What You Should Expect of Your Child
by Robert Mendelsohn, M.D.
Most baby books dwell at length on the developmental landmarks of early childhood - sitting, standing, crawling, walking - and the host of behavioral concerns that will surface as your child grows older. These milestones are of legitimate interest to proud parents, but only rarely should they be a matter of concern, and I don't need a whole book to give you my advice about them. I'll do it in one sentence: unless there is something obviously wrong with your child, don't worry about how soon he sits, stands, crawls, or walks.

If this is your first child, you will be sorely tempted to compare his progress with that of other children his age. I know that nothing I write will keep you from doing that, but I hope I can convince you that such comparisons are more apt to mislead than to inform. During the first few years of life the development of individual children varies so widely that comparisons are meaningless. However, if you want a rule of thumb, try this: most children suit with support at 6 to 8 months, sit without support at 8 to 10 months, walk at 12 to 18 months, talk at 18 to 24 months, ride a tricycle at 3 years, and copy a square at 4 years. Having said that. Let me urge you to resist the temptation to boast if your child reaches any of these milestones at an earlier age or to worry if his development is delayed. At some point in their development, all normal children arrive at the same place, and whether it is early or late makes no difference.

Sooner or later your children will learn to do what you expect of them if your expectations are realistic. All of us know, but we sometimes forget, that all children do not learn at the same rate, within the same time frame, with the same ease; not can they be expected to reach a uniform level of achievement by the time they become adults. That knowledge, unfortunately, does not prevent us from having grand expectations of our own children, which began with their birth. Nor does it keep us from making behavioral comparisons with other children that are both meaningless and dangerous. Today's "early bloomer" may be the backward child of tomorrow, and vice versa.

Our rosy expectations of our kids are beneficial if they encourage us to give them the attention and support they need to achieve the potential they have. They can also be devastating to our child's development and self-image if our expectations exceed his potential, or if we lack the patience to allow his skills and interests to develop naturally during the formative years.

It is sometimes difficult for parents with high expectations, who may themselves be high achievers, to remember that the occupation of children is to play and to learn. We must learn to accept the fact that during their developmental years, children cannot be expected to exhibit adult behavior. More likely, many of the things they do will seem almost calculated to drive you up the wall. Nothing I have to say in this chapter will make your child's annoying behavior any less worrisome or exasperating, but it may be easier to live with if you understand what's normal and where the child is coming from.

Physical Behavior That Concerns Parents

First let's separate physical behavior from emotional behavior. What are the physical things that parents most commonly worry about? All babies, often to the initial distress of their parents, cough, grunt, belch, hiccup, sneeze, pass gas, spit up, and vomit. You may worry about this at first and wonder whether it indicates some deficiency in your child's diet. You needn't, because as long as the baby is eating right and not losing weight you can regard all of this behavior as normal.

Let me caution you also not to get hung up on burping. Somewhere in the distant past, some mother found that her baby was less apt to spit up his lunch if she patted him on the back until excess air was released from his stomach. This procedure has become such a ritual that some new mothers appear to believe that their child will not survive if he doesn't burp loudly after every meal. In fact, there's nothing carved in stone that says your baby has to burp. Some babies swallow a lot of air and readily produce an earsplitting burp. Others swallow very little and don't need to burp at all. If you find that burping after a meal keeps your baby from spitting up, you may want to encourage him a bit, but don't make a production of it. There is no medical reason why he has to burp at all.

While we're on the subject, let me say a word about colic. This is the name mothers and doctors give to a phenomenon that usually occurs before three months of age. A previously placid and contented baby suddenly begins drawing up his legs and having paroxysms of screaming. It may surprise you, considering the eons that babies have been on earth, but there isn't a shred of scientific evidence indicating what causes it. However, the word colic is a convenient term for doctors, who use it to explain crying that they can't explain. Some medical textbooks refer to "gas" in the intestines, caused by excessive fermentation of carbohydrates, as a possible cause. But then they note that removing the carbohydrates doesn't relieve the condition, which seems to cast grave doubts on this explanation. The simple truth is that many mothers and most doctors talk about "colic" as uncontrollable crying caused by "gas" in the baby's stomach. Scientists say that they don't know what causes it. I'm with the scientists. I don't know, either!

Crying is the second worrisome behavior that appears at birth. The first cry you hear is reassuring, but from then on crying is something every parent could cheerfully do without. Over the years doctors have given parents a lot of bad advice about what to do when their baby cries, and a lot of kids have suffered because of it.

Children Cry Because They Have Problems

Children cry because they are hungry, or lonely, or tired, or wet, or in pain. Compassionate people do not withhold comfort from adults who are crying, for whatever reason. Why in heaven's name should a loving parent withhold comfort from a little child? If your child is crying, don't let it continue. Pick him up and find out why. If he cries at night because he is lonely or afraid, take him into your bed. [Editor's note: It is even more beneficial to keep your child with you all night. See "Ten Reasons to Sleep Next to Your Child at Night".]

Psychologists and psychiatrists always give me a bad time when I make that last recommendation. I recall being on the Phil Donahue show with Tine Thevenin, author of The Family Bed, and a psychiatrist who was invoking the Oedipus complex and other pet theories to try to put her down. Donahue turned to me for my opinion, and I told him I agreed with the psychiatrist. I said that psychiatrists should not take their children to bed with them, but that it was quite all right for everyone else!

Bowel habits, diarrhea, constipation, and toilet training are also parental concerns that begin at birth and continue through the years. Many first-time mothers are inordinately concerned with the appearance and condition of their baby's stools, particularly if the baby is being breastfed. The color and consistency of a baby's stools vary considerably depending on his diet. Breastfed babies, for example, usually have stools that resemble loose scrambled eggs. This is not diarrhea; it is perfectly normal and not a matter of concern. There is a danger, though, that your pediatrician may use this normal condition as an excuse to switch your child from breastfeeding to formula milk.

If that happens, pay no attention to him. The most sensible rule to follow is this: if your child is thriving and gaining weight, don't worry about the consistency of his stools, whether they are extremely loose or as hard as marbles. You need to be concerned only if he is not thriving, is losing weight, or if the stools are bloody. In that case, see a doctor. However,. if this does become necessary, be wary of medications unless your doctor is able to diagnose a specific cause. Pediatricians are inveterate stool-gazers, inclined to treat loose stools with opiates such as Lomotil. In the absence of a specific disease, a more sensible course, which really doesn't require medical supervision, is to look for food allergies, and then eliminate the offending foods. The most likely food is cow's milk.

This is also true of constipation. There is no magic number of bowel movements your child should have and no reason to be concerned if he fails to have at least one every day. If your child seems to be constipated, look for the cause in his diet and see a doctor only if the constipation is accompanied by pain or bleeding.

As for toilet training, pay no attention to medical advice, because your pediatrician doesn't know any more about it than you do. It's a family affair. It doesn't make any difference, except in terms of your own convenience, whether you train your child early, late, or neither of the above. Some children train readily. Others don't, and I have no magic formula you can use if you have one of those [children]. My daughters have, though. They turned to their mother for advice on training their children!

The emotional behaviors of children that may provoke frustration and anger in parents are almost endless, from the "terrible twos" to the "turbulent teens." What you must remember, when your nerves get frayed, is that they all stem from developmental processes without which your child could never become a functioning adult.

Your immediate reaction is likely to be anger when your toddling child jerks the cloth from a table and smashes your most cherished vase. If it is, you must learn to control it, because punishment won't solve the problem; it will merely confuse your child. A more appropriate response will be to remind yourself that the child isn't being deliberately naughty. He's simply exercising the normal curiosity that will enable him to learn, and trying out his newfound motor skills. Then put the rest of your cherished objects out of reach.

Punishment is not the Solution

Virtually all disturbing childhood behaviors stem from some emotional cause. Your response is not to punish the child but to isolate the cause. Often, the child who was finally toilet-trained after a long struggle may suddenly begin to wet his pants again. This isn't deliberate, because no child really enjoys wet pants or the negative maternal responses they evoke. It is virtually certain, when this happens, that the child is responding to some environmental stress. Don't spank your child, try to identify and eliminate the stress.

Remember, if your child suddenly becomes violent with his playmates, or becomes a discipline problem in school, that he is probably reacting to some situation or problem that is beyond his control. It could be illness, exhaustion, hunger, visual or hearing defects, or simply a reaction to turmoil at home. It may even be a response to his deteriorating self-image because you have unrealistic expectations of him. If so, he won't respond positively to punishment. Emotional support and constant displays of love and affection are more apt to be the cure.

Children must, of course, be guided toward responsible adult behavior, but parents shouldn't expect them to achieve it all at once. Nor is there any convincing evidence that it can be effectively achieved by employing the old maxim "Spare the rod and spoil the child." Corporal punishment at any age confuses and traumatizes the child, because he can't understand why the mother and father he loves, and who are supposed to love him, are suddenly raging at him and causing physical pain. He is made to feel insecure, resentful, and even worthless, and the consequence may be psychological harm.

The impact of physical punishment on child development has been studied extensively, and the consensus of this research is that violence damages both parent and child. It fails to teach children what to do and yields only a temporary benefit, if that, in teaching them what not to do. I won't deny that I've never raised my hand in anger on occasion, but for the most part I have tried to achieve the desired end with my own children through the use of example and the provision of tender, Loving encouragement. I am more than satisfied with the results. I hope and trust that my grandchildren, likewise, will rarely endure punishment of any kind.

Some Maxims About Childhood Behavior

  • Children aren't adults, so don't expect them to behave as though they were.
  • Children learn by doing, so don't expect to approve of everything they do.
  • It is a rare child whose behavior equals his parents' expectations.
  • Children are more likely to do as you do than to do as you say.
  • It is often less important for parents to control their children's behavior than it is for them to control their own.
  • Children react to anger; they respond to love and affection.

A secure and loving home environment and emotional stability within the family appear to be the major elements in overcoming some of the specific behaviors that concern or displease parents. These include thumb-sucking, nail-biting, nose picking, rocking and head banging, bedwetting and erratic sleep habits. You can deal successfully with these problems if you refrain from making an issue of them, pay close attention to the emotional needs of your child, make sure that he knows you love him, whatever he does, and exert yourself to make him feel secure. If you develop that kind of warm relationship with him, you'll do more than eliminate annoying habits. You'll be rewarded with a happy, confident, and emotionally stable child!

Excerpted from Chapter 6, How to Raise a Healthy Child In Spite of Your Doctor. New York: Ballantine Books, 1990. Reprinted by permission of Mrs. Rita Mendelsohn.
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