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Thanks to all of you who wrote your comments and emails of support over the past couple of weeks while I anxiously awaited our 2-year-old’s hernia surgery. He’s fine today; a little tender, walking around like an old man who put his back out. He’s covered in the dirty, gummy remnants of surgical tape, and has two (yes, TWO) inch-long diagonal scars in his groin. But he is fine. So while the memories are still fresh, here are some important things I learned yesterday:

Be Ready for Changes in the Surgery Schedule
Not easy for a control freak like me, but important to know. The schedule can be changed for any number of reasons, so plan accordingly. For us, T was found to need more extensive surgery, requiring more time (2 hours, as opposed to the 30 minutes we had expected). That meant the doctor had to shuffle his schedule, which affected our arrangements. Stay light on your feet, and keep your options open on the day of surgery. If at all possible, arrange to have both parents present AND a support person (like a grandma — Thanks Mom!) so you can juggle communication with the staff, care for your child, and other basics like parking, travel arrangements, and food.

Don’t Be a Hero
I’m a health-care professional, right? I grew up in a medical household; my Dad was a physician. The sight of blood doesn’t bother me, I have more than a passing familiarity with medical practices, and I’ve been roaming around hospitals since I was 3.

But yesterday, I was just “Mommy”. A shaky, scared Mom who was an idiot and asked to help carry her baby to the Operating Room, and assist with the baby until he was asleep. I thought that helping out as much as possible would be best for the baby. Big mistake! The sight of my baby struggling and screaming while he was being held down (by me) while the nitrous was administered — that’s an image I’ll never forget. And it certainly didn’t help T. Take my advice and don’t be a hero. Treat yourself with some TLC as much as you can. And let the professionals do their job. I don’t care if you’re in the profession yourself; on Surgery Day, we’re all Just Mom, or Just Dad.

Don’t Be an Idiot — EAT Something!
I assumed my stomach would be too upset with worry to eat anything, so by the time 11 am rolled around, I was shaky, dehydrated, and bitchy. Not too helpful (nor very appreciated by Mr. Dr. BabyShrink). If you’re used to caffeine in the morning, make sure you get some. And at least bring a banana and some trail mix to the hospital; I picked at it, and once T woke up, he devoured it (and the outpatient surgi-center usually doesn’t provide food afterward to the kids; you need to bring something for them, since they may very well get hungry afterwards). And since the surgery took so long, I actually did go to the cafeteria for 20 minutes. I forced myself to read the paper, have a snack, and NOT picture my baby being strapped down to the operating table. Even though part of me didn’t want to be farther away from the operating room, walking away from the surgi-center for a short break gave me some perspective and allowed me to decompress for a bit.

Thank You To The Doctors and Nurses
We are all incredibly indebted to the doctors, nurses, and other health-care professionals who take care of our kids; those like Dr. Sid Johnson and post-op nurses Jessica and Mike who were among those who took care of TT yesterday at Kapiolani Women’s and Children’s Hospital. These people have the stamina, dedication, courage and expertise to take care of difficult, challenging, and often very sad cases every day. But mostly they love kids, and it shows in the work that they do.

A Hernia Is Just a Hernia; Nothing More.
When TT was resting in the “wake-up room”, Jessica shared stories with us about some of the very sick children who come in and out of Kapiolani every day. It gave me some healthy perspective: To them, TT is a healthy, strong child who just needs a little patch-up work. The child on one side of T was a 9-year-old who has had leukemia for 3 1/2 years. On the other side was an 18-month-old who has had multiple surgeries from birth defects, and had reconstructive work done on her pelvis. She was put into a full-body cast. And although our little guy will be sore for awhile, in comparison, this was small potatoes. So while the day was grueling, and we hit some tricky spots, we’re home, and everyone is on the road to recovery. We’re extremely grateful for the health of our family; even more so, after our experience yesterday.

Today, my sister in North Carolina called. I could barely hear her, with her 12-month-old screaming in the background. “We’re trying to give her a bath, like usual. But all of a sudden, she HATES it. What happened?” She remembered me telling her about one of our kids at that age. “It’s as if there’s an electrical current in the water,” I had said. “Just putting his foot into it makes him shriek with terror and pain, and he pulls his foot up high, away from the water, until I take him out of the bathroom.”

Actually, we went through it will ALL of our kids. Each of them previously had loved their bath. Suddenly, it was Bathing Terror.

There must be a weird moon in the Baby Bath Constellation, because I’ve gotten this question quite a lot recently. BabyShrink reader Erik is a stay-at-home Dad to this little 16-month-old cutie, who previously enjoyed her bath. “All of a sudden,” he writes,”she seems to panic when we get her in the tub. We have measuring cups, bubbles, and all sorts of distractions. We’ve even tried to join her in the tub, but this seems to panic her even more.” Erik googled the problem, and found that, often, there is some traumatic experience before the panic starts (such as slipping and falling in the tub, or otherwise being frightened in the bath). But Erik assures me this has not occurred. So what can he do?

Sudden Bath Fears Are Common
There are major cognitive changes that take place, along with the development of walking. All of a sudden, your toddler can purposely move — away from you, and known safety, into strange and new situations. Discovery of a new thing leads to excitement — and then fear. This stage is characterized by the back-and-forth of moving out into the environment — just until it gets a little scary — and moving back to be with Dad or Mom to get “refueled” for future discovery. As my Parenting Guru Dr. Brazelton says, there is an upsurge in fears at this point, starting at about 12-18 months. The bath is a common fear. Think about it: your baby is just getting used to walking, and in the process, her sense of equilibrium and body control get messed up for awhile. She’s not quite sure what her body can — and can’t — handle.

Your Toddler’s Perspective on Bath Time
The bath is slippery. She thinks, “I can get soap in my eyes. I can bonk my little head on the side, or on the faucet. If I have a scrape or a cut, it hurts in the bath, and I can’t always figure out why, or how to tell Dad about it. Then there’s this weird wall between me and the outside, and I’m not allowed to just jump in and out if I get nervous. And when the water gets sucked down into the drain, I wonder, will I fit down that thing? Am I going to get sucked down there too?” She’s still figuring out cause and effect, and she’s not quite sure how that drain thing works. But it’s powerful, it makes noise, and it sucks all the water into it.

So Do I Have to Let Her Be Stinky Until the Next Developmental Phase Kicks In?
No. Well, maybe just a little. Pediatricians say that we Americans bathe our babies way too much anyway; it’s not necessarily good for young skin. So you can back off the nightly baths. Don’t feel temped to FORCE the issue; I promise, it will only make things worse. But of course, smashed banana needs to be cleaned out of hair, and dirt needs to be dislodged from various nooks and crannies. And I wouldn’t suggest giving in to the bathing fears, simply being a little more flexible about it than usual. Here are a few other suggestions:

Know that this IS a phase.
It’s not permanent. This is a temporary blip in your bathing routine. Eventually, your toddler will regain confidence and enjoyment in the bath.

For Now, Rely on the Kitchen Sink
At this age, they need to be wiped down after every meal and snack anyway, right? So keep a bottle of her bath soap in the kitchen and strip her down at the sink after meals. Clear the sink area of unsafe stuff. Then let her splash away — with you holding her firmly, of course — and wipe her down as you play with her there. And most kids still love to play with the hose or the kiddie pool, despite bath fears. So sneak in a little cleaning while she’s splashing around in the yard.

Keep Trying, But Don’t Force It, If You Can Avoid It
Every few days, make a big deal out of preparing a really fun bath. Use bubbles, add new toys, and be silly. Allow your toddler to play in the water from the outside of the tub, but don’t make her get in. Talk about what fun she will have, when she decides to get back in. You want her to have a good experience — at her pace — with the bath. Let her “help” you with bathing a sibling — sitting with you, outside the tub. Let her get in — and get out again — if she’s even slightly interested. Or let her walk away — it’s her choice, at this point. Make a big deal out of letting HER decide about the bath.

What If I Forced It Already?
Don’t feel guilty. Listen, when TT was going through this phase, he woke up one night, puking. There was no way around it — he had to have a bath. So I explained to my very miserable little guy that we had to have a bath, and I knew he was not going to like it, but that I would make it very, very fast. He screamed bloody murder the whole time. But he eventually got over his bathing fear in about the same amount of time as his older brother and sister did (about 3-4 months). The main thing is to convey your empathy about the situation. “I know you’re afraid of the bath, and I’m willing to do whatever I can to help you through this time. I know that one day you’ll like it again, but for now, we’ll take it at your pace.”

Erik: Let us know what happens. Readers: Got any other suggestions to add?

Aloha,

Dr. Heather
The BabyShrink

I love 2-year-olds. I really do. It’s amazing to see how much they have learned in their very short time on this planet — and some of that includes finding exactly what bugs their parents. I mean, think of the cognition involved in this process. First, they have to be able to understand the complexities of language. Then, they must remember key phrases that upset others. Then, they must be able to replicate those phrases at just the “right” moment, socially. All of this intricate ability is the reason that humans have such huge brains; the outer cortex is necessary in order for your 2-year-old to be able to insult you in public. In fact, when I evaluate a 2-year-old in my practice, I worry when I don’t see signs of oppositional behavior. It’s developmentally appropriate for him to be challenging things. Not exactly reassuring to parents, but I do try to point it out as a strong sign of healthy cognitive development.

But wait, you want GOOD MANNERS, too?? BabyShrink reader Carmen does. Here’s her question:

Dear Dr. Heather,

Carmen from Seattle

Dear Carmen,

One thing to remember is that your 2-year-old doesn’t really understand what he’s saying, but he’s loving the reaction he’s getting to it. So you want to change the reaction he gets, in order to shape his behavior.

Your little guy is picking up that kind of language from the sources you mention — older brother, daycare, Disney movies — and has seen that it makes a big impact when he talks that way. So you actually have a couple of ways to tackle the problem.

First and foremost, reward and praise nice talking. Make it a family rule that “nice talking” gets rewarded, praised and acknowledged. Include both kids in the plan. Make a big deal out of “catching” them speaking nicely. Make up a sticker chart or find another way of rewarding them, whenever they’re doing it.

Next, try to cut out the “negative talk” input he’s getting. Talk to his daycare provider about instituting the same kind of program at school; rewarding nice language. And cut out the movies and TV he’s watching with that kind of “negative talk”. I know it’s pervasive, but there really is a selection of better shows out there. (And just because it’s Disney doesn’t mean it’s automatically appropriate for every age. There are very few Disney movies that I show our kids yet.) Make a point of watching what the adults say around them, too.

And when you’re out and about, make a point about having nice manners – and that includes How We Talk. Give them a little speech ahead of time. “Now, when we are in the restaurant, we use our inside voices, and talk nicely. Anyone who “talks mean” has to sit outside with me. Who wants to talk nicely? Who wants to eat inside the restaurant? Who can get sticker points for sitting nicely and talking nicely at dinner?” Then you have to be prepared to set the example for them; if one of them goes off on a negative talk tangent, calmly lead him outside and remind him of the rule. “Only boys who talk nicely are allowed to eat in the restaurant. We can sit out here until you can talk nicely.”

It might take awhile for the kids to get the hang of it, but if all the adults are on the same page, it should work. Let us know!

Aloha,
Dr. Heather
The BabyShrink

And: Is your toddler a screamer? Check out my post on that topic here.