Four Basic Guidelines about Toilet Training
- Relax.Toilet training is often the first task that parents take a strong stand on. Sure, it is important to you, but adding tension and pressure to the process will not make it any easier for you or your child, and may make it worse. Remember, unlike eating, sleeping, and playing, there is no natural, immediate payoff for your child when he or she uses the toilet. Your child may not always cooperate with you during toilet training, but your tension will just make things worse. You know your child eventually will learn to use the toilet, so don’t make it a contest of wills. Be calm and patient, and allow your child some time to get the idea.
- Wait.Most children are toilet trained when they are 2, 3, or 4 years old. A few children are ready earlier, but just to be on the safe side, wait until your child is at least 2 years old.
- Make sure you are ready.As a parent you need to make sure you are ready to invest the time and effort in toilet-training your child before you start. The process can be slow and long drawn. Have the grandparents and any other care-giver let up on their pressure about toilet training. Remember, toilet training need not be a community affair. Has the crisis at work passed? Is the household relatively stable now, and will it continue to be so for a few weeks? Having other parts of your life running smoothly will help ease the chore of toilet training.
- Make sure your child is ready.If you are really ready to toilet train, see if your child is ready. Parents and others (grandma, aunt, friends) sometimes push toilet training before there are clear signs that the child is ready. Your child is not ready:
- Just because he’s told you he wants to wear “big boy” pants.
- Just because she wants the Big Wheel you promised as a reward.
- Just because he or she has had some dry days playing on the potty chair. (Many children do this around 18 months of age.)
What Is Readiness?
Age: Your child should be at least 20 months old and preferably 2 years old or older.
Physical readiness: Your child should be able to pick up objects, lower and raise his or her pants, and walk from room to room easily.
Bladder readiness: Your child should already be staying dry for several hours at a time, urinating about four to six times a day, and completely emptying his or her bladder. If your child is still wetting a small amount frequently (7 to 10 times a day), you should wait.
Language readiness: Your child should understand your toileting words, words like “wet,” “dry,” “pants,” and “bathroom.” If your child does not understand what you are talking about, you should wait.
Instructional readiness: Your child should be able to understand simple instructions, such as “Come here, please” and “Sit down.” Just as important, your child should be following the reasonable instructions you give. If your child opposes you much of the time and has frequent temper tantrums, you will probably have problems with toilet training.
Bladder and bowel awareness: Your child may indicate that he or she is aware of the need to void or eliminate. Children usually indicate this awareness not through words but through actions – making a face, assuming a special posture like squatting, or going to a certain location when they feel the urge to urinate or defecate. This may be a positive sign that your child is ready to begin toilet training.
Getting Your Child Ready
You can take some steps now that will help your child when, at some time in the future, you begin toilet training.
Let your child watch you. Your child can learn a lot about how to use the toilet correctly by watching a parent. Frequently let your child come with you when you go to the bathroom. Use simple words to explain what you are doing (for example, “Mommy is going pee-pee in the potty.”).
Teach your child to raise and lower his or her pants. You can do this gradually when you are dressing or undressing your child. With your daughter, for example, you can first pull down her pants with little or no help from her. Then, do less pulling and let her do more. This process may take many weeks, but it is worthwhile. Later, when you begin toilet training, you will be glad that your child already knows how to pull down his or her pants and that you don’t have to tackle that learning task in addition to toilet training.
Help your child learn to follow your instructions. Make sure you have your child’s attention when you give an instruction. Immediately praise your child if he or she does what you ask. If your child does not follow your instruction right away, gently guide him or her through what should be done, and do not give another instruction until the first one has been followed. If your child starts to cry, ignore the crying. When your child has calmed down, repeat your instruction. If you often have trouble getting your child to follow your instructions, ask your health care provider for guidelines on managing your child’s behavior.
Set out a potty chair. A few weeks, or even months, before you think you will start toilet training, make a potty chair available to your child so that he or she can get used to it. Put it in the bathroom or in another room so your child has a chance to investigate it. Let your child get used to sitting on it, with clothes on. Encourage your son to sit on the potty (instead of standing in front of it) so that he will be used to sitting when you start toilet training. (Later on, when he is well past being toilet trained, he can stand.)
Praise your child. Every time your child does something the right way, be sure to let him or her know. Praise your child with words that are brief and to the point, such as “You did a good job pulling down your pants.” Or, give your child a smile, a hug, or a kiss. This attention is how you teach your child what behavior pleases you.
Just remember the things you can do before beginning to potty train:
- Frequently let your child watch you go to the bathroom.
- Teach your child to raise and lower his or her pants.
- Teach your child to follow your instructions.
- Make sure you are ready before you try to toilet train your child.
- Make sure your child is ready.
- Wait until your child is at least 2 years old.
- Set out a potty chair so your child can get used to it.
- Praise your child every time he or she does any part of toileting behavior correctly.
Family is the most important influence in a child’s life, but television is not far behind. Television can inform, entertain, and teach us. However, some of what TV teaches may not be the things you want your child to learn. TV programs and commercials often show violence, alcohol or drug use, and sexual content that may not be suitable for children or teens.
Studies show that TV viewing may lead to more aggressive behavior and less physical activity. By knowing how television affects your children and by setting limits, you can help make your child’s TV-watching experience not only enjoyable, but healthy too.
How TV affects your child
There are many ways that television affects your child’s life. When your child sits down to watch TV, consider the following:
Children in the United States watch about 4 hours of TV every day. Watching movies on tape and playing video games only adds to time spent in front of the TV screen. It may be tempting to use television, movies, and video games to keep your child busy, but your child needs to spend as much time growing and learning as possible. Playing, reading, and spending time with friends and family are much healthier than sitting in front of a TV screen.
Children who watch too much television are are more likely to be overweight. They do not spend as much time running, jumping, and getting the exercise they need. They also see many commercials for unhealthy foods, such as candy, snacks, sugary cereals, and drinks during children’s programs. Commercials almost never give information about the foods children should eat to keep healthy.
If your child watches 3 to 4 hours of noneducational TV per day, he will have seen about 8,000 murders on TV by the time he finishes grade school. Children who see violence on television may not understand that real violence hurts and kills people. Even if the “good guys” use violence, children may learn that it is okay to use force to handle aggression and settle disagreements. It is best not to let your child watch violent programs and cartoons.
Television exposes children to adult behaviors, like sex. But it usually does not show the risks and results of early sexual activity. On TV, sexual activity is shown as normal, fun, exciting, and without any risks. Your child may copy what she sees on TV in order to feel more grown up.
Alcohol, tobacco, and other drugs
Young people today are surrounded by messages that say drinking alcohol and smoking cigarettes or cigars are normal activities. These messages don’t say that alcohol and tobacco harm people and may lead to death. Beer and wine are some of the most advertised products on television. TV programs and commercials often show people who drink and smoke as healthy, energetic, sexy, and successful. It is up to you to teach your child the truth about the dangers of alcohol, tobacco, and other drugs.
The average child sees more than 20,000 commercials each year. Commercials are quick, fast-paced, and entertaining. After seeing the same commercials over and over, your child can easily remember a song, slogan, or catchy phrase. Ads may try to convince your child that having a certain toy or eating a certain food will make him happy or popular. Older children can begin to understand how ads use pictures, music, and sound to entertain. Kids need to know that ads try to convince people to buy things they may not need.
Television affects how your child learns. High-quality, nonviolent children’s shows can have a positive effect on learning. Studies show that preschool children who watch educational TV programs do better on reading and math tests than children who do not watch those programs. When used carefully, television can be a positive tool to help your child learn.
A word about…TV for toddlers
Children of all ages are constantly learning new things. The first 2 years of life are especially important in the growth and development of your child’s brain. During this time, children need good, positive interaction with other children and adults. Too much television can negatively affect early brain development. This is especially true at younger ages, when learning to talk and play with others is so important.
Until more research is done about the effects of TV on very young children, the American Academy of Pediatrics (AAP) does not recommend television for children age 2 or younger. For older children, the Academy recommends no more than 1 to 2 hours per day of educational, nonviolent programs.
10 things parents can do
As a parent, there are many ways you can help your child develop positive viewing habits. The following tips may help:
- Set limitsLimit your child’s use of TV, movies, and video and computer games to no more than 1 or 2 hours per day. Do not let your child watch TV while doing homework.
- Plan your child’s viewingInstead of flipping through channels, use a program guide and the TV ratings to help you and your child choose shows. Turn the TV on to watch the program you chose and turn it off when the program is over.
- Watch TV with your childWhenever possible, watch TV with your child and talk about what you see. If your child is very young, she may not be able to tell the difference between a show, a commercial, a cartoon, or real life. Explain that characters on TV are make-believe and not real. Some “reality-based” programs may appear to be “real,” but most of these shows focus on stories that will attract as many viewers as possible. Often these are stories about tragedy and violence. Much of their content is not appropriate for children. Young children may worry that what they see could happen to them or their family. News broadcasts also contain violent or inappropriate material. If your schedule prevents you from watching TV with your child, talk to her later about what she watched. Better yet, videotape the programs so that you can watch them with your child at a later time.
- Find the right messageEven a poor program can turn out to be a learning experience if you help your child find the right message. Some television programs may portray people as stereotypes. Talk with your child about the real-life roles of women, the elderly, and people of other races that may not be shown on television. Discuss ways that people are different and ways that we are the same. Help your child learn tolerance for others. Remember, if you don’t agree with certain subject matter, you can either turn off the TV or explain why you object.
- Help your child resist commercialsDon’t expect your child to be able to resist ads for toys, candy, snacks, cereal, drinks, or new TV programs without your help. When your child asks for products advertised on TV, explain that the purpose of commercials is to make people want things they may not need. Limit the number of commercials your child sees by watching public television stations (PBS). You can also tape programs and leave out the commercials or buy or rent children’s videos.
- Look for quality children’s videosThere are many quality videos available for children that you can buy or rent. If you have questions about children’s videos or just want some suggestions, contact The Coalition for Quality Children’s Media at 505/989-8076 or visit their Web site at http://www.cqcm.org.
- Give other optionsWatching TV can become a habit for your child. Help your child find other things to do with his time, such as the following:
- Activities with family, friends, or neighbors
- Learning a hobby, sport, instrument, or an art
- Set a good exampleYou are the most important role model in your child’s life. Limiting your own TV viewing and choosing programs carefully will help your child do the same.
- Express your viewsWhen you like or don’t like something you see on television, make yourself heard. Write to the TV station, network, or the program’s sponsor. Stations, networks, and sponsors pay attention to letters from the public. If you think a commercial is misleading, write down the product name, channel, and time you saw the commercial and describe your concerns. Call your local Better Business Bureau, or send the information to:
Children’s Advertising Review Unit
Council of Better Business Bureau
845 Third Ave
New York, NY 10022
Encourage publishers of TV guides to print ratings and feature articles about shows that are educational for children.
- Get more informationThe following people and places can provide you with more information about the proper role of TV in your child’s life:
- Your pediatrician may have information about TV or can help you get it through the American Academy of Pediatrics. Ask for the AAP brochure Understanding the Impact of Media on Children and Teens
- Public service groups publish newsletters that review programs and give tips on how to make TV a positive experience for you and your child. Check with your pediatrician.
- Your local Parent/Teacher Association (PTA).
- Parents of your child’s friends and classmates can also be helpful. Talk with other parents and agree to enforce similar rules about TV viewing.
The Children’s Television Act of 1990
The Children’s Television Act ensures that TV stations pay attention to the needs of children from age 2 to 16. Under this law, stations must air at least 3 hours of educational and informational shows for children each week. They must also limit advertising during children’s shows to 12 minutes per hour on weekdays and 10.5 minutes per hour on weekends.
TV stations that do not follow the law risk losing their licenses. The Federal Communications Commission (FCC) makes sure stations obey the law. For the law to be even more effective, keep tabs on TV stations in your community and report any violations to the FCC. If a station does not appear to be complying with the Children’s Television Act, inform the FCC by sending a written complaint to:
Mass Media Bureau
Federal Communications Commission
445 12th Street SW
Washington, DC 20554
TV Parental Guidelines and the V-Chip
In 1996, Congress passed a law that gives parents the ability to control what their children watch on television. The law set up a rating system called the TV Parental Guidelines. The ratings can help parents avoid programs that contain sex and violence. By using a computer device called the v-chip, parents can block these programs from their televisions. Since the year 2000, all new television sets with screens 13 inches or larger have the v-chip.
The ratings apply to all TV programs except news and sports. They can sometimes be found in your local TV listings and appear for 15 seconds at the start of a program. The ratings are as follows:
||For all children
||For children age 7 and older. The program may contain mild violence that could frighten children under age 7.
||For children age 7 and older. The program contains fantasy violence that is glorified and used as an acceptable, effective way to solve a problem. It is more intense than TV-Y7.
||For general audience. Most parents would find this program suitable for all ages. There is little or no violence, no strong language, and little or no sexual content.
||Parental guidance is suggested. Parents may find some material unsuitable for younger children. It may contain moderate violence, some sexual content, or strong language.
||Parents are strongly cautioned. The program contains some material that many parents would find unsuitable for children under age 14. It contains intense violence, sexual content, or strong language.
||For mature audience. The program may not be suitable for children under age 17. It contains graphic violence, explicit sexual activity, or crude language.
This ratings system was created to help parents choose programs that are suitable for children, even without the use of the v-chip. Before watching, check your local TV listings to find out if a program contains violence, sexual content, or strong language. Remember that ratings are not used for news programs, which may show content that is not suitable for young children.
Also, TVs with screens smaller than 13 inches will not have the v-chip. So, if your child is allowed to watch TV alone, choose a set that is at least 13 inches so you can use the v-chip to block programs. Avoid putting a television in your child’s bedroom.
When used properly, television can inform, educate, and entertain you and your family. By taking an active role in your child’s viewing, you can help make watching TV a positive and healthy experience.
This information should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on the individual facts and circumstances.
© COPYRIGHT AMERICAN ACADEMY OF PEDIATRICS, ALL RIGHTS RESERVED. American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL, 60007, 847-434-4000
Is My Baby Getting Enough Formula, Or Too Much?
Signs that your baby may be getting too little formula are:
- Slower-than-normal weight gain
- Diminished urine output
- A loose, wrinkly appearance to baby’s skin
- Persistent crying or fussiness
If your baby is showing signs of being underfed, increase the amount of milk offered. Feed more volume and or at more frequent intervals. Burp as needed.
Signs that your baby is being fed too much at each feeding are:
- A lot of spitting up or vomiting immediately after the feeding, more than considered normal
- Colicky abdominal pain (baby draws his legs up onto a tense abdomen) immediately after feeding
- Excessive weight gain
If these signs of overfeeding occur, offer smaller-volume feedings more frequently, burp baby once or twice during the feeding, and occasionally offer a bottle of water instead of formula.
Nipples can be made of rubber, latex and silicone substitues and come in a variety of contours all claiming to imitate the natural action and shape of the mother’s breast. None actually do!
Latex nipples are softer and more flexible, but they don’t last as long and some babies are allergic to them. Silicone nipples are firmer and hold their shape longer.
Nipples are also available in a range of sizes and flow speeds. You may have to try a few sizes to find the one that works best for your child.
Watch to make sure your baby isn’t having a hard time getting milk or isn’t getting so much that he’s choking or spitting up. Don’t alter a small nipple to increase its flow and, of course, discuss any feeding concerns with your baby’s doctor.
Because you can’t know beforehand which type or size nipple your child will prefer, it’s best to play it safe and buy one of several types. Once you’ve determined your child’s preference, you can purchase enough to last for months.
Orthodontic- type nipples
- Insert farther back into baby’smore natural milking action of the tongue, but inconveniently require a “which way to turn the nipple” decision. Be sure baby sucks on the widened base of this nipple, not just the mouth, allowing a tip.
Expandable rubbin nipples
- Designed to elongate during sucking but only if baby opens his mouth wide enough and sucks hard enough to draw the nipple farther in. Most, however, only suck on the protruded part. This nipple should be avoided for the breastfeeding baby, who may learn lazy latch-on habits from it.
Standard bulb-type nipples
- The easiest, with a wide base that best allows baby to form a tighter seal.
For the full-time bottle feeding baby, simply experiment with various types of nipples to see which one works best for your baby. If baby is both breastfeeding and bottle feeding, use a nipple with a wide base.
To lessen the rubbery taste of an artificial nipple and to sterilize them, boil for five minutes before first use. To avoid the possibility of a baby choking on a nipple, carefully follow the manufacturer’s caution advice on the package.
When To Replace Nipples
Formula should drip steadily out of a nipple. If it pours out in a stream, the hole is too big and the nipple should be replaced. Check nipples periodically for signs of wear, such as discoloration or thinning, and replace worn ones, which could break and become a choking hazard.
If the nipple becomes cracked or torn, discard it. Some nipples come with a variety of hole sizes to fit the type of liquid and the age of the baby. The nipple hole should be large enough for the formula to drip at an approximate rate of one drop per second when you hold a full, unshaken bottle upside down. Larger nipples and nipple holes are available for older babies.
Once the decision to breast feed is made, the next important thing is to select the type of formula you want to use. For most babies who are bottle fed, this process is usually initiated in the newborn nursery, and if the chosen formula is being well tolerated, there is really no need to switch to a different formula.
If there is a need to change to another type of formula, please call your pediatrician, or contact our office, to make an appointment to have your child evaluated. We will be very happy to discuss the options with you.
Choosing a Formula
Be sure to choose a DHA-enriched formula. Most, if not all of the US formula companies offer AA/DHA-enriched formulas.
There are some subtle differences among the major brands of infant formulas which may affect how your baby tolerates one formula over another. The vitamins and minerals in all formulas are similar, however, the nutritional fine points of the fats, carbohydrates, and proteins differ from one brand to another.
Standard formulas are those that are tolerated by most infants. Infants with special digestive needs require special formulas.
You may click here for some guidelines on how standard formulas differ and compare formula content. This may be of help in matching the formula to your baby’s needs.
Bottle Feeding Basics
Most mothers who make the decision to bottle feed their babies usually have a lot of questions about the process. There are several things to consider if you choose to bottle feed. These include formula preparation, sanitizing utensils, and feeding positions.
Here are seven simple steps that you can follow to successfully bottle feed your baby.
- Make sure all bottles, nipples, and other utensils are clean.
If the water in your home is chlorinated, clean the utensils in your dishwasher or wash them in hot tap water with dishwashing detergent and then rinse them in hot tap water. If you have well water or non-chlorinated water, either place the utensils in boiling water for five to 10 minutes or use a process called terminal heating.In terminal heating you clean, but do not sterilize, the bottles in advance. You then fill them with the prepared formula and cap them loosely. Next, the filled bottles are placed in a pan with water reaching about halfway up the bottles, and the water is brought to a gentle boil for about 25 minutes.
- Read the directions.
Be sure to follow the manufacturer’s directions exactly for the formula type you choose. Too much water and your baby won’t get the calories and nutrients she needs; too little water and the high concentration of formula could cause diarrhea or dehydration.
- Preparing the formula.
Bring the water you plan to use in the formula to a boil for approximately one minute. Then add it to the formula powder. If you’re preparing this in advance, be sure to store it in the refrigerator. If the formula is left out of the refrigerator for longer than one hour or if you don’t use refrigerated formula within 24 hours, throw it out.
- Warm the refrigerated formula.
Refrigerated formula doesn’t necessarily have to be warmed up for your baby, but most infants prefer it at least at room temperature. The easiest way to warm refrigerated or frozen milk is to place the container in a pan of water on the stove at low heat and rotate it frequently. Microwave ovens should not be used for heating bottles; this can overheat the milk in the center of the container. Even if the bottle feels comfortably warm to your touch, the superheated milk in the center can scald your baby’s mouth. Also, the bottle itself can explode if left in the microwave too long.If you warm a bottle or use it immediately after terminal heating, test it in advance to make sure it’s not too hot for your baby. The easiest way to test the temperature is to shake a few drops on the inside of your wrist.
- Place your baby in a proper feeding position.
Cradle her in a semi-upright position and support her head. Don’t feed her lying down — formula can flow into the middle ear, causing an infection. To prevent your baby from swallowing air as she sucks, tilt the bottle so that the formula fills the neck of the bottle and covers the nipple.
- Take note of your baby’s intake.
The pediatrician will probably ask you how much your baby has eaten, so be prepared to answer the question. Your newborn will probably take between two and four ounces per feeding during his first few weeks (during the first few days, he may take less than an ounce at feedings), and will probably be hungry every two to four hours. It’s best to feed your baby on demand.Don’t force your baby to finish the bottle if he or she is not interested. And if your baby is still sucking enthusiastically when the bottle is empty, offer more.
- Burp your baby.
Babies get fussy and cranky when they swallow air during feedings. This happens more often with bottle fed infants, though breast fed infants can also swallow air. To prevent a tummy full of air, burp your baby frequently — after every two or three ounces of formula. If your baby doesn’t burp after a couple of minutes of trying, resume feeding. Here are the three best positions:
- Over the shoulder: Drape your baby over your shoulder and firmly pat or rub her back.
- On the lap: Sit your baby upright, lean her weight forward against the heel of your hand, and firmly pat or rub her back.
- Lying down: Place baby stomach-down on your lap and firmly rub or pat her back.
Types of Formula
- Ready To Feed – Premixed liquid. Do not add water. Be sure to shake well before feeding as it may have settled.
- Liquid Concentrated – Mix with equal amount of water. Be sure to shake well before mixing to blend ingredients.
- Powder – Mix 1 level unpacked scoop of powder, using the scoop that comes with the container, with 2 ounces of water. Be sure to shake all together.