Thursday, March 19, 2009

Toilet TEACHING

Toilet Teaching

Signs of readiness in your child:
Stays dry for a few hours at a time.
Understands words like potty, wet and dry.
Participates in dressing and undressing.
Follows simple directions.
Appears to know he is about to go.

Preparing your child:
Teach child the words for bathroom functions and body parts.
Allow child to observe others using the toilet and explain the steps involved.
Have child assist in dressing and undressing
Read child books, watch videos about toilet learning.
Get a potty chair/toilet topper and explain that it is his/her chair.

Changing from diapers to pants:
Transition all toileting activities to the bathroom. Stop using a changing table. Keep all toileting items within child’s reach and have him/her responsible for getting them and using them to their ability.

Have child wear loose-fitting training pants and clothing. This is not the time for a lot of buttons, zippers and overalls. S/he needs pull-and-go clothing.

Provide reminders to go to the potty, and don’t ask if s/he needs to go potty the answer will usually be no, even if s/he does. Use a timer and take child in regularly every 2 hours. Encourage dry pants.

Be sensitive to child’s fear, if any, of flushing.

Place poop into the toilet every time out of the Pull-Up (or diaper) and have child flush it to build an understanding of that is where it belongs.

Practice the entire process with a doll or stuffed animal if the child shows interest.

Keep wipes, Pull-Ups/underwear, and clothing changes where the child can reach them independently. The child should be able to change a wet Pull-Up by him/herself and encouraged and allowed to do so.

Expect accidents and be relaxed about them, helping the child to clean up and change clothing to the best of their ability with your follow-up. Make the child responsible for their own toileting. Toilet training is the first thing that s/he has complete control over and will or will not use that control. Don’t shame or punish.

Begin when family environment is calm, without new or upsetting events, such as new baby, new job, a move or holidays.

It is hard for a child to stop an activity to go potty. Follow a not so desirable activity (potty) by a desirable activity (story, outside).

Make it a given that before going to bed, going out to play, leaving the house in the car, eating, etc., everyone goes potty and washes their hands, including the potty training child. Then it becomes routine, something that will need to happen anyway once the child is potty trained. Build in time for this routine.

Make it a routine that the child is sat on the potty immediately after waking up. S/he usually will need to go at that time and will learn to hold it until you get him/her there. This is non-negotiable. Leave the child there with a toy or book until s/he goes. If the child gets up, return him/her to the potty. This is the one time of the day that you can guarantee they have to go, and provides the perfect, consistent scenario to establish that this is what we do now, absolutely every morning, no matter what. Consistency is key!

Children know that Pull-Ups are the same as diapers. I have seen potty trained children suddenly go in their pants when placed back into a Pull-Up. Why make the effort to go to the potty when they can comfortably go where ever they are and keep doing what they want to do?
The reasons for moving from diapers to Pull-Ups are to utilize the feel-and-learn aspect many of them have now so that they can feel some wetness when they go, and to learn the behaviors of pulling the pants up and down to go. The wetness aspect can also be achieved by placing a strip of paper towel into the diaper at every change.

Once you transition to Pull-Ups and again to underwear, do not go back to diapers! Using Pull-Ups at night after transitioning to underwear is fine.

When the child is transitioned to Pull-Ups, act as if they are underwear when changing the child. Have them stand up and bend over to be wiped down and wipe with toilet paper for poop, placing it in the toilet. Do not have them lay down to be changed.

Once the child shows a good understanding of potty training, the most effective thing you can do is to transition to 5-ply training pants with plastic pants over them. You will need many sets at first. This is a messy process but highly effective. It is a huge wake up call to a child when they feel that soaking wetness all over themselves.

A good activity for quick results is to have a potty boot camp. By taking two consecutive days and devoting them to potty training your child. This is the time to give him/her all the juice, kool-aid or other coveted beverage s/he can drink and loading them up with it. Camp out in the bathroom (hopefully tile) with books and toys, or somewhere else in the house or outside in a tent with a plastic drop cloth underneath and a potty chair or toilet topper at the ready.
In the beginning, offer incentives and hold potty parties for their accomplishments. As success is gained, transition to celebrating new skills, such as staying dry, asking to go, or pooping in the toilet.

Before making the decision to potty train, ensure that all care providers are equally committed to the process. If you decided that, “Oh, it’s vacation time and we don’t really want to mess with it this week,” then your child will regress. This is a huge control issue for your child and you must be committed to making it work for your child or it can lead to feelings of shame, inadequacy, frustration, fear, and confusion, rather than empowerment and pride.

Remember that this is a skill. It takes time for the concepts and steps to come together, and it takes practice to build the muscle memory necessary for success.

Girls are born with the physical ability to be potty trained. Boys are not. Boys develop the muscles necessary to control their bladder usually by the age of three. However, it is not uncommon for these muscles to not develop within this time frame, or to not develop fully at all. That is why there are thirteen-year-old boys who still wet the bed. Please keep this in mind if you have a boy to toilet train. If there are continuous problems, it may be that they are physically unable to be potty trained at this time. Especially at night when the muscles relax.
Nighttime dryness and pooping in the toilet may follow much later than daytime dryness.



Good books:
Everyone Poops
I’m a Big Kid Now

Good Websites:
www.drgreene.com
http://drphil.com/articles/article/264

Juice Issues-Various Research Notes

Research on why children shouldn’t be given fruit juices. It is recommended that juice be given after age 3, preferably age 4, since that is when a child’s digestive system is mature enough to completely handle them.

Dr. Tobias Nobrigot, co-author of the study, explains, "Previous studies suggest that the less complete absorption of the carbohydrates in apple and pear juice is commonly attributed to two factors: the imbalance of fructose and glucose—in both apple and pear juice that ratio is approximately two to one—and the presence of sorbitol. White and purple grape contain no sorbitol and the fructose/glucose ratio in each juice is approximately one to one. This study indicates, among other things, that young children gradually develop an ability to absorb the sugars in apple and pear juice. The three year old group handled apple juice nicely but was still digesting the pear juice incompletely. By five, all four juices were being digested properly."
***
Many experts agree that juice should be introduced in a cup, not a nippled bottle. Recent studies have also shown that excessive juice consumption can contribute to obesity and failure to thrive in some children. Decisions on proper juice amounts should be made in consultation with a pediatrician.
***
Fruit juice contains four forms of carbohydrates: sorbitol, fructose, glucose, and sucrose. Not only is sorbitol hard for some babies to digest, but juices with a high ratio of fructose to glucose have also been shown to be rough on young gastric systems. Apple and pear juice, in particular, are both high in sorbitol and have a fructose-glucose imbalance. Earlier research has suggested these drinks may pose problems for some babies.
***
Fruit Juice - Not a Whole Food
Fruit juice, which is consumed heavily by children, is not a whole food and adds little nutritional value. Juicing removes the fiber, and unless the juice is freshly squeezed and consumed immediately, most of the nutrients are lost. Commercial canned or bottled juices are mostly sugar (even if you buy unsweetened) and most likely contain pesticides. Excess sugar can make your child more susceptible to illness.

Many researchers and health care providers are now saying that a lot of fruit juice consumed every day can be harmful to a child's health. This is due to the large, concentrated amounts of sugar (even though it's natural) contained in the juices. In addition, fruit juices contain sorbitol, which isn't absorbed well and can create gas and bloating or even chronic diarrhea. Apple juice has high sorbitol levels. White grape juice doesn't contain sorbitol and may be tolerated better than other juices, although you still have the problem with sugar and pesticides. Drinking large amounts of juice can also decrease the appetite. If your children drink a lot of juice, they may not have an appetite for the food they really need.

A child who drinks a lot of fruit juices may be susceptible to yeast overgrowth. This can lead to chronic nasal congestion, eczema, or throat and ear infections. If your children are drinking too much fruit juice, you can wean them by diluting one-third white grape juice with two-thirds water. You can slowly cut the juice out altogether. Pure water is the best drink for children.
***
Fruit juice consumption by infants and young children has increased over the past 30 to 40 years because of increased availability, convenience, marketing and children’s preferences. Sweetened beverages are preferred over unsweetened drinks even by neonates, as well as young children [1,2]. By one year of age almost all children drink fruit juice [3]. Concerns about children’s excessive consumption of fruit juice have been raised by a number of professional groups. The American Academy of Pediatrics (AAP) and the American Academy of Pedodontics have expressed concerns about tooth decay and fruit juice [4]. The AAP Committee on Nutrition has expressed concern about sorbitol, a naturally occurring, but nonabsorbable sugar alcohol present primarily in pear juice and apple juice; they cautioned that the "excessive use of fruit juice" may result in gastrointestinal symptoms, such as chronic diarrhea, abdominal pain or bloating [5]. The role of juice carbohydrate malabsorption (especially fructose) in chronic nonspecific diarrhea in children has been recognized for some time [6,7].

Among children referred for evaluation of failure to thrive, excessive fruit juice consumption was reported as a contributing factor in nonorganic failure to thrive in eight children, aged 14 to 27 months [8]. In some children, an association between excessive fruit juice consumption and short stature was reported, while in other children, a relationship between high intakes of fruit juice and obesity was found [9].

Discipline

Discipline is what you do to help the child learn to control himself.
Punishment is what you do to control the child.

What kind of child do you want to have?

The behaviors you model, the behaviors you encourage, and the behaviors you reward are the behaviors your child will embrace. If you model aggression, anger, reactionary actions, and demeaning comments toward your child then you will gain a child who is out of control, has low self-esteem and is unable to appropriately express his/her feelings. If you model calm, thoughtfulness, respect, politeness and place the child in control of their life through providing appropriate choices for them to make, then you will gain a child who is emotionally secure, responsible, confident, and in control. Mental and physical disorders aside. If you have a goal of the child you want to have raised at the end of age 18, then your every action and parenting choice can have a meaningful agenda.

Keep Your Expectations Realistic. If you demand too much, your child may feel out of control and frustrated.

Praise your child for cooperation. Don’t spend a lot of time explaining why you want them to do it, but do tell them what’s in it for them.

Respond Immediately

Don’t over explain to toddlers. The more you engage your child in discussion, the more attention s/he gets from acting out.

Label your childrens emotions for them, since they can’t do it themselves.

Praise your child for good behavior. It will inspire them down the road. For every negative comment made by a parent or caregiver, a child really needs about 10 positive statements to keep their confidence and self-worth at the highest level. So beware of harsh criticism. As with adults, it eats away at a person's self-esteem, and every child deserves the right to feel good about themself.

Some times it just takes a little attention from a caregiver to defuse a situation.

Beware the television. Children who watch violent images in any manner, newscasts, parent’s movies, or cartoons, are more aggressive. Don’t think that just because they are playing in the corner that they are not picking up on what is portrayed.

Spanking breeds hitting. If you do it, then the child sees it an acceptable form of behavior. They will begin to hit, especially smaller children, if no smaller children are around, they may start hitting the pets. Or themselves. An aggressive household breeds aggressive children, a calm, thoughtful household breeds calm, thoughtful children. Appropriate DISCIPLINE, not punishment, is time out or the removal of a privilege, only after the child has had the opportunity to self correct the behavior and has been provided with a warning of the consequences of continuing an inappropriate choice of behavior. The exceptions being harmful behaviors such as hitting another child, which requires an immediate, firm response with the maximum time in time-out or the loss of a favorite privelege.

Remember that certain stages are temporary. Biting, tantrums, yelling “no” to everything, bad language - don’t worry about them too much. Just make certain your child knows that the behavior isn’t acceptable and won’t be tolerated, but keep a calm reaction. A harsh reaction to these will simply reinforce the behavior and extend them much longer than they would normally occur.

Remember that defiance is good. It means the child is secure enough in your relationship to challenge you.

Accept your child’s feelings, which he cannot control. Stop the disruptive behavior, which they can learn to control.

Set reasonable limits for your child’s age and needs.

Establish the rules and consequences, keep them simple, keep them consistent, and respond appropriately and immediately.

Don’t expect your young child to be able to do what even teenagers can’t do: resist temptation and peer pressure, and react rather than act. Children lack full impulse control and logical reasoning into their early twenties. How many times have you yelled at the idiot who cut you off on the road, with your child in the car? That is a reaction rather than an action, and your child picks up on that type of thing. If you can’t keep your cool in all situations, just think how your child feels when they have very little cool to begin with.

There shouldn’t be a “bad guy” syndrome. If the consequences are clear, then it is the child’s choice and decision to do the unacceptable behavior and take the consequence. It should be worded in just that way.

Correct your child’s behavior with love and respect.

Avoid embarrassing your child.

Avoid threats. “If you do that one more time, you’re going to time-out.” Instead: “You may go play with your toys or sit at the table and draw. If you choose to continue (misbehavior) then you will go to time-out.” This takes it from your reactionary threat to placing the responsibility for a choice upon your child. They may choose to continue with the behavior and go to time-out. Make certain they know it was their choice.

Give two acceptable choices to your child, and respect the one they choose. “You may play with your blocks or your puzzle.” Don’t continue with, “Instead of sitting on your brother to get his toy.”

When a child misbehaves and needs a reminder, couch what they are not suppose to do between two statements of what they are suppose to do. “We sit in our seats. We don’t stand in them. We sit in our seats.” Rules should be simple and repetitive.

Consistency. Trust and good behavior stem from consistency in routine and expectations. This includes knowing where things will be, when things will be done, and how they are to be done. As much consistency as possible between all of a child’s caregivers is important, so be sure to communicate and get on the same page.

Sleep and a consistent sleep time. Children to age six need 12 hours a night. Studies have shown that everyone, adults and children, need a consistent time to go to sleep and wake up to keep their bodies in sync. This is especially true for children. The occasional holiday or special event won’t hurt them, but a daily sleep routine is a must. Sleep is the number one key to behavior issues. Children deserve to have their behavior issues be their own choices, not because of lack of sleep.

Use when/then statements. “When you put your pj’s on, then we can read a book.

Make “yes” fun. Make a not-so-desirable task into a game.

Time-out should be given for specific behaviors or levels of behavior. Such as hitting, or stubborn refusal to stop an inappropriate behavior after several reminders and warnings. Time-out should be a given for hitting or other harmful behaviors, and it should be given as an option to the child when reminders, choices, or distraction haven’t worked. Children should be fully aware that they are going to time-out when they chose the behavior that will put them there.

Time-out should be for one minute per age of child. It should be somewhere segregated, within your perimeter, and not fun. Often this is facing a corner, or for older children it is the bottom step of stairs. There should be no entertainment value in sight, including lures to abandon the position. The child should sit or stand quietly for the time allotted.


The first stage of child development is the first year, where the infant learns trust. That the world is a safe place to be and my needs get met.

The second stage is ages 1-3, where the child learns to be independent and to control him/herself. One of the reasons for the “terrible two’s” is due to the child coming to the realization that what they have been told they “can’t” do, is actually stuff that they can do, only adults won’t let them. Most of it is stuff that they really want to do, also. Like throwing things, hitting things, climbing, taking really cool toys from other children and exploring away from the grown ups. When they get away with these behaviors, even once, they realize that not only can I do it, but I just might get away with it. One study states that for every time a child gets away with an inappropriate behavior, s/he will attempt it a minimum of ten more times, even if every one of those other ten times they receive correction. This is the time period where it is most important that the child have consistency in expectations and consequences.

The third stage is ages 3-5, where a child plans and does tasks. They have a need to belong. Children at this stage need to be taught and be responsible for tasks such as folding washcloths, putting away some of the dishes, choosing items for dinner, setting the table, and helping with pets.

Lastly - lying is not cognitively active until the age of 8. At age 6 you can begin to start your child questioning their statements, such as "Is that real or make-believe?" Until the age of 6, lying is simply wishful thinking/story telling. The child does not have control over it. They do it because they truly want it to be the way they say, to keep out of trouble, or to make you happy. They will also alter their thought processes so that they ACTUALLY BELIEVE that is what happened. Once again, you can not punish a child for something they have no control over. Lying is NOT LYING until age 6-8. Let it go. However, there does need to be an appropriate response to inappropriate behavior. "There are crayon marks on the wall, so the crayons have to be in time-out for a week." (denied writing on wall) "Your friend is crying because you were not a nice friend, so you have to go into time-out." (denied pushing/hitting/taking toy) Story telling, "I have a pet lion," should simply be encouraged. "Really, what color is he? Does he eat a lot of meat?" Imaginary friends, etc. should be thoughtful encouraged as your child explores their emerging imagination and learns the intricacies of using it in all it's many colors. One of these is the black and white thing that adults view as lying.

Separation Anxiety article

Separation anxiety
Approved by the Medical Advisory Board
Reviewed by Paul Young, M.D.
Last updated: July 2006

Do all babies experience separation anxiety?

Yes, to a degree. At certain stages, most babies or toddlers will show true anxiety and be upset at the prospect — or reality — of being separated from a parent. If you think about separation anxiety in evolutionary terms, it makes sense: A defenseless baby would naturally get upset at being separated from the person who protects and cares for him.

In many ways, attitudes about babies and separations are cultural. Western countries tend to stress autonomy from a very early age. But in many other cultures, infants are rarely separated from their mother in the first year of life.

Regardless of the origins of this normal developmental stage, it's frustrating for babies and parents. The good news is that separation anxiety will pass and there are ways to make it more manageable. And in the meantime, enjoy the sweetness of knowing that to your child, you're number one.


When does it most commonly occur?

Babies can show signs of separation anxiety as early as 6 or 7 months, but the crisis age for most babies is between 12 to 18 months. Most commonly, separation anxiety strikes when you or your spouse leaves your child to go to work or run an errand. Babies can also experience separation anxiety at night, safely tucked in their cribs with Mom and Dad in the next room.


How can I help my baby through it?

Several options are available to parents:

Option I
Minimize separations as much as possible and take your baby along if he seems to feel anxious. With this option, you're basically waiting for your baby to outgrow this stage.

Option II
If you have to leave your baby — for example, to return to work — try leaving him with people who are familiar, like his father, grandmother, or aunt. Your baby may still protest, but he might adjust more easily to your absence when surrounded by well-known faces.

Option III
If you need to leave your child with someone he doesn't know, give him a chance to get to know his caregiver while you're still around. (See below.)


How should I prepare my baby for separations?

As with any transition, give your baby an opportunity to gradually get used to the idea. Whether you're leaving him with a family member or a paid childcare provider, try the following suggestions:

• New sitter. Let your baby get comfortable. Ask a new sitter to visit and play with your baby several times before leaving them alone for the first time. For your first real outing, ask the sitter to arrive about 30 minutes before you depart so that she and the baby can be well engaged before you step out the door. Employ the same approach at a daycare center or at your nursery, church, or health club.

• Always say goodbye. Kiss and hug your baby when you leave and tell him where you're going and when you'll be back, but don't prolong your goodbyes.

• Always say goodbye: Part 2. Resist the urge to sneak out the back door. Your baby will only become more upset if he thinks you've disappeared into thin air.

• Keep it light. Your baby is quite tuned in to how you feel, so show your warmth and enthusiasm for the caregiver you've chosen. And don't cry or act upset if your baby starts crying — at least not while he can see you. You'll both get through this. The caregiver will probably tell you later that your baby's tears stopped before you were even out of the driveway.

• Once you leave, leave. Repeated trips back into the house or daycare center to calm your baby will make it harder on you, your child, and the caregiver.


How should we handle nighttime separation anxiety?

Your baby's fear of being separated from you at night is very real for him, so you'll want to do your best to keep the hours preceding bedtime as nurturing and peaceful (and fun) as possible. In addition:

• Spend some extra cuddle time with your baby before bed by reading, snuggling, and softly singing together.

• If your baby cries for you after you've put him to bed, it's fine to go to him — both to reassure him and to reassure yourself that he's okay. But make your visits "brief and boring," and he'll learn to fall back to sleep without a lot of help from you. [Limit eye and voice contact. Do not pick up child or remove from crib. Simply lay the child down. If you decide to remain in the room with the child, stay as far away from the child as possible, within view, and pretend to sleep.] Eventually, he'll be able to fall asleep on his own.

Homemade Baby Wipes

Homemade baby wipes
From the forthcoming “The Duggars: 20 and Counting”
Our friends Gil and Kelly Bates, now the parents of 16 children, shared this recipe with us years ago.
Ingredients
One roll of Bounty paper towels
One-gallon ice-cream bucket, clean and empty
Two cups water
Two tablespoons baby oil
One tablespoon rubbing alcohol
One tablespoon baby bath (optional)
Cut a whole roll of Bounty paper towels into thirds. (We've found that Bounty is the only brand that works. Use an electric knife for best results.)

Place one of the halved rolls vertically into an empty and thoroughly cleaned one-gallon ice cream bucket. In a large measuring pitcher, mix two cups water, two tablespoons baby oil, and one tablespoon rubbing alcohol. (Some families also like to add a tablespoon of baby bath.)

Pour the liquid over the halved roll of paper towels in the ice cream bucket, and soak for 30 minutes. Remove the cardboard center. Feed the top corner of the paper towels through an X-shaped slit you've cut in the lid of the ice-cream bucket so you can pull out and tear off one "wipe" at a time.

Daycare Must Haves (Parent's too)

Under Age 5

DVDs
Must Haves
Rock n Learn Colors Shapes and Numbers
Mommy and Me Playgroup Favorites
Mommy and Me More Playgroup Favorites
Letter Factory (Leapfrog)

Good to Have
Word Factory (Leapfrog)
Math Circus (Leapfrog)
Rock n Learn Spanish (way beyond them, but all enjoy it and you’d be surprised what they pick up)
Dvds or recorded episodes of Dora, Little Einsteins, Bob the Builder
Magic School Bus (even the 1-year-olds like these)

Don’t Bother
Movies longer than 30 minutes. Attention span isn’t there

TOYS
Must Haves
Playdoh, mainly cutters, mashers, and building accessories. Don’t bother with the extruder or people because they just get clogged and frustrate the kids.
Wooden train set(s)
Wooden blocks, the larger and more shapes the better, be aware of small ones as they are choking hazards
Baby dolls 1 per child and bottles. Don’t waste money on stroller and other stuff, they tear it up.
Set of musical instruments
Dry erase books/boards of things they can trace and draw on, not blank. Even the littlest ones can practice pre-writing skills
Duplos and/or baby Duplos
Cars

Good to Have
Large Fisher Price car set. Must be large/sturdy enough for them to abuse. (see mine)
Bendy people. Hand size, no parts to come off and pose risks.
Doll house, one that folds out. Could also use a cheap bookcase. Use bendy people in it.

Don’t Bother
Stuffed animals. Collect dirt, dust and germs.
Lacing items. They get a string in a couple holes then sling them around at each other
Rocking horse. They use it as a climber and is a huge liability.
Barbies, etc. They will tear them apart and eat them, clothing and accessories are hazards.