Q&A: helping a toddler understand that Mommy is sick

Sevin writes:

"I have a spirited 21 month old daughter. I work during the day and she has a wonderful babysitter whom she adores. In the mornings, I used to get up with her at 7-7:30 feed her her breakfast, play with her until the babysitter came and then leave for work. She would wave me bye bye and go back to playing. At night, we always had the same routine. I prepared dinner while my husband played with her and then while he cleared up the dishes I gave her a bath. We would both read her stories and say goodnight and tuck her into bed, turn off the light and she would go to sleep on her own (most nights, some nights she wanted some company in the room while she fell asleep).

Well, about 5 weeks ago, I found out I am pregnant with our second baby. A few days after I found out, I was hit with the first trimester fatigue, but also with nausea like I have never known before. I was diagnosed with hyperemesis gravidarum; I could not even keep water down, I lost 8 lbs in 3 weeks and needless to say, I became very incapacitated. So the above routine was disrupted, she still had a similar routine, but my husband had to do it all. I am now on nausea medication that takes the edge off, so I can function a little, but I feel sick quite often still and I just have 5% of the energy I used to have. To top it all off, I was put on bedrest for a threatened miscarriage and I am not allowed to pick her or anything heavy up.  So over the last 5 weeks, I have been spending a lot less time with her, appearing and disappearing from the family room (usually to rush to the bathroom), unable to play certain games with her and unable to pick her up. Her bedtime routine has gotten longer, because my husband has to do everything himself, rather than the parallel fashion we accomplished these tasks. So she ends up going to bed an hour later and having trouble falling asleep on her own and calling for me. When she sees me, she is extremely clingy and does not want her father or the babysitter to even touch her. She has huge fits when I leave the house or even the room. My husband is convinced it's terrible two tantrums and we should ignore her and let it blow over, but my instinct tells me that she is scared of the fact that she does not see me much, is anxious about me not being around, knows something is different but cannot comprehend or express her fears and hence has "anxiety tantrums" rather than the "manipulative 2-year old tantrums". I am trying to be more comforting and lenient during these times, but my husband says I am simply spoiling her.

What is your take on the situation? Any advice to survive this pregnancy without causing her huge anxiety? What can I do to help her ?  How do sick parents with small kids deal with situations like this?"

Congratulations on your pregnancy.

It seems pretty clear to me that she's upset and anxious because you're sick and she doesn't have as much access to you as she used to. She's probably scared and worried and can't express it except by clinging to you and throwing tantrums. Add that to the fact that she's two, and there's no way she can be calm about it.

The good thing about 2-year-olds is that they have great receptive language. Even if she can't tell you how she feels, she can understand a whole lot. So I'd start by talking to her about how you're feeling very sick right now and can't spend as much time with her and can't put her to bed, but you'll feel better in a few weeks.

You could even describe exactly how you feel, so it's not mysterious. Pretend to throw up, and let her pretend with you if she wants to. Laugh about it and make it seem not as scary. She needs to know that you can't pick her up and do all the things you used to, but not be afraid that there's something so wrong that you'll never get better. Try to give her as much time as you can, even if it's just snuggling together on the couch or in bed.

And ask her specifically to help Daddy get her to bed on time. You may have to cut out a bunch of steps and order in food and skip some baths. It's important to stick to her normal sleep schedule, because being sleep deprived by even an hour can make her mood and behavior lots worse. This is a temporary crisis, so go on lockdown and only do what's necessary. It might also help if you put a chair in her room and sat in it while she went to sleep. This wouldn't be too much physical activity for you, and it would help her feel like you were really there for her when she was trying to go to sleep and scared that you wouldn't be there when she woke up.

I would definitely not connect your feeling bad with the new baby (you don't want her to blame the baby for hurting you). And I wouldn't ignore her tantrums. She's asking you for reassurance the only way she knows how. It's clumsy and counterproductive, but it's all she's got. You may end up with a shadow until you start to feel better and can resume taking care of her more, so if you just have to hole up on the couch hugging her for half an hour every day, that will help her better than anything else you can do.

Make sure she understands that you are going to get better, and that it's not her fault. You'll all get through this together. Encourage your husband to take some breaks for himself. He's got to be stretched emotionally and physically from all of this, too. Poor guy. (And have you tried acupuncture and/or vitamin therapy for the hyperemesis?)

Comments

[Kate]

Not exactly the same situation, but I gave birth to my second (3 day labor that ended in a C-section) when my first was 22 months. We were camped out at my in-laws, who were her caregivers while we were at the hospital; dh went back and forth, but I was in from Thursday to Monday. We spent a few more days with my in-laws (where she was sleeping well and generally behaving normally) and she was fine, but once we decamped to home she was up 2-3 times a night, screaming for me. So I definitely think this could be anxiety. (We moved her toddler bed back to our room, and things got better over 2-3 weeks.)

I think with a kid this age, you just have to repeat over and over (in simple language) that mommy doesn't feel well, but she can do "x" (read books on the couch, watch you build with legos, watch a video etc.) We had to tell our daughter for weeks that mommy has a boo-boo and couldn't pick her up, but she eventually "got it." Even now--I've recovered enough to lift her--when I tell her I need to change her diaper, she lies down on the floor.

If you don't object to videos, PBS Kids, etc., I'd definitely say use it when you are feeling crappy. And as far as the routine goes, Moxie had good suggestions; unless she's really dirty/food in hair/etc, a bath every other day won't hurt.

Do you have relatives that can pitch in? Or a "mother's helper" you can hire for an hour or two at a time?

[Kay]

Oooh - something I know about. I got pregnant for my 2nd when my son was 2 (the kids are 3 years and 1 month apart). I had the bad hyperemesis from when I was 5 weeks - and had to be on Zofran to even stand up. I can't tell you how many times Jake would come in and say "Mommy - are you frowing up again?" Kids really DO understand sick. What I would do was have him "take care" of me - that way - he still got to see me and I was not forced to overstress my body. I would lay on the couch or in my bed - and have him tuck *me* into bed - instead of the other way around. I also took my bath with him - so we could spend that time together, but I was sitting in the tub and could hand him out to my husband, who dressed him and put him to bed.

The key is to explain to the child that Mommy just doesn't feel well, and that she loves you very much. Have Daddy and the babysitter repeat that constantly. The tension should ease up.

Good luck - it's not easy - and is actually the main reason I don't want to try for a 3rd. I could deal with the misery - but it's really tough to watch the kids have to see it.

[lolismum]

Hello Moxie and all the commenters,

Thank you so much for replying to my message. I think the suggestion of explaining my illness to her over and over again is great. I will start doing that right away. I am also glad to see that you also think it's the anxiety caused by my illness that's leading to the tantrums. The nausea is still quite bad, (and no, I have not tried acupuncture, but I did try vitamin B6 therapy, which did not help unfortunately), the only thing that does help is Zofran. I am able to keep some food down with Zofran. The tantrums have become worse in the last week, though. She now ends up screaming for 1/2 hr before going to bed, even if I sit in the room with her and she wakes up very early, not well rested and cranky.

[lolismum]

By the way, I posted as "lolismum", but it's me Sevin.

[liz]

One thing that worked for me one time when I'd hurt myself and couldn't really take care of Muffin Man was to put a spare mattress on the floor of his room and sleep there (he actually ended up sleeping with me on that mattress, occasionally). He felt like I was still really there for him, but I didn't have to lift him or strain in anyway. And we were still in his room (with light-blocking curtains) so he slept like normal.

[Kate]

I wasn't nearly as sick as you, but I well remember the nausea and fatigue while parenting a 2yo. I agree that explaining that you're feeling sick can do a lot.

I used to keep saltines by my bed, so I could get up in the morning without throwing up, and Mr. Baby would come into bed with me and we'd munch on them together. Crumbs in the bed, yeah, but at least he wasn't clamoring for me to come downstairs and play.

One time in the grocery store, I felt so awful that I asked Mr. Baby to say, '"Feel better, Mama." He did, and I swear I made it through the store without falling to the floor and throwing up by having a 2yo repeatedly tell me to "feel better."

P.S, Moxie, I just wanted to say that I found my way here via a link at Parent Hacks, and I am so impressed with the quality of your advice!

[posthipchick]

Not completely on-topic, but:

I don't know about the side effects of Zofran, but having just recovered from nine full months of hyperemesis, may I recommend Anzemet as an alternative? Less side effects and excellent results.

[Teresa Mattimore]

Congrats on baby #2! I was moved by your words because while I didn't have the exact same issues as you, when I was expecting baby #2 - I was SO sick, and had little to no energy & that is exactly the time when I turned over my half of routine to hubman - I felt so badly for everyone but couldn't deny how cruddy I felt either or what my needs were to get through that trimester.
My daughters were 22 months apart - and I was explaining a lot to her - still am now that she is 3 and dd #2 is almost 17mos.
It's always good to follow your instincts - which you wrote they told you her tantrums were different - that's great! ALL of Moxie's advice is awesome - so you can't go wrong there - and don't beat yourself up either ok? I had to look at it this way - both Moms and Dads bring different things to the job of parenting and caregiving - and even though she was very clingy w/me I reminded myself that she needs BOTH of us caring for her in all situations/times...becuase sometimes it just has to be that way...and I want her to learn to be flexible and know that she is loved no matter WHO is tucking her in or giving her a bath...now that we have 2 we are still dividing the routines, and trading off here and there to keep it fresh w/ the girls so they don't get too dependant on just one of us for one thing or the other...sorry to ramble on so - I am just trying to say to hang in there, it WILL get better and it will ALL work together for the better of your family energy and teamwork! Take care of yourselves and DO look into Accupuncture - I had a friend w/this issue and it worked wonders for her! Good Luck!

[Anne]

Late to the post, but if you haven't been there, get thee hence to the Forums on the HelpHER site www.helpher.org. There is an excellent group of women there supporting eachother through hyperemesis, and the challenges of HG with taking care of toddlers. I've only had one HG pregnancy, but there are brave souls there who knowingly chose to have HG while caring for toddlers. I thought they were crazy when I first stumbled upon this group! But it is workable, and you may, for example, find that combining Zofran with another drug (Phernergan, Meclizine, Ambien) might help make you less nauseated. And lots of tips for setting yourself and toddler up in a room with all their toys etc so you can rest while spending time with them.