Don't Look Back In Anger

Parent complaint: "Everytime I ask my three year old to do something he doesn't want to do he flips out. He seems to be full of rage. I'm worried he will turn out to be a serial killer or something. Please FIX HIM."

Diagnosis: Normal

While I can't promise that any given three year old won't turn out to be a serial killer, this behavior definitely doesn't guarantee it.

You may also be worried that they will turn out like this woman:



Again, I can't make any promises. I do have some advice, though. The answer is the same one you hear when you go to therapy for any relationship: communication. Your child still has limited vocabulary and it can be frustrating to want to say something, but not know how. Plus, ever since they were a baby, the way they got attention was by crying. Here's a few tips to help your toddler/preschooler with their 'rage' issues (actually most of these work at any age):

- Help them identify their feelings by pointing them out yourself. Example, "It looks like you are really disappointed that you can't have any more red hot Cheetos."
- It is important that you remain unemotional in your exchange. It shows your child that emotions don't have to heightened for every trivial matter. Plus, yelling at them only seems to fuel the fire at times. (My wife will readily admit that this is one area I have the hardest time with)
- Encourage them to 'use their words' instead of tantruming. Only give them what they want when they ask in a calm voice. Example, "It seems like you want these red hot Cheetos, but you can only have them if you uses your words in a calm voice." If you give them what they are 'raging' over without improving their behavior, you are just rewarding their rage, and it will be harder to overcome later.... which leads to my next point.
- Ignore. We've heard this one from when we were kids. "Why can't you just ignore your little brother, he's only doing it to get attention." Well you'll find its even harder as a parent to ignore it. There may be a component of attention-getting to their behavior. The less attention they get, the less reward they get. My parents always tell a story of a preschooler tantrum I threw at a movie theater once laying on the floor and kicking. They said they just left me there and walked away. I stopped my tantrum, jumped up and ran after them. Apparently that was my last tantrum.
- Work on your own feeling communication. Explain to your child why you are doing what you are doing. Don't say, "because I'm the daddy, that's why." Say, "I don't want you to have any more red hot Cheetos because you've already eaten a lot, and we are going to eat dinner soon."
- Positive reinforcement. When they respond in a 'grown up' way give them a reward. A sticker. A healthy treat. While they usually won't choose it over the other things, physical affection (a hug, etc) seems to work best of all. "I'm so proud of you that you were able to talk in a big boy voice instead of whining" (accompanied with a hug). Kids are suckers for that crap.

The good news is most people grow out of it (ignore the woman in the airport above). Through your excellent parenting skills you can help them get there sooner rather than later.

Fell free to add any comments of methods you have used to share...

Flu update

There have been many developments on the 'swine flu' front, so I thought I'd give my readers an update... I guess we are now calling it H1N1 to start off...


I'll be honest and admit that there was a much more significant outbreak this summer than I expected. It is still about equivalent to the regular flu for your average healthy individual. Here are some numbers you may be interested in: H1N1 deaths in the US = about 300. Number of deaths of regular flu per year in the US = 36,000.

We have learned a few things about this new strain of flu: It seems to be harder on pregnant women than previous strains of flu. There seem to be some concerns that it is easier to develop secondary infections (like pneumonia) from this strain than the average American strain. This risk seems to be increased in the teenage/20-something age group than 'regular' flu.

Things to do to protect yourself now, and during flu season
1) Get vaccinated (more on this later)
2) Be free with the hand sanitizer/hand washing especially before touching your eyes, nose or mouth (they both work!)
3) DO NOT wear a mask. There are very few masks (which are currently in low supply) that work for more than a few minutes against flu particles. In fact, wearing a mask in public may increase your risk of getting it, because it may make the flu particles get lodged between the mask and your face, increasing exposure time. You can wear a mask if you think you have swine flu to keep it from spreading to others, but do yourself and others a favor and just stay home (the CDC recommends staying home until your fever is gone for more than 24 hours).
4) Take antiviral medication. One of the antiviral medications appears to be more affective against this strain than others, but it is in short supply, so you may not be able to get it unless you are at high risk of developing severe disease. Ask your doctor if you are concerned.

5) Get plenty of rest, exercise and a healthy diet while you are well to keep your immune system up. Always good advice!

Should I vaccinate my family?
Unfortunately the regular flu shot isn't very affective against H1N1, and as of this year, the H1N1 strain is too new to be added to this year's flu shot. They are, however, feverishly working on developing an H1N1 flu shot. Which means this: you will have to get multiple shots to be protected from all strains of flu this year. It will likely be combined in the future, but not now.

Some people feel it isn't worthwhile to get vaccinated against something that probably won't kill you, since you are healthy. In fact, there's a good chance you won't even catch it. You may be right, unfortunately, your kids don't fit in that group. I highly recommend getting the flu shot (flu shot's' this year) if you are a kid or have kids. ESPECIALLY if you are pregnant or want to become pregnant. 6% of the swine flu deaths have been pregnant women. Here are the target groups the CDC gives for those who should be vaccinated this year:

- Pregnant women
- People who live with/provide care for infants besides being a pediatrician - and everyone knows pediatricians love to torture children with needles): kids are the vectors! Studies have shown that just vaccinating school age children signficantly decreases the load on ALL OTHER demographics. Kids spread germs. That's the reality. You decrease the germs amongst the kids, and everyone is better off.


For more info, see the CDC webpage on H1N1
http://www.cdc.gov/h1n1flu/