**** Please note NEW acetaminophen oral suspension dosing below, this will
replace the OLD infant concentrated drops. There may be a time when both
preparations will be sold or you still have them in your cabinet. It is OK to use either
preparation, just verify which preparation you have and be sure to administer the
correct dose according to the chart below.**** July 2011
Tylenol Dosage Table
Acetaminophen (Tylenol) may be given every 4 hours. Weight (pounds) Chewable Tablets (80mg/tablet) 6‐11 12‐17 18‐23 24‐35 36‐47 48‐59 60‐71 72‐95 1 ½ tablets 2 3 4 5 6 Children’s/Infant Oral Suspension (160mg/teaspoon) “NEW” CONCENTRATION
¼ tsp or 1.25ml ½ tsp or 2.5ml ¾ tsp or 3.75ml 1 tsp or 5ml 1 ½ or 7.5 ml 2 tsp or 10 ml 2 ½ tsp or 12.5ml 3 tsp or 15 ml Drops (80mg/0.8ml) “OLD” CONCENTRATION 0.4ml 0.8ml 1.2ml 1.6ml Ibuprofen (Advil/Motrin) Dosage Table
Ibuprofen may be given every 6 hours.
We do not recommend alternating Tylenol and Ibuprofen drops because of potential confusion in
dosing.
We do not recommend Ibuprofen for children under 6 months of age. Weight Chewable Tablets
(50mg/tablet) 12‐17 18‐23 24‐35 36‐47 48‐59 60‐71 72‐95 Over 96 2 3 4 5 6 8 Infant’s Oral Childrens Suspension Suspension (100mg/5ml) (50mg/1.25ml)
1.25 ml ½ tsp or 2.5ml 1.875 ml 3/4 tsp or 3.75ml ‐ 1 tsp or 5 ml ‐ 1 ½ tsp or 7.5ml ‐ 2 tsp or 10ml ‐ 2 ½ tsp or 12.5ml ‐ 3 tsp or 15 ml ‐ 4 tsp or 20 ml Toilet Training Guidelines for Parents
owel and bladder control is a necessary social skill. Teaching your child to u se th e toilet takes time,
understanding, and patience. The important thing to remember is that you cannot rush your child into
using the toilet. The American Academy of Pediatrics has developed this brochure to help you guide
your child through this important stage of social development.
When is a child
for toilet
There is no set age at which toilet training should begin. The right time depends on your child's physical and
psychological development. Children younger than 12 months have no control over bladder or bowel
movements and little control for 6 months or so after that. Between 18 and 24 months, children often star t to
show signs of being ready, but some children may not be ready until 30 months or older.
Your child must also be emotionally ready. He needs to be w illing, not fighting or showing signs of fear. If
your child resists strongly, it is best to wait for a while.
It is best to be relaxed about toilet training and avoid becoming upset. Remember that no one can control
when and where a child urinates or h as a bowel movement except the child. Try to avoid a po wer struggle.
Children at the toilet-training age are becoming aware of their individuality. They look for ways to test their
limits. Some children may do this by holding back bowel movements.
Look for any of the following signs that your child is ready:
• Your child stays dry at least 2 hours at a time during th e day or is dry after naps.
• Bowel movements b ecome regular and predictable.
• Facial expressions, posture, or words reveal that your child is about to urinate or have a bowel movement.
• Your child can follow simple instructions.
• Yom child can walk to and from the bathroom and help undress.
• Your child seems uncomfortable with soiled diapers and wants to be changed.
• Yom child asks to use the toilet or potty chair.
• Your child asks to wear grown-up underwear.
Toilet Training-Page 1 of 5
American Academy
of Pediatrics
Stress in the home may make learning this important new skill more difficult. Sometimes it is a good
idea to delay toilet training in the following situations:
• Your family has just moved or will move in the near future.
• You are expecting a baby or you have recently had a new baby.
• There is a major illness, a recent death, or some other family crisis.
However, if your child is learning hmv to use the toilet without problems, there is no need to stop because of these situations. How to teach
child to use the toilet
Decide what words to use
You should decide carefully what words you use to describe body parts, urine, and bowel movements.
Remember that friends, neighbors, teachers, and other caregivers also will hear these words. It is best to use
proper terms that will not offend, confuse, or embarrass your child or others.
Avoid using words like "dirty," "naughty" or "stinky" to describe waste products. These negative terms can
make your child feel ashamed and self-conscious. Treat bowel movements and urination in a simple, matter­
of-fact manner.
Your child may be curious and try to play with the feces. You can prevent this without making him or her feel
upset by simply saying "This is not something to be played with."
chair
Once your child is ready you should choose a potty chair. A potty chair is easier for a small child to use,
because there is no problem getting on to it and a child's feet can reach the floor.
Children are often interested in their family's bathroom activities. It is sometimes helpful to let children watch
parents when they go to the bathroom. Seeing grown-ups use the toilet makes children w ant to do the same.
If possible, mothers should show the correct skills to their daughters, and fathers to their sons. Children can
also learn these skills from older brothers and sisters, friends, and relatives.
Help your child
Encourage your child to tell you when he or she is about to urinate or have a bowel movement. Your child
will often tell you about a wet diaper or a bowel movement after the fact. This is a sign that your child is
beginning to recognize these bodily functions. Praise your child for telling you, and suggest that "next time"
she let you krlOw in advance.
Before having a bowel movement your child may grunt or make other straining noises, squat, or stop playing
for a moment. When pushing, his or her face may turn red. Explain to your child that these signs mean that a
bowel movement is about to come, and it's time to try the toilet.
Toilet Training-Page 2 of 5
American Academy
of Pediatrics
It often takes longer for a child to recognize the need to urinate than the need to move bowels. Some children
do not gain complete bladder control for many months after they have learned to control bowel rnovements.
Some children achieve bladder control first. Most, but not all, boys learn to urinate sitting down first, and
then ,lid!
Ililing up. Rememblr
ildren are different!
pott)'routine
Make
seems to need to urineltl'
r a few minutes a1
don't insist. Such resi:.
Wheli
on the
protcsb
1'1'
howe] movement;
in what you want tn
nli:&n that it is not
Keep your child
I.
h eerful and casua i
start training.
It may be helpful to make trips to the potty a regular part of your child's daily routine, such as lirst thing in
the morning when your child wakes up, after meals, or before naps. I{emember that you cannot cuntrd when
your child urinates or has a bowel movement.
Success at toilet training depends on teaching at a pace that SLlits your child. You must
your child's
when succe,. I
e££or:·..
force quick resul
)ur child with lots
occurs.
ist:.ike happens, treat
try not to get upset
.md scolding will I·
make
bad and may make
ake longer.
Teach
plC1per hygiene habit:,.
chId how to wipe
d
.; should wipe
thoroughly
tront to back to prevent bringing g('rms fron1 the r e c t l l l or bladder.) Ma
sure both boys and girls learn to wash their hands well after urinating or a bowel movement.
Some children believe that their wastes are part of their bodies; seeing their stools flushed avvay nlay be
frightening and hard for them to understand. Some also fear they will be sucked into the toilet jf it is flushed
while they are sitting on it. Parents should explain the purpose of body wastes. To give your child a feeling of
control, let him or her flush pieces of toilet paper. This 'will eliminate the fear of the sound of rushing water
and the
disappearing.
Once
repeated succeSSh.
I lit' use training pan
t will be special.
child
Ij of this sign of trust
up. However, be ;
Iccidents." It may
weeks, even months, before toilet training is completed. It rnay be helptul to continue to have your
lei Sit
on the potty at specified tlm.es during the day. 1£ your child uses the potty successfully, it's an opportunlty for
praise. If not, it's still good practice.
In the beginning, many children vvill have a bowel movement or will urinate right after being Llken off the
toilet. It may take time for your child to learn how to relax the muscles that control the bowel and bladder. If
these "accidents" happen a lot, it may mean ',-(l1JT child is not really reach; for
will ask for a diaper
bo'.\el movement is
considering this a LI1
m child for recogli
he or
b"wel nlOvement in i
,vhile wearing a d i
work toward sitting on the potty, without the diaper.
II
Toilet'
3 of 5
in a special place I
signals. Suggest:
Academy
of Pediatrics
Stooling patterns vary. Some children move their bowels 2 or 3 times a day. Others may go 2 or 3 days
between movements. Soft, comfortable stools brought about by a well-balanced diet make training easier for
both child and parent. Trying too hard to toilet train your child before she is ready can result in long-term
problems with bowel movements.
Talk with your pediatrician if there is a change in the nature of the bowel movements or if your child
becomes uncomfortable. Don't use laxatives, suppositories, or enemas unless you r pediatrician advises these
for your child.
'viost children achieve bowel control and daytime urine control by 3 to 4 years of age. Even after your child is
able to stay dry, it may take months or years before he achieves the same success at night. Most girls and
more than 75% of boys will be able to stay dry at nigh t by age 5.
Most of the time, your child will let you know when he is ready to move from the potty chair to the "big
toilet." Make sure your child is tall enough, and practice the actual steps with him.
Your
If any concerns come up before, during, or after toilet training, talk w ith your pediatrician. Often the problem
is minor and can be resolved quickly, but sometimes physical or emotional causes will require treatment.
Your pediatrician's can help, advice, and encouragement can help make toilet training easier. Also, your
pediatrician is trained to identify and manage problems that are more serious.
The information contained in this publication should not be used as a substitute for the medical care and advice of your
pediatrician. There may be variations in treatment that your pediatrician may recommend base d on individual facts and
circumstances.
Toilet Training-Page 4 of 5
American Academv
of Pediatrics
'
1to 2 Years
1 TO 2 YEARS
Safety for Your Child
Did you know that injuries are the leading cause of death of children younger than 4 years in the United
States? Most of these injuries can be prevented.
Often, injuries happen because parents are not aware of what their children can do. At this age your
child can walk, run, climb, jump, and explore everything. Because of all the new things he or she
can do, this stage is a very dangerous time in your child’s life. It is your responsibility to protect
your child from injury. Your child cannot understand danger or remember “no” while exploring.
Firearm Hazards
Children in homes where guns are present are in more danger of being shot by themselves,
their friends, or family members than of being injured by an intruder. It is best to keep all
guns out of the home. Handguns are especially dangerous. If you choose to keep a gun,
keep it unloaded and in a locked place, with the ammunition locked separately. Ask if the
homes where your child visits or is cared for have guns and how they are stored.
Poisonings
Children continue to explore their world by putting everything in their mouths, even if
it doesn’t taste good. Your child can open doors and drawers, take things apart, and
open bottles easily now, so you must use safety caps on all medicines and toxic household
products. Keep the safety caps on at all times or find safer substitutes to use. Contact your
Poison Center for more information.
Your child is now able to get into and on top of everything. Be sure to keep all household
products and medicines completely out of sight and reach. Never store lye drain cleaners
in your home. Keep all products in their original containers.
If your child does put something poisonous into his or her mouth, call the Poison Help
Line immediately. Attach the Poison Help Line number (1-800-222-1222) to your phone.
Do not make your child vomit.
Falls
To prevent serious falls, lock the doors to any dangerous areas. Use gates on stairways
and install operable window guards above the first floor. Remove sharp-edged furniture
from the room your child plays and sleeps in. At this age your child will walk well and
start to climb, jump, and run as well. A chair left next to a kitchen counter, table, or
window allows your child to climb to dangerously high places. Remember, your
child does not understand what is dangerous.
If your child has a serious fall or does not act normally after a fall, call your doctor.
(over)
Burns
The kitchen is a dangerous place for your child during meal preparation. Hot liquids, grease, and hot foods
spilled on your child will cause serious burns. A safer place for your child while you are cooking, eating, or
unable to give him your full attention is the playpen, crib, or stationary activity center, or buckled into a
high chair. It’s best to keep your child out of the kitchen while cooking.
Children who are learning to walk will grab anything to steady themselves, including hot oven doors,
wall heaters, or outdoor grills. Keep your child out of rooms where there are hot objects that may be
touched or put a barrier around them.
Your child will reach for your hot food or cup of coffee, so don’t leave them within your child’s reach.
NEVER carry your child and hot liquids at the same time. You can’t handle both.
If your child does get burned, immediately put cold water on the burned area. Keep the burned area in cold water
for a few minutes to cool it off. Then cover the burn loosely with a dry bandage or clean cloth. Call your doctor for all
burns. To protect your child from tap water scalds, the hottest temperature at the faucet should be no more than 120˚F.
In many cases you can adjust your water heater.
Make sure you have a working smoke alarm on every level of your home, especially in furnace and sleeping areas.
Test the alarms every month. It is best to use smoke alarms that use long-life batteries, but if you do not, change
the batteries at least once a year.
Drowning
At this age your child loves to play in water. NEVER leave your child alone in or near a bathtub, pail of water,
wading or swimming pool, or any other water, even for a moment. Empty all buckets after each use. Keep the
bathroom doors closed. Your child can drown in less than 2 inches of water. Knowing how to swim does NOT mean
your child is safe near or in water. Stay within an arm’s length of your child around water.
If you have a swimming pool, fence it on all 4 sides with a fence at least 4 feet high, and be sure the
gates are self-latching. Most children drown when they wander out of the house and fall into a pool that is
not fenced off from the house. You cannot watch your child every minute while he or she is in the house.
It only takes a moment for your child to get out of your house and fall into your pool.
And Remember Car Safety
Car crashes are a great danger to your child’s life and health. The crushing forces to your child’s brain and body
in a crash or sudden stop, even at low speeds, can cause severe injuries or death. To prevent these injuries
USE a car safety seat EVERY TIME your child rides in the car. Your child should ride rear-facing until she is at
least a year old AND weighs at least 20 pounds. It is even better for her to ride rear-facing to the highest weight
and/or height her car safety seat allows. Be sure that the safety seat is installed correctly. Read and follow the
instructions that come with the car safety seat and the instructions for using car safety seats in the owners’
manual of your car. The safest place for all infants and children to ride is in the back seat.
Do not leave your child alone in the car. Keep vehicles and their trunks locked. There are
dangers involved with leaving children in a car; death from excess heat may occur very
quickly in warm weather in a closed car.
From Your Doctor
Always walk behind your car to be sure your child is not there
before you back out of your driveway. You may not see your child
behind your car in the rearview mirror.
Remember, the biggest threat to your child’s
life and health is an injury.
The information in this publication should not be used as a substitute for the medical care and
advice of your pediatrician. There may be variations in treatment that your pediatrician may
recommend based on the individual facts and circumstances.
TIPP®—The Injury Prevention Program
© 1994 American Academy of Pediatrics
HE0021-C
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Sample Menus for Your Child
Day 1
Breakfast
1 scrambled egg
1/2 slice toast
1/2 cup milk
1/4
1/4
1/2
Snack
1/4
3/4
apple, peeled and sliced
ounce small cheese pieces
water
1/2
Lunch
peanut butter sandwich
(1 slice bread, 1 tablespoon
peanut butter)
2 tablespoons peas
1/2 cup milk
1/2
1/2
1/2
Snack
1/2
1/4
1/2
Dinner
1 tablespoon baked chicken
2 tablespoons
mashed potatoes
2 tablespoons broccoli
2 tablespoons applesauce
water
How can I make mealtimes happy?
◆
Make mealtime a family time. Children like to eat with other people.
Sit down and eat meals with your child.
◆
Try to have meals and snacks at about the same time every day.
◆
Do not bribe, play games, or force your child to eat. Children need
to control their own eating.
◆
It is normal for children to play with their food. If your child
stops eating or throws food, take the food away.
◆
Young children are messy eaters. Expect your child to spill.
Your child can use a child spoon or fork or fingers at this age.
Always wash hands
before and after eating.
◆
Relax and enjoy your meal. Do not
make your child’s eating the center
of attention.
◆
Keep the TV off during meals. Make
mealtime a quiet time for talking.
◆
Set a good example. Eat many
different kinds of food. Your child
will want to eat what you eat.
How can I make it easier for my child to eat?
Serve foods that:
◆ are bite size or easy for your child to hold
◆ are soft and easy to chew
◆ are mild and simple
◆ are not too hot or too cold
◆ have a lot of colors, textures, and shapes
Always stay nearby when your child eats. Children can choke if they run
and play with food in their mouths. Be sure your child sits down to eat
at the table.
Day 2
Snack
cup dry cereal
cup juice
2 graham cracker squares
1/2 cup milk
cup cereal
banana
cup milk
Feeding Your
1 to 2 Year Old
cup yogurt
2 crackers
water
cup vegetable beef soup
tortilla or 2 crackers
cup milk
slice toast with
1 tablespoon peanut butter
water
soft taco with beans and
meat (1/2 tortilla,
2 tablespoons beans,
2 tablespoons meat)
1/4 cup rice
2 tablespoons cooked carrots
1/2 orange, sliced
water
4 animal crackers
cup milk
1/2
Children this age only need 4 to 6 small servings of milk or milk products
every day. No more than 24 ounces (710 milliliters) of milk per day. Limit
juice to 1/4 cup (60 milliliters) per day. Serve fruit instead of juice when
you can. Your child should be drinking only from a cup now, not a bottle.
If your child is thirsty at other times, offer your child water instead of
sweet drinks. Sweet drinks like pop, Kool-Aid®, and juice drinks can
make your child feel full. Then your child will not be hungry for meals
or snacks. If you are still breastfeeding your child, that’s great! Breastfeed
after meals and at night.
Warning: Children under age 4 can choke on foods like hot dogs,
popcorn, nuts, raw carrots, grapes, jelly beans, gum, and hard
candy. Avoid these foods. Cut hot dogs into very small pieces.
This is my goal:
Washington State Department of
Health
DOH Pub 961-187 9/2005
Adapted from California Department of Health, WIC Supplemental Nutrition Branch.
Printed by Washington State Department of Health WIC Program. WIC is an equal
opportunity program. For persons with disabilities this document is available on
request in other formats. To submit a request please call 1-800-525-0127 (TDD/TTY
1-800-833-6388).
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Food Guide Pyramid
One Serving Is About...
6 to 11
servings
each day
Feeding your
1 to 2 year
old
3 to 5
servings
each day
Fats, Oils,
and Sweets
2 to 4
C
hildren know how much they
need to eat. But they do not know
what kinds of foods they need.
Milk Products
4 to 6 servings
When it is time to eat, offer your
child healthy foods. You decide
what to serve and when to serve it.
Protein Foods
2 to 3 servings
Let your child decide how much to
eat from the foods you serve.
Vegetables
3 to 5 servings
Fruits
2 to 4 servings
Breads, Grains
and Cereals
◆
Serve your child 3 meals and 2
to 3 snacks every day.
◆
Serve a variety of healthy foods
every day.
servings
each day
4 to 6
servings
each day
2 to 3
servings
each day
Breads, Grains, Cereals
Bread slice, tortilla, roll, muffin, pancake, waffle...............................1/4
Dry cereal .....................................................1/4–1/2 cup or 60–120 mL
Noodles, rice, cooked cereal............................1/8–1/4 cup or 30–60 mL
Crackers ................................................................................1–2 small
Offer your child some whole grain foods every day.
Vegetables
Cooked ..................................................2–3 tablespoons or 30–45 mL
Raw .......................................................2–3 tablespoons or 30–45 mL
Offer your child a dark green or yellow vegetable every day, like cooked
carrots, broccoli, spinach, sweet potato, or squash.
Fruits
Fresh .................................................................................1/4–1/2 small
Canned or frozen...................................2–3 tablespoons or 30–45 mL
Juice ...........................................................................1/8 cup or 30 mL
Offer your child a good vitamin C fruit every day, like orange, strawberries,
melon, mango, papaya, or juices.
Milk Products
Milk or breast milk....................................................1/2 cup or 120 mL
Cheese .......................................................................3/4 ounce or 20 g
Cottage cheese .........................................................3/4 cup or 180 mL
Yogurt, pudding or custard made with milk ..............1/2 cup or 120 mL
Frozen yogurt, ice cream ..........................................3/4 cup or 180 mL
Give your child whole milk up to age 2, then lowfat milk.
Protein Foods
Animal Protein
Meat, chicken, turkey, fish.................................1 tablespoon or 15 mL
Eggs.................................................................................................1/2
◆
Children eat more on some days
than others.
◆
What your child eats in one day
may not match the food guide.
Think about all the foods your
child eats over several days.
Cooked dry beans, lentils ...........................................1/4 cup or 60 mL
Peanut butter ....................................................1 tablespoon or 15 mL
Tofu ............................................................................1/4 cup or 60 mL
Meat and beans have the most iron!
◆
It is normal for children to eat
less after the first year. They are
not growing as fast.
Fats, Oils, and Sweets
6 to 11 servings
Vegetable Protein
Give your child these foods once in a while.
Start with small servings. Give about 1 tablespoon (15 mL) of each food
for each year of your child’s age. For example, if your child is 2 years old,
serve your child 2 tablespoons of vegetables and 2 tablespoons of rice.
Let your child ask for more.
SPOILED CHILDREN, PREVENTION OF DEFINITION
Expected Outcome
Without changes in child rearing, spoiled children run
into trouble by school age. Oth er children do not like
them because they are too bossy and selfish. Adults do
not like them because they are rude and make exces­
sive demands on them. Eventually they become hard for
even the parent to love because of their behaviors. As a
reaction to not getting along well with other children
and adults, spoiled children eventually become un­
happy. Spoiled children may show reduced motivation
and perseverance in schoolwork. Because of poor self­
control they may become involved with adolescent risk­
taking behaviors, such as drug abuse. Overall, spoiling
a child prepares that child poorly for life in the real
world.
A spoiled child is undisciplined , manipulative , and un­
pleasant to be with much of the time. He has many of
the following behaviors by age 2 or 3:
-Doesn 't follow rules or cooperate with suggestions
-Doesn't respond to "no," "stop," or other commands
- Protests everything
- Doesn't know differe nce between his needs and wants
-Insists on having his own way
-Makes unfair or excessive demands on others
-Doesn't respect other people's rights
- Tries to control other people
-Has a low frustration tolerance
-Frequently whines or throws tantrums
-Constantly complains about being bored
Causes
The main cause of spoiled children is a lenient, permis­
sive parent who doesn't set limits and gives in to tantrums
and whining. If the parent gives the child too much
power, he will become more self-centered. Such parents
also rescue the child from normal frustrations (such as
waiting and sharing). Occasionally, the child of working
parents is left with a nanny or baby-sitter who spoils the
child by providing constant entertainment and giving in
to unrealistic demands.
The reason some parents are overly leni ent is that they
confuse the child's needs (for example , for demand feed­
ing) with the child's wants or whims (for example, for
demand play). They do not want to hurt their child's
feelings or to cause any crying. In the process, they may
take the short-term solution of doing whatever prevents
crying, which in the long run causes more crying. The
child's ability to deliberately cry and fuss to get some­
thing usually doesn't begin before 5 or 6 months of age.
There may be a small epidemic of spoiling in the United
States because some working parents come home feeling
guilty about not having enough total time for their chil­
dren and so spend their free time together trying to avoid
any friction or limit setting.
Confusion exists about the differences between giving
attention to children and spoiling children. In general ,
attention is good for children. Indeed, it is essential for
normal development. Attention can become harmful if
it is excessive, given at the wrong tim e , or always given
immediately. Attention from you is excessive if it inter­
feres with your child's learning to do things for himself
and deal with life's frustrations. An example of giving
attention at the wrong time is when you are busy and
your child is demanding attention. Another wrong time
is when a child has just misbehaved and needs to be
ignored. If attention is always given immediately, your
child won't learn to wait.
Holding is a form of attention that some parents un­
necessarily worry about. Holding babies is equivalent to
loving them. People in many cultures hold th eir babies
much more than we do. Lots of holding by the mother
and father does not cause a spoiled infant or child.
HOW TO PREVENT A SPOILED CHILD
1. Provide age-appropriate limits or rules for your
child. Parents have the right and responsibility to take
charge and make rules. Adults must keep their child's
environment safe. Age-appropriate discipline must begin
by the age of crawling. Saying "no" occasionally is good
for children. Children need external controls until they
develop self-control and self-discipline. Your child will
still love you after you say "no." If your children like you
all the time, you are not being a good parent.
2. Require cooperation with your important rules.
It is important that your child be in the habit of respond­
ing properly to your directions long before entering
school. Important rules include staying in the car seat,
not hitting other children, being ready to leave on time
in the morning, going to bed, and so forth. These adult
decisions are not open to negotiation. Do not give your
child a choice when there is none.
Child decisions, however, involve such things as which
cereal to eat, book to read, toys to take into the tub , and
clothes to wear. Make sure that your child understands
the difference between areas in which he has choices
(control) and your rules. Try to keep your important rules
to no more than 10 or 12 items and be willing to go to
the mat about these. Also, be sure that all adult care­
takers consistently enforce these rules.
3. Expect your child to cry. Distinguish between
needs and wants. Needs include crying from pain, hun­
ger, or fear. In these cases , respond immediately. Other
crying is harmless . Crying usually relates to your child's
wants or whims . Crying is a normal response to change
or frustration. When the crying is part of a tantrum,
ignore it. Don't punish him for crying, tell him he's a
crybaby, or tell him he shouldn't cry. Although not de­
nying your child his feelings, don't be moved by his
crying. To compensate for the extra crying your child
does during a time when you are tightening up on the
rules , provide extra cuddling and enjoyable activities at
a time when he is not crying or haVing a tantrum. There
are times when it is necessary to temporarily withhold
attention and comforting to help your child learn some­
(Continu.ed on the reverse side )
Instructions for Pediatric Patients by Barton D. Schmitt, M.D. , Pediatrician
Adapted from YOUR CHILD'S HEALTH, Copyright © 1991 by Barton D. Schmitt, M.D.
Reprin ted by permission of Ban tam Books.
© 1992 by W. B. Saunders Company
159
SPOILED CHILDREN, PREVENTION OF (;ontinu"d
thin£; that is important (such as he can't pull on your
Farr!
4. Do not allow tantrums to work. Children throw
temper taLtrums get. \our entl(lll, to v.ear vou du\\n,
to change your mind, and to get their way. The crying
" vote ..T antrull1s
1·
to r1angc
your " no " vote to a "
yes
may include whining, complaining, crying, breath hold·
ing, pounding the floor. shouting or sbmming a donr.
As long as your child sLays III One place and is not too
nisrllptive or in a positinn to harm himself 'lOll can leave
him "iune al these; time;S, By all wcans, don't give Hi to
tantrums.
5. Don't overlook discipline during quali!> tirne. If
you are working parents, you will want to spend part of
each
with YOU! child. This special tiene spent
with your child needs to be enjoyable but also reality
based. Don't eas::' up on the rule,. If :cour child mis­
behaves, remind hIm ot the eXisting limits. Even dUring
fun adivitips, you Occ;JsionaIly neprl to hp the parent
6. Don't start democratil: child rearing until your
child is 4 or ,I) years old. Don't give away vour power as
parent.
2 years
age, be careful not
talk too
much with your toddler about the rules. Toddlers don't
play
the rules, By 4 or 5 vears of age, you can begin
to reason with your child about discipline issues, but he
ill b!'ks tlH~
nec('ssan to make the niles.
During the elementary school years, show a Willingness
to discuss tbe rules By 14 to 16 years old, an adolescent
can be negotiated with as an adult. At that time you can
ask for his input ahout what rules or consequences would
be fair (thal is, rules become Joint decisions).
The more democratic the parents are during the first
or years the Inore dem<luding the children tend to
become. Generally, young children do not know what
to do \lith per.ver. Left their own
the\ usually
spoil themselves. If they are testing everything at age 3,
!1 IS
. If you hdve given a\VdY your pO\\'er, lake
it back (that is, set new limits and enforce them). You
don't have to explain the reason for everv rule. Some­
lImes it is
because
said so."
7. Teach your child to get himself unbored. Your
is to proVide toys, boob. and art supplies. Yom
child's job is playing with them. Assuming you talk and
iay with your cliild several hours each
you do not
need to become your child's constant playmate, nor do
constantl\' provide him \Iith an outside
ye,u Jit'ed
friend. When you're busy, expect your child to amuse
himself Evcn l-ye~n·-o]ds call keep themselves occupied
lor 1.5-winute blCieks of time. By ,3 years, most children
CRn entertain themselVf~s half the time. Sending your
child outside to "find something to do" is doing him a
1;1'/or. \1 Ueli good creative play, thinking, alld daydreillll­
ing come out of solving boredom. If you can't seem to
resign
social director. enroll your child ill a
8. Teach your child to wait. Waiting helps children
better deal with frustration.
in the adult world
carry some degree of fl-ustration, Delaying immediate
gratification a trait YOllr chilrl must gradu;Jlly learn and
it takes practice. Don't iE,el guilty if you have to make
vnur child WRit a few minutes now and then (for example,
don't allow lOur child to interrupt your conVCl'sations
60
with others in person or on the telephone). Waiting
he doesT,r bCicol11e over­
doc'sn't hurt him as long
whelmed or unglued by waiting. His perseverance and
emotional fitness will be
9. Don't rescue your child from normal life chal­
lenges.
such as moving and st:lrting 'ichou! are
normal life stressors. These are opportunities for learning
and prohlem
Alw3\'s bE; avaiLLle
support·
ive, but don't help your child if he can handle It for
he
himself. Over81L make yom child's life as realistic
can tolerate for his age, rather than going out of your
wav to make it as plpasant as possible. His coping skills
anJ self·confidence \\ill bellcfit hum tillS practice,
10. Don't overpraise your child. Children need
pnIise, b it C:.!1.l be nVerd(lllt:. Prillse YI)t!r child for good
behavior and follOWing the rules. Encourage him to try
ne" thin and "I'ork (1l1 difii cult t asks. hut tcach h; III to
do things for his own reasons too, Self-confidence and a
sense of I1ccomplisbnent come from doing and com­
pleting things that he is proud of. Praising your child
while he is in the process of doing something may make
him stop at each step alJd wallt more praise, Giving your
chilel constant attention C811 make him "praise depen­
dellt' and demanding. Avoid the tendency (so cowman
with the first born) to overpraise your child's normal
developn\cnt.
11. Teach your child to respect parents' rights and
time together. 'I'he needs of \ our childrpil for
f:)od,
clothing, safety, and security obViously come first. How­
ever. your need,) should COllie nexL Your children's wants
(for example, for play) and whims (for example, for an
extra bedtime story) should come after your needs are
met and as timc is available on that day, This especially
important for working parents where family time is lim­
ited. It is both Ie quality and quantity of tirnc that vou
spend "'ith your children that are important. Quality
tim!" is tirne that is
inferacrive, and focused
on your child. Children need some quality time with
their parents evcry day. Spellding everv free m.ompnt of
every evening and weekend with your child is not good
for your child or your marri;Jge. You need a balance to
preserve your lilcntal health. Scheduled nights out with
your mate will not anI v nurture vour marriage but also
help you to return to parenting \vith mure to give, Your
child needs to learn to trust other adults and that he can
sunjve separations from you, If \our 'illildisn't taught
to respect your rights, he may not respect the rights of
other adults.
CALL OUR OFFICE
During regular hours if - You feel your child is becoming spOIled, discipline, - You and vour spouse often disagree
- Your chIld doesn't improve after 2 months of tight­
ening lip on limit setting.
- You have other questions or concerns.
IllstructiC!lS fa!" !J)ediat(c Palis1its by Bartor. D. Schmitt, M.D., Pediatrician
Adapled from YOUR CHILD'S HEALTH. Copyright © 1991 by Barton D. Schmitt, M.D. R':r,Iinted
permls:::ion of I:L:ntarr jj':ioks. © 1992 by W. B. Saunders Company DISCIPLINE: TIME-OUT TECHNIQUE
h a fornl of disciplll1c
ll1lcrrupt unacceptab
isolating a
child m a chair or room for a cerialll penod of time. Time-oul has the advantage of
providing a cooling-off period for both the child and the parent. It gives a child over 2 to
3 years old a chance to think about his misbehavior and feel a little guilty about it. When
a child is less than :2 years old, time-out mainly establishes who is in charge.
Misbehaviors that respond best to time out are aggressive, harmful, or disruptive
CalIDOt be ignored Tl
lit is much more
spanking,
or shouting at
a child grows older.
Inc-outs can
replaced with logl
Place for Time-O
Playpens or Cribs - Playpens or
are a convenient place
timeout [or older
infants. A playpen near a parent is preferable to isolation in another room because most
infants are frightened ifthey are not in the same room as the parent.
Chairs or Comers - An older child can be told to sit in a chair. The chair can be placed
facing a comer. Some parents prefer to have their child stand facing the corner.
- Many parents
and safest room
ren become frightened I
your child in
that blocks the
covers the bottom half of the door.
for time-out
the child's bedwolll.
put in a room with
completely closi
door frame, or a
tTlOre
years of age,
Other
a gate, a
plywood that
Closed Rooms Some children will come out of the bedroom just as soon as they are put
in. If you cannot devise a barricade, then the door must be closed. You can hold the door
closed for the 3 to 5 minutes it takes to complete the time-out period. If you don't want
door that allows i 1
locked.
door, you can put
[0 forget your child.
[line-out should not last
minister Time-O
Dcciding the Length ofTime-OuL The tllllC-Out should be long enough for your child to
think about his misbehavior and learn the acceptable behavior. A l:wod rule ofthumb is
per year of the chi
a maximum of 5
kitchen timer
If your child
early
the required
should be returned
and the time sho
By the age of
children can be
11
room and asked to
they feel
Putting Your Child in Time-Out - If your child misbehaves, briefly explain the rule she
has broken and send her to the time-out chair or room. If your child doesn't go into time­
out immediately, lead or carry her there. Expect your child to cry, protest, or have a
tantrum on the way to time-out. Don't lecture or spank her on the way.
Keeping Your Child in Time-Out - Once children understand time-out, most of them will
stay in their chair, comer or room until the time is up. However, you will have to keep an
eye on your child. Ifhe gets up from a chair, put him back gently but quickly without
spanking him and re-set the timer. If your child comes out of the room, direct him back
into the room and reset the timer. Threaten to close the door if he comes out a second
time. If your child is a strong-willed 2 or 3 year old and you are just beginning to use
time-outs, you may initially need to hold him in the chair with one hand on his shoulder
for the entire 2 minutes. Don't be discouraged; this does teach him that you mean what
you say.
If your child yells or cries during time-out, ignore it. The important thing is that he
remains in time-out for a certain amount of time. Your child will not be able to
understand the need for quietness during time-out until at least 3 years of age, so don't
expect this of him before then.
Ending the Time-Out - Make it clear that you are in charge of when time-out ends .
When time is up, go to your child and state, "Time-out is over. You can get up (or come
out) now." Then treat your child normally. Don't review the rule your child broke. Try
to notice when your child does something that pleases you and praise her for it as soon as
possible.
Practicing Time-Out with Your Child - If you have not used time-out before, explain it to
your child in advance. Tell him it will replace spanking, yelling, and other such fonTIs of
discipline. Talk to him about the misbehaviors that will lead to time-outs. Also discuss
with him the good behavior that you would prefer to see. Then pretend with your child
that he has broken one of the rules. Take him through the steps of time-out so that he will
understand your directions when you send him to time-out in the future. Also teach your
babysitter about time-outs.
Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Provided to you by:
Piedmont Pediatrics
900 Rio East Court Suite A
Charlottesville, VA 22901
(434) 975-7777
Clean plastic containers with
push or screw-on lids are great
places to "hide" a favorite object
or treat. Toddlers will practice
pulling and twisting them to solve
the "problem" of getting the
object. Watch to see if your tod­
dler asks you to help.
Add a few Ping-Pong balls to your
toddler's bath toys. Playa "pop
up" game by showing your toddler
how balls pop back up after hold­
ing them under the water.
Play the "show me" game when
looking at books. Ask your toddler
to find an object in a picture. Take
turns. Let your toddler ask you to
find an object in a picture. Let him
or her turn the pages.
Playing beside or around other
children the same age is fun but
usually requires adult supervi­
sion. Trips to the park are good
ways to begin practicing interact­
ing with other children.
Make a book by pasting different
textures on each page. Materials
such as sandpaper, feathers, cot­
ton balls, nylon, silk, and buttons
lend themselves to words such as
rough, smooth, hard, and soft.
Make your own playdough by
mixing 2 cups flour and'!. cup
salt. Add 'I, cup water and 2 table­
spoons salad oil. Knead well until
it's smooth; add food coloring,
and knead until color is fully
blended. Toddlers will love squish­
ing, squeezing, and pounding the
dough.
The ASQ User's Guide, Second Edition, Squires, Potter, and Bricker. © 1999 Paul H. Brookes Publishing Co. www.agesandstages.com
I
Rhymes and songs with actions
are popular at this age. "Itsy-Bitsy
Spider," "I'm a Little Teapot," and
"Where Is Thumbkin?" are usual
favorites. Make up your own using
your toddler's name in the song.
Put small containers, spoons,
measuring cups, funnels, a buck­
et, shovels, and a colander into a
sandbox. Don't forget to include
cars and trucks to drive on sand
roads.
"Dress up" clothes offer extra
practice for putting on and taking
off shirts, pants, shoes, and
socks. Toddlers can fasten big
zippers and buttons.
Use plastic farm animals or
stuffed animals to tell the Old
McDonald story. Use sound
effects!
Give your toddler some of your
old clothes (hats, shirts, scarves,
purses, necklaces, sunglasses) to
use for dress up. Make sure your
toddler sees him- or herself in the
mirror. Ask him or her to tell you
who is all dressed up.
Make grocery sack blocks by fill­
ing large grocery sacks about half
full with shredded or crumpled
newspaper. Fold the top of the
sack over and tape it shut. Your
toddler will enjoy tearing and
crumpling the paper and stuffing
the sacks. The blocks are great
for stacking and building. Avoid
newsprint contact with mouth.
Wash hands after this activity.
Turn objects upside down (books,
cups, shoes) and see if your tod­
dler notices they're wrong and
turns them back the right way.
Your toddler will begin to enjoy
playing "silly" games.
Make your toddler an outdoor
"paint" set by using a large wide
paint brush and a bowl or bucket
of water. Your toddler will have fun
"painting" the side of the house, a
fence, or the front porch.
A good body parts song is "Head,
Shoulders, Knees, and Toes." Get
more detailed with body parts by
naming teeth, eyebrows, finger­
nails, and so forth.
Hide a loudly ticking clock or a
softly playing transistor radio in a
room and have your child find it.
Take turns by letting him or her
hide and you find.
Many everyday items (socks,
spoons, shoes, mittens) can help
your toddler learn about match­
ing. Hold up an object, and ask if
he or she can find one like yours.
Name the objects while playing
the game.
Cut a rectangular hole in the top
of a shoebox. Let your toddler
insert an old deck of playing
cards or used envelopes. The box
is easy storage for your toddler's
"mail:'
Toddlers enjoy looking at old pic­
tures of themselves. Tell simple
stories about her or him as you
look at the pictures. Talk about
what was happening when the
picture was taken.
Set up your own bowling game
using plastic tumblers, tennis ball
cans, or empty plastic bottles for
bowling pins. Show your toddler
how to roll the ball to knock down
the pins. Then let your toddler try.
ACTIVITIES FOR TODDLERS 20 -24 MONTHS OLD