Nightime Potty Training and Bedwetting - How to Stay Dry!

My family was on vacation, and the six of us were packed into a small studio apartment.  Some of us were sleeping on inflatable mattresses, and my two older sons were sleeping on a futon on the floor.   One night, my husband and I woke up when we heard our 4-year old start to move around.  Wondering what was wrong, we watched speechless as he proceeded to climb out of bed, stand up, take his pants down, and pee… on his older brother who was sleeping on the floor futon.

“Noooooo!” shouted my husband.  “Stop!”

My 4- year old, startled awake, looked up at him with big eyes.  Then he calmly pulled up his pants, turned around, and crawled back into his bed. 

Seriously?

And my oldest son, now a little damper than a few minutes ago, was still snoring away!

I guess it’s best that he not know what happened to him.  

We’ve been working on nighttime potty training with my youngest for the past several months.  He can make it through most nights dry now.   That was actually the first time he woke up on his own to go pee in the middle of the night.  So… we were kind of happy that he did that.  But not so happy that he chose to do it on his brother!

Every child learns how to keep dry at night at a different age.  My oldest son took forever it seemed.  He is a very deep sleeper which makes it harder for a child to recognize that he needs to go in the middle of the night.  My second son and my daughter did it nearly instantly.  And it looks like my youngest one is going to be somewhere in between.

In general, children achieve nighttime dryness by five to six years of age.  

How do you start nighttime training?

1.     1.) Limit fluids after dinner.  Any fluid that your child drinks will become urine in the next few hours.  If she drinks a lot before bedtime, she will have to pee in the middle of the night.  Give your child plenty of fluids during the day.  If your child says she is thirsty before bed, limit fluids to a small sip just enough to wet her mouth.

2.       2.) Have her go to the bathroom before going to bed.  This will empty the bladder and improve chances of success.

3.       3.) Wake your child to go to the bathroom before you go to bed.  Assuming that you go to bed at least 1-2 hours after your child, you can help your child empty her bladder of the urine produced from the liquids that she drank in the evening.  Don’t expect your child to be fully awake.  Just guide her to the bathroom and help her go.

4.       4.) Training pants – these are an easy way to prevent having to change the sheets in the middle of the night.  However, since they are absorbent, your child won’t notice the wetness.  This will not really help with nighttime potty training but will keep the bed clean.  If your child is mostly waking up with dry training pants in the morning, then you are ready to switch her to regular underwear at night.

5.       5.) Waterproof pads – These are great for making changing wet sheets at night a simpler process.  Just put one on top of your bedsheet.  If it gets soiled, just pull it off and instantly the bed is dry again!  I highly recommend buying an oversized one like the one shown to cover more area on the bed since children tend to move around on the bed in their sleep. Waterproof Training Pad

For children who are heavy sleepers, it can take longer to potty train at night.  Sometimes bedwetting alarms can help if your child is old enough (usually eight years or older).  Also if your child is taking medication that can make him drowsy, such as some cold or allergy medicines, he may sleep through the feeling.  

Fifteen percent of children are still wetting their beds after the age of 6 years.  So, don’t get too frustrated or angry because your older child is still bedwetting.  It can be very normal.  The age for being nighttime dryness can be genetic.  So, if either parent was a late bedwetter, then the child may also take longer to learn to stay dry at night.
 

If your child used to be dry every night and is starting to wet the bed regularly, then there may be a problem such as a urinary tract infection and you should take your child to the doctor.  Or if your child is wetting so often that he cannot participate in activities such as sleepovers or overnight camp, then your child’s doctor may have medication to temporarily help him stay dry.  The good news is that everyone manages to stay dry at night eventually!

Sleep well, and thanks for reading!

Traveling by airplane with kids - tips and tricks!

I awkwardly pulled my iPad out from under the airplane seat in front of me while trying not to spill the little plastic cup of water and bag of snacks precariously balanced on my tiny tray table. My son across the aisle from me whined, “Mommy, I’m hungry!”  My other son chimed in with, “I need to go to the bathroom!”  (and of course, the fasten seat belt sign was on - so getting up to go was not an option).
 

Meanwhile, my two youngest children sitting next to me were impatiently waiting to use the iPad.  I had already spent the last 40 minutes trying to explain to them that we had to wait until the airline staff said it was okay to use electronics.  They had already blown through the coloring books and playdough that I brought to entertain them during taxi and takeoff.  This generation is so electronics dependent for entertainment... someone seriously needs to come up with technology can be used at any time on an airplane!

 

At the same time, my husband had his eyes closed, resolutely ignoring the clamor and noise.  How does he do that?

Thank goodness it was only a three hour flight.  We were on our way to our summer vacation in the sun and would have a wonderful time there.  However, the travel part always seems to be a day-long adventure.

Flying with kids can be a challenge or it can be smooth-sailing.  Very much it depends on the age of your child, the length of your flight, and the time of day of your flight. 

Packing is the first challenge.  I remember taking my oldest on a flight when he was five-months old.  He was a tiny baby, and he had an entire full-size suitcase dedicated to him and his STUFF.  You know what I’m talking about – the diapers, the wipes, the bottles, the warmer, the clothes, and the backup clothes, the baby soaps and shampoos, the bibs, and the backup bibs, the blankets, etc.  Not mention the car seat, toys, and so on.  

So, how to survive a flight with your little one?  Here are some ideas (based on age):

Young Infant –  Most of the times babies this age are content to eat, sleep and poop as they normally do when not in an airplane.  The biggest issue will be helping them to “pop” their ears and equalize the pressure in them during the flight.  Generally, if your ears are popping, their little ears are trying to do the same.   To help your baby with this, make sure that he/she is swallowing during takeoff and landing.  You can do this by feeding your baby during these time periods.   Just make sure to pack extra clothes and diapers, including extra clothes for yourself for unexpected soling from spit-up or diaper accidents.

Check the TSA website listed later in this blog post to familiarize yourself with rules regarding bringing formula or breastmilk onto the airplane.

Older Infant/Toddler – This is a challenging age for flying.  You can certainly fly successfully with a toddler, but timing is of utmost importance in this age group.  Choose your flight time by avoiding anything near naptime or bedtime.  Tired toddlers make lousy travel companions.  Pack plenty of snacks, favorite toys and distractions.   If at all possible, try to book nonstop flights to minimize the total travel time.  For really long flights, a break in the middle at a connecting city for a few hours may be ideal – however leave enough time so that you won’t be running for a connecting flight with a toddler in tow.  

You can bring your stroller all the way to the gate and check it in at the gate just before you board.  It will make getting all your belongings and your baby to the plane easier.  Also, bring an empty sippy cup and then buy something in the airport to fill it, or ask them to fill it on the airplane.

 

For very long flights, some pediatricians recommend bringing along a weight-appropriate dose of Benedryl along in case your toddler is really having a difficult time resting on the plane.  Benadryl is an allergy medication that generally causes drowsiness as a side effect.  However, be aware that a small percentage of children actually get hyper instead.  If you are going to use Benadryl, try a dose at home before you travel.  You don't want to discover that your child get crazy on Benadryl on an airplane!

Children Ages 2-5 Years Old – This age group generally loves airplanes… at least they love looking at them.  Flying in them may be a different issue.  Reading about flying or going on an airplane is a good idea if this is your child’s first trip.

I usually try to have a surprise activity for each child on the airplane – a new coloring book or new activity that travels well.  The fun of trying out a new coloring book and new markers will entertain most children for at least a portion of the trip.  Don’t give it to them until you are actually on the plane to enhance the surprise (and distraction) factor.

Also, while I don’t normally advocate video watching or video games, it can work wonders to keep little minds occupied for a good portion of longer trips.  With smartphones and portable electronics, it's easy enough to bring something along for entertainment.  Also, taking a few walks up and down the aisle midflight helps to break the monotony of sitting in the seat.  Be sure to bring snacks or food for a meal on the plane based on the timing of your flight.

School-Aged Children and Older – Luckily, this age group tends to be able to entertain themselves.  Favorite activities, including books, handheld games, videos and iPads/iPods, make flying a more enjoyable and less boring experience for this group. Let them pack their own backpack and have them each carry their own carry-on.  It's such a liberating experience when your child can help with carrying the luggage!

Again, food is an excellent way to pass the time, so bring a meal or snacks onboard.  This will also ensure that they will not be hungry during the flight.

International Travel – If you are traveling abroad, make sure to plan for the time it takes to get through customs.  It can sometimes take an additional hour to get through the customs lines in some countries.  In many of the popular tourist countries, they will allow families with three or more children to move up closer to the front of the line.  If you fit this criteria, it never hurts to ask if you can do this!

 

With the many travel rules these days from TSA, it’s a good idea to check out their website for rules about traveling with children.  They have a useful website at:  http://www.tsa.gov/travelers/airtravel/children

I hope this helps if you are traveling by plane this summer with your kids!  If you tried some tricks for successful flying that have worked for your children, please share them by posting a comment!  

Thanks for reading and have a wonderful summer!

My Son Said The F Word!

I was attending an evening meeting last week when I got a call on my cell phone.  From the caller ID, I saw that it was someone calling from home.  Worried that it was my babysitter calling with an emergency, I picked up the phone, hit answer, and whispered, “Yes?”

“Mommy, he said the F word,” reported by ten-year old son, confident that I would want to know this information.  He was referring to his seven-year old brother.

“Oh, I see…” I stumbled… trying to wrap my mind around the fact that my ten-year old was calling me so late, and trying to figure out how to respond.  “Uhhhh…  I’ll take care of it tomorrow morning, okay?”

“Okay, mommy,” he answered, satisfied that his brother would be appropriately disciplined for this violation of our house rules.

The next morning, I called my seven-year old over to have a discussion about what words were not appropriate to say and why.

“Did you say the F word last night?” I asked him sternly.

"Umm.... yes?" he said meekly.  Then realizing that he was in big trouble, he started to explain.  “I said ‘The F word’ and it meant ‘Funny’!   I told him that was what the ‘F’ was for!”  

I was confused.  So, I said again, ‘Did you say the F word?”

“Yes,” he repeated.  “I said… ‘The.. F... word...’ and it meant ‘Funny’!”  

Ahhh...  So here’s a lesson for those parents with very concrete children.  In the past, I cautioned my children about bad language when I overheard an adult using profanity nearby.  I told them quite seriously that we do not use “the F word” because it is bad to do so.  It would appear that they took the instruction quite literally.  They thought that the phrase “the F word’ was taboo.

Ooops…  and I can’t really fix this, can I?  How do I explain what I meant instead?   I suppose that my ten-year old will figure it out soon enough… but it may be awhile until the seven-year old hears it again (hopefully).

Addressing profanity is a task all parents have to face at some point.  It is important for parents to agree on what is and is not acceptable for their child.  Many times the first time a child utters a bad word, they are very young and haven’t a clue as to what it means.  So try to keep a straight face when you are delivering this important message.  By laughing, you may be reinforcing the behavior since your child wants to make you happy. 

For school-aged children, it’s often an attempt to be cool, or get a laugh.  While everyone has different points of view on what is reasonable and what is not, there are certain social situations where foul language is inappropriate, such as in school.  Teach your child early before they become accustomed to using these words.  Many times they do not know what the word means.  If you can explain why the word is hurtful or offensive, that can help them to understand why it is inappropriate.  Help your child come up with alternative words to use in these moments.

 

Many tweens and teens swear as a way of expressing themselves emotionally when they are angry or depressed.  Instead of getting too worked up over the words, try to get to the root of the reason for the profanity.  Your child may need your help and swearing is just an outward signal.  When things are calmer and you are both no longer in the heat of the moment, you can then address your family's rules on swearing and provide alternatives.

Setting a role model is the best way to teach.  If you are prone to letting swear words slip out when emotions take the best of you, try to come up with other words to use when venting.  Be sure not to have a double standard in the home where the adults swear, but the children cannot.  This sends mixed messages to your child and can make it more confusing for them.

So, according to my sons, have a really F day!  (and I mean "fantastic"!)

Thanks for reading!

Finding Childcare - How do I do find someone as good as me?

“I’m going to need four weeks off to visit my family,” said my nanny to me one morning as I was rushing around trying to get my coffee and breakfast so that I would not be late for work.  I nearly choked on my breakfast. 

“Really?  When?” I asked, my heart rate already racing with fear as I awaited the response.

“Well, my sister is having a baby in two weeks, and I’d like to be there to help her,” she says nonchalantly.  “It’s her first baby, and you know how hard that can be!”  She looks at me for understanding and empathy. 

“In two weeks?!” I sputter.  Then recovering from my incredulity, I stop and realize how I must sound to her.  “Oh, wow.”  Then I started to think about our family’s hectic schedule the next few weeks.  Between tae kwon do, gymnastics, piano, swimming, school and work…. This was going to be a challenge without help.  And of course… my husband was going to be out of town.  Great.

So, I said, “Ummm, I can understand that you’d want to help her. But that’s really going to be hard on us.  Can you give me more time to find other arrangements?”

“I’ve already booked my airplane tickets,” she explained.  “You know how expensive it can be to fly.  The price was really good and so my husband bought the tickets.  We’ll only be gone for three weeks or so.”

Yikes!

Now… I love my nanny.  She’s been with our family for years.  She wonderful with my children and they adore her.  Finding a good person who you can trust to take care of your children can be one of the most stressful times in a parent’s life.  Once you find someone, you will do nearly anything to keep that person happy (at least it feels that way sometimes). 

This is true for any type of childcare it seems – nannies, daycares, preschools, babysitters.  I know parents who drive well out of their way from home or work to keep their kids in the same preschool to minimize the disruption for their child and to avoid having to look for another caretaker. 

So, how do find that wonderful person or childcare provider?  If you’ve never done this before, start with asking people around you who have been through the process recently.  While everyone has specific needs and different criteria for childcare, it will help you to narrow down your search.  Make sure to start well in advance (at least a few months) before you will actually need the childcare.  Then make sure you have a backup plan for when your childcare falls through.   

Daycares – these should be licensed.  Take a tour.  Take a list of questions to ask during your tour.  You can find several lists online, or in my book “Dr. Sandy’s Top to Bottom Guide to Your Newborn.”  Often, you can tell just by the feeling you get while you are there.  Is it clean?  Do the providers seem like they care about the children?  Are the children happy?  For babies, is someone with them, or are the babies just sitting alone in swings?  Does the location and cost suit your needs?  Are the hours what you need?  Is there a waitlist? 

Home daycares – these are smaller and may provide more individualized care for your child.  These may not be licensed in some states. This can make it harder to ensure the quality of a home daycare.  Some states have certifying boards for home daycares.  While this does not guarantee safety and ability, it will at least mean that the daycare has met basic standards.  Speak to the parents of other children who are there to see what they think of the daycare provider.  You should be able to get references for the daycare provider.  Spend time visiting the day care and consider randomly stopping when your child is there.

Nanny/babysitter – this is usually someone who lives with you or someone who comes to your house.  There are many services that can help you find potential sitters. If you belong to a homeowner’s association or have a community center, you may be able to find or place an ad. It is a good idea to interview several candidates before deciding on someone. Ideally, you would have one interview without your child present so you can go through the first round of questioning.  Then do a second interview with a candidate with your child present.  This will allow you to observe his or her interactions with your child.   You can find suggested interview questions online and in my book.  Some of your questions should include experience with childcare, how she would react in sample scenarios of emergencies or in routine situations. Check to see if she is certified in child and infant CPR.  Does she smoke?  Is she comfortable around pets? (if you have any)  Has she had traffic tickets or been in any accidents (if she will be driving your child)?  You can do background checks for a small fee easily to rule out criminal history, including sex offender crimes.  Checking references will be very important to get information about that person’s character and work ethic. 

Aupairs - this can be an economical way to find flexible childcare if you have the space to have someone live with you.  Aupairs are usually young adults who are interested in coming the U.S. for a year to learn more about American culture in exchange for taking care of your child.  This can be a great way to expose your child to multiple cultures from around the world.  There can be a bit more work involved on your part since you are responsible for helping this person transition into the American culture and you need to help them with meetings requirements such as taking classes while they are here (part of the exchange visa requirement).  In general, the cost is less than hiring a nanny and the hours are more flexible than what you may be able to get with other types of childcare. 

Finding childcare can be stressful.  However, there are many wonderful childcare providers available.  Put the work into researching and doing the necessary background and reference checks.  It will pay off in the long run.

In the meantime, I’m going to start calling my neighbors and friends… because as wonderful as your childcare provider may be, it’s vital to have a backup system just in case your child cannot go to childcare or your provider decides to leave for a vacation!

Thanks for reading!

Why aren't you like your brother? Comparing your child to others

“I don’t like it,” said my nine-year old son, looking into the mirror.

He was referring to his new hairstyle that I crafted for “Crazy Hat and Hair Day” at school today.  It was a spiked up, high volume, super hair-sprayed, absolute work of art (if I may say so myself).

“What do you mean you don’t like it,” I replied, flummoxed by his less than enthusiasm over my skill at styling hair.  I had just spent nearly ten minutes trying to get his hair to stand straight up.

“Can I wear a crazy hat instead,” he said morosely, still staring at his reflection.

And then I committed a horrible parenting mistake, I said, “Your brother likes his crazy hair!  Why don’t you?”  As soon as the words left my mouth, I thought… oh no, that was the wrong thing to say.  This son was a shy, conservative child who was happiest in front of a computer or working on puzzles.  His brother on the other hand was an outgoing, jokester, who loved attention and being active.  As I reflect back on the moment, I wasn’t surprised by his resistance to looking like a crazed cartoon character… I think I was just disappointed that he wouldn’t try it.

We all know that kids are different.  Siblings are different.  Personalities, temperments, athletic ability, academic achievements… all different.

So, why do we compare them?  

It’s human nature to compare.  We get through much of our lives checking to see if we are doing the “right” thing by comparing to what we decide is the norm or the goal.  We choose what is valuable to us and then compare our behaviors or abilities to see how we are doing towards reaching those values.

In this competitive society, we are exposed to a culture of comparing to see who is smartest, most achieved, has the most money, looks the nicest, wears the best clothes, runs the fastest, and so on.  It is hard to resist the tendency to compare. It’s natural to look at your child and see how he/she does compared to siblings, friends, and children who you’ve never met that you saw on the playground!

The good news is that the world needs all types of people, and that there is no one thing that predicts success or happiness.  It is important to dentify your child’s strengths and help them develop these strengths to their fullest potential.  If your child has a weakness that worries you, try to put yourself in their shoes and think of a solution that would make them feel confident and be successful in small steps.

One mom told me that she was worried about her three-year old daughter who was terribly shy and would not participate in group activities.  This was her second child, and her first one loved to be the star of the show.  This child seemed so different and she was worried that there was something wrong with her child.  “Could she be autistic?  Or does she have an anxiety problem?” she asked me.

She had put her daughter in music class, gymnastics classes, and similar programs, thinking that with more exposure her child would get more comfortable with being in large groups.  She was frustrated because her daughter would either just stand off to the side, or cry until they had to leave.   She was worried that her child would be a social outcast forever.  

During the office visit, initially the child hid behind her mother refusing to come out to be examined.  By coaxing her out with the crayons and paper, I was able to get her to start talking to me as she learned that I was not going to do anything scary.  By the end of our twenty minutes together, she was happily coloring on the paper, telling me about her drawings.  She made eye contact and communicated appropriately for her age.  It appeared to me that she was a child who was shy, very cautious, and needed time to acclimate to something new.

I recommended to mom that she should start with a setting that her daughter would be comfortable with, such as a playdate with one child in her home.  Then, once her child was comfortable with that, she should include more children in the playdates.  The next step would be to go to an unfamiliar place with these friends so that her child would have people she knew to play with.  It was also important to recognize that her daughter was still very young, and that likely as she grew older, her child would gain more confidence. 

The mother happily reported a year later that by introducing her to others in a smaller, safer, familiar environment, her daughter now had several little friends and was comfortable going out with them.  “She even went to a birthday party and led her friends to the moonbounce!” mom exclaimed proudly.  “She still will sit on the side if she is really nervous, but usually she will try it after watching for a bit.  I think she’s just a perfectionist and wants to make sure that she can do it right before showing anyone else.  She’s a lot like me!”

Find your child’s strengths, and focus on their abilities and unique qualities.  This will go a long way towards building self-esteem and confidence… this is likely to be more important than being the first child to know how to read in preschool, being the best at catching a football, or having the craziest hair on Crazy Hair Day at school!

Thanks for reading!

Ear Infections – What Are They and How to Prevent Them?

“For the last two nights, he keeps waking up at night.  He used to be a wonderful sleeper... I don’t know what’s wrong with him,” reported a tired mom holding an cute infant on her lap.  She wiped his runny nose with a tissue.

Another dad tells me about his toddler daughter, “She’s been congested for over a week, and woke up last night with a fever to 101.  She seems a little better during the day when I give her ibuprofen, but she’s miserable at night.”

"My son woke up this morning and told me that his ear hurt," said another mom about her four-year old.

All of these children have signs of a possible ear infection. 

What is an Ear Infection?  

When doctors refer to an “ear infection,” we are talking about a viral or bacterial infection in the middle ear.  This is a space behind your ear drum that is connected to your nose via your Eustachian tube.  See illustration below.

Fluid is produced in the middle ear space all day long and normally it is not a problem.  However, when our noses get congested, then our Eustachian tubes can become blocked.  Then the tubes do not function to drain the middle ear.  This is especially true with young children and infants because their tubes are much smaller and are more horizontally oriented.    

When fluid builds up in the middle ear, then bacteria and viruses can replicate in the fluid and cause an infection.  If it is a bacterial infection, then antibiotics are needed to treat the infection.  More than 50% of ear infections are caused by viruses and do not require antibiotic treatment.  Your child’s doctor can assess for the possibility of a bacterial infection.  If your child is having significant pain, fever, ear drainage, or other signs of bacterial infection, then your child’s doctor may prescribe antibiotics.

How do you know if your child has an ear infection?

Well, unfortunately, the answer is that you may not know.  The good news is that if your child is not acting sick, has no symptoms other than a cold lasting less than two weeks, then he is unlikely to need antibiotics, so do not worry about missing an ear infection.  Some symptoms of an ear infection that need to be treated are described below.

Pain:  Generally, children experience pain and pressure from the fluid accumulation – so they do not sleep well or complain of pain when they are old enough to talk.  Pulling on the ears is not a good indicator of an ear infection since some infants pull on their ears when they are just tired or when they are teething.

Fever:  Many children have fevers with their ear infections.  If your child has a fever after having a cold for several days, then he may have developed a secondary infection, such as an ear infection.  Take your child to the doctor to be checked. 

Congestion/Cold:  Since the fluid builds up because the drainage system or Eustachian tube is not functioning, then your child is more at risk for an ear infection when she has been congested for several days.  If your baby is fussy or has a fever after having a cold for several days to weeks, it may be an ear infection.

Ear Drainage:  If you see drainage of fluid from your child’s ear, then the eardrum may have ruptured from the pressure.  While this sounds horrible, your child will probably experience relief since there is less pain.  In general, small ruptures of the eardrum heal well.  However, the infection still needs to be treated, so see your child’s doctor.

How can I prevent my child from getting an ear infection?

Focusing on the nasal congestion is one of the best ways to prevent the fluid from building up and getting infected.  Nasal saline works well for all ages.  For younger children, help to clear their noses by putting a few drops of nasal saline in each nostril and then cleaning the nose using a bulb suction device.  For older children, spray or drop the nasal saline into their nostrils and then have them blow their noses.  Running a humidifier (cool or warm) in your child’s room will also help with the congestion.  If the congestion is from allergies, treating the allergies with antihistamines may be appropriate depending on your child’s age. 

Some children are more prone to ear infections due to their anatomy.  Unfortunately, these children will get ear infections despite their parents’ best efforts to keep their noses clear.  If your child has multiple ear infections in a year (usually 5 or 6 episodes), then your child’s doctor may recommend myringotomy or PE tubes to prevent recurrent infections.

Stay healthy, and thanks for reading!