Parenting

Perhaps no other undertaking is as intimidating and as rewarding as raising children. From their first wail as they enter the world until they assume the total responsibility of adulthood, never a day goes by without some self-doubt about "how will they turn out?" The purpose of this article is to provide a perspective and a bit of guidance to consider as you do the hardest and best job you'll ever have.

By definition, parenting is on-the-job training with a very steep learning curve. There is a fortune to be spent (or sometimes gained) on "new school" classes, books, DVDs, Internet sites, etc. Many of these sources can provide solid information and support. Historically much of parenting was handed down one on one by the extended family -- grandparents, aunts, uncles, and close family members. This "old school" approach was often a double-edged sword -- broad concrete advice for particular children and particular situations. The unintended consequence, of course, was often unsolicited advice and value judgments. While today's society often has a seemingly overwhelming set of choices for how "to do the right thing," the best advice often is "if it seems right, it probably is." There are often multiple ways to manage a situation or problem. It is very important for parents to remember that children are tremendously resilient and will often thrive in spite of their parents -- after all, we did!

Children don't learn by reading the owner's manual. For the first few weeks of life, they study with their eyes; then very rapidly they are capable of reaching and drawing everything toward their mouth. Very quickly they are crawling everywhere to continue this visual and tactile learning process. It isn't until near the end of their first year of life that verbal comprehension starts to play a role in their learning style. Effective parenting, therefore, allows children to develop at their individual pace and manner in a safe environment. While it may be both physically and emotionally exhausting to keep up with them (regardless of their age), a parent's primary responsibility is to foster progressive independence in a nurturing environment. Their child's primary responsibility is to mature so as to ultimately become independent of this loving support system. How something so inherently simple can be so complex and sometimes frustrating is one of life's great mysteries.

Most children (from infants to elementary school age) eat for two primary reasons -- hunger and its enjoyment. As they become older, some children will start to use food as a replacement for "something missing" in their lives and eating may become a way of handling this void, or dealing with frustration or boredom. This "management style" is a learned behavior -- often learned at home. As a pediatrician, I have seen obese parents raising obese children. It is not uncommon to reward a child's behavior with a promise to stop at the local fast food restaurant on the way home -- and I doubt a salad is purchased. I was once astonished when a very obese father told me he wasn't going to keep high-fat items (in this case donuts from a famous chain) out of the house in order to help his obese 8-year-old son avoid such items. "I like them. I'm going to keep eating them. It's his job to stop eating them." Raising a healthy eater requires setting a good example -- often no more and no less.

When I was growing up (and I bet it was the same for you), our parents told us to "go outside and play" and that was often the last they saw of us for many an hour. Playing didn't require organized teams, daily practices, subspecialty coaches (for example, pitching coaches for baseball), seasons lasting longer than those of their professional counterparts, and the creation of the end of last century -- the soccer mom! Our playtimes fostered independence and creativity along with the development of social skills necessary to solve disagreements without innumerable rules. If we did play team sports, the season was short, enabling development of different muscle groups and coordination capabilities as you marched through the sport calendars. Many pediatric sports medicine doctors and orthopedic surgeons believe that the tremendous rise in overuse and/or traumatic injuries (for example, tear of the anterior cruciate ligament) is due in part to repetitive chronic abuse of an immature musculoskeletal system. The simplest way to foster outdoor play (adults exercise -- children play) is to separate them from all electronics -- cut the umbilical cord to the computer and cell phone. We certainly survived and thrived and so will they. Of course, as noted in the segment above on healthy eating, don't get trapped in the "do as I say, not as I do" game -- put down the cell phone and the designer coffee and get outside yourself and try playing with your kid. I bet you'll enjoy it!

It is unfortunate that the phrase "slept like a baby" implies a long and restful sleep of many hours when any parent of a newborn quickly learns the harsh reality of the sleep deprivation their infant imposes upon them. Principles which encourage the establishment and maintenance of good sleep habits include: (1) development of a routine/ritual in the 15 minutes before "lights out"; (2) get 60 minutes of vigorous play after school and before dinner; (3) avoid overstimulation in the hour prior to sleep (for example, no TV/computer games/social networking); and (4) keep the room dark (excluding a small night light to certain age ranges) and cool (less than 70 degrees).

Only two points are necessary: lead by example and practice the "Golden Rule." To paraphrase the latter, treat others as you want to be treated. Let your children know your expectations and that these are not subject to negotiation. Courtesy will be expected their entire life -- they better get used to that now.

Whether a mother and father are married or divorced should have little relevance when considering how to raise their child/children. It is presumed that they both want their offspring to feel safe, develop a sense of right and wrong and empathy for others, and have an opportunity to develop their intellect and body to the maximum potential. Parents should establish a fundamental framework of how they believe these goals can be achieved and realize that their strategy may need adjustments based upon circumstances. In a divorced setting, the children are not pawns to be manipulated to "get back at" a former spouse. Criticism by one parent of another only places the child in an unfair and vulnerable position, having to choose between two people whom he/she loves. It is well known that many children harbor inappropriate guilt regarding the divorce and associated acrimony. ("If I had not done this or that, mom and dad would still be happily together.") A corollary to this belief is the conviction that if the child just were "better," his mother and father would recant and there would be a united and happy family unit. Finally, it is important to remember that children (of all ages) learn by observation. Youngsters develop a sense of how males and females behave by watching their father or mother; teens will tend to model their same gender parent (for example, girls model after their mother) in that person's treatment of the spouse. In short, divorced parents must leave their prejudice against their former spouse at the curb.

Having been a single parent of three children following the death of my wife 10 years ago, I can suggest several strategies to ensure the best possible outcome for both you and your child/children. First and foremost, realize that two adults raising children is a daunting challenge. A solo parent simply cannot provide what two parents can when it comes to helping with homework, watching soccer practice, and having the financial resources that a two-income family offers. While the above are obviously desirable, they pale in importance to providing to your child a sense of security and love. Single parents must absolve themselves of any guilt when it comes to the material needs of their children. Instead, focus on your job of raising individuals who will ultimately become successful adults and (perhaps) parents themselves.

Stepparenting can sometimes be analogous to walking blindfolded through a minefield. Generally successful stepparenting involves three integrated actions: (1) provide emotional support and be a neutral sounding board to your spouse (the parent); (2) provide emotional support and be a neutral sounding board to the child/children; (3) don't try to become what you aren't -- their parent or their best friend. Try to avoid criticism of your spouse's former husband/wife. While children may recount a myriad of deficiencies of their other parent, criticism by you will commonly generate a protective reaction and devalue your credibility as an objective adult.

Discipline strategies by necessity are often age related. Fundamental to effective parenting are a set of realistic expectations and the awareness of developmental, emotional, and physical skills their child should have achieved. Their child's pediatrician can serve as a resource in this area.

Birth to 2 years of age: During the first year of life, a child is functionally dependent upon his parents for nutrition, love, and safety (from his environment and himself). Infants have no sense of the future and thus are unable to plan for or anticipate consequences. After this first year, children have matured substantially and are more independent. They are mobile, have refinement of hand/eye coordination, and have progressively improving receptive and (later) expressive language skills. During this timeframe, parents should become familiar and comfortable with the establishment and enforcement of discipline. Fundamental to this goal is that parents realize that children are used to "running into brick walls." All of their newly found skills required frequent repetition in the face of failure (for example, learning how to walk). Don't expect a child to abandon his plan to play with a special vase just because you moved it and said "no" once.

2-4 years of age: Temper tantrums are the hallmark of this age range. These emotional and physical "meltdowns" are a reflection of the egocentric developmental level of the toddler age range. Their mantra might be "I want what I want when I want it, and I want it now!" This age range has limited appreciation of both safety and delayed gratification. Techniques to deal with temper tantrums include the following:

1. Try to distract and/or redirect the child. This works better at the younger age range. Older children are harder to "buy off."
2. Physical separation (time-out) is effective but a simple explanation is necessary. ("You are going into time out because you kept pinching your brother. We don't pinch. It hurts.")

5-12 years of age: This is a period of psychological warfare ("I don't love you anymore!") coupled with a growing internal sense of introspection and concern for others (especially the peer group). A fundamental requirement for this age range is the learning of consequences. Try to engage the child in helping to sort out expectations and punishments (if this, then that) and commit this agreement to writing. This will reinforce to your child that you are serious with regard to this subject. Parents should teach their children how to solve problems with suggestions and guidance. Don't sweep in and rectify the situation. This will not foster maturity or independence. Lastly, reward good behavior (even when you expect it...for example, cleaning up their room without being reminded).

Over 12 years of age: Discipline is derived from the Latin word "to teach." The teen years are full of angst for both teens and parents as the road to independence is traveled. Parents should reinforce behavior of which they approve (for example, getting home before curfew) and develop realistic consequences for infractions. It works more smoothly to discuss rules and consequences before a crisis -- plan ahead. Parents must avoid overkill. Discipline should be reasonable, immediate, and enforceable. "You're grounded for the rest of the school year" won't work.

Your child's pediatrician should be a resource for local parenting classes. Many local hospitals provide free or low-cost programs as part of their outreach to the local community. Check with the local children's hospital for resources it may offer. Contact your medical insurance company and inquire regarding contracted individuals (often marriage and family therapists) who are in your community. If you have a religious affiliation, check with the local clergy regarding any suggestions they might offer. Whatever you do, don't view the need for guidance as a personal weakness or evidence of failed parenting. Often all that is necessary is a new perspective and approach.

Many parents find support and valuable suggestions from group experiences (for example, Mommy and Me), neighbors, and the extended family. Pediatricians also are a valuable resource and reviewing parenting experiences is part of the well-child exam in certain family situations. While there are many ways to accomplish a goal, different approaches may be more successful than others. Web sources of parenting tips are listed below. Lastly, take the important stuff seriously and don't worry about the rest. Look how well we turned out!