of time with us and answered all of our questions but I was embarrassed to ask about my biggest worry, which is starting shots. I am scared of shots myself and I hate the idea that she will have to have so much pain. I don’t know what to do. I know the immunizations are important, but I don’t want my baby to suffer. What can I do?

Answer:

First, congratulate yourself about being aware of your feelings and thinking ahead so that you can help your baby get through her immunizations with the least possible stress. Many parents have the same worries that you are expressing and don’t know that they have the ability to help their babies and toddlers avoid the fear of “shots” that is so common in older children and adults.

The good news is that parents, by offering comfort and soothing before and during the immunization process, really can make a difference. Even more good news is that there is excellent medical research supporting the importance of these methods. Even better, using these methods now is the way to prevent your baby from developing the fears that you have expressed.

Here’s how to help your baby:

Plan ahead for your visits by practicing at home how you will help your baby. Babies get the most comfort from parents when they are held in a position of comfort. For younger babies, that will be cradled in your arms. Wrap her in a blanket folded so that you can unwrap her leg or arm for the injection. As babies get older an upright position sitting in your lap facing towards or away from you may be better. If your baby is a wiggler, practice how you can use a blanket to wrap her and help her stay still in your lap rather than placing her on a table. You know already how to comfort your baby, but since you may feel anxious at the visit, practice now how you will take slow, deep and rhythmic breaths while you are
holding her.

A number of studies have shown that breastfeeding your baby beginning a few minutes before an immunization significantly reduces observable pain and stress. There is no evidence that nursing during immunization will cause a baby to choke. Sucking on a pacifier that has been dipped in glucose water (1 teaspoon of sugar mixed in 2 teaspoons of water) can be equally effective. Let your baby continue to suck while injections are being given and for a few minutes after. Let your healthcare provider know that you would like to do this so that you can be seated comfortably ahead of time.

Older babies are soothed by watching the movement of a rattle or seeing and listening to a musical toy, so take a few with you to help her feel relaxed before and distracted during the immunization. Practice at home how you will wrap your baby with one arm to hold her while holding a toy with the other (or enlist someone else to help — this is a great job for an older sibling!) And of course, many parents find that smartphone screens and music will focus a baby’s attention for a few minutes.

As important as the way you hold and comfort your baby is the way you take care of yourself. You know, of course, that you will help your baby the most by staying focused on her needs and letting go of your own fears. Your state of calm is the single best way to shape your baby’s experience during any stressful experience. Before you go into the pediatric office, take some time to practice deep breathing and visualize yourself cuddling and holding your baby when she needs you. You will be going through this experience on every well-baby visit, so taking measures to manage your own feelings well is key.

Most pediatric office will be supportive of your desire to minimize your baby’s discomfort. The suggestions here may already be standard practice. However, you may have to politely explain your approach and occasionally you might be told that there is not time or space to offer your baby this type of comfort. You may have to advocate for your baby and explain that the extra time needed to prepare and soothe a baby now will be more than made up for in the months and years to come when your child is cooperative with other immunizations and procedures. In fact, most public health officials agree that a serious barrier to adult immunizations is the fear of “getting shots” that dates back to early childhood.

Even if your baby cries during the immunizations, remember that her experience of being cared for by her parent while she is unhappy is one of the ways she learns about love.

MEG ZWEIBACK, R.N., M.P.H., PEDIATRIC NURSE PRACTITIONER

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Top Strategies For Dealing With Defiant Toddler

1/3/2015

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Question:
I don’t know what has happened to my beautiful baby! We were so excited when Evelyn started walking right after her birthday. We thought that it would make life so much more fun for her and us when we could go places and do things with her without having to hold her or strap her in a stroller. It’s been a few months and now I dread leaving the house—she is so difficult to take anywhere. She runs away, won’t listen, and then laughs when I try to stop her. She does the same sort of thing at home, but not as extreme, and it’s not as embarrassing. I feel like she’s saying “No” even when she’s not talking! What can we do?

Answer:Sounds like you have a toddler now, not a baby!

A toddler’s saying “No” is a symbol of her increasing ability to tell you she has a will of her own. Most toddlers, just like Evelyn, begin saying “No” in non-verbal ways for months before they say the word. Do you remember the first time she pulled back from a spoonful of food you offered her and shook her head from side to side? The shaking movement of an infant to avoid her parent’s spoon is one of the earliest ways she says “No”!

Once a 1-year old begins to express “No” you will probably see an increase in the number and variety of ways she resists you. The term “oppositional behavior” has been used to describe this resistance, because at times parents feel that whatever they suggest, the child wants to do the opposite. At times you may feel as though whatever you say or do it’s wrong. As one parent said, “I asked my toddler if she wanted a cookie or ice cream. She threw herself on the floor saying ‘No! No!’ I finally found out she wanted a cupcake like she had a week ago, but we didn’t have any. I can’t figure out how to make her happy.”

If you try to please a defiant 1-year-old, you probably won’t be successful. The more absurd and trivial her demands are, the less likely they are to be ones that you can fulfill. In fact, if you keep attempting to please her, you may find that she simply increases her demands until you are exhausted, angry, and finally willing to say “No” to her as well.

If parents can treat their toddler’s negativity as a part of normal daily life, they find it easier to stay casual and matter-of-fact when they are faced with an outburst. When your one year old says “No!” check to see if she is resisting something that she is reasonably within her rights to resist. If she refuses to eat her cereal, or to wear her pink socks, or to kiss Aunt Mildred, it’s okay. to respect her “No!” But if she refuses to sit in her car seat, or to let you change her diaper, or to put down the scissors she found in the desk drawer, you’ll have to be firm.

No matter what the issue, it helps to stay calm. Most parents try either to give their child a brief explanation of why she can’t have or do what she wants, or ignore her protests and get on with their activities. As you watch your toddler’s reactions to these different responses, you’ll figure out which ones work best for both of you.

Occasionally parents are told that a toddler learns to say “No!” because she hears it from others, and that if parents can avoid confronting their children with the “N” word they won’t hear it directed back at them later. This advice sends parents the message that their toddler’s defiant “No!” is something bad to be avoided. In fact, your toddler’s saying “No!” is an important sign that she is becoming her own person, willing to take the risk of defying the parents she loves and needs. It may be too much to ask parents to enjoy this stage of development, but it is a stage that should give you the satisfaction that your child is ready to begin becoming independent.

You don’t need to be so strict with your toddler that you wind up challenging her into a battle of wills about issues that don’t matter. That battle has no winner. If you force your child to give in she will feel angry and resentful. If you then decide to give in because it’s not worth a fight you will feel silly for taking on the issue in the first place.

StrategiesOne strategy that often works to avoid head on collisions is to offer your one year old a choice between two realistic options. Instead of asking “Do you want milk?” ask, “Do you want milk in the red cup or the blue cup?” Instead of, “Do you want to go shopping?” ask, “Do you want to go to the store now or after a story?” Don’t ask her to make a choice that isn’t reasonable: “Do you want to take your nap now or later?” isn’t a fair question to ask an overtired and cranky toddler. Offering choices is one way to avoid some negative responses, but it won’t always be practical and will not help you to avoid ever having to deal with your child refusing to cooperate.

Some toddlers can be more challenging than others because of inborn temperamental characteristics. For example:

An active toddler will have more trouble being cooperative in situations where she has to be still. She’s resist sitting in a stroller or car seat or in a group because she needs to move, not just because she’s being oppositional.

A persistent and non distractible toddler can be stubborn and refuse to follow even the most clear limits. The best that you can do will be to be very firm and act rather than argue (as in take away a toy immediately if he throws it, remove him from the table if he spits his food)

An intense toddler may shriek or scream when you tell her no or try to keep her from doing something she wants to do. Her protests may tempt you to back down or to walk on eggshells to avoid frustrating her.

A highly sensitive toddler may seem oppositional when she is actually trying to avoid a situation that is physiologically uncomfortable, such as being in a noisy environment or wearing clothing that scratches her.

Figuring out how to manage Evelyn’s behavior, whether it stems from her age and stage of development, her temperament, or from causes that once understood can be resolved will be a challenge, but over time the patterns that are unique to her will emerge.

The bottom line is this: all toddlers, sometime between 1-1/2 and 3, will begin to be unreasonably and mystifyingly resistant. It’s not a sign that you have a difficult child or that you are a failure as a parent. It’s simply a stage and it will pass (and recur, and pass, and recur again . . . sorry to say!)

Meg Zweiback, RN, MPH, is a certified pediatric nurse practitioner and family consultant in Oakland. She is an associate clinical professor of nursing at University of California, San Francisco and posts articles and other resources on her Web site, bringingupkids.com. To possibly have your question included, please send your questions to editor@parentspress.com

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Should I Be Concerned With My Child Sucking His-Her Thumb?

12/27/2014

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It’s Usually Fine, Depending on the Intensity

Question:
     Our 3-year-old Jamie is sweet and bright and pretty. Her only “flaw” is that in between playing or talking or running around, she’s likely to be sitting somewhere sucking her thumb. It’s not constant, by any means. In fact, when we are at a park or out with friends, she hardly ever has her thumb in her mouth. But once she’s home, she grabs her “lovey” (a striped blanket she’s had since she was a baby) and heads for the sofa where she hunkers down for some sucking time. If we distract her or she hears her sister playing, she’s usually done in a few minutes. She puts her blanket on the hook in her room (which we installed when the dog seemed as fond of it as she was), and then she’s her usual busy self. At pre-school no one seems to care — in fact, at circle time, she’s one of several who suck their thumbs or twist their hair. But we get a lot of negative comments from grandparents and other family members. What should we do
about this?

Answer:
     Don’t worry! Jamie is doing just fine.
     Sucking is the first way that babies learn to soothe themselves, and almost all babies and toddlers take pleasure in sucking their thumbs or fingers or a pacifier. It’s a myth that babies who don’t breast feed are more likely to suck their thumbs or a pacifier. In fact, some babies actually prefer to get their soothing without the added calories! As most children get older, they gradually suck less and less during the day, but they may continue to suck when they are falling asleep or feeling distress.
Some children, like Jamie, develop habitual patterns of comforting themselves throughout the day. Sometimes it’s only when they are tired or in the midst of transitions. Sometimes the habit evolves, as you’ve observed with Jamie, into sucking while holding a lovey, sitting in a special place and going through a familiar routine. When the habit is pacifier sucking, parents can control access to a pacifier or remove it entirely. You don’t have that choice with a child’s thumb!
     Fortunately, there is no evidence that a 3-year-old’s thumb sucking is harmful to her. In fact it’s probably helpful.
     Here’s why: Children who suck their thumbs have the ability to calm themselves readily, often before they
get so unhappy that a parent notices that they are upset. If you expect your child to give up such a useful way of coping, what will be her substitute? Will she still be able to quiet herself when she is feeling stressed, or to fall asleep independently? Future teasing isn’t a cause for concern. A pre-school age child doesn’t worry about what others think of her now, and she can’t imagine or care what the future might be like.
     The only reason to discourage thumb sucking in a 3- to 5-year-old, or in any child, is if the degree of sucking is so frequent and of such intensity that it is likely to interfere with permanent tooth development. This would be highly unusual at this age. If a 5- to 6-year-old child sucks her thumb with strong suction throughout the day and night, many dentists would advise parents to intervene. However, you have noticed already that Jamie has long periods when she does not suck and that she is gradually becoming less dependent on her thumb; her teeth may not be affected at all as she gets older. (If her parents have overbites or needed braces, Jamie might still need an orthodontist no matter what you do!)
      There are a few things you can do now to help Jamie continue to gradually reduce her dependency on her thumb. The first is to make sure that she is also developing other ways to soothe herself and to accept comfort from others. Make sure that Jamie gets lots of hugs and cuddle time. Encourage her to practice relaxation in ways that don’t involve her thumb: stretching and splashing in a bathtub, blowing bubbles, playing with sand or clay and doing slow deep breathing while you play music. These aren’t strategies to “fix” the thumb sucking. This is long-term skill building that will be helpful to any of your children.
      Many young children suck when they are bored or when they are in a situation where they have learned to automatically suck their thumbs. At those times, a child doesn’t need comfort. She’s just unconsciously doing what she’s used to doing. You can interrupt that type of sucking (or any other unconscious habit) by introducing an activity that is incompatible with the habit. For example, you may notice that providing Jamie with something else to do with her hands — holding a doll, drinking a glass of milk, doing a puzzle — gives her enough distraction for her to forget about sucking. If she tends to suck her thumb when you are driving in the car, you can give her an interesting toy to play with. Having a conversation or singing a song together may also keep her mouth busy without her thumb. You aren’t trying to stop the thumb sucking all the time; you are just substituting ways for her to keep her hands busy.
     Sometimes a child’s sucking pattern is connected to a comfort object, as you’ve noticed with Jamie and her blanket. By having her keep the blanket at home, in a special place, you have helped her to think first before she decides when and where she wants to suck. That’s a good way to interrupt an automatic habit. However, I would not advise you to set any further limits on blanket use now — when Jamie needs comfort, her blanket and thumb are valuable, not harmful.
     You may hear that children should have their thumbs painted with nasty tasting substances to discourage thumb sucking. Some parents who have taken this path regret it later. They discover that their child develops another habit that may be less pleasant than the thumb sucking — lip licking and nose picking are common — or that their child becomes whinier and more easily distressed without a way to comfort herself.
     If a parent reacts with disapproval when a child sucks her thumb, or even worse, nags her to stop, the thumb sucking is likely to increase. Some children will become defiant and suck more in reaction to comments. Others will simply hide the thumb sucking from the critical parent and may wind up seeking ways to sneak in extra sucking time.
     Comments from adults other than parents or regular caregivers aren’t as likely to cause this kind of rebound effect. However, children naturally avoid being with people who disapprove of them, so you may want to advise critical family members to keep quiet.
     You can also explain to them that pediatric and pediatric dental organizations have all issued statements that thumb sucking does not need to be interrupted at this age, if ever. If that doesn’t work, you’ll be setting a good example to your child about resisting peer pressure if she hears you say, “We think it’s fine for Jamie to suck her thumb, and we don’t see it as a problem.”

Meg Zweiback is a certified pediatric nurse practitioner and family consultant in Oakland. She is an associate clinical professor of nursing at University of California, San Francisco and posts articles and other resources on her Web site, bringingupkids.com. To possibly have your question included, please send your questions to editor@parentspress.com

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What You Need to Know About Toddlers, Sharing and Social Play

12/24/2014

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The Ins and Outs of Sharing and Sociable Play

Question:
    My toddler is fighting over toys. He’s so sweet at home, but he will grab and hit when he’s with other children. Our baby group that meets once a week is falling apart because some of the now 15-month-olds can’t share their toys. Instead of peaceful play, we have toddler meltdowns. Some of the moms are ready to quit. How can we fix this?

Answer:
     When a 1-year-old is with other toddlers, you will see him behave in ways you haven’t observed at home. One-year-olds enjoy being with other children, but their play is not the sociable interaction that parents can expect from 3- and 4-year-olds. If you understand what you can reasonably expect from a group of toddlers, you will be able to enjoy yourself more and help your child to gradually learn how to play with others.
    Think about how your toddler plays with a parent. He probably demands your attention, he wants you to respond to him right away and he probably likes to tell you what to do, rather than the other way around. His highest compliment to you, or to a visitor, is to bring you a toy. He may decide that it is a lovely game to continue to bring toy after toy, but he may also decide that it is time to take away the toys. Of course, an adult doesn’t mind having a toy truck deposited in her lap and then removed. However, when your 1-year-old wants to play this game with another child who also wants to control the giving and taking, the two toddlers may wind up in a tugging match.
     The “give and take” of play is not something a toddler can understand yet. If a parent pressures a 1-year-old to “share nicely,” the toddler will cling even more strongly to his possession, even if the object of desire belongs to someone else. In fact, some children who are constantly pressured to share will get so anxious about being forced to let go that they will hold on even tighter, becoming more possessive than they would have been if left alone.
     Toddlers also want to imitate what someone else is doing. A toy may be ignored by two children for half an hour, but as soon as one toddler picks it up and begins to play with it, the other toddler wants it for himself. Within moments, quiet play can dissolve into an intense battle. Most of the time, the struggle will be brief, because 1-year-olds, despite the passions of the moment, don’t attach the larger meaning to these quarrels that their parents do.
     That doesn’t mean that adults should ignore warring toddlers. Adults need to intervene when children are struggling and redirect their play, but they shouldn’t pass judgment on the behavior as being selfish or aggressive. They must simply tailor their responses to the needs of each child to help the child learn to play with less conflict.
     If your child always seems to grab from others, he may need to have you stay close by him. If he starts to move in on another child, distract him with another toy or try to engage both children in playing with you. Helping your child to avoid getting into repeated conflicts gives him a chance to find ways of having fun without being labeled as a bully.
     Some toddlers don’t seem to mind if another child pushes them aside or takes their toys. They may cry for a moment or simply find something else to do. A parent may worry that his child is being too passive and feels that he should stand up for himself. But in another year, the child will have the maturity and the verbal skills to be able to assert himself more. At this age it’s best to allow him to react in the way that he chooses. If he comes to you for comfort, you can help him to find another activity. If he is very upset, you can verbalize his feelings by saying, “It makes you sad when Jimmy takes your toy.” But if you give him too much attention and sympathy, he may figure out that it is more interesting to be the victim than it is to solve problems on his own.
     One 18-month-old boy in a playgroup seemed to be so in awe of an older and bigger toddler that he allowed the other child to grab all of his toys without protest. His mother saw the disappointment on her son’s face but refrained from getting involved. One day, when the children were playing outside, she saw her son quickly set aside the shovel and pail he was using when he noticed the other child approaching. Her son picked up a plastic car, and the bigger boy, as usual, took it from him right away. Her son went back to the shovel and pail he had been playing with in the first place, and his mother realized that he had figured out a way to solve the problem on his own!
     There are some ways to teach toddlers about sharing and playing sociably. (Sometimes it works better to use the phrase “taking turns”). When you play together, take one toy and say, “Will you take turns with me?” and if he says yes, thank him. If he refuses, say, “Maybe you’ll want to take turns later.” When your toddler wants to taste your food, or wants you to taste his, label that “sharing.” Let your child learn that sharing is a nice word to hear, not a word that he only hears when there is a conflict.
     To further prevent conflicts you can plan ahead when your toddler will be playing with others. As the number of children playing together increases, so does the level of stimulation and potential for conflict. Parents need to stay close to toddlers at play rather than waiting for problems to occur before moving in. If certain toys are very popular, it’s a good idea to have several of them. If a child has a special toy he never shares, it’s best not to bring it to the group. Having activities that everyone can be a part of, such as water play or messing with play dough, will keep toddlers satisfied. When you take your child on a visit, if he brings a few of his own toys, the host child may find it easier to share. When you leave, be prepared to distract your child from his host’s toys by offering a favorite object from home that you’ve saved for this moment. Don’t stop on the way home to buy the toy that your child couldn’t let go of — he may be much less interested in it if no one else is playing with it!
     Think about this year as the time to teach your child what it means to be sociable, and how much fun it can be to be with other children. Prevent conflict when possible, don’t force the issue of sharing, and wait until your child is 3 years old before expecting him to understand another child’s point of view some of the time.

Meg Zweiback is a certified pediatric nurse practitioner and family consultant in Oakland. She is an associate clinical professor of nursing at University of California, San Francisco and posts articles and other resources on her Web site, bringingupkids.com. To possibly have your question included, please send your questions to editor@parentspress.com

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Anger Management 101: Tools for Teaching Your Toddler Emotional Control

12/21/2014

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Question:
     Sometimes I don’t know who gets angrier — me or my 3-year-old! It’s usually about something small — like not being able to get his shoes on when I’m going to be late for work. At first I might be nice, then I get irritated, then I explode! I feel as though we’re both having meltdowns and I’m being as much like a toddler as he is. Help!

Answer:
    Good for you for asking for help. As we all know, everyone — young or old — gets angry. So it’s important for children to learn how to express anger in a way that doesn’t hurt themselves or other people. Over time, they will learn that they can get angry, feel bad and then be free to experience other, more pleasant feelings. With practice, they can even learn to notice when feelings other than anger might be more appropriate for a situation — feeling frustrated or impatient or annoyed rather than only feeling angry.
      If that sounds hard to you, think of how hard it must be for a young child. He isn’t old enough to understand feelings very well. Sometimes he just expresses them — happy, sad, angry — by laughing, crying or yelling.
Using Words
      A 3-year-old first needs to learn words to name his emotions. A parent can help him learn by labeling his expressions of emotion with words: “I can see by your big smile that you’re happy now!” “You look so angry when your face is all turned down like that.” You can talk about characters in the stories you read, describing their feelings in words. “The boy in the picture sure looks sad.”
      You can also use stuffed animals or puppets to tell your child stories that show how characters express their feelings in the way they act. You can recreate situations in storytelling that are similar to what has happened in your child’s real life. Let your child watch a little bear saying “No” when it’s time to put on his shoes, and getting upset when Mama Bear insists. Mama Bear can then say, “I know you get angry when I make you do something you don’t want to do, but sometimes it’s important to get your shoes on before we go outside.” You might even tell a story in which the little bear doesn’t cooperate, and then the Mama Bear yells at him. Then Mama Bear can say, “I’m sorry I yelled so loud. It hurts my ears when I yell — and maybe it hurts yours, too. So I’m going to try not to yell.”
      As you use these ways to teach your child the words for feelings, you can also talk about the ways that the feelings can best be expressed. You could tell your child that when you (or, in a story, Mama Bear) get mad, you feel better if you stamp your feet. “But what would happen if when I stamped my feet I stamped so hard that I broke my toe? Or broke the floor? Or stamped on the cat?” (It’s OK to get silly — it usually helps children to listen better!) In this way, you show your child that expressing anger is OK, but that you are careful not to hurt people or things when you express yourself. These techniques only take an extra minute or two as you play or talk with your child. Most parents find that their children enjoy the storytelling and learn the concepts the parents are teaching them. Imaginary play usually works faster and better than lectures.
Offer a Solution
      Sometimes a young child needs help in using words to express what he needs and wants — before he gets angry. Using the storytelling or puppet play methods, you can suggest ways that characters can cope with anger by figuring out solutions. For example, a puppet could be angry because he has to go home while his friends are still playing. A puppet mother could be understanding of the anger and ask, “What can we do to solve this problem?” The angry child puppet could make suggestions, and the mother and child might agree to arrange another play date. Children can also use art materials to express themselves: pounding clay or painting or coloring on big pieces of paper can be an outlet for strong emotions. A parent can ask a child to tell a story with a drawing, or ask the parent to draw the story, which can include ideas for making things better. Another way for young children to express themselves is by using physical activity to release energy: throwing pillows or balls (outside!), playing with water or just running. A parent can tell a child, “When you’re angry, you can tell me in words, but if words aren’t enough, here are things you can do.” After the child gets the feelings out, the parent can say, “Now, let’s talk about helping solve this problem.”
Establish Rules
      It is also helpful to have family rules for expressing anger, and these should be rules that all members of the family can accept and follow. An easy rule for young children to understand is, “In our family, we don’t hurt people or things.“ When your child hits or hurts someone physically, you can remind him of the rule. If his behavior is unusual, you may want to immediately try to find out what has caused him to act that way. But if your child often has » trouble controlling his impulse to hit, kick or bite, it’s usually better to remove him or yourself from the setting for a “time-out” and deal with his feelings after you are both calm again. You can ask him to use words to tell you, or the person with whom he is angry, how he feels. You may be able to help him solve the problem that caused his anger. You may have to let him know that you accept and understand his feelings but that you can’t fix the problem. Either way, your child is learning that you want to help him with his frustrations, not just shush him.
      Sometimes it is helpful to keep a diary to record “flash points” to notice when, where, and why you or your child gets upset. You might find that he gets upset mostly when he’s tired, hungry or in the middle of a transition. Or you might find that it’s not just his behavior, but your own mood that sends you into your own outburst. If that’s the case, this may be the time to learn some new ways of reacting.
      Children learn to express feelings by watching you and the way you react to them and to other people. If you’ve noticed that it’s hard to hold back your feelings, it may mean that you haven’t yet learned to express frustration, impatience or anger in a healthy way. Fortunately, there are good resources in the Bay Area for learning these skills. Parent classes and support groups can be found through Bananas (bananasinc.org) or through the Berkeley Parents Network (parents.berkeley.edu). Some parents find that a stress-management program approach works well for them. Sometimes called Mindful Parenting, these groups are offered by local leaders. Yvonne Mansell, (yvonnemansell.com) a Berkeley therapist who leads these types of groups, says, “Many moms find it easier to learn new methods for managing anger and stress when they are in a supportive group setting with other parents dealing with similar issues.” Another resource for parents is Kaiser Permanente (kp.org). Most Kaiser locations offer an excellent class on managing anger that is open to the general public. Parents come to the class for the reasons you’ve described, to learn to respond to a toddler tantrum without having a tantrum of their own.

Meg Zweiback is a certified pediatric nurse practitioner and family consultant in Oakland. She is an associate clinical professor of nursing at University of California, San Francisco and posts articles and other resources on her Web site, bringingupkids.com. To possibly have your question included, please send your questions to editor@parentspress.com

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When Grandparents and Babies Collide

12/15/2014

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The Art of Interacting With Infants

Question:
     Our baby Marie is the first grandchild in the family and of course she gets lots of wonderful attention when we visit relatives. Unfortunately, she is not fond of being held by very many people other than her parents. (We have a nanny share, and she’s fine with the nanny but doesn’t seem to care for the other parents.) We hoped she would get easier as she got older, but if anything she’s worse. She’s almost 7 months old now. At the last family dinner, she started crying as soon as her grandfather leaned towards her! He says we’re spoiling her by giving her too much attention. I’m starting to dread family events.

Answer:
      A new baby is irresistible to first-time grandparents and any other baby-friendly people who come near. Some babies are naturally adaptable and outgoing. They can be passed around a group of relatives like a bowl of salted peanuts. Other babies are more cautious about the unfamiliar. In new situations they may be reluctant to leave the familiar arms of their parents. As you have discovered, family gatherings can be particularly difficult. The bustling activity and new voices and sights may be so stimulating to an infant that she pulls back and clings even more to the people she knows best.
      Grandparents, who are dying to get hands on a new grandchild— especially the first! — may interpret the baby’s pulling away or distress as a personal rejection. If a grandparent doesn’t know how to gently communicate with a baby to win her acceptance, he may simply blame the parents for being overprotective. Your baby’s grandfather is a first-time grandparent, so he does not have much experience in playing with babies who don’t know him well. He may not realize that you don’t have much control over your baby’s initial reactions — they are just who she is right now. His putting blame on you for “spoiling” doesn’t solve the problem and may actually make it worse with Marie sensing his frustration.
     Marie’s responses are very common among babies. Every baby has certain characteristics that are inborn, part of her natural temperament. It sounds like Marie is the type of baby who has an initial response of withdrawing from new situations, is somewhat slow to adapt and is sensitive. These temperamental differences are not deficiencies. They are a part of who we are, just like the color of our hair.
      Try to explain to your relatives, especially Marie’s grandfather, that Marie seems to be a very discriminating baby who needs time to get comfortable with people. In addition, she is at a stage of development where babies are noticing visual differences. (If a parent shaves off a beard or changes the style and color of her hair, a baby this age may become very upset.) A 7-month-old baby can’t “remember” that these people she sees only occasionally are her relatives who adore her. To her, they are strangers. She needs time, and her relatives need patience.
     You can help your father and other relatives to “woo” Marie by trying these ideas:
•    Try to arrange visits for times when Marie is rested. A tired baby will be reluctant to let anyone but Mom or Dad hold her.
•    When you go to visit or when relatives come to see you, protect Marie from being suddenly surrounded by new faces and voices. She’ll do better if she just sees one new person at a time.
•    Hold Marie in your lap and let her watch her grandfather while you talk to him. It’s usually very effective if the “new person” avoids making eye contact with the baby for awhile. Marie can then examine him from a safe place and get used to his voice.
•    Ask Marie’s grandfather to speak very quietly. Loud and deep voices can make babies pull back or turn away, while soft and higher pitched voices will cause them to lean forward and become interested.
•    Give Marie’s grandfather a brightly colored toy to dangle in front of her to engage her interest. He can talk to you while he does this, letting her watch without being asked to respond. As she starts to focus on the toy, he can gently move it or even playfully pass it back and forth to her. As the two of them begin to engage over the toy, he can begin to say a few words directly to her. The trick is to be slow and low-key.
•    If Marie pulls back, her grandfather should follow her cue and sit back as well. If she responds again, he can gently move forward. Engaging a baby is a bit like learning to dance with a new partner — it can take time to figure out the steps and the rhythm.
      It can take a while to teach anyone, especially a grandparent, the art of interacting with a baby. Just as grandfathers get nowhere with impatience, you won’t get anywhere that way either. However, if Marie’s relatives are patient enough to learn how to engage with her, their relationship will flourish.

Meg Zweiback is a certified pediatric nurse practitioner and family consultant in Oakland. She is an associate clinical professor of nursing at University of California, San Francisco and posts articles and other resources on her Web site, bringingupkids.com. To possibly have your question included, please send your questions to editor@parentspress.com

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