Category Archives: 6-12 months

“He won’t eat”

I regularly encounter children whose caregivers report that they “won’t eat” and I don’t mean while feeling ill.  The parents think the problem is chronic.  When I look at the child I know that this statement is not accurate because the child does not look under nourished.  In fact, some of these children are fat.  How can that be?  

1)  The child is expected to eat much more food than their body actually needs.  A toddler is not supposed to eat half as much as an adult.  One tablespoon for year of age up to a max of a half cup is a good rule of thumb for portion sizes for children.  That means a 2 year old might only eat half of a chicken tenderloin, 2 tablespoons of mashed potatoes and 2 tablespoons of veggies at a large meal.  The website has a calculator for daily food portions for preschoolers.  (Use this one for ages 6 and up. )

2) The child drinks hundreds of calories of juice, milk or worse each day.  They fill up on what they drink and are not hungry.  Anyone who drinks 5 glasses of apple juice has consumed at least 500 calories.  Milk has at least a few more calories.  If you eliminate the juice, soda, etc and limit milk to 2 cups, the child’s appetite will increase and they will eat more.  Be ready for some tantrums though.  It is often easier to completely eliminate juice, KoolAide or soda than to moderate portions.  Then you can simply say “It is all gone.”  Some children go on strike and refuse to drink if their favorite beverage is not available.  Don’t worry.  Thirst is a powerful force.  Everyone will eventually drink water if they are thirsty enough.

3) The child and parent argue over eating and the child views eating as a struggle for power.  Even 9 month olds can get in this battle for control.  The solution is easier said than done.  Stop showing an interest in what and how much your child eats.  When there is no grappling for control, the child will eat if they are hungry.  Depending on age, this process can take days to weeks.

Temper Tantrums

In children who are not yet verbal, tantrums are commonplace.  They send a clear message to adults that the child is unhappy with the current situation.  He might want down on the floor, want the m&m’s in the checkout line, not want to give up that magazine he was destroying or just be tired.  Almost all children go through a stage of frequent tantrums.  The goal is to make tantrums only a temporary stage.

For children under 12 months, distraction often resolves the tantrum.  For older toddlers, ignoring works well.  After you start to ignore tantrums, you may notice that your child checks to see if you are watching and then revs up the tantrum to get your attention.  In other words, “if I’m a little more obnoxious, maybe they will give in.”  Shortly after this part of the tantrum, your child may attempt to get your attention by being cute or kind.  This is your cue to give some attention while remembering you still need to ignore the tantrum.

Tantrums are a lot of work.  If they never result in getting what your child wants, your child will give up and try a different strategy.  If they work occasionally, then they are worth the effort.  (Think of how many times you checked the change slot of a coke machine after finding a coin once.)  You may also find that your child stops tantruming with the adults who ignore the tantrum and continues with the adults who occasionally give in.

Ignoring tantrums in public places can be difficult.  In a store, you can take your child to the car until the tantrum is over.  The employees will happily hold your grocery cart for a few minutes.  The restroom is another way allow your child to finish in a less public area.  Regardless, if you give in while in public, your child will realize that tantrums work in public places even if they don’t work at home.

But he only has two teeth!

Brushing teeth is a widely acknowledged good habit for health but how young should you start?  Do you brush the teeth of a four month old?  Do you wait until your child is off the bottle?  Do you wait until your child shows an interest?

Using a traditional (small size) toothbrush in a four or six month old is difficult.  At that age, a damp washcloth works well.  The rubber “brush” that fits over your finger also works.  Of course, neither is a good choice if your child bites hard enough to hurt.  At such young ages, using whatever is convenient for the parent is fine.  By six months of age most children are skilled at eating off a spoon.  Shortly thereafter, you can teach toothbrushing etiquette–no biting, etc.

Some infants and toddlers are motivated to cooperate by the taste of tooth cleanser.  You notice I did not say “toothpaste”.   Most children under the age of 4 years do not like the flavor of adult toothpaste.  Many kids describe it as burning or hot.  For any child who is likely to swallow the tooth cleanser, fluoride-free is the safest option.  This is often labeled “training paste” in the store.  It comes in flavors like grape.  Since it is tasty, some children will eat it.  Eating fluoride toothpaste is not safe so stick with fluoride free until you can trust your child to spit.  There is also an enzyme based cleanser for infants and young toddlers that is safe to swallow.

So how do you teach good toothbrushing etiquette if you missed the window at 4-8 months?  You can still start.  If your child has 2 or more teeth at 6-12 months, I would not choose to put my fingers in his mouth.  By that time, biting is inevitable!  Stick to the little toothbrushes that look like adult toothbrushes.  If you child is starting to grab the spoon when you feed him, go ahead and buy two toothbrushes.  That way, your child can hold one while you use the other.  This greatly reduces snatching and frustration.  For children who are starting to want to brush their own teeth, bath time is perfect.  After undressing and before getting in the bath means less mess to clean up.  The time it takes to ready the tub is great for how long to brush too!

You may have noticed the wide variety of ages mentioned in this post.  The age range  considered to be normal for the first tooth is between 4 and 15 months old.  Yes, it is a huge range.  Average is 6-7 months.  Fortunately teeth have little bearing on a baby or toddler’s ability to eat food so this variability is harmless.  Go ahead and teach your child gum cleaning etiquette at six months even if she doesn’t have teeth.  It will save you lots of frustration later.

Lastly, every community’s water supply has different amounts of fluoride.  Different brands of bottled water also have different amounts of fluoride and some filters remove fluoride.  If you are unsure if you child needs fluoride supplementation, ask your pediatrician, dentist or local health department.

Slapped in the face, again

I often hold 10-12 month olds on one hip while I do something else with the other hand.  Invariably, after a few minutes, I get slapped in the face.  The child is not unhappy, in fact he usually smiles as he does it.  Why oh why do children this age hit so much and how can you stop it?

Let me start by pointing out that they often hit without realizing that they are hurting you.  They would also hit the neighbor’s dog when you finally decide to allow them to pet it after being assured that the dog is “child friendly”.  (See post on dog safety.)

The wrong way to stop this behavior is to hit your child back.  Your child does need to be taught not to hit but will never understand that you can hit him but he is not allowed to hit you.  That is way too complex for your child to follow.  First off, if you can tell it is coming, grab your child’s wrist and stop them from hitting you.  Use a firm voice and say “No!”  (“No hitting!” is really too complex for a child under the age of a year.)  You must use a firm, no-monkey-business voice to be effective.  It is impossible to smile while using this voice.  Your baby may whimper or whine to show that they did not like your serious voice.  This is okay!  You are now going to change your tone to a quiet, sweet voice and say “Gentle” or “Love” while directing your child’s hand to gently stroke your face.  Within a few tries, your child will begin to understand that you enjoy being gently loved on.  You can stop the popping and start petting!

Snatching Earrings, etc

You are holding a baby on your hip only to be poked in the eye out of the blue.  If this sounds familiar, you have held a 9 month old!  By this age, they are coordinated enough that you only need one arm to hold them.  For many kids it seems, your free hand must constantly deflect that inevitable grab for your glasses, hat, or earring.  Of course, if you wear glasses, you don’t have to worry about being poked in the eye like the rest of us! 

Nine month olds do these things for several reasons.  First off they are curious.  Eyes, ears, mouths and even noses are holes they want to explore.  Think about toys for children this age, many have crevices designed for little fingers to prod.  Nine month olds have not yet figured out that your tongue is always in your mouth, even when it is out of sight.  (Check out my post on object permanence for an explanation.)

The most tempting earrings to 9 month olds are hoops and dangling earrings that sparkle or move when the wearer turns her head.  The hoop is a circle that was designed for a little finger to grasp.  I very rarely see a baby grab a stud earring even if it is the size of a quarter.  Those dangling earrings usually have moving parts.  If you offered either of these attached to a burp cloth, a 9 month old would still be interested.  Of course on your ears, they are exactly at eye level for a baby held on your hip.  My suggestion is to consider how appealing your earrings are before you decide to wear them.  You could even see which ones your child is least interested in before you decide on your new favorite pair.

For glasses, start off by never letting your child play with anyone’s glasses, not even cheap sunglasses.  It will take a few weeks, but your child will learn that glasses are off limits.  In the meantime, buy a sports glasses strap to keep them on your face.  You can also reduce temptation by holding the baby so her back is facing you.  A firm “No!” in your no-monkey-business voice can also help deter glasses snatching.  Popping her hand will not be effective and will make hitting you a bigger problem later on.

Throwing Things

Object permanence is knowing that an object you can no longer see still exists.  It is why Peek-a-boo is so fun.  The child is not sure if you are around the corner or not.  Oh wow! Mommy’s back!

A typical scenario involves a child sitting in a high chair playing with a toy while mom cooks dinner.  Mom is talking to the baby and the baby is banging the toy on the high chair tray.  Suddenly, the child throws the toy on the floor.  She then leans over to see if it still exists.  She smiles and is pleased with herself because it does and then starts to fuss because she can no longer reach it.  Most often, mom interprets this as a game of fetch.  In reality, her child is checking object permanence.  It is simply inconvenient that the toy is now on the floor and mom must pick it up again.  Having mom hand the toy back is merely a consequence of this exercise in checking object permanence.  The best part of the game is looking over the edge and seeing the toy.

Parents can take advantage of this developmental milestone.  If you eliminate your child’s pacifier before object permanence develops, it will be easier on your child.  He will forget it because it is out of sight.  Also, babies no longer get endorphins from nonnutritive sucking (ie. Pacifiers) by 6 months old.  For lots of children, learning about object permanence starts around 8 months so throwing away the pacifier at 6 months makes a lot of sense.  After 7-8 months, babies are often very noisy just for fun.  Pacifiers stifle this and can quickly be a crutch for parents who want their child to be inappropriately quiet.

Do you want your baby to look like Maggie Simpson?

Even before a baby is born, it enjoys non-nutritive sucking, that is, sucking just for fun.  Many ultrasound photos show this behavior.  Sucking a fist, thumb or pacifier can be self-soothing.  The important thing to remember is that babies stop getting endorphins from non-nutritive sucking by 6 months old.  Endorphins are brain chemicals that make you feel good.  (Sex and chocolate both cause the adult brain to release endorphins.)

Using a pacifier to distract an infant during a particularly unpleasant brief event is a good use of a pacifier.  Putting a pacifier into a baby’s mouth every time it makes a sound is not appropriate.  Babies are supposed to be noisy for goodness sake!  Do you put candy in your kindergartener’s mouth every time he gets loud?  Of course not.  Is a pacifier candy?  No but still, think of Maggie Simpson.

Pacifiers certainly have their uses but I see them overused.  By 6 months old, a child should be able to self-soothe without a pacifier.  Interestingly, this is before object permanence develops and therefore eliminating the pacifier suddenly will be well-tolerated.  The pacifier after 6 months is often used to make noisy babies or children be quiet.  I see far too many children take their pacifier out of their mouth to repeat what they said because their mother didn’t understand them with the paci in their mouth.

If you are going to stop the paci habit, choose a day and make it happen.  The Farmers Almanac has a day each month that is well-suited to weaning baby animals.  Will starting on this day make it easier?  I don’t know but it can’t hurt.