Progressive Parenting Secret #2: Extreme Listening

Two simple tips to help us really listen to our little ones. Again, in my progressive parenting “Extreme” Series, I simply mean that these “secrets” are extreme because they are not the usual  :)

 

Oh, the Whining!

1) Saying, “I hear you”. Say “I hear you” both when your child is staying something wonderful and also when your child is whining. Letting your child know they are heard and not ignored when you are about to say “and” or “but” or “no” as in:

“I am hearing that you want a cookie and I said you will have a cookie after you have had a few bites of beans.”

And then, instead of just saying “I love you” back, I sometimes say “I hear you say you love me. That makes me feel so happy. I love you too.”

For my daughter and myself, we both feel so much better after I have said that I’ve heard her.

2) Refraining form Shushing. Saying “Shh” can be a helpful calming technique for some infants, but it is a very disrespectful thing to do to a toddler or preschooler. So your little one is whining for your attention or saying something awful, or “fake” crying, or repeating ad nauseam or crying dramatically. Yes, it is annoying and sometimes we run out of the right things to say in response. But the first time I ran out of something to say as a response to whining and I said “Shh” was a very difficult experience for me. I heard it come out of my mouth and I felt I had stabbed both of us in the heart and I had “shut her up.”

Turning to someone who is trying to vocalize a need, perceived need, a want or a discomfort and telling them to hush is extremely disrespectful. We would never “shh” an adult. Shushing does equate to “shut up and shut down.”

Instead, you can breathe a loud, deep breath and ask for the child to breathe with you. Instead, we can we can simply say “I hear you.” Instead, we can say “I don’t know what to do/say.” The child gets to have his experience. You get to witness his experience. We don’t  always have to change or fix his experience.    #greatestlessonofall  #codependentnomore

http://mamalady.wordpress.com/2013/03/01/progressive-parenting-secret-1-extreme-modeling/

Ask The Natural Parenting Mentor

Did you know that I’m a “Ask the Mentor” at Natural Parents Network?

Below is the link to the latest question and answer. Here is how you can send us your difficult questions:

http://naturalparentsnetwork.com/ask-np-mentor/

An NPN reader asks our natural parenting mentors:

How do you deal with other parents who behave aggressively toward their children?

My son is in kindergarten and it is necessary for him to ride the school bus. My daughter and I walk with him to the bus stop each morning and wait with him. While there, the other kids play around. This is normal, and all of the kids do it. There is a mother there who screams at, yells at, and threatens her children constantly. Usually, the children are doing nothing wrong, and they completely ignore her because they are so desensitized to her.

Read more at Natural Parents Network >>

Progressive Parenting Secret #1: Extreme Modeling

Very little parenting is effective without modeling the desired behavior. This is because our little ones are very visual, can’t read, are distracted and don’t always have full cognition of our words. Modeling  isn’t always easier than other parenting tools,  but it feels so much better than barking orders, shame or punishment. To a young child, there is no room for confusion or a communication breakdown when his parent’s body simply shows it like it is, rather than tells it like it is. Babies, toddlers and even preschooler identities are still so very much wrapped up in the identities of their parents. They really truly want to be like us and they do follow our lead if we lead by example.

I only call it “extreme modeling” because I have noticed that it is unusual. Modeling really isn’t a secret, but many people just don’t know how to do it, or they feel GOOFY doing it or they don’t do it repeatedly enough to have any effect.

Scenario A:  Modeling Sleep

All you want is for your 18 month-old to lay down in her crib and sleep for the night, but she seems scared, stays awake and cries. Your child knows that you may be doing something fun staying up without her, she can even see lights peeping in from the other room. She doesn’t want to be without you and you don’t want her to cry it out. So,with a mattress on the floor in her room instead of a crib (since you are too big to model sleep in a crib), you are able to lay with her until she falls asleep, quietly modeling that you are about to sleep. With the door to her room closed and the lights off in her room and in the rooms around her room and you can say “I am sleeping now because it is getting very dark outside and it is night night time, come cuddle with me.”

You remain with your head on the bed and relax and eventually your child will come to the bed and cuddle down. Keep doing this so that it becomes an expected behavior of you and then, an expected behavior of the child. My child occasionally has protested bedtime even when it happens this way, but the protest or the tears are short-lived when our kids are actually tired and we are offering presence.

Scenario B:  Modeling Potty

You started potty training at 2.5 years old and your child had one painful constipated bowel movement and now is afraid to poop. I always feel crazy when I say this, but it works and so I risk my own humiliation for you, dear reader. Model pooping for your child. From the beginning to the end; from “Oh, I feel a poop in my body, I better run to the potty.” all the way up until “This is what my poop face looks like, isn’t it silly? Do you hear my poop plop?” and even “Would you like to see my poop?” and/or “It felt a little stretchy coming out, but It feels so good now that it is all out!”  Your child can see and hear from you a positive sense or normalcy and actually see how things work without fear for another human.

Scenario C: Modeling Gentle

Your child is pulling the fur of a friend’s dog while you are in conversation with that friend. “Don’t! Don’t Don’t” It seems to be the go-to word in parenting, but it is a word that for babies and toddlers needs more information, context and re-direction. You can provide all of that info, context and re-direction by modeling what your child should be doing instead of using only “no” or  ”don’t”. The child, even at 10 months, needs to know why we don’t pull fur (It hurts! and doggies don’t’ like it.) A young child is only going to “get” gentle if we get down on his level and first show with our hand what gentle petting looks like and with narration “Look. I am petting the doggie gently with my hand flat like this. Oh, the doggie likes it! Can I help your hand try it now? Would you like to try petting gentle on your own now?”

Don’t forget that the best way to effect change and closeness through modeling is to model these things consistently. One time won’t do it, but consistent, fair, respectful modeling of behavior will make life with young children livable even if that means we have to hold ourselves to the same standards as our toddler.

Eating and table challenges? modeling. Sharing troubles? You guessed it!

email me at mooreamalatthicks@gmail.com

visit me: http://www.mamaladyparenting.com

6 Tips for Managing Screen Time for Tots

Check our my new article over on Natural Parents Network! I would love for you to comment over there on what screen time looks like at your home? Do you use it for a purpose like getting laundry folded?

http://naturalparentsnetwork.com/6-tips-managing-screen-time/

Binky Be Gone! 5 Step Plan for Giving up a Pacifier

Why help your child give up a pacifier as soon as possible? Sucking is totally natural. It just feels good to suck! And for parents of a cranky baby, simply a Godsend! But, sucking for comfort (NNS- non-nutritive-sucking) becomes a problem as we transition our of babyhood and into toddlerdom.  Pacifier use can inhibit vocal expression, communication and language skills. It can cause dental problems (cross bite and palate issues), is documented to increase the incidence of middle ear infections and can hinder the emergency of adult teeth.  Pacifier use could even stunt emotional development, especially in boys. *Findings from studies appear at the bottom of this page.

As a nanny, there were three families that I helped make the binky be gone- I learned by trial and error and I hope this article will help many families. I tend to go for gentle and gradual methods when attempting to change behaviors and habits in young children. But for certain topics, or for certain children, this can be confusing if you go a bit too slowly. Why? Because the when rules are always changing – that can feel unsafe and unstable.

There seems to be two schools of thought out there on pacifier cessation: cold turkey or gradual extinction (constantly changing when and how frequently the child can have it.) I prefer to aim for this middle way:

Binky Be Gone: A Plan:

1) First, Set One New Boundary around when a pacifier can be had: At nap and bedtime, or just one of those? Only at preschool or daycare because she is newly transitioning into a new situation? Stick with that for a while until the new way becomes comfortable. Decrease usage by way of setting a timeframe boundary and also tell the toddler that he is growing up and will need the pacifier less and less and then one day he won’t need it at all.

2) Plan a Place for the  Pacifiers to Go. Talk it up for 1-2 weeks. Will they go to a new baby you know? They are collecting them at the doctor or naturopath or dentist when I don’t suggest planting it in the ground with some seeds as some websites suggest. We want the pacifiers far away from home and now there the child could stand over it and cry!  If your child is 3 or older, you can let your child choose from two good options for where the pacifiers will go. If your child refuses, you get to choose. Ask people nicely to play along

3) Plan Replacement Therapy. This is not bribery. Like any physical habit/addiction, it is much more humane and comfortable to replace the unhealthy habit with a lesser evil as opposed to having nothing to turn to. But stuffed animals aren’t evil. Let your child choose a new one- fully informing them that they will have the new stuffy INSTEAD OF the pacifier tonight.  I also know plenty of kids who like to sleep with a hard dinosaur guy- whatever they want! This won’t always work for every child on the first night. Occasionally a child will decide she hates the stuffy when you redirect from wanting a paci to holding the stuffy. Comfort you child and try again the next night.

4) Add Positive Peer Pressure. I’m a big fan of this for learning to eat new foods, being willing to sit on the potty, etc. Children do really well learning from children their age or older. It simply points out that there is a new and different way to be, something to grow into. This is much more effective than a doctor and a parent simply forcing their will explaining in heady adult terms why the paci must go.  Resist using this method with children who are younger and not using a pacifier, as the words we choose in that situation can be shaming without our meaning them to. Quick- find a play group or preschool with children who are older or who do not use pacifiers.

5) Comforts in Place, Expect Two or Three Hard Nights. Now that you have a plan for how the binky will go, make sure that you write down a list of your child’s best comforts. How do you comfort your child when they are cranky and sick? Remember those thing and write them down so that you can turn to them in a moment of desperation.  To remove a Pacifier for sleeping, expect the first nights to be really hard.

Expect crying and expect to have to physically comfort your child in extra ways for at least the first night. Expect the bedtime routine to be very long and so start earlier than usual with bath and books. If your child attends daycare or preschool, you also will want to begin this on a weekend so any sleep interference doesn’t mess with your child at a time when you can’t be around for comforting. You can cuddle in bed or use a rocking chair for the first night or two with stuffed animals, a sippy cup of water.  You could plan the first binky-less night to be one where you have had tons of family fun and activity that afternoon and also a nice calm down period before bed. That combination should help sleep come faster even when there is much crankiness or crying.

If your child typically wakes at night to find the pacifier, you will have to attend to your child when they wake, reminding the sleepy sweetie about the new plan, where the pacifiers went and re-directing to another form of comfort, “Here, have a sip of water. Hold your little bear, cuddle up to me.” Resist adding new behaviors in the middle of the night like getting up for food or to read another book.

***Children who have learned to suck to sleep have not learned how to what I call “Work themselves down” to sleep. This comes with any major change in sleep association. It will be an entirely new process for the child to learn how to calm her body and mind without a pacifier. We all must learn this eventually- as adults, we toss, turn, complain, have some more water, our mind races, we process the day, we pee again. Expect that it could take 30min-2hrs for the first few nights. If your child is content in the bed alone, that is fine even if it takes a long time to nod off. If your child is upset, please be with him in the dark but model sleep so that you aren’t keeping the child awake.***

If your child only needs non-nutritive sucking when they are supremely ill or supremely tired, if the time with the pacifier is ten minute for less per day, and the pacifier is not being used as a means to fall asleep at night- then you don’t have a problem that needs to be fixed. Minimal NNS like this will simply be gone one day on its own.

The World Health Organization reported a positive correlation between pacifier use and increased incidence of otitis media (ear infections).  The impact of otitis media on speech and language development is well documented (Niemela, Pihakari, Pokka, Uhari, & Uhari, 2000).

-Boshart (2001) suggested that dental problems associated with prolonged pacifier sucking could lead to speech articulation problems such as distortion of the fricative and alveolar phonemes.

-A recent study of dental malocclusions from approximately 15,000 children from one orthodontic clinic concluded that a sucking habit resulted in 60% of the dental malocclusions that were seen in those patients (Van Norman, 2001).

-The American Dental Association (2003) reported that pacifier use in 3- to 5-year-old children led to anterior open bite, posterior crossbite, mean overjet, and smaller intercanine distance of the upper arch.

*note* The pacifier in the photo pictured is the best kind to use with babies- over time it loses shape, squishes and takes on strange flavors, making it less appealing later on. Everyone I know who used this one gave the pacifier up early. This photo is of my little friend Sylvie pretending with the paci from her babyhood. Best to never start with a binky, but for parents of very fussy babies..here it it: http://www.zoeborganic.com/natursutten-pacifier/natursutten-orthodontic-new-packaging.html

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10 Ways to Speak Respectfully to Toddlers

 

Drawing of Mama. I.H. 2.5yrs.

Be Informational, Specific and Clear. (Avoid “Later” and “Soon”) Our young children understand more than they speak and more than we usually give them credit for.  Even if our child may not understand our words or concepts, they will over time and they deserve the respect of a clear explanation and a real timeframe projection, especially when you have to say No.  They don’t read clocks, but if you are consistent, they begin to learn what five minutes/ after dinner feels like, and they begin to learn patience.

Reframe to the Positive. (Avoid “Don’t”). There are many ways to stop a behavior or say no without constantly saying “No” or “Don’t.”  Some creative frames for this are If/Then, When/Then. “When we put your toys away, then we can go for a walk outside.” A positive with a qualifier also works wonders,  “After you have eaten some bites of lunch, then you will have a cookie.” Taking the time to give more information about why we are or aren’t doing something right now can also help.

Use “We” language. (Avoid using child’s name, pointing a finger and authoritarianism).  At school or at home, we are a community and a culture. Use “We” to help the child understand what behavior is expected within the culture and to let him know that you hold yourself and everyone else to the same standards. Therefore, no child feels singled out as “bad” or “wrong”.

Use “I “ Language.  In a one-on-one setting- if there is something you cannot allow your child do, and where explanation isn’t enough, simply take responsibility for how you feel about it. “I don’t like it when you climb that high. It makes me worried and I would be sad if you fell and got hurt. Do you like it when you get a boo-boo?.”  We are interconnected beings and occasionally we can be asked to see things from a loved one’s perspective.

Be in the Child’s Reality. (Avoid Should/Shouldn’t and You Can’t). Shouldn’t is a very hard to understand concept for a toddler. Our shouldn’t and can’t clashes with a toddler’s concept of what is possible, with what the child desires and with what the child is experiencing to be true. Use explanation, information and re-direction instead, and be as clear as possible about the sort of behavior you expect instead.

Give Only Two Options.   In a challenging moment, three options are often way too much for a toddler (I tend to say wait until 3 years or more for 3 choices). It is our job as parent, teacher or caregiver to provide a healthy set of boundaries so that our children feel secure and we can do this by providing two choices. We hope to provide two acceptable options for the child, so refrain from asking a yes/no question, if a No answer is unacceptable.

Say,  “You are learning!”  (Avoiding  “Good Job” is really hard but it means nothing after a while and doesn’t help with true self-esteem or sense of accomplishment.) Try to pepper your speech instead with questions about how it feels to be accomplished “Did if feel good to do it yourself?” or “You tried so hard and then you got it!”

Ask Questions and Lead by Example. (Avoid correcting efforts). It can be especially difficult for teachers who have created precious curriculum to do this.  It is almost impossible for a toddler to get something “wrong”. They are simply exploring the ends of the earth and must test every boundary in order to come to understanding.  You know how things work and what is expected, but you could occasionally pretend you don’t and watch the child figure it out.  Magic.

Elaborate and Expand.  Your toddler/preschooler may be content with a simple answer to his question, but we respect a love of learning and a growing cognitive ability when we offer up more information, more explanation and ask the child further questions on the topic. “What is this thing?” can become a very long and enriching lesson.

Talk to the Child, About the Child.  When wanting to tell another adult in the room about one child, we strive to do this through speaking to the child, on the child’s level, about behavior or accomplishments- and allowing the other adult to listen in. This way there is no telling-on the child, no blaming the parent and we let the child know that he will be responsible for his own behaviors and can take pride in his own accomplishments! We preschool teachers struggle to do this as much as possible but are imperfect, as parents will also be imperfect with this entire list! But isn’t it nice to have some healthy guidelines anyway!?

Moorea Malatt, All Rights Reserved.

Moorea is a Parent Coach on Potty, Sleep, Gentle Discipline and more, and the Director of Genius: A Baby Academy in Seattle.

9 Tips for Teaching Young Children to Share

It has been 18 years now of teaching and caring for children! The thing comes up as the most difficult things to teach and learn? Sharing (well, besides sleep, of course!)  So now I am mom to a 2.5 year-old and I am the director of a school and a parent coach. I am ALWAYS thinking about sharing. So I’m happy to share my tips.

1) What Is Mine? The biggest tip I will give you for school or at a friend’s house is that the child be allowed to bring/carry something special of her own that she does not have to share. Something she sleeps with or dearly loves is an example. We don’t have to share everything with everyone, but having something that truly is “mine” around is a good way to help her see that there are differences between shared things, things that belong to others that are okay to share, things that others aren’t willing to share, and her own things. You can also model this as well. “This is my special necklace that I don’t share, but I would like to share all of my scarves with you!”

2) Repetition. Then, parent and teachers can reiterate,  ”Now is Jason’s turn with the doll, you can hold your bear from home which is yours.”  The adult can hand her her own personal item as a re-direction in challenging share situations. If she goes back to take the doll? Repeat.

3) Teach Communication. If there is pulling, I simply say,  ”We don’t pull toys, it might hurt somebody or hurt the toy. We ask ‘Please may I play with that?’ or we ask a grownup for help.”  These are really big concepts that aren’t understood immediately, so the main thing is consistency in what you are telling him, and saying it over and over again. (The third time, I remove the child from the situation where he cannot see the other child or toy, onto my lap in a quieter spot to get eye contact and repeat again why we don’t pull toys.) This is part of the 6 Steps for Halting Harm in my Gentle Discipline workshops.

4) Model and Narrate Sharing! Make a big deal of your own sharing your things with her and point out how good you are at sharing. “I’m would like to share my lip balm with you. It feels really nice to share. Okay, now I would like to use it again. May I play with it for a minute? Okay now I’d like to share it with you again”  If she is demanding something of yours, use it as an opportunity to request that she ask nicely. Try to avoid rewarding her when she is grabby at something in your own hand, even a cookie- by just handing it to her as a quick fix. Building good communication and patience is very hard work that really pays off.  Point out other sharing when you see it happen in the world.  I credit this one for why my daughter shares so well. I obsessively modeled and narrated sharing as does her Poppy. You might notice this is easiest to do once your child grows into pretend-play mode.

5) Timed play. In a play group where you supervise, a duo or at preschool etc, you can set a timer for two or three minutes of someone playing with the coveted toy. When clients or teachers first come to me, they have heard that young people have no concept of time. Well, they don’t, until you teach them! By consistently showing what 2 minutes feels like. You must follow through with the switch in toy time, or you lose trust. We build patience this way, and that’s brilliant! As I teach in my workshops and coaching practice- this “if/then, when/then” approach works well with whining and as a way to say no in a specific and positive way.

6) Logical Reinforcement.  I’m not always big on positive reinforcement as a way to manipulate children, but this topic is one where it is very logical because we are already dealing with material items. “When I hear or see you have a good sharing day at school, sharing toys with friends, I will feel like sharing some stickers (or a scone or my iPhone app!) with you after lunch/after school!”. Sharing does tend to beget sharing in the real world anyway!

7) Practice together! Make art or baked goods and share them with others! “We just get a little bit, but then we will share the rest so we can help other people feel happy!”

8) Start Socializing Early in Groups. Whether it be a class setting or an informal group of friends, regular, early meetings with babies around the same age with communal toys to share is an ideal start.  It helps to have some things which do not belong to anyone and to share communal experiences around a table, water play or sand box so that tools can be shared and switched. Even if your child is a “grabber”, continue to covet these environments and try to let go of what others think of your child/parenting. How can we learn if there are never any opportunities to be gently corrected, and to improve?

Tots at Genius: A Baby Academy in Seattle sharing a water play experience and toys.

9) After all, be patient. Sharing takes a while for most children. Before 5-ish (or without modeling, or without being schooled in empathy by parents), young children still don’t understand the boundaries between you and me, him and her, yours and mine, my desires and yours etc. This is a beautiful part of your child’s identity as a new person on the planet. We must respect the process by being a gentle teacher, and giving it time.  Also recognize your child’s unique personality, challenges and attachments as reasons why sharing comes earlier or later for some children.

Moorea Malatt-Hicks

MamaLady Parent Education & Coaching

moorea malatt hicks at gmail dot com

http://www.geniusbabyacademy.com

This article may not be reposted or reprinted without the permission of the author.

Stop Poo-Pooing EC and Early Potty, Dr. Hodges!

Here I was peacefully teaching my early potty workshop this past weekend and writing my early gentle potty book when along comes Dr. Steve Hodges on HuffPost telling parents, “Don’t Potty Train Your Baby” by asserting that Elimination Communication causes stool withholding (what?!) and that waiting longer for potty learning has no consequences (he simply does not believe the many studies -below- which suggest it is detrimental). One article in the Huffington Post and suddenly early potty-ers like me are wrong along with an entire planet full of parents who practice infant elimination communication. The point of the following article is to separate what Dr. Hodges knows scientifically from merely his opinions on potty learning and to remind parents: THERE ARE ZERO STUDIES THAT SHOW EARLY POTTY LEARNING OR E.C. TO BE HARMFUL.

Everything I have read in 3 years of collecting research points to THE OPPOSITE OF DR. HODGES OPINION: Stool withholding is more prevalent the LATER a child learns potty.I am depressed and saddened that by reading this article, parents will further push back potty learning and that will cause further widespread UTIs, bowl withholding and infection, constipation and bedwetting almost into the preteens. I know the research as well as the science, anthropology and biology behind Elimination Communication and Early Potty and from 17 years of working with small children. My practice has been helping children potty. His practice has mainly been finding bowel obstructions and causes of acute urinary tract infection.

I believe I know exactly what’s going on here with Dr. Hodges. He is using the research he knows best (stool withholding and nighttime incontinence), taking a large jump and conflating stool withholding problems and the age of potty learning.  Dr. Brazelton took a swift jump just like this in the late 1950′s when he conflated the forcing/shaming/suppository stuffing bad parenting methods of time with the age at which parents were starting potty. Since Dr. Brazelton began speaking about the “Readiness Method” of potty (and since the advent of Pull-Ups in the 80′s), the age of beginning potty learning has gone up dramatically, the amount of time it takes to learn potty from start to finish now takes a year on average and the rates of stool withholding, constipation, urinary tract infection and diaper rash infections have sharply risen.

Prior to hearing this opinion from Dr. Hodges, I have only been able to find studies that show late potty learning to be medically detrimental. And what’s more?  ZERO STUDIES SHOW EARLY POTTY TO BE DETRIMENTAL.

I don’t want to be at odds with Dr. Hodges. I’ve looked back at articles he has written and while I can’t find a study of his to back up his claim that many of his patients with stool withholding problems were the ones who potty trained around 2 years had more stool withholding problems than those who trained at 3 (maybe it was actually harsh parenting and not the age?)- I have noticed that this doc has a great heart and purpose. He, like me, is very concerned about the increase in bedwetting, stool withholding and constipation of children n this country. However, I don’t understand why he is failing to see the bigger picture here-that what has constantly risen parallel alongside these bedwetting and withholding problems is the age of beginning potty  training.

Hey Doctors! Let’s stop making huge jumps, assumptions and sweeping generalizations based on a hunch, ignoring the numbers and  the previous studies or without presenting the details of your own studies with regard to the age of potty learning.  Apparently Dr. Hodges has never heard of  Dr. Jill M. Lekovic MD who recently spend years compiling the medical, psychological, sociological and anthropological literature about toilet training from all over the world and put it into a book called “Diaper Free Before 3.”   Dr. Lekovic is not a friend of mine and she’s not super crunchy like me either- she’s not into extended breastfeeding and she doesn’t love cloth diapers, but I can still recognize that she wrote a very medically thorough book urging parents to begin potty learning earlier to protect the health of their children. Dr. Hodges, you should read it!

First, let’s talk about what Dr. Hodges does know. He tends to say, “In my experience” in this article which is valid. There are plenty of other pediatricians and pediatric urologists whose work I have read (below) who have had a different experience. Dr. Hodges believes that he has both experience and research to say that full bowels at night cause bedwetting and this is his primary area of concern and research.  Now, I didn’t see the images of full bowels during sleep on XRAY, so I have to let him have this one. I do have a daughter who learned potty early and refused to go to  bed until she has emptied her bowels and was dry through the night by 15 months, so he may be onto something with the bedwetting!  But I do also know that a previous study from the Pediatric Journal of Urology shows that there is a very significant genetic component to nighttime bedwetting which Dr. Hodges doesn’t mention here.

STOOL WITHHOLDING

Dr. Hodges said, “Chronic holding is a damaging habit, and in my experience, children trained early — especially before age 2 — are more prone to developing this habit than kids trained around age 3, though kids trained later are certainly not immune from holding, and early trainers are not destined to become holders.”

If 2 year-olds are more likely to withhold than 3 year-olds, I’d love to see that study because I don’t believe it one bit and what is the theory as to why that would be true? And it certainly sounds like he was talking about a difference between a 2 year-old who has not had infant elimination practice and a 3-year-old who has not had infant elimination practice, so why is he telling parents who practice Elimination Communication that they are wrong? Has he treated children who have stool withholding problems that you believe came from infant elimination communication? No. Of course not, or he would certainly say that. The truth is: BABIES WHO LEARN POTTY EARLY GENTLY DON’T HAVE STOOL WITHHOLDING ISSUES. PERIOD. Stool withholding is something that often comes from issues of constipation and/or in children who learn potty after the age of 2.

Dr. Hodges,I think you just need a short education on E.C and early potty. You see, when babies are taken to the potty frequently to empty bladder and bowels (as is done in E.C families, most of whom are extremely attentive to these needs and not cruelly making their children wait -as you suggest) – they are learning to go to the potty and empty frequently, an extremely healthy lifelong habit. When we let older children decide if or when they will start using the potty, we create toddlers who hold it because they are busy and don’t want to go.

And that is why I teach parent-led gentle early potty (starting between 10-18months of age when they can begin communicating about their needs). When breastfed babies gradually learn to hold poop or pee for very short periods of time  and gradually learn to communicate to help thier parents get them to the potty, they are slowly and gradually with a parents help -building the muscle control they already inherently have.

Dr. Hodges goes on to posit that learning to “put off peeing and pooping” (meaning hold it until you can’t hold it anymore) is the definition of toilet training. WHAT?  Then we are not talking about the same thing here. EC and Early Potty is about helping a child learn to make frequent trips to the bathroom to eliminate by beginning early that way- taking them frequently. I certainly agree that holding it for long periods of time is a major problem!  And although this doctor says he has some anecdotal evidence from his practice that some kids who are potty trained a little earlier are the ones, he does not state what method these families used, how harsh the parents were or whether any of them practiced elimination communication in infancy. But if he’d like to provide more than one case study or some numbers from his practice or a study looking at withholding in toddlerhood and having practiced early potty/EC before 15months, I’d love to read it.

CONSTIPATION

As I said above, I believe stool withholding to be a problem stemming from constipation that hurts.  Even a normal bowel movement that is slightly large can be uncomfortable at any age. No matter the age of potty learning, starting potty during a bout of constipation might lead to associating potty with pain and subsequently the child not wanting to poop on the potty. Toddlers who eat a lot of dairy and not enough fiber or who resist drinking water will have more constipation. Babies or toddlers who are still on breast milk or who are not eating mostly solids are much less likely to have constipation which is one of the huge benefits of starting potty early. Older toddlers often can become more picky over time and will choose white-yellow-orange fiber-less foods and dairy products. Younger babes have softer poo and that makes toilet learning feel better.

URINE WITHHOLDING AND UTI

When a parent decides it is time to start potty learning based on perceived cues of the child as in the readiness method, it is still the parent who decides to buy a little potty and encourage going. By 2.5 years or so, even the gentlest parent is personally invested in making potty happen and this can translate into unspoken anxiety children are very perceptive about (E.C parents are actually often less concerned with a certain age to be trained by because they are starting plenty early). Toddlers this age of 2 or so are also very playful, funny, tricky, defiant, busy, fast, hyper independence-minded and not exactly prone to doing those things which you are most hoping for- like cleaning up his toys. This is why they are so darned cute and also why potty learning after 2 is so talked about and challenging! Pediatricians know that many toddlers simply hold pee because they do not want to take time out from activities. Early potty learning while the child is still looking to the parent for entertainment and constant connection is a much better time/way to teach the healthy habit of visiting the potty often to relieve oneself.

And if you want to talk about urinary tract infections, you absolutely must not leave out Diaper Rash! Pee stings diaper rash and so babies and toddlers withhold pee- causing infection. So away with the diapers and onto the potty. Early Potty is how I cured my daughter’s recurrent UTIs and why I am such a fervent early potty advocate. I believe that reason Dr. Hodges says he sees many newly potty learning toddlers (2-3 years) with UTIs in his clinic is because the children are at a cognitive age of development where they don’t want to pee in the pull-ups because they don’t want to disappoint a parent or because they are so busy in their play.

It is not because children in diapers don’t get UTIs as Hodges suggests. A regular Pediatrician doesn’t send a diapered non-pottying patient to a Pediatric Urologist like Dr. Hodges, she simply helps cure medicates the diaper rash and treats the UTI with antibiotics. Just because Dr. Hodges hasn’t seen diapered children with UTIs, doesn’t mean they don’t exist. I hear about them very week from parents and they happened to my family! They are a very common pediatric issue that does not usually require a urologist. This is a simple example of a specialist using his tiny frame of reference to make a generalization. As a specialist, you must realize that the insights gained come from your specific practice don’t always hold true for most healthy children. And diet and method of toiling (child-led versus parent reminders) has much more to do with the stool problems you see in your practice, no?

Dr. Hodges seems to suggest -that the bathroom situations in this country and in schools being awful makes early-trained children ill-equipped to use the restroom (because it isn’t up to their standards?- my kid can squat anywhere!)  Actually, the healthy, clean,sanitary and sane thing to do is to bring a travel potty for your child (6-months or 6 years!) wherever you go!  So that problem isn’t an age-of-potty issue either.

And how bull-headed and closed-minded is Dr. Hodges’ assertion that we don’t need to look cross culturally, historically or anthropologically when we are looking at a health practices issues?  Why would somebody say that we should ignore those things with regards to keeping or changing health practices? And it is also so easy for him to poo-poo the effect on the environment and your pocketbook, but last I checked those were both very real concerns for parents.

But where Dr. Hodges and I totally, wholly agree? This part:

“Watch your child like a Secret Service agent once he is out of diapers. (This applies to all newly trained kids, regardless of when they trained). Have him on a peeing schedule so that he never goes more than about two hours without using the toilet. Have him sit on the potty to poop after breakfast and dinner. Never ask, “Do you need to go potty?” All kids will say no. It’s your job to instruct your child to go. Don’t lose track of the last time he pooped and what his poop looked like.”

But hey, isn’t that what I’ve been saying all along about why early potty is wonderful? You are already taking your baby on your hip with you everywhere. You can give them such frequent sing-song-sitting opportunities to eliminate, versus waiting for your toddler to decide it all himself, tell you “No!”  and hold it until the cows come home.

Dr. Hodges didn’t include the many articles and studies from the U.S. and Europe which he said not to post in his comments because he’d already read them and didn’t agree with any of them, but since they are highly regarded by other pediatricians and psychologists. So…here: I believe you deserve more than just my opinion and the case study of one child.

UPDATE: I came across a very important study. Oliveira da Fonseca et al in the April 2011  Journal of Pediatric Urology found no association between Infant Potty Training (defined in this study as < 24 months) and dysfunctional elimination syndrome (symptoms include urinary tract dysfunction and constipation). Here there were 80 patients between the ages of 3 and 17 years, looking back at age of potty learning.  Given that this study’s  larger sample size (Dr. Hodges study had a sample size of 30, all patients at his urology clinic)and that they specifically looked at the impact of Infant Potty and and constipation, it seems clear that the relationship established is that there is not a relationship between IPT and constipation. (Since Hodge’s collection of data from his practice did not look at infant potty learning at all, and in fact, he may have himself had zero patients who learned as infants and his feelings about infant potty learning may be only a theory. A theory which had been proved wrong when looked at by these other researchers the year prior.) http://www.jpurol.com/article/S1477-5131(11)00080-5/abstract

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American Academy of Pediatrics. 2006. Toilet training readiness American Academy of Pediatrics website. (visited November 24, 2006)

Bakker E; Wyndaele JJ. 2000. Changes in the toilet training of children during the last 60 years: the cause of an increase in lower urinary tract dysfunction? British journal of Urology, 86(3):248-52.

Bakker W. 2002. Research into the influence of potty training on lower urinary tract dysfunction. Unpublished MD dissertation, Department of urology, University of Antwerp, Belgium.

Bakker E, van Gool JD, van Sprundel M, van der Auwera JC, and Wyndaele JJ. 2002b. Results of a quaestionaire evaluating the effects of different methods of toilet training on achieving bladder control. British Journal of Urology, 90: 456-461.

Bakker, Els, and Jean Jaques Wyndaele.”Changes in the toilet training of children during the last 60 years: The cause of an increase in lower urinary tract dysfunction?” BJU International, 86 (2000) 248-252

Barone JG, Jasutkar N, Schneider D. 2009. Later toilet training is associated with urge incontinence in children. J Pediatr Urol. 5(6):458-61.

Blum NJ, Taubman B, and Nemeth N. 2003. Relationship between age at initiation of toilet training and duration of training: A prospective study. Pediatrics, 111: 810-814.

Blum, NJ and B. Taubman and M.L. Osborne. “Behavioral characteristics of children with stool toileting refusal.” Journal of Pediatrics, 99 (1) (1997)50-53

Brooks, Robert C, et al. “Revidw of treatment literature for encopresis, functional constipation and stool-toileting refusal.” Annals of Behavior Medicine, 22 (3) (2000) 260-267

Poole JM, Stadtler AC, Wright CL. 1999. Instruction, timeliness, and medical influences affecting toilet training. Pediatrics, 103: 1353-1358.

Canadian Pediatric Society. 2000. Toilet learning: Anticipatory guidances with a child-oriented approach. Paediatrics and Child Heath, 5: 333-5.

DeVries, Marten W.; and M. Rachel deVries.  “Cultural relativity of toilet training readiness: A perspective from East Africa.” Pediatrics, 60 (2) (1997) 170-177

Gladh G, Persson D Mattsson S and Lindstrom S. 2000. Voiding pattern in healthy newborns. Neurourology and urodynamics, 19: 177-184.

Gorski PA. 1999. Toilet training guidelines: Parents—the role ofparents in toilet training. Pediatrics, 103: 362-363.

Hellstrom AL, and Sillen U. 2001. Early potty training advantageous in bladder dysfunction. Decreases the risk of urinary infection (in Swedish). Lakartidningen. 98: 3216-9. Ned Tijdschr Geneeskd., 147(1):27-31

Horstmanshoff BE, Regterschot GJ, Nieuwenhuis EE, Benninga MA, Verwijs W, and Waelkens JJ. 2003.[Bladder control in 1-4 year old children in the the Eindhoven and Kempen region (The Netherlands) in 1996 and 1966]

Jansson, U.-B et al. “voiding pattern in healthy children 0-3 years old: A longitudinal study.” Journal of Urology, 164 ) (2000) 2050-2054

Kinservik, Margo A., and Margaret M. Friedhoff. “Control issues in toilet training. Pediatruc Nursing, 26 (3) (2000) 267-272.

Largo RH, Molinari L, von Siebenthal K, and Wolfensberger U. 1996. Does a profound change in toilet-training affect development of bowel and bladder control? Dev Med Child Neurol. 38: 1106-16.

Luxem M and Christophersen E. 1994. Behavioral toilet training in early childhood: research, practice, and implications. J Dev Behav Pediatrics, 15(5):370-8.

Monsen, Rita B. “Giving children control and toilet training.” Journal of Pediatric Nursing, 16 (5)  (2001) 375-376

Rubin, Greg. “Constipation.” Clinical Evidence, 7 (2002) 292-296

Schum TR, Kolb TM, McAuliffe TL, Simms, MD, Underhill, RL and Lewis M. 2002. Sequential acquisition of toilet-training skills: A descriptive study of gender and age differences in normal children. Pediatrics 109: 48-54.

Sillen U and Hanson E. 2000 Control of voidings means better emptying of the bladder in children with congenital dilating VUR. British Journal of Urology, 58: 13.

Smeets PM, Lancioni GE, Ball, TS, and Oliva DS. 1985. Shaping self-initiated toileting in infants. Journal of applied behavior analysis, 18: 303-30.8

Taubman B. 1997. Toilet training and toileting refusal for stool only: A prospective study. Pediatrics, 99: 54-58.

Yeung, CK, Godley ML, Ho, CK, Ransley PG, Duffy PG, Chen CN, Li AK. 1995. Some new insights into bladder function in infancy. British Journal of Urology, 76:235-40.

Gentle Discipline: Parent Boundaries and Emotional Coaching

While punishment might be temporarily effective, wouldn’t emotional coaching benefit the child and the family more? And while style of discipline is a choice (some choosing more discipline and some choosing more permissiveness), all of our children must eventually learn that others have boundaries.

We live in a world interconnected with other people and animals and we must learn to play respectfully and also to stand up for ourselves. By disciplining our children gently and respectfully, we teach respect for others and respect for the self as well as general gentleness toward all who inhabit our planet. Learning gentleness starts with how the first caregivers react, what boundaries they set and whether they teach emotional literacy.

Hitting and Biting start can start as early as 5 months and it usually starts with a parent. Yelling meanly also starts with the primary caregivers. This is the first opportunity to teach empathy and emotions. If a child bites, we can immediately jump to a punishment (putting the baby down in another room/separation? biting back?), or we can choose instead to exaggerate the feeling of being hurt and show that in voice and face to her child. We can state the emotion we are feeling:

“Hurt. Biting hurts. I’m sad.”  Then we can show a way of interacting in a way that we enjoy instead, like kissing:

“Mama likes kisses instead. Like this.”

The first time my child bit me it was very hard and on the back of my arm. It actually made me cry. The crying was very effective. Many parents worry that by having a sad or hurt reaction to harm, it will make the child cry and feel guilty, but I believe that the child is learning interconnectedness: “When I hurt you, I see you hurting and then I feel hurt.”

Even before we know whether our babies understand us, we can begin to emotionally coach them-to talk about the fact that emotions cause behaviors.  In my parent coaching practice, I encourage parents to teach children a sign for “frustrated” and signs for “sad” and “hurt”.  We can ask our child, “Were you frustrated I was on the phone and not listening to you? Did that make you want to hurt mama?”

Losing the opportunity for emotional coaching is why I believe punishments and especially time-outs are detrimental to our children’s development. By punishing and separating kids, we ignore the fact that we, the parent, have a responsibility in the situation not only to have been paying attention, but to have set boundaries, to own our rules and preferences and then to teach and model proper emotional release. Sometimes there may be nothing inherently wrong with a behavior other than the child is relating to another human being who has different preferences and expectations- and a human being who has feelings and preferences, say, to not have my hair pulled even when it comforts the sleepy child. That brings me to:

Boundaries

Teaching proper boundaries is one way that gentle discipline is certainly different from permissiveness. As a parent, we do not have to allow physical harm, nor do we need to accept and ignore being yelled at by our children. And yet, we also do not have to punish them. To discipline means: to teach.

I suggest that this is a time where a firm “No.” is important, as is an explanation, “ouch hitting hurts!” and once again modeling and re-directing toward your preferred way to be treated. “Papa likes to be touched nicely on the face like this..” (using your own hand to caress, and then the child’s hand).   The same goes for yelling, “Ouch. That hurts my ears and makes me feel sad.”

If we allow our children to hurt us, not only do we show our children that it is okay to hurt others; we show our children that is is okay for other people to hurt them.

Both emotional coaching and having boundaries in a calm and gentle way is such hard and time-consuming work. Where time-outs have been shown to stop behavior temporarily, they are also shown to lead to a lack of physical and emotional boundaries and understanding later in life. Gentle Discipline, instead, is worth all of the effort for the long-lasting life skills it promotes.

Part of emotionally coaching and protecting our babies, toddlers and older children is showing and talking about our own feelings and boundaries.

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My next couple of parenting workshops are sold-out, but here are some on the horizon:

Beginning Gentle Discipline April 15th 3pm at Birth and Beyond: http://www.birthandbeyond.com/beginningdiscipline.html

Potty Savvy April 22nd  3pm at Birth and Beyond: http://www.birthandbeyond.com/pottysavvy.html

Beginning Gentle Discipline April 28th at 3pm at Genius: bottom of page: http://www.geniusbabyacademy.com/signup.php

Preschool Gentle Discipline May 5th 3pm at Genius: bottom of page: http://www.geniusbabyacademy.com/signup.php

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As always, I am always available for private phone coaching sessions akin to all of my workshops if you cannot attend.

Like a Turtle: The Sleep Learning Process

And by “like a turtle”, I just mean SLOW and STEADY wins the gentle parenting race.

Long ago, I posted this article on our first “sleep training” process which was not the typical sleep training at all but more of a gentle night-weaning. This is my update, and some tips. I have since taken on clients in my Parent Coaching Practice who want gentle steps toward better sleep. I tell them its not easy and it doesn’t happen in three days.  I tell them there will be some crying but that they shouldn’t ever leave a crying baby alone. I tell them NO FALLING ASLEEP ON THE BOOB!  Well, not after 12 months anyway, if you are trying to change your child’s sleep habits. 

For 16 years as a nanny and infant nanny and then postpartum doula, I taught other people’s children how to sleep. I did what the parents asked. Sleep training either worked or didn’t work depending on if the method worked with the parent’s emotions and the child’s personality. I learned what I would never do. I learned I could never let my own child Cry It Out.

Things for us are not perfect since starting the process of gentle sleep learning months ago. My daughter still has a sleep disorder which makes her wake up every hour at the point in her sleep cycle where other people usually can fall into REM instead of waking fully. My family is full of sleep disorder and my own sleep has always been *expletive*.

Eventually, it was apparent that I needed to try and teach her how to fall back asleep with less and less help from me for the sake her heath and for mine. But it was very emotionally complicated to do any sort of sleep modification with a child I knew had a medical disorder and really couldn’t help it.

As happens to all families and with any method, there is some backward movement for us with respiratory illness because I do not want extra snot to accumulate with crying

But on good nights, Iris nurses one time as opposed to back when it was hourly or more. I stopped letting her fall asleep on the boob ever, for good sleep associations and not just pulling off after she was almost asleep- I had to teach her how to fall asleep with me there but on her own and it wasn’t easy. It also wasn’t as hard to listen to as Cry It Out would have been (with me not in the room). There was a little crying and a little thrashing around but I was there with her comforting with voice and a pat on the back. No boob in bed, sleep got a little bit better.

Then, I had to stop feeding her every time she woke up.  That was really hard. I went with only feeding her after 3 hour increments even if she woke every hour and worked toward 4. There was crying, a bit of thrashing around. I was there, modeling sleep myself because it was sleepy time. Sleep got even a little better. (And it tends to really help with the night wakings for my clients even more than it has for us, likely because of the apnea. Sigh.)

Now on bad nights she nurses twice in a chair. On good nights she nurses once. She still wakes frequently to gasp for a breath or after a huge snore because of her sleep disorder but now she is capable of finding my head and touching it and falling right back asleep. My sleep is still not optimal but we do feel she is very slowly in a turtle-esque way growing out of her sleep disorder like the doctors suggested. I could have just let her nurse every hour until I went insane. Or I could have done Cry it Out until we all went insane. Instead, I made slow and gentle modifications and I admit to myself that the attachment parenting route I have taken means that I put myself and my sleep on a lesser priority until Iris grows into an older and easier human. Some nursing babies wake more frequently, it is part of our biology and anthropology to check in with one another at night and night nursing keeps us doing that.

Tips for Gentle Sleep Learning from Me, the non sleep-trainer: *for co-sleeping parents*

1) Perfect your schedule for optimal. Are you on the right amount of naps for the right amount of time? Yep, unlike some other natural parents, I’m very pro-schedule for the sake of sanity and good sleep. I don’t believe in migrating bedtimes or “child-led bedtimes” or carting your child everywhere and sometimes not allowing for any naps.

2) Is your child going to bed too late for optimal sleep? All of the sleep books say this. This is probably the only thing they are all right about. It is scientific and biological and about circadian rhythms and the planet and being an animal and we adults should go to be earlier too. Your baby/toddler is going to bed after 7pm? Bad idea.

3) Only falling asleep on the boob? Work on that. Are there periods of time (like the morning) where there is total attachment to the boob and it is hampering your own sleep. Work on that. Cover them up, even. (The only time I’d ever suggest you cover up your boobs

4) Do you have a nighttime ritual with books and low lights and calmness? Have you tried turning a sound machine on at the beginning of bedtime for the sleep-association of the sound?

5) Did your child have a before-bedtime snack. Something like a whole grain carb and a protein but not sugary. Hummus and crackers.

6) Can your child fall asleep again in the middle of the night by just noticing that you are there or does he always need the breast/to be walked/to be rocked.?  Try working on that.

7) Are you nursing on demand all day like every 20-30 minutes or every hour? Nursing on demand is ideal for babies. But remember that your nursling might not know how to sleep for hours at a time without nursing if she cannot do it during the day.

Sleep Training in (a supposed) 3 nights with a screaming baby alone in a room is torture. Studies have shown that it can cause brian damage and lifelong emotional problems. It isn’t easy and it does leave many parents with lifelong feelings of guilt. Gradual and Gentle sleep learning methods like what I have done and what I teach can also feel like torture for many nights. I won’t lie. But there is nothing wrong with an older baby/toddler crying because they are tired and not getting exactly what they want- with you there for re-assurance. In fact, studies have shown that a child who cries with a loving parent present does not experience the same negative effects a child left alone to cry does. More on cortisol levels, sleep  and crying here: http://www.kangaroomothercare.com/1new-page.aspx

Giving in to constant night-nursing just works for some moms who can sleep through it! Bless them. Damn them! But if giving in to night nursing when a child cries for it doesn’t solve your sleep problems or doesn’t help you and the child sleep for live-able time chunks, it is time to change something. And I am the first to tell you any change sucks until it doesn’t.

And turtles…turtles can sleep under water, but not for long periods of time and not very soundly and there are predators. They must come up for air. Parental Presence is like air to babies.