Bad Habits
As children grow up, parents need to step back and loosen their control on their children's lives. But it's often difficult to know when parents should intervene and when they should give their children the opportunity to succeed or fail on their own. We have a duty to supervise two year olds very carefully since they are unlikely to learn from their mistakes and can hurt themselves easily due to their bad choices. If we're lucky, our young adult children will know to avoid the often fatal behaviors that we can't stop them from trying. In between these two extremes the decisions we make often depend on our tolerance of risk as much as our children's personality. But sometimes it's our understanding of the problem that motivates our choices. Let's look at a few examples.
Here's an easy one – thumb sucking. Unlike when a child is unable to give up a pacifier, you can't take away the thumb. I've often used this expression: “It's like trying to teach a pig to sing. It's a waste of your time, and it annoys the heck out of the pig.” In other words nobody wins. As far as I know, nobody ever got married with his thumb in his mouth. Yes, some vigorous thumb suckers will need braces eventually, but unless the child actually wants to try to stop, using punishments or bad-tasting chemicals will cause more harm than good. Incidentally, I am personally against pacifiers. If you must use one, it's time to get rid of them when the child can ask for it in a sentence.
How about bed wetting? In years past (and no longer, I hope) some parents tried to shame and punish their children for wetting the bed. Our understanding of the cause of bed wetting makes that policy unacceptable. Some children have an unfortunate situation. In brief, they are very heavy sleepers, they have very sensitive bladders, and they tend to lack a hormone that reduces urine production at night. Fortunately, in the absence of any specific treatment children will outgrow this problem – eventually. Yes, they may be in their teens, but they will outgrow the problem. In the early years pull-ups are an effective first step. Reducing evening liquids also helps. If the problem has not resolved by age 6, there is medication which is usually very effective. Your pediatrician can guide you.
As long as we're on the subject of bed wetting, we might touch on toilet training. It is interesting to me how important this subject is to some mothers. You certainly will save on the cost of diapers if you can get your child to use the toilet early, but there is no developmental significance to early toilet training. By that I mean it's nothing to brag about. It's usually due more to the parent's persistence. My experience is that when a child is verbal, willing, and ready, he can be toilet trained in a very few days. Age 2 ½ is not unreasonable. Some children reach their third birthday in diapers. If they don't care, take a deep breath and back off. It's nothing personal. If your child has a developmental delay, it might take longer, but most children who are late to toilet training are developmentally normal.
I am not going to spend much time discussing the other toilet training. Some children learn to poop on the toilet early, some late. For some there is a psychological reason for withholding stool. For others there is a true physiological (body function) problem. The discussion of these body functions should be part of your visit with your pediatrician. I have only one piece of advice. If the child is able to use a potty, and you think he's ready to switch to a toilet, make sure you have something he can use to push down with his feet. The higher his knees are and the closer to his chest, the easier it will be for him to go. By the way, this works for adults, too!
Finally, a word about rebellion. Kids are always testing their limits. It's not personal. “I never yelled. I never swore. I never lost my temper. I never lied.” said no parent ever. That doesn't mean you shouldn't aspire to that high standard. Do your best, and don't beat yourself up about your impossible job. But don't stop trying. Please remember that kids notice everything. You are their role model. Also, taking a child's point of view into consideration can be very helpful – especially in the case of adolescents. Sometimes that allows you to compromise with something you didn't care about in the first place, like hair style and color. Hair will grow back. Good luck, and don't be afraid to ask for help from the people you trust.
Robert B. Golenbock, MD