New Babies, New Parents -- T. Berry Brazelton, MD, and Joshua Sparrow, MD. -- 01/23/03

WebMD Live Events Transcript

Babies don't come with instruction manuals, but don't you wish they did? We offered the next best thing, when renowned pediatrician T. Berry Brazelton, MD, and pediatric psychiatrist Joshua Sparrow, MD, co-authors of the new Brazelton Way book series, joined us to answer our members' parenting questions.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Hello Dr. Brazelton, Dr. Sparrow. Welcome to WebMD Live. We have quite few questions from our members, so let's jump right in.

Member: My 7-week-old baby is still sleeping in bed with us. The first few weeks he slept in his crib, but after a rough night when he was three weeks old we decided to have him sleep in bed with us, but now we cannot get him to sleep in his crib. It's becoming frustrating and we would love suggestions on how to transition him to his crib.

Brazelton: You have to make up your mind you really mean it. Then plan to transfer him to his crib and pat him down. Don't pick him up but rather pat him down when he starts fussing; then he can learn to sleep by himself. I don't think you can desert a child or would want to, but you can teach them to be self-sufficient. It has to be done over a long period of time, no matter how long it takes.

Moderator: What is your philosophy about getting a child to sleep successfully on his/her own?

Sparrow: There are differences in the nature of sleeping troubles from one age to another and though there are some general principles it really does make a difference in the age of the child. And in Dr. Brazelton's Touchpoints book as well as in our Sleep book we talk about the kinds of sleep disturbances that parents can almost predict at different ages.

But the general principles to start with is that first parents have to make sure they have made up their minds to have their child sleep on their own. The parent has to be ready to separate. When they are busy and at work all day they have mixed feelings about both wanting to be with their babies and wanting their sleep. Once they have made up their mind, they have to understand it's a process of learning. If you do it all for the child, they won't learn. But if you leave it all to the child, they won't know where to begin.

Brazelton: I would add learning to sleep is a long-term process at any age. You can sit beside a child and help them learn to get themselves down. Picking them up and jazzing them up does not though help that process.

Member: Dr. B, my 6-week-old pulls away and yells when nursing, and then frantically searches for my breast only to let it go again. What could be bothering him?

Brazelton: A lot of babies do that. It's not unusual. I am not sure why; maybe they suck, suck, suck and get so overloaded that they have to pull away and cry out. It could be a bubble or overloading. I am not sure which.

Member: My daughter (2 1/2) is going through a very defiant stage now. I find myself losing my temper with her and her with me all the time. How can I make this stage in her life go more smoothly?

Sparrow: Discipline is teaching and one way children learn is from parents' examples. And it is, of course, entirely understandable for a parent to lose her temper. But first take a step back and then settle yourself. Then go back to the child when you're ready to model to the child how to settle herself. With a temper tantrum, when a child can be safely left, the best thing to do is to walk away. The more involved you are the more likely you are to fan the flame. When you walk away, you are actually saying you know that they can do it. You are saying you know they are ready to settle themselves down.

Member: How can I get my 2 1/2 year old to use the potty? He will go pee just fine, but he has only pooped in the potty once in the year that he has been training. I stopped potty training during the year because of a lot of events (husband and I split up and a new baby sister) but now he is back into using the potty. I would like to make this as easy as possible for him, but am not sure how to do so.

Brazelton: Take it as slowly as he does. It's really up to him when he's ready. The main job is to let him know it's OK to use his diapers for his bowel movement. If he has to go in a corner and hide from people, do it. Don't flush it away until he's lost interest in it. He is telling you, "I have to hold onto everything right now in this family because it's falling apart for me."

Member: We are in the process of potty-training our daughter, who will be 3 in March. The process has had its ups and downs, although she increasingly wants to put on panties rather than a pull-up. The difficulty arises, however, when she has an accident in the panties. She refuses to allow us to change her clothes and will throw an absolute tantrum if we persist in trying to clean her. She insists on leaving the dirty panties on. Do you have any advise as to the proper response to this?

Brazelton: You know I think I wouldn't push it too hard. She may be telling you she's not ready to go beyond the panties. I would say to her of course, "I would like to put you back into diapers when you are having a BM and then you can keep them on as long as you want." The danger is pushing her farther than she is ready. When a child holds back BMs, you have to make sure they are soft. You don't want them to hurt at the sphincter level and have also a psychological reason for holding back. Consult your pediatrician for a bowel softener. Don't push her to do the psychological work until she is ready.

Member: My 2-year-old son immediately looks to me when he has a conflict with another child. I have read not to step in too quickly and resolve the conflict for him (unless there is danger involved). I'm afraid that his daycare providers (which I am very happy with otherwise) are stepping in and separating the children too quickly to avoid conflict. How do I teach him to "work it out?" How involved should I be? This is my first child.

Sparrow: I think you can start when he looks to you to look back at him encouragingly and say, "I think you can figure this out and work it out." If he insists, you can say, "Do you want some help?" And then you offer help without fixing it. You might offer your child options, rather than doing it yourself. I also recommend talking it over with the provider. Go to them and ask them as if you are curious and want their advice. Then they won't be defensive and it won't backfire.

Member: I am newly expecting, but my question relates to self-soothing and putting the baby to sleep. I understand that you are not supposed to get into the habit of feeding and rocking and then laying the baby down, so what do you do? Bottle, bath then lay the baby down while still awake and pray that he/she will fall asleep? I don't get it. Also, with self-soothing, I guess you are not to immediately pick up the baby when he/she cries, but pat and talk to reassure? I don't get that process either. HELP!!!

Brazelton: You are properly confused. I would certainly pick a baby up whenever you feel the baby needs you. If the cry is not understandable to you, try whatever you need to and see if it works. But you are right about putting himself to sleep. Feed him and soothe him and then put him down. Then he learns the process of getting himself from semi-down to sleep. And then sit there and pat him down so he knows you are there but he also knows you are expecting him to learn how to do it himself. You will wait until 4 or 5 months for this type of advice.

Sparrow: It sounds like you are overwhelmed by too much advice. There is no simple recipe. Every parent finds his own way. You are right to question all of this advice, and find out what works for you and what works for your child.

Member: How can I get my 2 1/2 year old boy to stop hitting his 10-month-old sister?

Brazelton: I am not sure you can. But I would say to get him a doll or some type of symbolic replacement and to beat up on the doll instead of the sister. You have to let him know you have to protect her, but that you also understand that he gets frustrated. Pick him up often and say you are my big boy and I have not deserted you.

Member: At what age can kids start helping with picking up their toys? My son (2 1/2) looks at me with a blank stare if I try to get him to clean up, which I'm sure he does at daycare.

Brazelton: This is a time when kids begin to put things where they belong. I am amazed they are willing to do that. If you want him to do that at home, and it doesn't surprise me he won't, say you and I will pick up together. Make it fun and make it a game. But his resistance to cooperating with you and not at daycare is certainly understandable. I would not take it too seriously. You will just add to it.

Member: How do I get my 2 1/2 year old to stop picking her nose? She picks her nose so much that sometimes it bleeds.

Brazelton: Vaseline. Also you could teach her to suck her thumb (laughs).

Member: My 2 1/2 year old girl is starting to hit. She feels frustrated whenever she does, but I am slowly putting an end to it by disciplining the first time it happens. I either put her in a time-out or make her go to bed.

Sparrow: I think it's wise to respond as you do right away, the same way each time. Time-outs are effective. I would be concern if you use her bed as punishment she may end up resisting her bed at bedtime because of the association with it.

Brazelton: Hitting, biting, and scratching are common in the second year. If overreacted to, they go onto the third year. Maybe take it less seriously than you do, or it may be reinforced.

Member: What suggestions do you have to help a 2 1/2 year old give up her pacifier at nighttime (which is the only time she uses one)?

Brazelton: I wouldn't. You are lucky she only uses it at nighttime. It helps her make the transition from waking to sleeping. When she is older and it's a social problem, then you can have her use a special toy or blanket and tie the pacifier to that special toy. As she learns to accept that new toy, then you can suggest she might give up the pacifier for that toy. But do it at her speed.

Member: What would you suggest to get a 2 1/2 year old to stop sucking her thumb?

Brazelton: I would rather wait until she didn't need it and could be given a substitute for it. I would be ready to wait that long. Everyone will say "what about dental problems?"

I would say what about psychiatric problems?

Member: My 5-year-old son confuses me because sometimes he wants me to baby him and at others (which is the majority of the time) he is very independent and doesn't need or seem to want me around. Do I continue to allow him this babying time or do I just stop it?

Sparrow: At age 5 that kind of confusion and mixed behavior is typical. It appears again at other specific moments, like at the verge of adolescence. It says, "I both want to be a big boy but also want to hold onto being little." I think you can respond to both by nurturing him and also fueling him to move past this point as well.

Member: What is the best sleeping position for a newborn?

Brazelton: On the back. We are aware that sleeping on the back is a protection from SIDS; however it is very tough for active children. They start moving, startle, cry, disorganize, and then can't get back to sleep. You may have to tilt her to one side so she can find her own thumb or fist to calm down with. You can also swaddle from the waist down to stop the startling.

Member: What age can you stop worrying about SIDS?

Brazelton: The peak of SIDS is 3 to 4 months. After that it decreases rapidly. By then the child is less fragile and has learned how to manage interferences with breathing. Be careful not to put the baby in a hammock-like bed where they breathe their own CO2, plus make sure there are no pillows, etc., that the baby can get trapped under.

Member: It is a pleasure to get to ask you a question; I cherish all the advice you have given in the past with your books! I have 3 boys, 10, 9, and 5. My 5 year old is really having sleeping issues, fear issues that are completely unlike his brothers. He is certain there are monsters under the bed, nightmares 1-2 minutes after I put him to bed, and he is quite certain that I cannot go back to work in fear he will be in daycare before and after kindergarten. HELP!

Brazelton: Nightmares are common at age 4 and 5. I am not sure if these are new and represent a stress the child is going through. If not, take them seriously enough. Look under the bed with him and go through all of it. Then talk to him and say children your age have fears and there is nothing there. Children this age are made aware that their aggressive feelings are coming to the surface and it scares them. And these fears come out at night. As they model on you during the day, to learn to deal with their aggressive feelings, they become more comfortable with them. Then the fears go out the window. Meanwhile he needs your comfort.

Member: My 2 1/2 year old is going through a really negative phase right now. It's been going on since around Christmas. Every time I try to get her ready to go somewhere she starts saying she doesn't want to go, she doesn't like the person we want to see, etc. Then once we get there she has a great time and doesn't want to leave. I try to give her ample warning. The night before I tell her what we're doing the next day (she has a two-hour preschool one day and a 45-minute music class with me and her brother another). Then when she wakes up I remind her. We talk about what might happen when she's there, etc. But once it's time to put her coat and shoes on she starts yelling and runs away. It's driving me crazy! Any suggestions?

Brazelton: I think you are doing a wonderful job. Don't take it so seriously that it interferes with the routines you have set up. She may be more comforted by going through with the routines you have set up and have confidence then by going through them.

Member: Our 5-month-old baby was sleeping through the night and now is getting up 2-3 times again. This has been going on for a month now. He is breastfeed exclusively. Do you think it is a hunger issue? Our pediatrician recommended not feeding him when he wakes up, but he always seems hungry. And when I do feed him he goes right back to sleep. Any thoughts or recommendations?

Brazelton: He's probably ready for solids at night and then he would sleep better.

Member: What can I say to my 2-year-old when he doesn't want to share with his friends? His feelings always get hurt easily and he cries if he has to share. He is in a play group once a week. Do you think that more interaction with other children will help him learn how to share?

Sparrow: Rarely expect a child to be able to give up a precious belonging and share. Just understand you will have to keep repeating this.

Brazelton: Ask the child when the other kids are coming, "Which toys do you want to share?" and put the others up. The funny thing is that they will still fight about it (laughs).

Member: Do you have any suggestions on how to get your newborn (7 weeks old) to take a pacifier? She only takes a finger and that calms her every time, yet when we try a pacifier, no luck.

Sparrow: There are lots of different shapes; not just the nipple but even the plastic part by the mouth. If a manufacturer says it's safe to boil it, do so and it may change the texture. Also you can put some milk on the tip. Some breast fed babies will only take the breast nipple and will not take the pacifier. The other suggestion is to teach her to use her own thumb or fist.

Moderator: Gentlemen, we are almost out of time. Before we wrap up for today, do you have any final comments for us?

Brazelton: It's fun working with you. Thanks for chatting with us today.

Sparrow: It is so reassuring to see on this web site the incredible passion of parents for their children. We hope you find suggestions and solace in our books. We also hope you can turn to your pediatricians for the answers you need.

Moderator: We are out of time. I'm sorry we couldn't get to all of your great questions. Our thanks to T. Berry Brazelton, MD, and Joshua Sparrow, MD, and thank you members for joining us today. For more information, please read the new Brazelton Way book series: Sleep, Calming Your Fussy Baby, and Discipline. Visit the parenting message boards and our Parenting and Pregnancy Center for the latest parenting news stories, features and archived interviews with experts on WebMD. If you didn't get your question answered, please visit Dr. Steven Parker on the Parenting Message Board.

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