DIET
Vitamins are only necessary if your child does not get a balanced diet. Many children, who don’t seem to get a balanced diet, actually do get one if you average what they eat over a few days. In other words, they eat meats well one day, and fruits and vegetables well the next. You may still give a vitamin if you wish.
COMMON ILLNESSES & PROBLEMS
Temper tantrums and behavior problems are a common complaint at this age. There are probably more opinions on this subject than there are grandparents in the world. I will give you some basic pointers, but ultimately, you should listen to all those opinions (mine included) and as parents decide how you want to proceed with child rearing. The pointers:
- Never hit a child. 70% of pediatricians advocate corporal punishment only as a last resort or when safety is involved.
- Be as consistent as possible. This is the absolute key to raising a good child. If you cannot be consistent in how you react to your child’s behavior problems, then you are going to have problems. This is probably more important than what you actually decide to do.
- Try redirecting the child’s attention. A child’s attention span is very limited, and they are easily moved to another area of interest when they are getting into something that you don’t want them into.
- Don’t expect more than your child is capable of. You can’t expect a 9 month old to be potty trained anymore than you can expect a 3 year old to stop something they are doing, and take out the trash.
- Don’t let your anger guide your decisions. It is very easy to turn a spanking into abuse, even by the best of parents.
- You can reason with a child, just don’t try to over-reason with them. As the child’s speech improves, you can bargain with them about expected behavior and punishments. Expect the child to live up to his or her expectations, and apply the punishment you both decided on. Don’t expect perfection.
- Try to ignore what you can. Just as a child learning how to speak will say something again if you respond, they will misbehave again if they think you like it. Children often misinterpret “no” or anger for attention, and will still misbehave.
- Praise them when they are good. Children obviously need much love and attention. Children are like clay that is easily molded by a parent’s love. While children are often born with a certain temperament, they can definitely be shaped by your love. Also, ignoring will not be effective unless the child knows the difference between this and attention.
- Pick your battles. When you ignore a child, they throw a bigger fit, and then you give in, you are only teaching that child that bigger fits gets them what they want. I have patient’s that can vomit at will to get what they want. It’s very difficult to be consistent when you know the item you are fighting about is not important. The child innately knows this, and will simply push you. If it’s not important, then give it to them. If it is important, then you had better send them a consistent message.
Most children are potty trained by 3 years of age, but some are not quite done yet. For those children a few pointers:
- Most children will urinate on the potty up to 6 months before they start having bowel movements on it.
- Your child is already trying to be independent in many ways. Every time they do this, let them know that “big boys and girls get to do the things they want and big boys and girls also wear big boy or girl underwear and go potty on the big potty”. This backfires when they want to be a baby, but it works for most kids.
- Pull-ups and the new very absorbent diapers prevent your child from feeling urine on their skin. While this prevent rashes well, it has led to later potty training. You can get around this by putting underwear on under the diaper or pull-up. This will allow them to feel the urine while preventing messes.
SAFETY
Remember to buy a helmet with the first tricycle. Children have had surprisingly bad head injuries from even falling off a tricycle. Please don’t let this message prevent you from buying a tricycle, just buy the helmet also, and be careful. Booster seats are meant to raise your child’s hips so that the seatbelt works as a lap belt like it should, instead of a waist belt. If the belt is above the hips, then it could tear into the abdominal organs or aorta with even a mild crash.
NEXT VISIT
We give check ups every year starting at 3 years of age. The vaccines given at the 4 year check up must be given on or after the 4th birthday, not earlier, and are also known as the school boosters. The vaccines are: DaPT, IPV, MMR and Varicella.
The tuberculosis test (TB, 4 pronged test on the forearm) is no longer required, unless your child lived out of the state before starting school in WV. The DPT includes the Tetanus, and your child will not need another Tetanus for at least 5 years from the 4 year check up DPT, no matter what kind of wound they have. After five years from the last Tetanus shot, you only need a tetanus shot for a wound, then at 10 years from the last one, you need a Tetanus shot anyway. We try to move the check ups to the summer after the 4th one. Having check ups in the summer prevents missed school, allows us to fill out school / sports forms on the spot, and leaves space for the younger kids and sick visits in the winter.
Please remember yearly check ups are necessary, not optional. When a pediatrician does a check up and the parent says absolutely nothing is wrong, we find a significant problem in every 20-50 kids. Good parents always bring their kids when they feel something is wrong. Good pediatricians just find significant things earlier, when they are easier to treat.
