How can I stop my daughter from biting her nails?

My seven-year-old daughter has been biting and picking her nails on and off since she was a toddler. I know she’s just like me: she tears and chews when bored/anxious/worried/nervous/shy, or when she’s been sitting still for too long with nothing to keep her hands busy. I don’t want her to suffer from the embarrassment of having ugly nails, and I worry about the health implications. How common is this problem, and how can I help her to stop?

Nail biting is common, occurring in between one third and one half of children. It is not a large health problem but putting hands in the mouth can transfer germs and parasites. It can result in deformed nails. It often runs in families. Most likely because of a child learning from their parents.

You can help her by working with her. Both of you could start a “Pretty girls, pretty nails club”. You and she could help each other to avoid biting nails. Work as a team.  Figure out strategies together to help overcome nailbiting. Encourage each other and praise each other when successful. Maybe you can each help the other by reminding.

Both of you could apply one of the bad tasting preparations that you can get from the drugstore.

Take a picture of each of your hands and put them up for both of you to see.

Keep your and her nails trimmed and without snags. There will be less impulse to nailbite.

When you are successful, do your nails up together. Or go out for a manicure. Team work will be more effective than you telling her what to do.

Make it positive. Make it a mother daughter thing.

Don’t punish or criticize. It doesn’t work and it makes everyone feel bad.

Posted in Behaviour | Tagged , , , , , , , , , , , , | Leave a comment

200th Ask Dr. Pat Blog! – A thought on Eating Together

Eating as a Family

People often ask how they can maintain a strong relationship with kids throughout their lives, perhaps especially during the difficult teenage years. There is no magic answer, no golden rule, all families have a different dynamic. But there is one very simple thing that every parent can do that will go a long way towards building a firm foundation for a strong relationship: Eat as a family. And the earlier you start the better.

The idea is not to simply eat in the same vicinity as each other. The key is the sharing and the communication that can come from this time together. Family dinners keep kids attached to their parents.

If your family doesn’t eat together you are missing out on one of the best opportunities to make a difference to your kids. It doesn’t have to be dinner, it could be lunch or breakfast. Families that eat out together may gain some of the same benefits. But those who graze for food at home, who watch TV while eating or have parents and kids eating at different tables, are out of luck.

I guess I was lucky. My parents always had family dinners. All of us (there were 10 kids) sat down and ate together every evening. There were always a few “extras” at the table. Sometimes the “extras” would be kids, sometimes adults. We talked, we argued, we learned how to relate. Our parents found out what we were up to.

Rituals were developed. When the discussion got heated, someone would repeatedly request “Pass the salt.” The conversation would change, sometimes suddenly, to an area that was less contentious. To the outsider, our dinners may have looked like a verbal brawl but it worked for us.

The family dinner is:

  • the glue that keeps parents and children in touch with each other
  • a time for children to learn the family’s values
  • an opportunity to learn social graces

Family dinners may also be a chance to learn how to:

  • cook
  • serve food
  • entertain
  • promote healthy eating
  • prevent obesity and other health problems

Dr. Pat’s simple rules for the regular family dinner:

  1. Serve food everyone likes. Some adventuresome side dishes are good too
  2. Show a genuine interest in others
  3. Turn off the TV
  4. Prohibit criticism or belittling
  5. Encourage everyone to tell something about their day

Celebratory meals at Christmas, Easter, Thanksgiving or Mother’s Day, for example, perform a somewhat different function. Celebratory meals provide shared traditions such as: the singsong that accompanies Canada Day celebrations; the seafood buffet or the tortiere that mom prepares for Christmas; the barbecue that occurs at Thanksgiving. Celebratory meals often involve extended family and/or friends. Traditional foods are often served.

However, celebratory meals can also be a disaster if longstanding tensions that haven’t been resolved are played out at the table. So, if Uncle Harry gets drunk and becomes obnoxious, or if Aunt Mary starts hitting on her sister’s boyfriend, then disaster can loom. So, keep an eye on potential conflicts.

As often as you can, and at least three times a week, sit down at the same time with your kids, eat a meal together and talk about whatever is important to them. Have celebratory meals that bring people together. You will be surprised at the difference it can make. Your kids will remember these times and pass the traditions on to their kids.

Posted in Eating | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

My son is headed down the wrong road fast. How can I get him back on track?

My son just turned twelve, he has pretty much stopped going to school, is lying, not following rules, bullies his little sister, has become violent and destroys doors, walls or whatever is in his path. He has been involved with the police on several occasions and is going through the restorative justice program, I believe he is using drugs and alcohol. All of these things are out of character for my son, he is a very kind, gentle, caring, smart, mild mannered, and has many other great qualities. He has a new “friend” who I think is a bad influence, and do not agree with him hanging out with him. My son will not admit or take responsibility for his actions or behaviours, he seems to think what he is doing isn’t all that bad. I have talked to him, begged and pleaded with him and nothing seems to help. I have referred him for counseling and finally got it after a few weeks wait but he refuses to go. I have been doing everything in my power to turn him back around, talking to him, telling him what I expect, counseling, have gotten him a mentor, spoken to the school social worker and guidance counselor, teachers, principals, child welfare, police. Pretty much everyone who I think will help and it seems to me that if my son doesn’t want to stop what he is doing no one can make him! I see him going down the wrong road fast and I can’t seem to get him back. Do you have any suggestions on anything else I can do?

You are right; you have to get control of him. Use a combination of positives and control. Let him know how much you love him and tell him again and again that you think he is a good kid. But make no excuses for his behaviour. Tell him clearly he is going wrong.

I would focus attention on his principal or child welfare. There are legal requirements that children go to school and the welfare authorities have legal power to make him do this. Get an appointment with one or both and make it clear that you demand their help. If they won’t help, demand to see their boss.

Your son’s chances of turning around are pretty good if he has not been like this for too long. But his behaviour needs to be controlled.

Posted in Behaviour, Uncategorized | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

My niece is having a lot of difficulties and I think there is a mental health issue. How can I help her?

My niece is visiting. She just turned 16 in January. She failed grade 9. Attended a special program to help her adjust/catch-up to grade 10 but became involved in an abusive relationship (that has thankfully ended). I’m not sure if she ever did successfully complete that program, she often tells a version of the truth or just straight out lies. Her lies often don’t make sense and the story can change in mid-sentence. During the time of the abusive relationship she was staying with this older boyfriend. My sister could not get her to come home or go to school. She says she cannot concentrate in school. My sister works long hours at a minimum wage job to provide for them. Her mom and step-dad are newly divorced and he has ceased all contact with her. Her Mom has also had her own difficulties. Since my niece has been visiting she’s run up my phone bill, stolen clothing (obviously has rummaged through my closets and personal drawers), had a tantrum when I insisted she not travel in bad weather, and left while my husband and I were at work the next day.  After going to great lengths to get her back home, she came easily, no questions and then chatted about her difficulties calmly that evening and the next day. She says her doctor thinks she may have bipolar disorder. Although I have suspected for some time that there may be a mental heath issue, my sister did not mention this. They don’t have a health plan so I think she was waiting on a list to see someone for help. How do I help my niece? I believe she needs immediate help and I am very motivated to try. My husband and I had decided that our family of two is enough for us. We do not and will not have our own children. He doesn’t want the responsibility but I feel I need to help her somehow. Finances are limited to include a teenager in our life but I want to help. What can you suggest?

She is lucky to have an aunt who cares for her. Your support will be important no matter what happens.

You will have to work out with your husband whether or not she can stay with you in the long run.  You may be able to work out some compromise.

Right now, help her get a mental health assessment. You can call the intake service to have her assessed. If you have difficulty, ask her doctor if he or she can refer her. You can tell her doctor what your concerns are. He or she may not be able to share with you what your niece has said. But the doctor can listen to you and act on your concerns.

Posted in Behaviour | Tagged , , , , , , , , , , , , , , , , , , , | Leave a comment

My son wakes up screaming at the same time every night. Is it an act?

My son is almost two, he is smart and a delight to be around. He naps at daycare on a mat and when I put him in his crib at night he goes right to sleep. Between 11:00 p.m. and 2:00 a.m. every night he will wake up and scream until either my husband or myself bring him to our bed where he falls asleep almost instantly. His screams sound so painful that it is hard to ignore him but the fact that he falls right to sleep in our bed can only mean it was all an act. He will scream/cry uncontrollably to the point of throwing up. He’s gone for close to two hours before we go get him. My husband and I both have demanding jobs. Our family (we also have a four-year-old girl) gets up at 5:30 a.m. on weekday mornings. Letting him cry it out is not working because he eventually gags and vomits and then we have to go in and clean him and his bed up. I’ve even tried getting up with him and letting him play and then trying to put him back to bed the way I initially do at the beginning of the night. I really need to know what I can do to help him sleep through the night.

It is difficult to determine what is happening. But it is important to figure this out.

If he has a very high heart rate and a scream that is almost unreal, he may be having night terrors.  Night terrors are a heightened state of arousal that occur about 90 minutes to 180 minutes after the onset of sleep.  When they are interrupted, children are still asleep.

If it is night terrors, it is not an act. It is real. It is caused by a bit of immaturity in the brain that stops the natural arousals we have during sleep. Discuss this with your son’s doctor in order to get a diagnosis.

I would suggest you continue to manage this as you have. He will likely grow out of this as he develops. Alternatively, you can try waking him up before the time he usually has the night terror. This may interrupt and change the pattern.

Your son’s doctor can prescribe medications that change his sleep patterns and may interrupt the night terrors.

Posted in Sleep | Tagged , , , , , , , , , , , , , , | Leave a comment

How can I stop my son from throwing his food on the floor?

My 17-month-old son is constantly throwing his food on the floor during meal times. He understands the word ‘no,‘ but he thinks it’s really funny and it seems like he’s testing me to see what I’ll do after he throws it. I know he’s still pretty young, but are there any strategies we can use to help encourage him not to do this?

Your son has talent. He has taught you a game called “Lets throw food on the floor”. It is a great game that many children enjoy. It has action and excitement. He has great fun with his mom.

If you are tired of the game, you can change it. You can teach him a new game called “Let’s eat the food”.

When he throws food on the floor, turn away from him.  Don’t react at all. Don’t scold him. Just ignore him. If he eats some of his food, pay lots of attention to him, smile, talk to him. Be really positive and fun.

At first, he may increase his food throwing because he wants you to play the old game. Continue to ignore him. When all his food is gone, after a few minutes give him a second chance. Use the same methods as the first time. In this game there are only two chances. If he doesn’t eat, just wait for the next meal. Unless he is very underweight, missing a bit of food will do him no harm. This is not a punishment. It is just that you don’t want a lot of practice with the old game.

There are two other things you can consider:

  1. You may be giving him more food than he needs. Try and make sure you don’t put more food on his plate than he wants or needs.
  2. There may be too many distractions. Make sure there is no TV on during meals.

Your son is smart. He will learn the new game. If you are consistent, it may take a week. If you are inconsistent, it will take months.

Posted in Eating | Tagged , , , , , , , , , , , , , , | Leave a comment

How can I get my daughter to stop cracking her knuckles?

My 14-year-old daughter is constantly cracking/pulling/crunching the joints/knuckles in her hands. Her friends and us (her parents) remind her stop – but it is a mindless habit. How can she stop?

Knuckle cracking is frowned upon by many parents. It is a mildly irritating habit. There have been several studies that have shown that it is not related to getting  arthritis in these joints. One study did show a relationship with swelling and weakness of the hands but it is not clear if the knuckle cracking caused the swelling and weakness. So there is no strong health reason to stop cracking knuckles.

I would suggest you ignore her knuckle cracking. If it bothers you, you can always look away or leave the room when she is cracking her knuckles. There are a lot worse things she could be doing.

Posted in Behaviour | Tagged , , , , , , , , , | Leave a comment

What can I do about my daughter being a very picky eater?

My question is in regards to my eight-year-old daughter. She is very limited in the foods that she will eat and she is very unwilling to try anything new. She has been like this since about the age of one and a half when we were transitioning into finger foods and more adult-like foods. I was certain she would outgrow this but now at eight she is not willing to try anything new. I try to make certain she gets the nutrients she needs to be healthy and grow properly and I am certain she is fine in that regard but…we are very frustrated and embarrassed by her behavior. She is a great kid, very social, outgoing and smart.  She does well at school and takes great pride in her abilities. The problem I foresee is that she is missing out socially. I view it as more than a psychological problem than anything and I’m at my wits end as to what I should do. She loves cheese, yogurt, peanut butter, cereal, bananas, apple sauce, tomato soup and a few other things…but that’s it. When we ask her to try something new she becomes very upset, starts to gag and can not even try it.  She eats no meat or vegetables. I do often make “smoothies” which contain milk, bananas, yogurt, an instant breakfast and tofu-she loves them and has no idea they are full of good stuff. I need some advice. A friend of mine is an OT, she had mentioned something to me about “feeding clinics.” Is this something we should look into?  Any advice you can offer would be greatly appreciated.

You have done a magnificent job in insuring that she is doing well in terms of her nutrition. You are right that the issue is her perceptions.  First of all recognize that you have won at least 80% of the battle.  I would suggest that you emphasize to her, her incredible achievements.  You and her together have managed to keep her healthy and well functioning in spite of her severe food restrictions. Talk to her about the social part.  Help her understand that it is important for her to have a small amount of flexibility.

Encourage her to try extremely small amounts of a variety of foods.  Put it to her that this is a social issue…gagging, throwing up and getting upset are not very sociable responses.  In fact they are downright rude, even if it is done in her own home.  I would have a tryout dish before every meal. This can be a miniscule amount of a different food. Let her choose between two options e.g. four peas or four kernels of corn. Give lots of praise for success, ignore minor rudeness and punish major rudeness. Teach her how to be gracious in her refusals so that she can function socially.

Bring her into your confidence. Let her know, gradually, that the fantastic smoothies have a variety of foods in them. She has to get enough nutrition and she has to navigate a social environment in which food is an important component. Fortunately, the world has come to respect a wide variety of food sensitivities. In summary, continue doing what you are doing, just don’t tolerate her being rude in this area.  In the end, she will have to manage the social aspects of her sensitivity in her own way. Given what you have done I don’t think it will be a major problem. She will learn that food is as much a social vehicle as a source of nutrients.

Posted in Eating | Tagged , , , , , , , , , , | Leave a comment

How can I get my three-year-old to stop picking his nose?

How can I get my three-year-old to stop picking his nose?

I don’t think you can. I would suggest you mention this to his/her family doctor to check his nose to see that there is nothing wrong.

You can insist that your child not nose-pick during meals, or maybe even in public. If you want to do this tell him it is not polite and that he should do it in private. Have him leave the table if he starts. Praise him for polite behavior.

Trying to control nose picking all of the time is doomed to failure. Focus on other goals.

Posted in Behaviour | Tagged , , , | Leave a comment

What are the pros and cons of raising a gender-less child?

Lately there has been a lot of attention in the media on the subject of raising gender-neutral or gender-less children. It is a notion we are intrigued in and considering for our own baby when he or she is born. In your professional opinion, what are the pros and cons of raising a gender-less child?

In my opinion, it is probably impossible to raise a child without them becoming aware of his or her gender.  Moreover, many people will react to a child in a gendered way. By pretending to raise a gender-less child, you may heighten awareness of gender. You may increase the chances of your child being treated more like a boy or girl as the case may be.

My own opinion is that raising a child who is aware of and proud of being a male or female is a good thing. I believe we should raise each child to believe that he or she can do or think whatever he or she wishes.  There is no reason why girls cannot aspire to be brain surgeons or plumbers. Boys can aspire to be nurses or kindergarten teachers. Girls can be ambitious, aggressive and career oriented. Boys can be gentle and family-oriented.

We should model for our children and encourage them to follow their dreams and not be constrained by gender.

In summary I am all in favour of raising children who are not constrained by gender. I fear that attempting to raise a gender-less child is impossible and may cause more emphasis on gender than is wanted.

Posted in Development | Tagged , , , , , | Leave a comment