Peaceful Parenting: Anxiety in Preschoolers

"Children may express stress differently according to their age, maturity level and previous experiences... In the pre-schooler age group, a child who expresses constant anxiety and fear of being alone is definitely showing signs of stress." - Dr. Markel

Dear Dr. Markel,

I would like to know about anxiety in preschoolers and to what extent that is typical and age appropriate. — My 3.5yo daughter is bright, creative, and fairly well adjusted but has what I consider to be a real anxiety problem. It doesn’t affect her every single day, but it definitely comes and goes in phases and when it is at it’s worst, it affects all the members of our family. When she was younger I worked, so she was used to being left with fantastic caregivers for almost three years. In February I lost my job and started staying home with her and her little brother, and the anxiety went from fairly typical separation anxiety to something more. She started being scared that I would leave her and not come back, even for example when I put her in her carseat and walked around to the other side of the car. She would become hysterical. This morning we were home together and I was doing normal household chores, every time I turned a corner or left the room she panicked and wanted to know where was. She is scared of doors being shut, of me going out into the yard for a second, even sometimes when she can still hear and see me. As I said, it is not everyday, but I feel there is something more going on than typical childhood fears. Can you tell me what’s age appropriate and if I should start looking for professional guidance for us?

— M.P. (Shelburne, Falls, MA)

Dear M.P.,

Children typically experience anxiety as they begin to understand some of the realities of the world, which to them may be disappointing and sometimes frightening. From your daughter’s point of view, the feeling of being afraid and out of control is probably a practical definition of anxiety. It is particularly common for children to experience this kind of anxiety between the ages of 2 and 6.

Young children may have short-lived fears such as fear of dark, storms or animals. Natural developmental fears during these years might include fear of being left alone – such as what your daughter is experiencing now – or fear of strangers. Life transitions are also stressful events for children, and the change from a daycare to a home situation is certainly that for your daughter.

Children may express stress differently according to their age, maturity level and previous experiences. Young children may react with certain symptoms and behaviors when the stability and security of their lives are violated. They may exhibit regressive behavior which is not to be confused with a child’s typical moment-to-moment inappropriate behavior. Regressive behavior is a cry for help from a child who is not feeling safe or who feels unable to cope with his or her situation.

In the pre-schooler age group, a child who expresses constant anxiety and fear of being alone is definitely showing signs of stress. It sounds as if she is in particular need of being cared for and protected. Children under stress need help in expressing their fears and concerns. Your daughter’s fears need to be address because they certainly are real to her. So my best suggestion is, yes, some therapeutic intervention would be helpful at this time.

— Dr. Susan Markel, MD


ABOUT THE AUTHOR

Dr. Susan Markel

Susan Markel, M.D. is a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981 and an International Board Certified Lactation Consultant (IBCLC) in 1997. For many years she served as a medical liaison for La Leche League and is the author of What Your Pediatrician Doesn’t Know Can Hurt Your Child.

  • SUBMIT QUESTIONS: Do you have questions or concerns on how you as a parent and/or your children can achieve a healthier and happier lifestyle you would like to see Dr. Markel address? Submit your question for consideration HERE.

(Photo credit: (ccl) Wilson X)

Peaceful Parenting: Transitioning from Co-Sleeping

To ease the transition from co-sleeping into their own bed, offer your child a transitional object, a soft toy or blanket, to provide comfort or solace during separation at bedtime.

Dear Dr. Markel,

“We have been co-sleeping with our son since we brought him home from the hospital 18 months ago, and now my husband and I are ready to transition him to his own bed. Any advise on how to ease this transition?” — S.F.

Dear S.F.,

Congratulations for being such wonderful loving parents providing a safe, peaceful home for your son. You used the apt word “transition” which signifies a gradually letting-go so that babies can develop their own ways of dealing with the world. To ease the transition, you might want to encourage your son to become attached to a “transitional object”, a soft toy or blanket, specially used to provide comfort or solace. Eventually your child associates the transitional object with the attention of a parent, and it is particularly helpful during separation at bedtime if you do not want to continue to have him in bed with you.

Attachment to the transitional object can happen quite organically when your child develops an affinity for a particular object, or it may be encouraged by you. The transitional object should be offered consistently at all times whenever your baby is learning to sleep alone or in any situation that is causing him to be sad, lonely afraid, upset or stressed.

Some babies maintain this attachment throughout the preschool years and beyond, There is no predetermined time for abandonment of a transitional object. Your child will put it aside when he is ready. Most children outgrow the need and use it less and less over time.


ABOUT THE AUTHOR

Dr. Susan Markel

Susan Markel, M.D. is a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981 and an International Board Certified Lactation Consultant (IBCLC) in 1997. For many years she served as a medical liaison for La Leche League and is the author of What Your Pediatrician Doesn’t Know Can Hurt Your Child.

  • SUBMIT QUESTIONS: Do you have questions or concerns on how you as a parent and/or your children can achieve a healthier and happier lifestyle you would like to see Dr. Markel address? Submit your question for consideration HERE.

(Photo credit: (ccl) brennaval)

Peaceful Parenting: Hay Fever

Dear Dr. Markel,

“My eight year old son has moderate hay fever.  This time of year for the past two his nose runs, his little eyes glaze over and he sneezes and/or coughs continuously.  He’s always rubbing his eyes and sticking his fingers in his ears because they “itch.”  I’m also noticing that every spring he has a hard time in school, which is making me concerned that it is effecting his learning too. I don’t want to put him on medication, but I don’t want to see him suffer or fall behind in school either.  Any advise what I can do to alleviate his discomfort?”  — Pam

Find out what the current pollen count is in your town - click on the photo for a list of towns in Massachusetts. (Willow Pollen - Photo credit: Sienna Wildfield)

Dear Pam,

Allergies are an incorrect response on the part of the immune system, which recognizes substances such as pollen as foreign invaders to the body. When it comes in contact with these substances that would be otherwise harmless, the immune system has an unexpected hypersensitive reaction.

Allergic rhinitis, which is affecting your son, is commonly known as hay fever, and it is the most common chronic childhood disease. Allergic illnesses are usually not life threatening, but they do put a strain on public health resources, work and school productivity, and the quality of life of the individuals concerned.

Two signs of allergic rhinitis in children are “allergic shiners” (dark circles under the eyes caused by increased blood flow near the sinuses) and the “allergic salute” (an upward movement of the hand against the nose that over time causes a crease mark on the nose). As described in your son, these are often accompanied by runny nose, cough due to post-nasal drip, watery eyes, and itchy eyes, nose, and throat.

Because of limited exposure to the environment, there are few things to which infants may be allergic, but once a child gets older, exposure to outside allergens, such as tree pollen, weeds, or grasses increases his chances of developing seasonal allergies because he spends more time outdoors.

Although many drugs are effective in treating allergies once they occur, many parents such as yourself prefer not to rely solely on drug treatments for allergies and prefer a more preventive approach.

You can take steps to reduce the occurrence of environmental allergens in your home by making such modifications as using zippered, plastic covers on pillows and mattresses and washing your bedding weekly in hot water. These steps can avoid the accumulation and continued exposure to pollen which comes into the home on a daily basis.  Optimally, carpets, upholstered furniture, or objects that collect dust should be removed from your son’s bedroom.

Dietary measures can help. Foods high in antioxidants protect against allergies because the antioxidants scavenge potentially harmful molecules called free radicals from the body. Free radicals can cause oxidative tissue damage, which triggers inflammation and problems like allergies and asthma.

  • Vitamin C acts as an antioxidant. Various fruits and vegetables such as oranges, apples, strawberries, grapefruit, cantaloupe, fresh tomatoes, broccoli, and Brussels sprouts are good sources of vitamin C.
  • Vitamin E also acts as an antioxidant. Tree nuts are a particularly good source.
  • Resveratrol is a powerful antioxidant found in peanuts and the skin of grapes.
  • The omega-3 fatty acids DHA and EPA, found in cold-water fish and algae sources, are anti-inflammatory. Wild salmon, mackerel, trout, herring, sardines, and albacore tuna are good sources of marine omega-3 fatty acids. (Be mindful of concerns about mercury contamination when consuming fish.)
  • Avoid foods with partially hydrogenated oils (trans fats); these cause inflammation, making allergy symptoms worse.

It is understandable that you want to avoid medical treatment of your son’s allergies Prevention methods described above are always the first line of defense for these conditions. However, if symptoms are interfering with your child’s lifestyle (school, sports, play) then seek proper medical advice from your pediatrician or allergy-and-asthma specialist. With appropriate education, prevention, and treatment, allergy symptoms can be well controlled.


ABOUT THE AUTHOR

Dr. Susan Markel

Susan Markel, M.D. is a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981 and an International Board Certified Lactation Consultant (IBCLC) in 1997. For many years she served as a medical liaison for La Leche League and is the author of What Your Pediatrician Doesn’t Know Can Hurt Your Child.

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Peaceful Parenting: Thumb Sucking

Dear Dr. Markel,

I was wondering your opinion on thumb sucking. My son is 7. He sucks his thumb a lot, except never at school. I feel he doesn’t “need” to, but that it’s more of a habit. His brothers are starting to really be annoyed at the sound of it. We have to tell him he can’t when we are all playing a game or watching a movie together. I don’t want it to turn into a negative thing. We have a happy, well balanced, non-stressful house with a lot of love. I know it helps some kids cope with their environment. Does he still “need” it or can we try to help him quit? Thanks for your help.

— Virginia Christi of Colrain, MA

Dear Virginia,

"...praising your son when he is not sucking his thumb is a good starting point." - Dr. Susan Markel, MD

Congratulations on providing the most important ingredient for your children’s health and well-being, a peaceful  home in a loving family.

While, in general, habits or “loveys” provide comfort and security (adults have their own forms of tension-relieving  behaviors), it is true that the thumb sucking has a few negative consequences for your son. First, the permanent teeth will in fact be positioned improperly if the thumb sucking is consistent. Also, his brothers are getting annoyed about the effect on them of listening to the sounds, and that, in turn, is a source of anxiety for your son (perhaps creating a cycle of discomfort and then relieving that discomfort with thumb sucking. Calling attention to the habit may have the negative effect of intensifying it).

Habits are difficult to break, for anybody, as they are by definition established patterns of behavior.  Your son associates certain activities with thumb sucking and those are the times when he does it. As well, other situations are associated with “not thumb sucking” and it is clear therefore that he is certainly capable of giving it up, given the right circumstances.  That said, one of the most important things to remember is that children respond to praise more readily than criticism (the same is actually true, again, for adults), so praising your son when he is not sucking his thumb is a good starting point.

Also, your child is old enough to be reasoned with, and to get into the act of decision making about stopping the thumb sucking.  He is mature enough to understand why this habit harms his teeth and disrupts family togetherness. Discuss with your child why it is better to stop the habit, and come up with some strategies for dealing with it together. One idea is to substitute other (harmless) behaviors, such as a squeeze ball, which will occupy his hands during the time that he would otherwise be sucking his thumb, or perhaps chewing sugarless gum would keep his mouth otherwise occupied.

From the tone of your letter, it is obvious that you realize that your son is not doing this to intentionally be “bad.”  It is not misbehaving in any sense of the word, and it is important that all family members treat your son with respect and understanding as you try to help him through this transitional time.

— Dr. Susan Markel, MD


ABOUT THE AUTHOR

Dr. Susan Markel

Susan Markel, M.D. is a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981 and an International Board Certified Lactation Consultant (IBCLC) in 1997. For many years she served as a medical liaison for La Leche League and is the author of What Your Pediatrician Doesn’t Know Can Hurt Your Child.

 

  • SUBMIT QUESTIONS: Do you have questions or concerns on how you as a parent and/or your children can achieve a healthier and happier lifestyle you would like to see Dr. Markel address? Submit your question for consideration HERE.

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Dr. Markel Joins Hilltown Families Team of Contributing Writers

Q&A: Peaceful Parenting with Dr. Markel

We’re delighted to welcome pediatrician Dr. Susan Markel, M.D. to our team of contributing writers! Starting in March, Dr. Markel will join us with a monthly Q&A column, answering questions submitted by Western MA families.

Every family is different, yet similar in seeking peace and joy in their lives. With her emphasis on natural lifestyles, and while applying her knowledge of communication skills and child development, Dr. Markel will answer your questions to help you make reasonable decisions with regard to your children. There is no such thing as perfect parenting, but peace of mind is an achievable goal that is not as elusive as it often seems.

ABOUT DR. MARKEL

Susan Markel, M.D. is a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981 and an International Board Certified Lactation Consultant (IBCLC) in 1997. For many years she served as a medical liaison for La Leche League. She is also a medical associate at Attachment Parenting International, a philosophy based in the practice of nurturing parenting methods that create strong emotional bonds between the infant and parent(s). As the author of What Your Pediatrician Doesn’t Know Can Hurt Your Child, Dr. Markel has been recognized as a trusted source of pediatric information distinct from the typical industry-supported medical dogma presented to parents today. www.AttachmentParentingDoctor.com

SUBMIT YOUR QUESTIONS

Do you have questions on how you as a parent and/or your children can achieve a healthier and happier lifestyle you would like to see Dr. Markel address? Submit your question for consideration. Dr. Markel’s column will appear on the fourth Tuesday of every month beginning in March, 2011.

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