Respect Makes Caring for Children Easier (an ER Doctor’s Story)

Every so often I receive a critical comment along the lines of this one:

“…reading things such as ‘I asked my baby if she wanted me to lift her up and with the slightest nod of yes, I did’ (not exact quote) — when talking about a month-old baby — makes me want to laugh. It is true that babies, infants and toddlers should be treated with respect, and I adhere to the notion of the calm parent and caregiver, but this is too much.” (A reader’s partial review of my book, Elevating Child Care: A Guide to Respectful Parenting)

She did misquote me. I admit I’ve never seen a month-old infant nod. What I have seen are infants only weeks old taking in certain words or phrases that we repeat from birth, then indicating they understand by demonstrating their readiness to be picked up – arching their backs and/or tightening their bodies in preparation to be lifted. The idea seemed farfetched to me, too, even laughable, until I tried it.

Perceiving babies as worthy of respectful communication requires a leap of faith that most either don’t consider or aren’t willing to take. But if we can suspend our skepticism and take the plunge, it often leads to a radical, life-changing conversion.

Dear Janet,

I have been meaning to write to you for a while. My wife is crazy about your stuff and to hear it second hand sounded to me like some serious hippy Mumbo jumbo. Talk to and treat an infant as a person? They don’t even understand English, I thought! However, I read your book and thought it made sense. Thank God I read it when she was little. Diaper changes are a piece of cake now. I let her know what I am doing, what to expect, and treat her with dignity and respect. All my interactions are guided now by this philosophy. I had feared speaking in this way would be formulaic and contrived. Quite the opposite. I feel my interactions are more genuine because I speak to her in the manner I would want to be spoken to. This has carried to my work as an ER doc. I now speak respectfully to children, let them know what is coming. I know it’s not the point of your work, but it makes my job so much easier! I have to spend half the time with wiggling children because they usually comply with my requests! So…thanks a lot!

Dr. Steve Kraunz

Dr. Kraunz’s note was encouraging on many levels, but what inspired me to share about it was his comment: “…I know it’s not the point of your work, but it makes my job so much easier!”

Making our lives with children easier is the point of my work for parents and caregivers, especially, but also for anyone that interacts with kids. Like all of us, children are far more inclined to trust and cooperate with people who communicate with them respectfully.

Respectful practices also make parenting easier in these key ways:

Clarity

We clear away the clutter of parenting gimmicks, gadgets, and control tactics, simplifying our job and clarifying the most wonderful part of our role as parents, which is to become intimately acquainted with a new and important person with whom we will share our life. She’s no passive, mindless blob or Mini-Me. We recognize her as a separate individual ready to actively participate in her life and relationships.

This approach differs from those that suggest infants are still fetuses and need to be tucked away, confined, and swaddled as if they are still in the womb; or those that advise parents to “turn off cries as easily as flipping a switch;“ or encourage tricks and distractions for infants and toddlers when they are doing something we don’t want them to do.  These practices might seem easier and more convenient in the moment, but transitioning out of these habits and mindsets can be intensely challenging. If we’ve been managing our children from day one, then when (and how) do we suddenly switch gears and perceive them as capable of developing skills, learning, entertaining themselves, or expressing their emotions?

With a respect-from-the-beginning approach, we don’t need to switch gears, alter strategies, wonder “now what?” during each new stage of our child’s development. We are on track as soon as we’ve made the paradigm shift to recognizing a baby is worthy of our respect and trust. We settle in and can stay there for good. For me and a growing number of others, there is relief in this approach because it is holistic, consistent, and clear.

Using our energy wisely

Switching our role from manager/director of our children’s emotions and development into one of a receptive, observant, attuned facilitator benefits everyone.  Our energy is not wasted constantly doing for children — fixing, finding, arranging, choosing, teaching, demonstrating, intervening — which ultimately convinces our child he actually needs us for these things, setting him up to be less confident and resourceful. Once given the freedom to experiment and learn, we find that children are usually quite willing, capable, and proud to do these things for themselves.

A simple structure for our day and quality time

My mentor, infant specialist Magda Gerber, suggested a (loose) daily plan for parents that I’ve found incredibly helpful. It is viable for stay-at-home parents, those employed outside the home, and families small or large. It offers a healthy balance that helps everyone thrive.

Between sleep and naptimes, our children’s day consists of extended periods of uninterrupted play and exploration in a safe space, punctuated by basic caregiving activities like diapering, bathing, dressing, feedings, and meals. It is during these caregiving moments that we connect with our child by giving him or her our undivided, one-on-one attention. No phones or other distractions. These are naturally intimate, relationship-building, “refueling” periods and often all children need to be able to release us with confidence while they re-engage in self-directed play, alone or with siblings, for the remaining waking hours of day. Our occasional presence during playtime, when possible, is icing on the cake. For young children, especially, predictable daily routines are empowering and, ironically, freeing.

Capable, self-confident, content kids

Children are ultra-aware, so our perceptions of them often become their self-image. Respect begets self-respect. Accepting and supporting our children’s uncomfortable emotions – letting them be —  encourages resiliency and authenticity and deepens our connection. A respectful, trusting approach is the surest way to raise content, kind, self-confident children. These kids are easier to parent, no question, and it’s never too early or late to begin.

When I asked Dr. Kraunz if I could share his story on my website, he replied:

Dear Janet,

I would be honored!

I’m not sure if I have all the philosophy correct, but I use it a lot at work. In fact, in some ways, there is nothing to “use”. That’s why I like it, it doesn’t seem like a trick.

The other day a young boy came in with a badly fractured leg. It was too painful for him to do awake, so I had to use a drug called ketamine. Often with ketamine there is bad emergence phenomenon. Essentially, kids wake up freaking out. When I gave him the needle he was screaming and crying, but I didn’t shove an iPad in his face as is often done. I sat right next to him, held his hand, and told him it was okay to cry, okay to express his fear and his pain. He went to sleep and woke up calm as a Hindu cow.

I think it is pretty weird that talking to kids like they are human beings is so revolutionary!

Thanks for all your work,

Steve

I share more in my book, Elevating Child Care: A Guide to Respectful Parenting

 

UPDATE: Just received this note from a pediatric nurse, who chimed in:

In response to the ER doc’s email, I whole heartedly agree!!

I’m a nurse, and spent 13-14 years working in pediatric oncology. Oh, how I wish your approach to communicating/relating with children would become a standard part of training in the nursing field.

Our son is now 3 (and 2 months) old – I first started reading your information when he was about 4-5 months old. How deeply grateful I am for all the work, and encouragement, and coaching you have provided to me and my husband. We are better at parenting, and have also found a lot of common ground to stand upon together for our son.

Thank you,
Kristen

At last! I’ve created the No Bad Kids Master Course to give you all the tools and perspective you need to not only understand  and respond effectively to your children’s behavior but also build positive, respectful, relationships with them for life! Check out all the details at nobadkidscourse.com. ♥

(Photo by Darla on Flickr)

24 Comments

Please share your comments and questions. I read them all and respond to as many as time will allow.

  1. Yes I had a thought a little while ago. That the majority of people spend the first 1-2 years of their child’s life saying “You can’t do that” “Stop” etc and then wonder why when they want them to start being more independent the children fight against it. Thank you for helping make my parenting journey a lot more enjoyable.

    1. My pleasure! I’m thrilled to be able to share Magda Gerber’s wisdom

      1. Curious what you would use instead of saying you can’t touch this or do this etc or stop. What would be a better way to stop a behavior that causes some damage to someone or something?

  2. “Calm as a Hindu cow” HA! I love that. Re-reading your book now because man, I feel like poor parenting responses are just hard-wired into my brain!

    1. I love the Hindu cow, too. Don’t beat yourself up! Very few of us seem to have had models for this way of parenting. This requires a rather huge paradigm shift, but is totally worth it. Hang in there!

  3. I am so glad this Dr. is incorporating these principles into the way he cares for children. I hope it catches on in more hospitals! When Sisi broke her arm, she was so baffled by the ER nurses and doctors who talked baby talk to her, tried to distract her, and kept trying to turn on movies. She was so stressed out and in pain, she didn’t want any of that. She just wanted someone to tell her what was going on, what she needed to do, and comfort her when she cried. Also, they kept giving her false choices, like “is it ok if I put this surgical hat on you?” but when she honestly told them “No, I don’t want that”, they would look at me like a deer in headlights. I had to tell them not to ask her for her opinion if they didn’t intend on listening to her.

    1. Wow, that must have been stressful for both of you. Yes, Kristin, let’s keep putting this message out there as best we can!

  4. Melissa Laurel says:

    Can you recommend one of your articles or some tips for helping our adopted 4 year old son with self-directed play? We adopted him at 23 months. He has been in child care since he was an infant (we were court ordered to keep him there during the time we fostered him). I now work at his child care center, so he continues to go there, but only part-time (which is also my schedule). I’ve noticed that he struggles with finding things to do when given time for self-directed play, no matter how many toys or the variety of options I provide. He will either hover and follow me around or wander aimlessly. We also adopted his baby sister (at 5 weeks). He often waits to see what she is going to do and then joins in, or in big brother fashion, takes over, which then leads to sibling refereeing. I would appreciate your insight into the situation and/or any tips on helping him learn to enjoy playing on his own. Thank you!

    1. Hi, my son is almost four year old and is pretty much the same as yours… If not entertained by myself or his dad or some cartoons (he is not allowed a lot of screen time), he will often sit down, lie down on the floor or wander aimlessly for quite a while. I am wondering about that a lot…

    2. AbiSakuraKids says:

      If you have lots of options, he may have choice paralysis. Maybe cut down the choices or even at first choose for them. As an ECE with a child like this in my class, I would probably sit down close by and model some play, eg I would build a tower with blocks or make a train track or ‘cook’ some play food by myself until child showed an interest and joined in. Once child joins in I would play together for a minute or two but then quietly disengage until child is playing by themself.

  5. Our goal is to always be honest and specific when talking with our 2-year old. Do you have any insight into why he will ask the same question, repeatedly, without pausing after you give the answer? His favorite is “Where’s Daddy?” “Where Daddy go?” As soon as I tell him, he asks again. I try to be patient, figuring he is looking for consistency. After a while I will try to elaborate on my answer, thinking he wants me to be more specific, or perhaps he really wants to know WHEN Daddy will be back in his sight. Or maybe he is just thinking out loud as he often does!

    1. My son loves to chat, and this sounds very familiar. For him, it was a way to extend a (very enjoyable, for him!) conversation about something real that we could both communicate about. The repetition doesn’t bother him, because for a 2yo, repetition is perfection!

      When I finally realized this, I could take a step back and say, “I’m not going to talk about this anymore. It makes my throat tired to talk all the time, but I will listen if you want to tell me a story about Daddy or sing a song.” It helped my frustration levels a lot to realize it was just his attempt to communicate with me with his limited language.

      (he’s 5 now and still a chatterbox. I was worried about his hearing because he developed a habit of saying “What?” every time I spoke, but then I realized, again, it was a gambit to make our conversations last twice as long as they normally would because I’d rephrase, possibly going into more detail and explanation, and for him, the longer we talk, the better. So I’m cutting out the unnecessary explanations and slowly he’s losing that habit.)

    2. My son does something really similar! He’ll say, “Dada? Dada? Takin’ the trash?” (He always thinks if Dada has left, he must be taking out the trash!). And he’ll just keep saying it until we’ve talked about it. Sometimes, I find that acknowledging rather than answering the question can help. He seems to just want me to affirm what’s going on– not so much to explain where Dada is now, but acknowledge that he’s not here anymore. You could try saying, “You’re wondering where Daddy went. He was here, and now he’s gone! You notice that he’s not here!” Then just listen. He may say something like, “Daddy not here,” or “Daddy at work,” and then you can affirm that by saying, “Yeah, Daddy is not here. You noticed that he went to work.”

      My son’s teacher at school is a master toddler communicator, and sometimes when a child is repeatedly talking about something, she just says, “Oh, you’re thinking about the tractor” (that drove by yesterday and you can’t stop talking about it). The kids just love that. My son sometimes just turns to me dreamily and says, “I thinking about the tractor” (or the sink, or his friend). I never would have thought about how satisfying it is for a child that young to just be able to communicate that he is thinking about something.

    3. Just put the questions back to him. Saying ‘where did daddy go?’ And having him give you the answer for his own questions nips that in the bud.

    4. Is it possible he’s expressing how much he misses daddy or how scared he is that daddy left? I wonder if you validate that it’s ok to feel that way if he might get what he’s looking for?

  6. Janet,

    What a beautiful (and well-deserved) confirmation you received from Dr. Kraunz! I love his description of the change in the young boy who, when heard and supported rather than distracted from what was happening TO him, woke up [from the ketamine] feeling (or at least expressing the feeling of) safety and calm. Beautiful. And bravo Dr. Kraunz.

  7. Before I even heard of Rie my husband and I have been describing what we were doing to our son since birth. By the age of 14 weeks he was communicating with us what he wanted. We would ask him do you want diaper change, do you want milk, or do you want to be held. He would let us know what he wanted by smiling, stop fussing, or babbling. Sometimes he wanted multiple things and get extra excited if we asked if he wanted more then one thing like milk and being held. He is now 6 months and still very much communicating his needs if we watch and observe what he is telling us.

    This is my first child, but I have worked for many years with dogs and other animals. I am very good at observing and watching non-verbal communication. It is amazing what these little ones will tell you if you just step and listen to what they are trying to tell us.

  8. Hannah-marie says:

    I’m in agreement, and incorporate into my work with infants, much of what you & Magda Gerber advise, but I think you are wrong to say that primary caregivers or parents should have only an occasional presence while babies and toddlers play. It’s possible to be present and interacting without directing their play, and it’s also nice to become playmate sometimes. The routines & taking care of physical needs shouldn’t be the only times of undivided attention & meaningful interaction. If they are, where’s the joy in parenting or caregiving?

  9. When I held my son as he cried in those first weeks, and talked to him the way I had read about in your articles, I often thought to myself that even if the responses I gave him weren’t really “getting through” yet, they were tremendously helpful to me. I found it emotionally very difficult to deal with my son’s newborn cries. I would run through all of the possible things he could be crying about– diaper, position, rocking or not, hunger, etc.– and he would still cry. It was one of those moments that I could have said to myself, “You’re a failure as a mother. You’re not able to help your baby.” Or I could have gotten angry with him– parents do!– and said, “Good grief, kid, what else do you want from me?!”

    But in those moments, I thought of your website, and just held him and said to him, “I sure wish I knew why you are crying. I bet you really wish you could tell me! For now, I’ll just hold you while you cry, and in time, we’ll both get better at communicating with each other.” Those words held me together. It made me feel closer to him even though I couldn’t always soothe him. And now, he’s 21 months old and I often feel like we’re on a wavelength. We “get” each other, because we’ve been practicing meaningful, honest communication all this time!

    So, I think that even if the “nod” isn’t really there yet at one month, practicing communication and listening with infants right from the start has meaningful benefits.

  10. What gave you the idea babies don’t understand English? If they didn’t people wouldn’t talk to them like they do.

  11. If even pets understand you when you ask them if they want a bath why would babies not?

  12. Alicia C. says:

    I love that this doctor is taking to kids like the little people they are! I remember hating as a kid when doctors talked to my parents like I wasn’t even in the room.

    Since I found RIE I’ve done this with my kids when getting shots- explaining why they’re getting them, acknowledging that it will hurt for a moment but that it’s needed for health and safety. I let them choose which arm they want the shots in and help them be involved in the responsibility of it. They may be scared, but they sit calmly through it, no promise of a “treat” needed after. Nurses and techs usually tell me distract the kids or restrain them, then they brace themselves for crying, screaming, hitting, kicking, etc. When that doesn’t happen they’re shocked! Maybe mine are just good shot takers, but it seems to me that kids just don’t want to be tricked and are up to the task if we trust them to be.

  13. Interesting as this was posted as my 2.5 year old is currently hospital after emergency admission for sepsis (!). It has been remarkable to see the difference in her response to medical caregivers who do and don’t ask permission/explain what they need to do for her, and why. We’ve got a little girl who when it is explained why – gives her finger for oxygen monitoring, leans forward for the back of her chest to be ausculted. We’ve had a few things that she doesn’t want done… we’ve explained that they need to be done and to tell us when she’s ready to proceed, and she takes a breath and let’s us do it! Amazing, and so much easier than struggling!

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