Ask Moxie

Q&A: late talker?

Suzanne writes:

"We had my daughter's 9 month check-up yesterday (a few days shy of her 9 month birthday) and the pediatrician said he isn't overly concerned about but that we should keep an eye on my daughter's babbling, or lack thereof.  She is on track developmentally with all other milestones but really doesn't babble at all.  She engages with my husband and me as well as others, smiles when smiled at, imitates certain actions like clapping or blowing raspberries, is very interested in activity - notices when someone leaves or enters the room, watches and is amused by the dog, and at our playgroups she seems interested in other babies.  Her hearing also appears to be completely normal, she passed her screening at birth and has not had any ear infections and responds to sounds.  So my gut tells me that if there is anything amiss it is probably specifically speech related and not something broader (autism spectrum).

I don't work and she is my only child so I thought maybe she's just not hearing as much language as babies her age with siblings or in daycare.  While I do talk to her a lot (narrating activity) and read and sing to her, you can't talk every minute of the day!  And the thing is, my husband is somewhat of an introvert and not much of a talker so maybe there's a genetic component?

I was hoping some of your readers may have experience with a late talker that sounds similar to mine."

I sometimes think we know way too much. I can't, in my wildest dreams, imagine classifying a 9-month-old who doesn't babble a "late talker." I'm sticking with the standard "20 words by 20 months" rule that's applied for years and years. (And by "words" they mean a noises that consistently means the same thing, like barking when they see a dog, or making fire engine noises, or saying a special word to mean something.)

What I've always been told, and what I saw playing out in rather dramatic fashion as the kids in our playgroup turned 2 and then 3, was that receptive language is the key. If kids understand and respond, then they'll be fine with language even if it takes them longer to get there and they need a little help. My older son was an extremely early talker, as was one of the other girls in the group. There was another boy and another girl who were hardly talking when they were 2, but understood everything and could follow directions (as much as any toddler does).

The girl was hitting all her other milestones, but barely said more than 5 words by the time she was 3. By the time she was 4, there was no difference in her speech and no one would have known who was the late talker. It just took her longer to get there for some reason.

The boy was also not walking by the time he was 20 months, so his parents got an early intervention assessment and it turned out he had some low muscle tone. They started working with a physical therapist and a speech therapist. It turns out that for some kids, movement and speech is linked. Once he started walking, it was as if someone just flicked a switch and he went from 5-10 words to 400 over the course of two weeks. It had all been stored up there in his brain, but he just wasn't able to get it out until the walking fell into place. They worked with a speech therapist for about 6 months to help with the low muscle tone in his jaw (which caused some enunciation problems), and by the time he was 4 you'd have had no idea he was late at either walking or talking.

I know these aren't expert assessments of what's going on with your daughter. They're stories meant to show that all kids are different, and some kids do some things earlier and some later. The mom of the girl never felt like there was anything wrong. The mom of the boy felt like there was something wrong, and it turned out she was right. I think that you should pay attention to your own feelings, your "mom spidey sense," and follow that. If you think there's something up, then look for help, even if your doctor brushes you off. But if she's on target and is responsive and happy, then she may just skip the babbling phase, or do it late.

Anyone want to share stories either of "late talkers," or of trusting your instincts and how that went?

They say it's my birthday

Happy Birthday to me! (And to Johnny Cash.)

Would you like to give me a present? Please post a link (the comments should do it automatically if you just cut and paste from the browser URL window) to something funny.

Thanks for sharing my birthday. Here's my present to you:

http://www.youtube.com/watch?v=uE1SgU1l46A

Please note the hair, glasses, and beard, as well as the dancing, especially at 1:14.

Q&A: "baby led weaning" for a formula-fed baby

Suzie writes:

"At our 4 month doctor visit the other day, the pediatrician brought up the idea of already starting to feed the little Pumpkin solids (rice cereal, purees, etc.), and my internal thinking was, "OK, whatever, I'm waiting for the girl to want to eat before offering her anything to much on." But the ped did leave me wondering: when you start your baby on "real" foods, do you offer only one thing at a time (a la "wait 2 weeks before adding anything new") or just go whole hog and offer a little bit of everything? How do you handle the potential for allergies?

Also, I know the whole premise of BLW is breastfeeding; but that doesn't mean I shouldn't give it a go with my formula-fed baby once she shows interest in what hubby and I are eating, right?"

First of all, BLW (baby led weaning) is explained by researcher Gil Rapley on this page, which now has a photo of a woman nursing about halfway down, with exposed nipple. (I'm not sure why that's necessary. And if anyone knows who makes that sexy nursing bra, please post in the comments.) If you don't want to or can't look at that page, just read the quick and dirty on Wikipedia (taking it the same way you take everything you read on Wikipedia). If you don't want to do that, the basics of BLW are:

Kids will eat solids when they're ready to, and if they aren't ready yet they won't swallow. They tested a bunch of babies and found that in general they were interested in tasting food at around 4 months but wouldn't really swallow until 6 months. Kids have more control over big chunks of food they can hold onto and shove in themselves instead of purees that are shoved to the backs of their mouths that they can't control. So in general they develop the smal muscle coordination to pick up small pieces about the time they can safely eat them. Keep giving them breastmilk or formula until at least a year, and they'll just transition to solid foods gradually and naturally. The End.

Anyway, the trend in the US is to offer only one thing (and people usually start with the totally disgusting rice cereal, which by now everyone knows I hate and think people should skip and go straight to bananas or avocado or something orange instead) for a few days because then you'll know if the baby is allergic to it before you move on to something else.

The problem is that I don't think that there's been any research about whether that has any effect on allergy rates or discovery of allergies, or if it's just something people came up with because it's logical. I don't think there's any harm in doing one thing every few days, but I also don't know if it's necessary. I'd like to see if there are any differences in allergy rates or allergic reaction rates in groups that separate and groups that don't.

I also think that parents know a whole lot about what our kids may be or probably aren't allergic to before we get to the solids phase. You know if they have problems with dairy or soy if you're using formula, and perhaps if you're nursing (anyone who's had to eliminate that sweet, sweet ice cream because of a baby's dairy intolerance is cringing right now). If your baby is your biological child you also know some family history of allergies, and you may have this info if your kid is adopted. Lots of food allergies seem to be connected to skin rashes and other external things you alreayd know about. So definitely take all of this into account, and if your child tends to have allergies to one thing, be cautious about introducing too many new things that tend to be allergens.

And, yeah, of course you can do BLW if you're formula-feeding. She's a human baby, after all, so all the stuff about food size and choking and her learning process (which BLW is about, as much or more than it's about actual nutrition) is the same for her and you as it is for the kid on that site whose mom is wearing that black lace nursing bra. Formula should be her primary source of nutrition for at least the first year, and she'll tell you when she's ready to eat other stuff.

Just beware of veggie burgers, because garlic poop is indescribable.

Turning

I'm sorry I'm not doing all the standard potty training and sleep questions this week. I think George's death, some of my kids' recent accomplishments, and my impending birthday are making me think a lot about who I am, where I am in my life, and where I'm going.

I'm turning 35 at the end of the month, and feel like in a lot of ways I'm starting a completely new phase. When I think about how much more I know about myself, my place in the world, and my potential than I did even two years ago, I'm astounded.

So I'm setting some goals and some wishes for myself for the next year:

* I took a Brazilian Portuguese class last summer, and got the basics, but need to start ramping up. I'm going to make an effort to spend at least a hour a week on Portuguese.

* I've just started taking a martial arts class (for the first time in my life) and am feeling completely out of my depth. I will remember that that feeling means growth is about to happen, and will press through.

* Streamline my Ask Moxie process so I can do some of the extra projects I want to do for you guys, actually answer all the emails I get (which I'm nowhere near right now), and maintain a more consistent posting schedule.

* Onward and upward with managing the process for getting everyone ready and out the door every morning.

* Spiritual development: Stop and listen, and move when asked to.

This list is personal, and I haven't talked about relationships with anyone else or my work life or any of that on purpose, because I think so much energy goes into those things that the personal side often gets shorted. Maybe part of my aging process is realizing that I'm worth my own time and energy, too.

Does anyone else want to play along?

Q&A; Rolling over in sleep...ACK!

I love it when readers answer their own questions. Nancy writes:

"File this under "don't brag about how your baby sleeps 11-12 hour per night" as it will come back to haunt you!  We sleep trained our 6 month old son with excellent results about 6 weeks ago and have had mostly amazing sleep-filled nights ever since (with the exception of a couple of teething incidents).  Last night at 1 am, he decided to roll over for the first time in his crib.  As he found himself on his belly, he immediately started screaming.  My husband flipped him over and was able to quickly get him back to sleep only to have him do the same thing again about an hour later.  This waking was much more involved and required about two hours of rocking, feeding, shushing to get him back to sleep.  He has very strong legs but his arms haven't quite caught up yet, and rolling over has been a pipe dream of his for the last month or so.  Any ideas about how to help him get through this? Is the prescription just lots of tummy time so he can master this milestone during the day?"

You've got it. He's more wakeful in general because he's working on the rolling over, and the only way around rolling over is through it.

There's no way to force a kid to get through physical milestones (hearing stories about someone "teaching" their kid to walk always makes me laugh), but the more a child can work on the skills the sooner s/he'll get good at them. So tummy time is exactly the prescription to end your nighttime wakeups.

Once he can roll over easily on his own, he'll stop waking himself up by rolling, and he'll also stop being up and cranky and needing to be soothed so much, because that part of his brain will be able to relax again.

You'll probably have to sleep train him all over again after this is over (the dirty little secret of sleep training), but depending on how old he is when he gets through this, you might be in the middle of the 8-9-month sleep regression. Which is one of the worst times to try to change your child's sleep, and will make you really frustrated. So I'm hoping he comes through it more quickly and you can get on a more even keel first, but if you end up with this movement leap transitioning into the developmental stuff of 8-9 months, just know that it won't last forever, and he will sleep all night again eventually.

Oh, and here's a good point to mention that although we're all told to make sure our kids sleep on their backs, once they can roll onto their stomachs we can let them keep sleeping that way (if they will).

Comments on rolling? Milestones? The upcoming weekend? Which of the new toys are still in favor and which ones have already been ignored?

Q&A: toddler understanding "no"

Dawn writes:

"At what point does a child understand 'No'?  My 13 month old son is very very active, a climber and so curious that he gets himself into places and things he really shouldn’t. I try the calm 'no', I try a louder 'no', I distract him, take him away from the object - (the tv, the phone, the dog dish) but he beelines right back to it. Over and over and over. It's really funny sometimes but we try not to let him see us laugh of course! Eventually he gets frustrated and starts to grizzle. I don’t give in but am I expecting too much to think he does understand the meaning when I say no?  He does sometimes seem to get it, and will stop or move off to other activities. I know he is not being 'bad' because he has no malicious intent but is just into everything. He seems to understand other things, like go get the ball, or do you want a cookie ;-)  Advice?"

Good question, Dawn. Actually, a few good questions:

• At what age do most/many (certainly not all) kids understand that when you say "no" you want them not to do something?
• At what age do kids care that when you say "no" you want them not to do something?  
• At what age is it reasonable to expect kids to comply with your requests for them not to do something?
• What are some ways that are as effective or more effective (depending on the age) to get kids to stop doing something?  

Feel free to give your own answers to these questions, or other related ones you come up with, in the comments section.

I think that a 13-month-old certainly understands that "no" is something you say when you're excited. It's the sign that the child has gotten a reaction from you. I'm not sure that at that age the child actually understands that "no" means you want them to stop doing something. (If you use pain to punish your kids, then yes, they will stop doing things when they hear the word "no" but only because they associate that word with pain and they want to avoid the pain, not because they actually understand the meaning of the word "no.") In fact, I think sometimes they take "no" as encouragement because it elicits such a funny (to them) reaction from you.

It seems to me, based on my observation of my two kids, that the real understanding that "no" means you want them not to do something kicks in some time between 18 months and two years. Or so. However, that still doesn't mean that they'll actually stop when you say "no." It totally depends on the kid. My 5-year-old still sometimes seems unable to stop when I say "no," and needs me to put my hands on his to move them away, or walk him away from the temptation, or replace the sharp stick with a bagel, or whatever. My 2-year-old sometimes stops, but sometimes looks at me like, "Ha ha, Mama! I know you want me to stop, but I am not going to!" So from my n of 2, I'll say that understanding the meaning of "no" is necessary but not sufficient.

I started writing this answer a few days ago, then asked Co-worker S, who has a 5-year-old and an almost-2-year-old, what he thought. He agreed that the ability to really understand "no" happened after 18 months but closer to 2 years. He also agreed that understanding "no" and complying with it are two very different things. "Sometimes it's just not in their best interest to stop what they're doing," he observed. It's funny because it's true.

So I'd say that "no" may be understood by 2, but not necessarily complied with until later on. Some time between 2 and 60, I'd say. (Although my dad still doesn't do everything my grandmother wants him to do, so maybe it's even later than 60.)

Now, on to the reasonable question. I think it depends on what it is that you want them to comply with and your general attitude about obedience and self-discipline and discipline in general. If it's something really serious, like not sticking a fork in an outlet or running into the street, you need to be more serious about enforcing your rules.

As with the rest of life, follow-through is everything. You can say "no" all you want, but unless you actually engage with your kids, you aren't teaching them anything about appropriate behavior and how to use self-control. I know a dad who used to ignore his 5-year-old, so the child would escalate and escalate and escalate his bad behavior as the dad just said, "Stop!" Finally, the dad would explode in a ball of rage and overreact to whatever it was the kid was doing and dole out severe punishments that always left the kid crying. It could all have been avoided if the dad had just engaged with the kid from the very beginning and stepped in to stop things before both of them got out of control.

If you're reading this and wondering what I mean by engaging as a way to stop bad behavior, click over immediately to buy Haim Ginott's masterpiece Between Parent and Child. It breaks down how to focus attention in a way that makes you partners with your kids in helping them learn to resolve situations for themselves, instead of engaging in a control game that leaves you both worn out, angry, and hopeless. Other books that people absolutely rave about (not surprising, since both are based on Ginott's work) are Faber and Mazlish's How To Talk So Kids Will Listen and Listen So Kids Will Talk and Lawrence J. Cohen's Playful Parenting. I think both these books are wonderful and I learned new things from both of them, but if you only have time for one, go with the Ginott.

But back to Dawn's 13-month-old. At that age "no" is tricky, because it doesn't really connect with them yet. Instead, you're probably better off telling the child what you want him to do, instead of what you want him not to do. It's human nature to focus on what someone says, even if they're trying to tell you the opposite. If someone said to you, "You don't look fat in those pants," it would be a compliment, but you'd start to wonder if you usually looked fat in pants and it would probably end up making you feel bad. In contrast, if someone said, "You look really slim in those pants" you'd just think about how great you looked.

Toddlers (and people older than toddlers) respond the same way. Instead of saying "no" when your child tries to stick a fork in the outlet, try "Put the fork on the table." That gives the child something to do and provides a distraction. Instead of "Don't hit the dog," try "Clap your hands together and jump up and down."

You may be thinking that you want to teach your child appropriate behavior, and if you don't tell them what not to do they won't know what's wrong. But a toddler has no impulse control anyway, so even if they know something's wrong they can't actually stop themselves from doing it yet. It's more developmentally appropriate (and gives them a greater chance of success) to tell them what you want them to do and helping them do it.

I was going to get into Hedra's "safe, respectful, and kind" idea now, but this post is already too long. So please do two things: 1) Go read the safe, respectful, and kind post and be ready to comment on how it's going in your family when I open that topic up next week, and 2) Tell us about when you feel your kids were really able to exercise self-control, and what worked best to help them guide their own behavior.

Q&A: baby not sitting up yet

Susan writes:

"I have a baby who will be 6 months old in two weeks and I can't help worrying about his development.  He was very big and strong from birth (holding his head up and putting weight on his legs within weeks of his birth). We do some tummy time every day but it seems he isn't making much progress towards sitting or crawling.  He still completely topples over when he is in a sitting position (I mean completely - he does not sit unsupported even for a couple seconds) and he rarely rolls stomach to back (though he easily rolls back to stomach). Should I be worried? Aren't almost all babies sitting unsupported by 6 months?"

These milestones are a pain in my butt.

Because, yeah, it is helpful to know what's supposed to be happening when in a general sense so you can have realistic expectations (I remember thinking that a one-year-old could probably speak in complete sentences back before I had one of my own), but at the same time kids are so varied and variable that you can really make yourself worry over things that don't mean anything.

Remember, I'm not an expert (sooooo not an expert), but this is what I've gathered from parents of kids with serious problems, not-so-serious problems, and no real problems: The first thing to notice is how your child interacts with you. Is your child alert and mostly happy (unless they're going through a cranky phase)? Will /she make eye contact with you? Does your child smile/laugh? Is your child interested in things? If all these are true, then things are probably going to either be nothing, work themselves out, or be managed in a doable manner. If these things are not true, then please ask your pediatrician for a referral to get your child evaluated, because the sooner you can get information the better off you'll all be.

Now, to specifically address Susan's concerns: The rumor that almost all babies are sitting unsupported by 6 months has been greatly exaggerated. Some are, but a whole bunch aren't. Lots of times kids go from just lying there like pitiful, frustrated little lumps one day to crawling like speed demons and sitting the next. Sometimes they sit first. Neither of mine sat unsupported until several weeks after they started crawling (maybe I'm a bad person, but I thought the slow list to the side and then the topple was consistently funny). Some kids crawl for half a day and then start running. As long as the child is given plenty of tummy time and not confined in a saucer for too much time at a stretch*, they'll develop the way they're supposed to, which may not be on the Official Schedule.

I think that if he's alert and responsive and grabs for things and flaps his arms and legs and all that stuff, he's one of those kids who will crawl at 8 months (yay!) instead of 5 months (quick--babyproof everything in one day!).

Now, as a public service, we will all share how old our kids were when they crawled, sat up unsupported (if you even remember), and walked. Please state gender and if they had any special circumstances. I'll go first: My first boy was born big (9.5 pounds) and crawled at 9 months, sat a few weeks later, and walked at 14.5 months. He is a supergenius. My second boy was born smaller (8.5 pounds), and crawled at 8.5 months, sat shortly after, and walked at 14 months. He is also a supergenius. Both of them run just fine.

(I'm going to go out on a limb and predict that someone will say that her kid crawled at 5 months, and someone else will say that her kid crawled at 11 months, and if we put them next to each other at 3 years you wouldn't be able to tell the difference.)

* I've heard from a couple of sources that the benchmark for saucer time is supposed to be something like 20-30 minutes 2-3 times a day. Which is about as much time as it takes you to shower, and then get a decent start on a meal later on. Or eat an entire dark chocolate bar slowly while reading Entertainment Weekly. If you're saucer-addicted and want to try some options that give more freedom of movement, check out the article on 10 ways to make tummy time more fun from SparkPlugDance.org.

Q&A: something wrong with 5-month-old?

Sarah writes:

"I would really appreciate your view.  I worry there is something wrong with my baby, or else he is just inexplicably unhappy.  He is 5 months old and only happy if he is in his Baby Bjorn on a walk, or watching Baby Einstein videos.  He can do any of the following -- look at his mobile, lie on his playmat, sit on my lap, or practice tummy time -- for about FIVE minutes before he starts to whine.  He whines in his bouncy chair.  He whines in his high chair.  He whines sitting on anyone's lap.  He nurses well, sometimes enjoys a little cereal or banana, and, thank goodness, sleeps extremely well (both naps and through the night).  Is it normal that he seems so bored and/or grumpy all the time?  He smiles, but doesn't laugh often.  Do you think there is something wrong with him?"

Normal, and normal.

He's at that age at which he's figured out that there's all sorts of stuff to do in the world, and he can't do any of it. Let's face it--mobiles and playmats are really only so much fun (almost exactly five minutes of fun, truthfully) but then he needs to be where the action is. He's a man on the town, a guy with places to go. Only he can't move around to get at any of that action himself. So it makes him pissed off and whiny.

He zones out with Baby Einstein because everyone zones out when they watch TV (which is why JetBlue flights are always so pleasant--everyone's anesthetized with the TV so they don't harass the flight attendants). And he's happy when he's up in the Bjorn with you because then he's up! where the cool people are! and he can see things! and he's moving! But then you want to get something done so you put him on the playmat and that makes him cranky.

Eventually this will pass, because eventually he will be able to crawl, and then walk, and then run, and then drive, and he'll be in charge of his own motion. But for now, the more you can keep him up and in motion the happier he'll be. The Bjorn is probably killing your back by now, so I'd just bite the bullet and spend the money on an Ergo or wrap. You can put him on your back that way and he'll be happy while you just go about your normal day. The motion all helps the neural connections form in his brain. When you put him down, put him on his tummy, because the more time he spends on his tummy the more practice he gets with the building blocks of crawling, but don't expect that he'll like it.

Other options are to borrow a big dog and/or a 5-year-old to entertain him in this premobile phase. But that might end up being more work than you want.

Any reminiscences or ideas?

Q&A: baby too distracted to eat

Sarika writes:

"My 5.5 month old baby boy is very naughty. It is very difficult to bottle feed him when he is awaken.

He started playing with bottle or me or the things nearby.So, most of the time we offer feed to him when he is in sleep.

Even he takes very less quantity of formula hardly 2-2.5 ounce in the interwal of 3to4 hours.

I am a working lady and always worried about his diet.

Recently, I have heard that it is not good to feed baby in sleep. Please suggest.

His weight is 6 k.g. Otherwise he is active and normal. We haven't started solids yet."

Oh, no! Your baby is NOT naughty. No baby that young is bad or naughty or doing anything wrong at all. He's just doing what he's supposed to be doing developmentally at that age. Yes, it's a huge pain for you, but there's nothing wrong with him.

This is actually really, really common, and I'm betting everyone's reading this and thinking about how frustrating that stage was. You finally feel like you're getting the hang of the eating thing, and suddenly the baby just won't do it because the world is just too! exciting! It can make you feel enraged with frustration and scared that you're doing something very wrong that's making him not eat like he was.

The solution is, of course, to try to stuff enough food into him in a dark room with no stimulation, or at night. Yes, this is extra trouble for you. Yes, you're going to lose a little sleep. But the good news is that in a few months it'll flip back around and your baby will be eating during the day again. There are no adults who are so distracted by the world that they don't eat during daylight, so your son will get there, too. The tough task is to maintain your sanity until he stops his nocturnal feasting.

As long as he's not sick (mood is fine, is engaged with you, normal diapers), he won't let himself dehydrate or starve. The only bad thing about feeding at night is that it makes you tired, but it's fine for him.

Please, I beg of you (and this is everyone, not just Sarika), don't start ascribing negative characteristics to your baby. Your baby is only doing what he needs to to get his needs met. Right now his need for stimulation is greater than his need for food. That shifts all the time. But if you start to think of your child as "naughty" or "a troublemaker," you're going to turn him into one. All he wants is to be loved and cared for. Your only job is to be steady and consistent and loving, and realize that sometimes babies do things that annoy us (or make us think we're going to lose it completely) but it's not a big plot to get us. It's just their normal process of development. You and your baby are partners together in helping him grow up healthy and trusting and bonded.

Q&A: gropey baby

S writes:

"My son is 18 months old and was weaned at 14 months. My problem is that whenever he sits in my lap he tries to play with my breasts. Also, when he drinks milk, he likes to sit in my (or my husband's or babysitter's) lap and relax by touching on my breasts or sticking his arm down my shirt and just resting it there. I guess this started back when he was nursing and would touch one breast while nursing from the other. I don't mind when he rests his head or hand on them to rest, but he actually has to fluff them like pillows before he does so. This behavior makes me very uncomfortable and I don't know how to get him to stop. Any advice?"

Oh, this question made me laugh out loud. File it under "It's funny because it's true." I remember sitting around at playgroup when my older son was this age, talking about how supremely annoying the groping was. It's just so undignified. One of my friends who adopted her daughter as a 9-month-old used to say, "I never even nursed her! Why is she so into my breasts?!"

I think they do it because a) they're there, and b) breasts are fun and comforting. If they weren't, no one would go to Hooters. Or put carvings of women on the prows of ships.

It doesn't really matter why they do it, though, when you're trying to get them to stop. Probably your best bet is to redirect his attention or distract him with something else. Maybe he wants a nice strand of Mardi Gras beads (just to go along with the showing your breasts theme) to hang onto while he nurses. Or a soft stuffed animal, or set of keys to jangle, or something like that. Anything else he'll hold onto that isn't you is going to make things easier for you.

Would anyone else like to commiserate or reminisce about the groping thing?