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Dr. Hillary is a pediatric nurse practitioner with a doctoral degree in health promotion and risk reduction. She knows that when it comes to family, everyone has questions that can't wait for the next available doctor's appointment. She also knows that some questions are too personal to ask a doctor face-to-face. For these reasons, Dr. Hillary is here for you.

Here are a few of Dr. Hillary's recent questions and answers!

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Q: My 3 year old hits his older brother, screams when he doesn't get his way, and tells us “no” and “I don't want to” all the time. I can tell him to do something, and he will just stand there and look at me. It seems like he’s getting worse everyday that goes by. I tried everything, and it seems like nothing works. I’m ready to cry because I know my son can be good but it seems like he doesn't want to be. I need help please!

A: A 3-year-old should be able to follow instructions and be cooperative most of the time. Temper tantrums are still common at this age, but if they escalate or are very severe, they might need a follow up.

Does your child exhibit mood swings? Does he destroy property? Is he mean to animals?

You may want to schedule an appointment with your son's health care provider for an evaluation. Your son may need bloodwork to rule out certain metabolic disease that may result in behavioral problems, and possibly see a counselor for an evaluation of his behaviors.

Q: My 3YO son snores so loud it keeps my wife and I up at night. What could be the cause of this?

A: Excessive snoring can be a symptom of allergies, a stuffy nose due to a sinus infection, a deviated septum, or enlarged tonsils or adenoids. If the snoring does not wake your son up at night, and he doesn't have a tendency to choke or gag on food, then it's most likely due to allergies. Make your son an appointment with his health care provider asap, as allergies can lead to sinusitis.

Q: How do I stop my 1-year-old girls from hitting each other?

A: Children need guidance in distinguishing acceptable from unacceptable behaviors. One-year-olds will hit, bite, push, and maybe even pinch in an attempt to test their limits. These behaviors are not acceptable forms of social interaction, therefore parents need to respond in a serious but loving manner.

Long explanations and reasoning does not work with 1-year-old children. After an unacceptable behavior takes place, the best approach is to get down to the child's level and look her in the eye. Then, with a serious facial expression and serious tone of voice, the parent needs to say "NO."

If your child cries, or her chin starts to shake, you succeeded in getting the message across. You hurt your child's feelings by reprimanding her. If you are consistent and respond in the same way to "offensive" behaviors, your child will learn that such behaviors are not acceptable.

On the other hand, praise your child for acceptable behaviors. That will teach her what is expected of her and help prevent "offensive" behaviors.

Please read this article: Practicing Healthy Discipline

Q: My children don’t like to eat. They always skip their meals. What should I do?

A: When it comes to food, our responsibility as parents is to prepare healthy and nutritious meals for our children. On the other hand, children have responsibility to eat it!

Children have an automatic ability to regulate how much food they need for growth. Forcing children to finish their meals may disturb that mechanism and promote overeating and obesity. If your children are not hungry for lunch, they will have bigger appetites for dinner, so I would not worry about skipping meals. In between meals, structure nutritious snacks to provide your kids with the necessary nutrients, and offer them a daily multivitamin.

Please read my article, The Power of Healthy Snacks

Q: My 9-year-old son was diagnosed with ADHD. His doctor gave him a medication named D-AMPHETAMINE SALT COMBO 5MG. I am so worried to give it to him. I asked his doctor about a diet, and he said only the medication works for ADHD. Do you have any suggestions? Please help.

A: Psychostimulants, like the amphetamine salts, are the gold standard of ADHD treatment. They can be effective, and, when the treatment is closely monitored by a health care provider, they are relatively safe. Medications for ADHD are not prescribed until a diagnosis of ADHD is made by a qualified practitioner, and the child's symptoms interfere with his or her academic or social development, or compromise the child's safety. If you worry about the medication and its potential side effects, please discuss it with your child's health care provider. He or she will be able to address your specific concerns.

As to the alternative treatments of ADHD, a body of preliminary scientific evidence suggests that neurofeedback and essential fatty acids supplementation might be effective in treating ADHD symptoms.

Resources:
ADD/ADHD: Conventional, Innovative, and Alternative Therapies for 21st Century
Attention Deficit Disorder Association
The Biofeedback Center: Brain Training for You, Your Family, for Life

Q: I just gave birth to my second child (a boy) 6 weeks ago and I'm worried my first born, who is 3, isn't taking the adjustment well at all. He has always been a little strong willed, but in a good way. With the new baby, he is acting out more than ever. I know this is common, but my worry is that I am not reacting to him correctly. I am so tired with all the lack of sleep that I find myself very short tempered. I do give him one-on-one time whenever I can and when we are together he is an angel. But when I am tending to the baby, he'll throw toys, scream, hit the cat, etc. And after I repeat, "Please stop. Please don't do that, STOP right now!" all I can do is scream back! I regret it as soon as I give in to this childish behavior because it is so not like me to be this way. We give time outs, and those do work, but I feel like I'm still yelling as I am telling him to sit down. (he actually will sit there and cry without trying to get off the chair, and it do calm him down. I follow the minute per age rule, so 3 mins is all I make him sit for.

What can I do to stop losing MY temper? It just seems the more I say the word 'stop,' the more he continues to do it, and then out of frustration I yell (almost hurtful things) at him. At bedtime is when he and I bond the best. We cuddle and I read him books and he is so sweet. This is how we were before the baby came. I don't want him to resent the baby.

Is it okay for me to say, "Please stop?" Do I need to sound more foreceful? I need to find the line between forceful and being a pushover. I know this is long, and I appreciaite you taking the time to read this. I love both my children dearly, and I miss the fun my 3-year-old and I used to have. I go back to work from my maternity leave in 6 weeks, and I would like to get a handle on this situation soon.

A: Sounds like you are extremely stressed out from taking care of a newborn and dealing with a toddler who is acting up. Being a mom is exhausting, especially when you don't get enough sleep because of your baby. If at all possible, find somebody to help you take care of the baby so you can get some sleep! When you are rested, things will look a little better and you might find more effective ways to deal with your toddler's behaviors.

First of all, ignore tantrums. They are just a way for your toddler to get your attention. He will take any attention you give him, even if it's negative, such as yelling, scolding, etc. If you react to his tantrums, they will continue, because he will realize that throwing a tantrum gives him what he wants: mom's attention.

Time out is a good way of punishing "bad" behaviors. However, using positive reinforcement might work a little better. Most children want to do things that will make their parents happy. So, try to involve him in activities with the baby as much as possible, and of course, praise him for his good behaviors (positive reinforcement).

Be consistent with your discipline, exercise it in a loving way, and above all, get some sleep!

You might want to read our article, How To Teach Your Child Respect, which shows simple examples of reinforcing and encouraging positive behaviors instead of negative.

Q: I feel very frustrated and embarrassed. Sometimes my boys (6 and 3) are very good, sweet, inquisitive, clever, playful... then I cannot figure out what makes them truly awful. It seems as if there is absolutely no getting through to them. It is a barrage of hitting the dog, spitting, running, yelling, hitting each other... When they are in this "mood" (I don't know how else to describe it) no discipline whatever seems to be even remotely effective. What do I do?

A: As much as it is stressful, phases like that are a part of growing up and being boys! A couple of suggestions: be consistent with discipline and pick your battles. Try to discipline behaviors that are absolutely unacceptable and try to ignore little things.

Please read this article: Practicing Healthy Discipline

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