A preschooler’s wet bed is more common than you think.  

Are you dreading your preschooler’s first sleepover invite, because he still wears a nappy?  Take heart. Bedwetting is so common that there are probably other kids in your child’s class who bedwet and whose parents keep it a secret too.  Here are expert answers to the questions you may be too embarrassed to ask.

Is it normal that my 5-year-old still wets the bed?

Bedwetting is a condition that shouldn’t set off alarm bells, but many parents are naturally concerned if their child still wets the bed past the age of 3. Most cases of bedwetting are attributed to physical causes—the child’s bladder control mechanism simply just isn’t mature enough.  According to Dr, Spock, only 2 to 3% of children still wet their beds at 12 years of age. Spock says that, as long as your child is growing well physically and psychologically without any other symptoms, gaining night-time bladder control will gradually happen in time.

Why does bedwetting actually happen?

Genetics can play a part in bedwetting. In Toddler Taming, Dr Christopher Green says that: “Delay in bladder training at night seems to have an extremely strong genetic relationship. Some studies show almost 70% of bed-wetters have a parent or a sibling with a similar problem.” It also seems to affect boys more than girls. Other reasons are that your child’s brain isn’t getting consistent messages to ‘get up and go to the bathroom’ once their bladder is full.  Another reason could be deep sleeping pattern—your child sleeps so soundly that his brain doesn’t respond to the bladder’s messages.

When does a child achieve bladder control?

Children achieve bladder control at different ages. By the age of 6 years, most children no longer wet the bed. However, bedwetting up to the age of 6 is not unusual, even though it may be frustrating, not to mention expensive, for parents.

What effect does bedwetting have on the child?

When kids hit the 7 to 8 year old mark, those who continue to wet their beds feel embarrassed and guilty about their condition.  These children may withdraw from social activities and suffer from a low self-image.  It doesn’t help if they are often criticized by frustrated parents. Dr. Spock says, “Since avoiding or lessening shame and self-doubt is important … both mother and father should look for opportunities to build lasting self-esteem in the child…[and] maintain an interest in their child’s attempts to remain dry, expressing pleasure when success occurs and encouragement when he fails.” 

Help your child with these strategies:

• Ditch the diapers.  The nappies on the market work a little too well and don’t allow your child to feel the discomfort of being wet.  Let your child wear regular undies.
• Establish a pattern.  Make sure your child has a consistent bedtime and that you limit his liquid intake at least 2 hours before bed.  
• Make sure he relieves himself before going to bed, even if he doesn’t feel the need to.
• Bedwetting or moisture alarms are now available.   The alarm wakes the child up once it senses wetness, so he can rush to the bathroom and relieve himself.  This conditions the brain to respond during sleep to messages from the bladder.
• Try night-conditioning—consistently get your child up at night to use the bathroom.  Be patient, and try to find a good hour when he responds best to being awakened.
• Dr T Brazelton, author of Toilet Training the Brazelton Way and Clinical Professor of Paediatrics Emeritus at Harvard Medical School, suggests trying to adopt a team approach with your child’s school and coordinate efforts and strategies. 
  

Santa Clara County officials vote to ban toys and other promotions that come with high-calorie children’s meals.

After a contentious meeting between parents and restaurant owners, the Santa Clara County Board of Supervisors voted in favor of banning the Happy Meal in Silicon Valley restaurants.

The five-member board in Silicon Valley voted 3 to 2 in favor of prohibiting fast food restaurants from offering prizes and toys if they contained more than 485 calories, 600 mg of sodium or high amounts of sugar and fat.  The decision is meant to pressure small fast food restaurants to big chains like McDonald’s to offer more nutritious menu items for kids. Happy Meals are one of the longest-running and most successful marketing campaigns for McDonald’s.

“This ordinance prevents restaurants from preying on children’s’ love of toys” to sell high-calorie, unhealthful food, said Supervisor Ken Yeager, who sponsored the measure. “This ordinance breaks the link between unhealthy food and prizes.”  It is said that that one quarter of kids in the area are overweight.

In favor of the item were public health administrators, parents and doctors; opposed were fast-food franchisees, other parents, and fans of fast-food toys who argued that the promotions are often used to provide Christmas presents for less fortunate children.

Once the ordinance gets final approval at a meeting in May, the fast-food industry will have 90 days to come up with a voluntary program for improving the nutritional value of children’s meals.

It would be interesting to learn whether such a ban indeed affects sales or pushes fast-food chains to offer grilled chicken sandwiches (instead of a burger or chicken nuggets) Unless the toy ban catches, the vote affects only about a dozen fast food chains under the Board of Supervisors’ jurisdiction.

Get your child ready for that first movie theater experience.

Is your little one ready for the big screen? You may remember your first time in a dark, cavernous theater as a thrilling experience, but for a preschooler, it might be overwhelming, even traumatic.  Much of this first foray into the movie theatre will also depend on your child’s temperament, interests and quirks.

Some 3-year-old children can focus on a movie for an hour or so.  Others may be bothered or fearful of odd-looking cartoon characters. Some may be fascinated by all the strangeness.

If your child can watch a full-length children’s film at home, that’s a good indication that he’s probably ready for the cinema. Before you get tickets, here are a few practicalities:

• Tell your little one what to expect before getting to the theatre – it will be dark, and there will be lots of other people watching with us. With preschoolers, it always helps to set the stage for a new environment.
• Practice at home.  Pop in a favorite film, and turn all the lights off.
• Pick a film with familiar characters.  A film a child can relate to or in which he actually knows the characters helps make the whole movie experience less intimidating.
• A matinee screening is a good choice as it fits in with your child’s post-nap, happy-and-alert time of the day.  Matinee audiences are likely to have kids in tow like you and will be more forgiving if you often have to whisper to your inquisitive child.
• Have their favorite snacks on hand. Popcorn and drinks from the food stand are good choices, but take along his sippy cup and a favorite snack from home just in case.
• Go to the bathroom before the show.  This will help avoid frequent pee breaks, which have the uncanny ability of occurring during the best parts.

Most important, expect the unexpected and take your sense of humor along. You are taking your preschooler for the first time into a movie theatre. To a 3-year-old who has never been there before, the whole experience may be about what it feels like looking at an oversized screen in a dark place filled with strangers. And that could be more interesting than the movie itself!

Children’s food allergies are unpredictable, and misinterpreting them could be deadly. Learn to separate fact from fiction.

MYTH:  Children are allergic to any kind of food that causes a negative reaction.

FACT: Many negative food reactions are unrelated to food allergies and are simply food sensitivities.  True food allergies are not as common as people think and only affect 2% of children. Lactose intolerance, for instance, is different from a milk allergy. Doctors say a milk allergy would have life threatening consequences and those that are allergic to milk would have to skip milk protein all together.  A real food allergy is a reaction of the body’s immune system to a certain component, usually a protein, in a food or ingredient.

Symptoms of food allergies can include watery eyes, wheezing and difficulty breathing, coughing, skin rashes, sneezing, vomiting, diarrhea and swelling around the mouth and throat.  The more severe reaction is anaphylaxis, which involves enlarging of the larynx and a choking sensation that can lead to death. 

The top 4 food allergens for children are peanuts (which are not true nuts but actually legumes from the bean and pea family), tree nuts (walnuts, peacans, cashews etc.), cow’s milk, and eggs (especially egg whites). Peanut allergies may be the most likely to cause life-threatening allergic reactions (anaphylaxis), but a cow’s milk allergy is the most common food allergy in young children. 

MYTH: Children with allergies have them at the onset of birth.

FACT:  While most food allergies begin at the onset of birth or early childhood, they can develop anytime in a person’s life. Interestingly, experts suspect that our society has become “cleaner” and healthier, which may be causing the immune systems in some children to fail in differentiating real threats from harmless invaders, such as food. Some also believe that because immune systems are no longer fighting real threats, they overreact and shift to turn on the body’s own tissues.  

It’s good to note, however,  that many children actually outgrow their food allergies. Some children can outgrow their food allergies if they eliminate them from their diet for two to three years. Approximately 85% of children outgrow their allergy to milk, but fewer will outgrow their allergies to peanuts, tree nuts and shellfish.

MYTH:  Giving your child small amounts of food that he is allergic to helps him build up a resistance to the allergy.

FACT: On the contrary, if your child develops adverse reactions to certain foods, you must try to eliminate them from your child’s diet as soon as possible.  Many children outgrow their food allergies if they completely avoid them for two to three years. If your child has multiple food allergies, eliminate all food he is allergic to, and rotate all other foods every four to five days.  

MYTH:  You can prevent a food allergy.

FACT:  In pediatric allergy circles, this is a subject of much debate. Although women are often advised to avoid certain foods, such as peanuts, when they’re pregnant or breastfeeding, no one can say for sure that if this will lower a child’s risk of allergies. 

What is known is that children who have parents with food allergies are more predisposed to allergies.  There is also general agreement that strictly breastfeeding newborns and only introducing cow’s milk after your child’s first birthday has a protective effect. Breastfed children are less likely to develop eczema (a rash that’s often considered the first sign that a child is allergy-prone).

A hypoallergenic infant formula should be used if your baby needs a milk supplement.  If your child is more predisposed to food allergies, only introduce  solids after the sixth month of life – eggs after your child turns 2 and peanuts (only as smooth as peanut butter) and shellfish when your child is at least 3 years old. Introduce new foods slowly (i.e, every four to five days) so that you can easily identify which foods cause a reaction or allergy.

Teasing can bruise young egos. Help your child tackle teasing without turning her into a tattletale or perpetual victim.

The preschool years is a time when kids grow more sensitive to individual differences. As children grow up and interact with others, inevitably, there will be conflict.  The schoolyard and the playground are melting pots for kids of all shapes, sizes and persuasions.  As your child opens her world up to more kids and more diverse types of kids, teasing will be part of life, and there is no way to prevent it.

There are many reasons why kids tease. Child-development experts believe that children who tease are working out anger, insecurity, or their fear over their ability to make lasting friendships.  Sometimes, it’s an effective way of stamping out competition, as teasing can result in the exclusion of a child from a group. 

Though you cannot referee school conflicts like you can sibling squabbles, there are ways to step in when your child feels the school ground has become a hostile environment.

Show empathy. Show your child that you understand that it is tough for a kid to simply ignore teasers.  Tell your child about your  own stories and experiences of being teased.  Tell her how you endured it.  This sends the message that teasing is universal and surmountable. Teach her how to react in ways that discourage teasing and make her a less tempting target, like laughing it off.  Tell your child that if a a teaser can’t get a rise out of her, it deprives the tormentor from feeling powerful and prevents other kids from having fun at her expense. 

Don’t demonize the teaser. Try not to cast teasers as the bad guys. Instead, help your child reflect about why teasers behave the way they do.  Is it the only way they know to get attention?  Is it because they’re insecure about themselves?  Children can even ask teasers why they act that way, which may cause some teasers to examine (and possibly change) their behavior.  This way, your child learns better that you can criticize an act without condemning a person.

Assess your child’s environment. Ask the teachers or other adults how they are teaching kids acceptable and unacceptable behavior, and encouraging compassion among the children. Some environments may condone teasing by turning a blind eye, thereby encouraging it. A teacher plays an important role in supporting your child in the school setting by promoting positive social skills and helping your child develop a broad range of friendships.

Build your child’s confidence. A child who is a model of self-confidence can shrug off teasing more positively and successfully.  This doesn’t come about by being told to be confident or being coddled, but from actual personal victories kids accumulate as they grow up.  Give them opportunities to develop themselves by finding their strengths and encouraging their passions.  Be it football, baton twirling, or Guitar Hero, a child who excels at something she likes will develop greater self-esteem, which will not only help against teasing, but will lead to other avenues of success.

Family meals ease anxiety — and asthma as well.

Family mealtime is great for many things… including better outcomes for children with asthma. U.S. researchers found children’s asthma symptoms decrease if their families have regular mealtimes together.

Barbara H. Fiese, director of the University of Illinois Family Resiliency Center, said family members play an important role in helping children emotionally manage their asthma symptoms.

Experts tell us, a supportive, organized environment during mealtime puts a child at ease whereas a chaotic, unresponsive atmosphere fosters worry and anxiety. What many don’t know is that stress and anxiety are major asthma triggers.

“It makes sense that children who have difficulty breathing might be anxious and prefer to keep their parents, who can help them in an emergency, close by,” Fiese said in a statement. 

”Supportive interaction during family mealtimes helps increase a child’s sense of security and eases separation anxiety symptoms. The reason is, when children are less anxious, their lung function improves.”

During the six-week study, 63 children ages 9-12 with persistent asthma completed questionnaires and were interviewed about their physical and mental health, including an assessment for separation anxiety.

“Children need regularity and predictability,” Fiese said. “When families are overwhelmed or lack the skills to keep routines in place, there are often physical and psychological costs to their children. Left untreated, separation anxiety can lead to adult panic disorder.”

Fiese’s study is published in the Journal of Child Psychology and Psychiatry.

Because a well-rested child is a happy, healthy child.

A good night’s sleep is crucial for anyone — especially babies, toddlers and preschoolers. If your child sleeps well, he will have better immune function and healthy growth. Did you know that growth hormones are only produced during sleep? That’s what our pediatrician tells us. Sleep affects behavior too. Kids who are sleep-deprived are cranky, impatient, distractible and do poorly in school.

Sticking to a good bedtime routine is key to developing healthy sleep habits. Start them young and be consistent. We’ll tell you how.

Set a bedtime. Wether it’s 7, 8 or 9 PM make sure you stick to it. Children’s body clocks are set by a consistent nightly schedule. Both my children are in bed and sound asleep between 8:30 to 9 PM. We have been on this schedule since they were babies and have made very few exceptions.

It also makes it so much easier for mom and dad in the long run. Since their body clocks are set to this schedule already, they’re automatically on their way to getting their zzz’s at a predictable time. They are also up at a predictable time in the morning — on their own, with no struggle  for us to rouse them up. Definitely helps if you need them on a schedule to get ready for school!

Establish a bedtime ritual. On the run-up to bedtime, a ritual or routine is also key. Children find comfort and security in a pattern of events they’re familiar with — particularly one that sets the tone for a good night’s rest. What elements you put into your family ritual is up to you, just as long as you’re consistent and it’s not too stimulating it will get your kids wired. Daddy, save the rough-housing for earlier! Here are some rituals that help with my kids:

• A Warm Bath — Warming up body temperature slightly is relaxing and great for inducing sleep.
• A Light Snack — For some reason my kids just have to have something to nibble on before their bedtime bath. Apparently, a light snack that has some protein and carbohydrates — for example, a small piece of cheese and one half slice of whole-wheat bread — can induce sleep and helps children stay asleep through the night. The carbohydrates make them sleepy, and the protein keeps blood sugar levels even until breakfast. Be sure to brush their teeth after eating.
• A Good Story — This is a particularly comforting routine for toddlers, especially if it’s a favorite story that’s associated with bedtime, such as Goodnight Moon. As your child grows, he’ll want more stories and more variety.

Don’t forget some bedtime love. Most importantly, kids could use some cuddle-time to end their day. Nothing like the comfort and assurance of mom and dad before going off to dream land. Bedtime bonding is especially important if you’re out the whole day at work. If your child has a lovey or teddy that gives him comfort, let him take it with him to bed. And don’t forget the all-important good night kiss!

Talk to me please!

I ask my 5-year-old son how was school today? Do I get a long answer about his latest science investigation? How about a detailed account of the playground drama for the day? Nope. Apparently, getting your child to talk with you entails refining our communication approach.

Dr. Atilla Ceranoglu is a child psychiatrist at Harvard Medical School and an expert in parent-child communication. She emphasizes how important it is to have satisfying conversations with your child — as soon as your child learns to speak. “Talking to children from early on keeps both child and parent attuned to one another. It is solid preparation for the more stormy, tumultuous days of adolescence,” explains Dr. Ceranoglu.

But have you had exchanges like these with your preschooler?

You: How was school?
Child: Fine.

You: How’s your new teacher?
Child: Okay… Can I watch TV now?

Now before you take those stunted responses personally, examine possible reasons. My son can talk to me at length about many of his interests, but I am particularly frustrated about how he holds-off about his school day.

Then I read the book How to Talk So Kids Will Listen and Listen So Kids Will Talk by Adele Faber. Faber made me realize that all kids need downtime after school. All that learning and playground drama can be exhausting. After a grueling day, you just want to kick off your shoes and relax before getting into a discussion about what happened at work. Sometimes, resting from work entails not talking about it too. The same goes for children – some personality types more than others.

Now I spark better conversations with him about school during dinner when he’s rested — and more receptive. I also ask him specific questions — What did you play in outdoors? Who was in your team? Which work area did you choose for today? What book did teacher read to you? What was it about? Our dinner chats have been more interesting lately.

If we want to our kids to tell us more about how their day was, “how was your day?” is actually the question we should avoid. It just begs for a standard one-word answer like “fine” or “okay.” Remember, kids are not little adults. Dr. Ceranoglu offers more advice on how to talk to our little ones:

Do things with your child. Create opportunities to take part in activities your child loves — swimming, playing board games or just hanging out at the park. If your child is still hesitant to talk, be patient. Dr. Ceranoglu says, “Bear the silence. Even if you were fishing for a good half hour in silence, know that there is a lot more being accomplished than if you were chasing your child in words. You are giving your child the strongest message in the loudest way: You are there and will be there when that silence breaks.”

Instead of questions, throw thoughts. Instead of asking, “Did that hurt your feelings?” try saying, “Wow, that would have hurt my feelings.” That gives your child a chance to respond without being put on the defensive. Also, you’ll get more mileage out of simple listening sounds like “hmm” or “huh,” because they reflect an understanding of the child’s concerns better than questions, Ceranoglu says.

Meet them at their level. Dr. Ceranoglu says this is especially important for toddlers and preschoolers. For younger children, it often helps to kneel down to their height and talk or play with them face-to-face. If your child is frustrated trying to communicate something, help him out by naming and acknowledge his feelings: “That is sad! It was your favorite toy.”

What makes them so sensitive, can also make them do so well.

As a baby, my son couldn’t stand the sound of the vacuum cleaner. A noisy blender would scare him to tears. When he was 2-years-old, I thought all kids loved carousels so I took him for a ride. He hated it. He wailed and begged to get off even if he was on my lap as we were riding a coach. Every strange noise, every new experience was met with trepidation.

My daughter was a bit different. Strange sounds were met more with curiosity than fear, but she was even more clingy than her also-clingy big brother. She was adventurous in the play ground, she made friends, but before getting that way she needed a long warm-up period.

A few years later and my little neurotics are now happy, well-adjusted preschoolers. Though I do notice they are essentially still cautious, still sensitive to everything and everyone around them. Still slow to warm. I had accepted these traits as part of their nature,  although it can make parties and play dates more difficult for me. Little did I know, that such sensitive children may actually have an advantage over their more easy going, gregarious peers. At least that’s what research tells us.

Scientists believe that children who are sensitive or highly reactive to stress may actually thrive better than those who just go with the flow. But — and this is a big but — these sensitive kids only tend to do better in the right environment. If they don’t survive a bad environment growing up, these kids could be your future depressives, drug addicts and social misfits. Flip side is, if they survive, they could reach Oprah-level success.

The journal Child Development published a new study on sensitive children early this year. Observing 338 preschoolers, researchers tested how easily stressed the children got, then measured behavior and school performance.

Among sensitive kids, “harsh and restrictive parenting,” exposure to a lot of anger and fighting, and family financial problems indicated a dip in social skills. The other sensitive kids in happy homes? They fared well. So well that they did much better than their easy-going counterparts. Highly-reactive kids who were well-nurtured had the highest rates of sharing, helping and initiating friendships. They also had the highest academic gains in school.

The calm kids who faced challenges with less stress were more resilient when there was trouble at home. For these children, school and social success was average across the board.

This latest study highlights new terminology being used among developmental psychologists — that some kids are dandelions, some are orchids. Dandelions are hardy and can grow well almost anywhere. Orchids can thrive beautifully, but with the right care.

How would you classify your own child? Let’s think hard about that, so whatever kind of “flower” they may be, we can give them the kind of nurturing they need. My little theroy… all kids are orchids and dandelions in varying ways. They all need good care. Still, with a feeling my kids are orchid varieties, I’d like to be extra sensitive to their needs.

Help! My baby bumped his head!

I cannot forget the first time my first child bumped his head hard. He was about 2 years old, running around the house, when he smacked into the corner of a wall. Within minutes, his forehead had a bump the size of a golf ball. He was hysterical too. I called our pediatrician, sure that my son needed and x-ray. My pediatrician actually just told me to relax… and observe my son before rushing to the emergency room. We have  a simple guide on how you can tell if that bump needs medical attention or just some ice, hugs and kisses.

Bumps on the head, even those the size of a golf ball, do not always warrant a trip to the ER or even a call to your doctor. As our pediatrician explained, the skull acts as a protective helmet for the brain. On top of the skull we have a richly vascularized scalp that can withstand most of the bumps and bruises of childhood. The swelling is actually a good sign, that the brain was protected from the bump.

In case your child bumps his head, do the following:

Don’t panic. A panicky grown up cannot calm down a crying, injured child.

Ice it. When you’ve managed to calm your child, hold an ice pack (a pack of frozen peas can substitute) over the bump. Keep the cold pack as long as you can, about 20 minutes. This can help with the swelling and pain.

Observe, observe, observe. If your child got himself a big bump but remains alert and conscious, all you have to give is a good dose of parental sympathy and that ice pack. However, keep an keen eye on your child’s state. The reason for this is because doctors often rely more on how the child behaves after the injury than what happened at the time of the injury. If the brain has been injured, signs may show immediately, or they may appear slowly during the next twenty-four hours.

Seek medical attention fast if the following happens:

• loss of consciousness
• vomiting
• child does not focus on you, look you in the eyes or respond to your questions or instructions
• loss of balance when walking
• prolonged crying of more than an hour
• child complains of a severe headache
• note the following eye signs: crossed-eyes or rolling eyes, or one eye pupil looking larger than the other one.

Trust your instincts, if something worries you or you have a question about your child’s head injury not covered here… by all means give your doctor a call. He or she will give you advice on what to do, just make sure you can give  him or her good notes from your observations.