Toddler Tantrums Over Medication

Question:

Hi my name is Teresa,
I have three kids: a 7-year-old girl, a 5-year-old boy, and an 18-month-old girl. The problem is with my 18-month-old girl she has a bad temper. She is well behaved, but when it comes to being put in her cot she throws a big tantrum. Today I needed to give her same panadole and she kept spiting it out at me, so I put her in the cot for 5 minutes then took her out, she was still crying so I put her back and shut the door, than I heard a loud thump so I raced in there and she had tried to climb out, I am at a loss. This is not the first time she has had a tantrum, I just don't know what to do, can you help?

Thank you for your time, Teresa

Answer:

Hi Teresa, I can tell from your e-mail address that you are from Australia, so let me explain for other readers of this question and answer that a cot is a crib. I'm not sure what panadole is.

I'm so sorry for your frustration. It is representative of what so many parents and children are going through when there is a lack of understanding of basic child development, age appropriateness, and effective discipline. Most people think discipline and punishment are synonymous. They are not. Following are the Four Criteria for Effective Discipline

1. Does it help children feel a sense of connection? (Belonging and Significance)
2. Is it respectful? (Kind and firm at the same time)
3. Is it effective long-term? (Does it consider what the child is thinking, feeling, deciding?)
4. Does it teach important life skills? (Respect, concern for others, problem-solving, cooperation)

I will relate these criteria to your concern after saying a few words about child development. It is very difficult to teach all you need to know about child development in a relatively short answer. I hope you will find a copy of "Positive Discipline the First Three Years' to get the whole picture. The piece that is important to the temper tantrums is that you are expecting some things of your child that she is developmentally not capable of understanding. I don't believe in punishment of any kind for any age child, and it is especially sad when it is used on children who have not yet reached the age of reason. Please take time to go to http://www.positivediscipline.com/articles/no.html  and read the article on "What Does Your Child Under Three Really ‘Know' About ‘No'?"
When punitive time out is used, how can they possibly understand what is happening except to get the "sense" that they are bad. Add that to the fact that they are developmentally programmed to explore, experiment, and develop their autonomy (power) at the same time many parents punish them for doing the very things they are programmed to do. You will find another article on "Time Out for Children Under the Age of Reason: at http://www.positivediscipline.com/articles/Time_Out_for_Children.html

I'm not advocating permissiveness. Children should not be allowed to do anything they want to do. I'm explaining why it does not make sense to punish children and why it is important to discipline in ways that are respectful. Later I'll discuss "discipline" that is appropriate for temper tantrums.

Now, for how this applies to your situation. Putting toddler in a cot (or any other form of punitive time out) is not effective – and makes matters worse. It does not meet any of the criteria for effective discipline and is especially harmful because it does not help children feel belonging and significance. Obviously, punitive time out achieves just the opposite. The child feels abandoned, isolated, shunned. It is very healthy that a child would fight against this.

You could search our website for other questions and answers on bedtime, but you asked about temper tantrums. You will find many suggestions if you do a search on our website using the word tantrums. Here I will give just a few suggestions.

1. Sometimes it is appropriate to simply allow your child to have her feelings (she may feel upset, mad, hurt, angry) without trying to rescue, change, or fix her feelings. Simple empathy can be very helpful – shown by your manner – or by validating her feelings. "I can tell you are very angry right now." PERIOD.
2. A simple hug might make you both feel better. (This is different than trying to fix or rescue. It is providing and opportunity for her to go through her own process – and to help you feel better.) Children DO better when they FEEL better. She may be receptive to a hug and she may not. However, it is important to remember that punishment is designed to make a child "pay" for what she has done. Discipline helps them "feel better so they can do better" or helps them "learn from what they have done."
3. If someone tried to put something in your mouth that you didn't want, wouldn't you spit it out? If panadole is a medicine that she needs to take, is there something you could do to make it more palatable – such as putting it with juice?

I don't have any other suggestions for a pre-verbal child who is having a temper tantrum, but some of the other things you will learn by reading the articles and/or the book will give you many suggestions for how to prevent many tantrums and other behavior challenges. I wish you the best down under. I will be giving a keynote lecture in Melbourne in November.

Jane Nelsen

P.S. From Dr. Jody McVittie

I'd love to comment on the taking medicine piece (put on my doctor hat for a moment). Lots of medicine tastes terrible. And sometimes it is hard to "get" kids to take it.


Here are some thoughts.

1. Does the child really NEED the medicine? Lots of parents think that kids need tylenol (panadol) when they have a fever or when they are teething. Most temperatures are not dangerous for a child. We start to get worried when the child is dehydrated (like heat stroke) or the temp goes over 105. But most fevers do not require treatment. It is true that some kids feel better (and can be less cranky) when their temperature is closer to normal, but that may not be worth the trauma of getting the "medicine" down.

2. Most medicines come in more than one form and in several different brands. For example you can get acetominophen (Tylenol) in several different brands which taste different. You can also get it as tablets to be swallowed, tablets to be chewed (several different flavors), and a rectal suppository.

3. If not taking the medicine is not an option work with your child to figure out how to do it. Here are some hints.
Taste buds don't work as well when they are cold. So sucking on an ice cube first, then spitting it out before quickly taking the medicine can reduce the bad taste. Mixing it or following it with strongly flavored ice-cream can work. Use small amounts of ice cream so you know your child got the medicine.

Sometimes it is easier to crush pills and mix them in jelly, peanut butter or nutella than taking a swallow of unpleasant tasting liquid. Crushed pills taste bad, but the bad taste can be buried a little bit.

Children can be taught to swallow whole pills at a very young age. We discovered this sort of by accident. It was one of those times when not taking the medicine was not an option...and we commented to our sick 4 year old that there was really no option but to take the medicine. We told him that when he got a little bigger it would not taste so bad because he could swallow a whole pill. Well, he decided then and there that he was big enough to swallow pills. He put the pill way back in the back of his mouth and downed it with a little water. Only do this for kids who really want to do it themselves.

4. When you are faced with one of those awful situations where your child has to take the medicine and it does taste bad do your best to avoid power struggles.
Stay calm and empathize. For example "I know this is no fun. I know you don't like this stuff, but I really care about you and want you to be healthy."
Offer limited choices. "We can do our best to make this a better situation...you can numb up your taste buds by sucking on an ice cube, or can have a small bowl of mint ice cream right after you down it."
Remind them (gently) of times that they have overcome difficulties. This works best when the parents attitude is "I have faith in you" rather than "This is nothing compared to what you have done before." Remember when you took icky medicine as a kid and that feeling of not wanting to proceed. A combination of dread of the horrible taste and not really being sure that you can muster the energy to complete the task.
Be a little flexible "I can tell you are upset right now....and you do need to take the medicine, but if you think it will be easier you could set the timer for 10 minutes if you'll agree to take it when the timer goes off."
Don't feel too bad for your child or for yourself. Children can smell this guilty feeling and know it is hard for you to do things that you feel bad about. Remember that life has its ups and downs. Modeling dealing with the less pleasant part of life and knowing that things get better will help your children understand that too. Their own experiences dealing with unpleasant things can be a remarkable source of strength for them when they grow up.

Jody