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September 2010

Into the Mouths of Babes

By Robin Goldstein, Ph.D.

Q: When will my child's desire to touch everything end?

A: Although it may seem like the touching phase will never end, you will see a gradual decrease in your child's need to explore everything in sight. By the time he's 3 or 4, he'll gain more understanding about objects, safety and impulse control and have less of a need to touch. Then you will be able to put back on your tables and shelves many of the things you had to keep out of reach. During this phase, remind yourself that touching and interacting with objects is the way babies, toddlers and young children learn about things in their world. They need to touch, grasp, reach, bang, put things together, take things apart and be allowed to feel stuff around them. When you say, "Stop touching everything," you interfere with your children's learning and development. The more children explore, the more they learn. Childproofing, being playful with your child's interests and supervising closely are ways of accommodating the normal developmental needs of a child under 3 or 4. Young children want to touch and try everything they are interested in, so if you prepare for this stage, you'll have an easier time getting through it.

Q: What should I do when my child touches things at other people's houses?

A: While you'll want to keep your child from handling some things at someone else's house, you might find that he is more cautious when he's away from home and that he does less exploring in other people's homes than you expected. When you visit others, keep a watchful eye on your child. He's probably too young to understand lessons that include, "We don't touch things that belong to others." Young children can't reason yet or anticipate what other people want from them. They can't think about the possibility that touching something at someone else's home may have negative consequences. If your child is at the stage of wanting and needing to touch things he's interested in, supervision and distraction is the most helpful thing you can do when you're at other people's homes. You may also need to do some temporary childproofing, especially if the host doesn't have young children. Ask if you can temporarily move fragile items. Most people will understand, particularly if you offer to put the objects back in place before you leave.

Q: My child puts everything in her mouth. What can I do?

A: Babies don't just put things in their mouths for pleasure or comfort; they also use their mouths for exploration. They learn about objects by tasting them, feeling their texture and experimenting with them. And biting, sucking and chewing on objects help relieve the pressure or pain of teething. Until your child is about 18 months to 2 years old, many things that she plays with will eventually go into her mouth. She'll pick up things from the floor, chew on her stroller safety strap and try to put your keys in her mouth.

Because your baby or toddler can't tell what's safe or unsafe, you have to be very watchful and pick up pieces of fuzz, crumbs and small toys so she won't accidentally choke on them. You also have to be sure that the objects she puts in her mouth are clean and safe. Inspect your home at your child's level so that you can identify unsafe objects she may be tempted to put in her mouth.

This developmental phase may seem long and tiresome to you, but if you start pulling safe objects out of your child's mouth or telling her, "Only food goes in your mouth," she'll get frustrated and you'll be depriving her of pleasure and a chance to explore the way babies and toddlers naturally are supposed to explore. Try instead to realize and accept the fact that she has to put objects in her mouth because that's a major way she learns about her environment. For young children, the world is a place to be tasted!

Q: When should I wean?

A: It's sometimes hard for parents to follow their young child's lead, especially when it comes to weaning. Often a child will nurse or use a bottle only as long as he needs to, but it can be hard to trust that a child will stop on his own. Parents sometimes try to hurry their child by taking away the bottle, breast or pacifier before he is ready.

There's a lot of pressure on parents to wean their child. The pressure can be strong when a child reaches one year old and will increase as he grows. Friends and relatives ask, "What's he doing with a bottle? Can't he drink from a cup yet?" The pediatrician may say, "He doesn't need to nurse or use a bottle anymore." Others may comment, "He's too big for a pacifier." Negative remarks are directed not just at a child, but also at the parents. "What's wrong with you? Why are you still nursing?" "Why don't you take his bottle away?" "He doesn't need a sippy cup anymore." "If you don't take the pacifier away now, he'll never give it up."

Parents feel especially self-conscious when judged by other parents. If parents of a 2-year-old believe theirs is the only child on the playground who still drinks from a bottle, they'll wonder how it looks to other people and what other parents are thinking. They may doubt their own judgment and wonder what they've done wrong or what's wrong with their child. "Do I baby him too much? Do we give in to him?"

If the bottle, breast or pacifier is taken away from your child too soon, he'll probably look for other ways to satisfy his sucking needs. He might become irritable or start sucking his blanket. One mother, who threw out her 15-month-old's bottles on the advice of her pediatrician, said, "My son seems okay, but he started sucking his thumb." Some breastfed babies who are weaned at 12 months may not yet be ready to give up sucking. If they're only offered a sippy cup, they may suck the top of the cup just as they would suck on a nipple, showing they still have a need to suck. Using a sippy cup may just seem more grown-up.

If you feel the need to hurry the weaning process, do it carefully. The process should be stretched over several weeks, slowing down when and how often you nurse. Give a bottle or the pacifier so your child is not forced to abruptly give up something important. And remember that many toddlers and preschool children become weaned during the day but relax before going to sleep with a bottle, sippy cup or pacifier.

As your child gives up the bottle or breast, you may have ambivalent feelings. If you nursed, you may feel good about having your body to yourself again or you may be glad to stop dealing with bottles. But you also may feel sad to give up the warm, close feeling you had as you held your child and offered him milk or watched him lie contentedly with his bottle. You also may miss the free time you had when he drank quietly by himself. Whatever your feelings--impatience or reluctance--in time your child will be weaned.

There is truly no specific age at which a young child should be weaned. Even if you read parenting blogs, there is a range of ages when children are weaned. It is often more helpful to think about whether your child is ready, instead of going by his age.

Adapted with permission from The New Baby Answer Book: From Birth to Kindergarten, Answers to the Top 150 Questions About Raising a Young Child, by Robin Goldstein, Ph.D., with Janet Gallant. Sourcebooks, Inc., Naperville, Ill., 2009.

Advice From a Pediatrician

By Christi Hay, M.D., MPH

For most children, the pediatrician will recommend that the parents transition to whole milk from either breastmilk or infant formulas at 12 months of age.

The transition to whole milk can be achieved in several ways. Mothers who are exclusively breastfeeding can offer whole milk in a cup or bottle. These infants are accustomed to having warm milk from the breast, so mothers may have better results initially if the whole milk is warmed as well. If the breastfed infant has not been introduced to water, 12 months is also a good time to introduce this as well.

Mothers who are expressing breastmilk and feeding in a bottle can transition to whole milk the same way as formula-fed infants. I usually recommend that the transition to whole milk for formula-fed infants start with half formula and half whole milk for two to three days, and then three-quarters whole milk and one-quarter formula for two to three days, and finally, a bottle of 100 percent whole milk.

As with any new food introduction, parents should watch their children for a rash or breathing problems as they transition to whole milk. Although I recommend a gradual increase in whole milk for bottle-fed infants, I have plenty of mothers who offer a whole milk cup or bottle to their 12-month-olds without any problems, similar to exclusively breastfed infants.

The transition to whole milk is a monumental step for mothers and infants as they graduate from infant nutrition to toddler nutrition.

Christi Hay is a general pediatrician with the Pediatric Village in Washington, D.C.