In Your Self-Confident Baby, child specialist Magda Gerber shares the story of her transformative introduction to the respectful care approach of pediatrician Dr. Emmi Pikler:
“One day my older daughter, Mayo, then six, was sick with a sore throat. Our regular pediatrician was ill so Mayo suggested I call a schoolmate’s mother who was a doctor. In those days physicians made house calls, so Dr. Pikler came to our home to examine Mayo. When I opened my mouth to speak, Dr. Pikler waved her hand indicating for me to be silent. Then she asked my little girl when her throat started feeling sore and how she felt now. My child answered so intelligently, so politely that I was surprised. The doctor then asked Mayo if she wanted to “look in her (the doctor’s) throat,” and afterward she asked permission to look in Mayo’s throat. “Open your mouth wide,” she told my daughter, “and I won’t have to use the tongue depressor.” She then told Mayo to go to her room so she could talk alone with me.
The cooperation Dr. Pikler elicited was so striking that I decided to ask her to become our pediatrician. What struck a deeper chord was the realization that she related to children in a more honest, respectful manner than I’d ever seen. After meeting Dr. Pikler, I raised my third child, a son, from birth following her ideas.
This encounter was the beginning of a long, fruitful collaboration between Dr. Pikler and me.”
As Magda discovered though Dr. Pikler (who became her mentor), the secret to eliciting our children’s cooperation is to respectfully include them in the activity. Through the years that she studied and worked with Dr. Pikler, Magda observed that this “secret” applies to infants, newborns, and even preemies, because the tiniest infant is already an aware human being. She recognized that from birth children are ready to be invited to participate actively in life and in a person-to-person relationship with us. However, this cannot happen unless we first take the leap of believing in them and beginning a partnership of trust.
We nurture our bond of trust by communicating with our babies throughout every activity that directly affects them: each diaper change, feeding, and bath; down to the details, like, “I am going to pick you up now… are you ready?” We invite active participation by asking, “Can you please lift your bottom so that I can move this diaper under it?” And then waiting a few moments for a response. If our child doesn’t seem able yet, we might say, “Okay, I will gently lift you…” Children feel the respectful intention in our offer. We are opening the door.
Like all of us, our children are far less inclined to cooperate graciously when things are being done to them rather than in partnership with them. Invitations to participate actively in an experience to the extent of their abilities are profoundly empowering, particularly at this early time of life when a child’s power in the world is severely limited.
There is no time more crucial for gaining cooperation than when our children’s health depends on it, and it is in these situations that offering respect and autonomy can go a very long way. Here are four stories that illustrate the power of respect and inclusion:
An end to WrestleMania (Sheny’s story):
I wanted to share a success story… So my son had an ear infection which required some oral antibiotics. In the past, that would mean me tackling him and putting him in a headlock, which would leave him upset. Eventually he figured out how to spit the medicine out. After reading your book, I decided to try a little more respectful approach. I announced to him that it was time for medicine — would he prefer to take it now or later? He just said “No.” So I said, “Okay, we can wait 5 minutes, but we have to take it then.” 5 minutes later I still had to tackle him, but the next day I repeated, “You have to take your medicine. Would you like to take it now or later?” Again, he said, “No.” So I said, “Okay, I’ll just put it here and you can take it when you want.” To my surprise, he took the medicine on his own! Now if I ever need to give him anything like that I just ask him if he would like to do it himself, and he always does. Sometimes I have to wait a bit before asking again, but no more WrestleMania episodes. Thank you so much!
A sense of control helps save face (Bethany’s story):
I just found your FB page a few weeks ago, but I wanted to share a mini success. My son, who turned 3 today, has pink eye, so we have to give him an eye drop on each eye three times per day. He hates them, and our “brute force” method, which we have used for a previous round of pink eye, left us all traumatized. Tonight, I laid him down and told him I wouldn’t do the drops until he was ready. He could cover his eyes as long as he wanted, and when he was ready, he could count “1, 2, 3,” and then I would do one eye. He didn’t trust me at first, but after about a minute, he moved his hands and then started the count. After he survived the first eye with no crying, he had trust and confidence to do the second. Giving him some control changed everything. I have only read a few weeks’ worth of posts, but I can already see this changing some of our most challenging moments. Thank you!
Maybe NoseFrida doesn’t suck after all (Stephanie’s story):
So excited this morning! My 15 month old daughter and I have been struggling with 2 things: diaper changes, and the snot sucker (NoseFrida) that is required with this nasty cold she has. Both activities usually involve a lot of screaming, tears, and attempts to flee, leaving both of us very frustrated. Well, I’ve really been working on preparing her before one of these events need to occur and offering her choices: “Who should I use the nose sucker on first? Raccoon (her favorite stuffed animal) or you?” She always tosses her raccoon at me and watches closely as I use the NoseFrida on him. Then the most amazing thing happened… She stood still, let me use it on her and actually SMILED afterwards!!!! No fleeing or tears. This has happened twice this morning. I’m so relieved that we are both feeling more confident and secure with each other. Diaper changes are looking similar, and I am excited to tackle new challenges as they occur. THANK YOU!
Why didn’t you just say that the first time?!? (Tova’s story):
We had a success story tonight that I’d like to share: my son decided he didn’t want any medicine, and last night in desperation we tried to squirt it into his cheek. He spit it everywhere, and it was just horrible.
Today we talked about the medicine and how it makes us feel better, and we talked about how everyone takes medicine when they are sick. Amazingly, he willingly took it and smiled. It’s so easy when it’s late and you feel pressured to forget that those few moments it takes to be calm and discuss things with your child make such a huge difference.
Later, when I asked Tova if I could share her story, she replied: “Absolutely! It worked so well that he asked for medicine even after he got better!”
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To learn more about this respectful approach, check out these resources:
Your Self–Confident Baby by Magda Gerber and Allison Johnson
Dear Parent: Caring for Infants With Respect by Magda Gerber
The RIE Manual
Pikler Bulletin #14 by Dr. Emmi Pikler
My books: Elevating Child Care: A Guide to Respectful Parenting and No Bad Kids: Toddler Discipline Without Shame (both available on Audio)
I have tried this approach with the nail clippers and it never works. We have the weekly nail clipping battle with a lot of tears and wrestling. I wonder what I’m doing wrong.
Hi G – Can you share a step by step of your actions and words and, most importantly, your feelings in this situation?
I usually try to pick up the “good ” time, meaning that I don’t interrupt him while he’s playing or doing something else. I hold him on my lap and I show him the nail clippers (sometimes I let him play with it for a minute) and I tell him that his nails are scratchy and must be clipped. As soon as I hold his hand he starts to wrestle, I hold him firmly and he cries and screams. Sometimes I can easily clip for a moment before the wrestling starts. Then of course I sound impatient and I try really hard not to yell (it’s very difficult because I have been raised by a yelling mother) . In the end I never yell at him but I really need to make an effort. I have also tried to give him an adult size nail clippers to “explore ” ( not as a distraction but as a choice) while I use the child sized one but it doesn’t really work. I acknowledge that nail clipping is annoying, that he doesn’t like it and I tell him that it’s going to be quicker if he cooperates. Toenails tend to be better (probably because his hands are free). In the end I’m just glad when it’s over . My husband doesn’t even try it.
He’s a VERY curious child, he’s interested (and distracted)in just about everything. I want also to add that we are a multilingual family and often he seems not to understand what we say ( we have clearly noticed that monolingual children of a similar age seem to understand better than him, even if they have a similarly limited vocabulary). He’s 19 months old.
Thank you so much.
This used to happen with both my daughters. Now I tell them that the nail clipper needs to eat or I speak for the nail clipper saying “is it ok if I eat your thumb nail?” and so on. It works well with my oldest who’s now 4. My youngest lets me do it at first but after a bit fights it.
I try this every time with diaper changes, but she still tried to get away and cried. Not as loudly as before, but still hates the diaper change.
Here are a couple of posts that might be helpful to you: https://www.janetlansbury.com/2011/08/dealing-with-diaper-changing-disasters/
And this one: https://www.janetlansbury.com/2010/05/how-to-love-a-diaper-change/
Also: https://www.janetlansbury.com/2014/11/the-evolution-of-a-diaper-change-2/
I love these success stories. And I’m so glad to see the Bulletin #14 by Emmi Pikler on your reading list. I think it would be so helpful to parents if it could always be on each page, Janet. It’s the one thing we have of Dr. Pikler’s in English and it is wonderful.
Hi Janet- I’ve been wanting to share this story for a while and this post is the perfect time. My daughter will be turning 3 and this happened about 6 months ago. We switched from a bulb syringe to a battery operated sucker. It was very loud, which I wasn’t expecting, and she freaked out. We did the holding her down thing which of course caused more turmoil. I knew though that I could get her cooperation because it’s worked with so many other things…nail clipping, tooth brushing, etc. So I brought her to her changing table, where we usually suck her nose, and explained that it’s loud but we needed to use it. I used it next to her so she could get used to the volume. There were a lot of tears and trying to get away, but I stayed and let her cry for what felt like an hour, but I also told myself that I would let her take as much time as she needed to get used to it. Finally I got her down, and she got two big pillows, laid them on the ground and let me do her nose. Oh I also let her hold it, press the buttons, and she gives it back when she’s ready. After that no issues. She would say ” it’s loud” and I would say yes it’s is loud, that’s right. She asks to do nose, press buttons, sings the song to the tunes it plays and it’s a very fun thing.
On the other hand, the only thing we were not able to do, around the same time 6 months ago, was give her some holistic cough medicine. I squirted some in, but just could not get her to cooperate. But she let me put drops in her ears for an infection, and we did other holistic remedies, so we cut out losses and let that one go.
As for nail clippings and other things, which I’ve been using your philosophy since she was about 1 year old, was that by letting her hold the clippers (closed of course) and explaining why we cut them (so you don’t scratch yourself and others, they don’t get dirty) and repeating each finger, there was a lot of cooperation from the start.
Thank you for your podcast and blog and all the other methods you share your wisdom for free. What an angel you are.
A classic Janet Lansbury story. In this moment of treating a six-year-old with respect, we see the key ingredients of treating anyone with respect. One of the tragic human flaws is our natural tendency to categorize other people and treat them accordingly. Would you treat an adult the same way after he told you he had Parkinson’s or Alzheimer’s as before. A six-year-old or a child with ADHD should be treated the way you would treat any human being. …and it starts with the tone of voice, right?
Some excellent advice here. People often don’t realize that children understand more than we give them credit for. Sitting down and reasoning with them – letting them know what medicine is for, and why we take it – can do wonders for how they’ll handle it.
a little respect goes a long way
my son is type 1 diabetic i have been diabetic all my life as well, as was my father. as a kid i remember always having an easier time whenever my father did my blood sugar checks or administered insulin. i used to check his glucose level before he checked mine even if he did not need it. there was something about his ability to understand what i was going through from his own experience that made it easeir for me to bear. My mother and i always fought about it though… i think there was a part of me that always resented it. with my son the difference is not as pronounced because my wife tries to practice empathetic respectful parenting however there is still a difference and 9 times out of 10, he would rather i do all of his diabetes management.
there are still times where my son fights my wife and she has to hold him down. he is 5. i am not sure if it is the pain so much as it has become a power struggle
Oh my – we have another similar success story! My husband and I also wrestled and forced medicine down my 1.5 yo daughters throat for months. It was awful and most nights we’d all end up in tears. While I attempted to “sportscast” and be respectful it didn’t work – seriously how can one respectfully wrestle someone?! Then we tried offering her medicine to her in a little tea cup. Now she has the control to drink her medicine on her own and does so happily! It’s an amazing 180 degree change. She even says “cheers” and asks for more, and everyone is much happier. Cheers!
I just wanted to chime in to give some support to the parents who have been consistently respectful and have included their child in the medicine process but have still met failure. My 10 year old has protested oral antibiotics, as well as pain relievers for almost her entire life. As a school psychologist I have used this respectful approach and we have calmly reasoned with her on the importance of medication. That being said it is an absolute nightmare to bring about cooperation from her most times. She is very strong willed and has some oral sensory issues on top of it which makes matters worse. I am not really seeking more advice but wanted other parents to know that even if they are using these calm, therapeutic, and empowering methods with their child there may still be moments of anger and frustration. It doesn’t mean that your approach is wrong….sometimes kids come into this world with a temperament that can be very challenging
I’m having this problem but with a 6-month-old. I try moving slowly, showing him how I put the medicine in the syringe, and even letting him grab the syringe and, eventually, put it in his mouth. But as soon as I start dispensing the medicine he turns away and cries. I try to dispense it as kindly and patiently as I can, talking to him as I go, but while he doesn’t feel well it’s tough going. Now it’s started making him gag and throw up. Any advice for children that are still too small for the kind of meaningful verbal/play interaction that has worked for some of these other parents? (He’s too small to do it himself, decide to take it now or later, etc.)
I found with my little girl who had to take a fair bit of medicine at the 6 – through to 15 months months stage, after much trouble similar to what you describe Zoe – I put it in a bottle for her to drink, I also added flavoured milk……. From the health store. This goes against all my princables but I was at my wits end.
I actually tried the medicine myself & totally understood why she was gagging and vomiting – it’s totally disgusting! Good luck!
After a traumatic and failed medicine attempt with my almost three year old, I have discovered your website. I’m excited by your philosophy, which I think is very much in line with my own! But I’m also having trouble believing my daughter will ever take medicine willingly. Any advice would be appreciated!
My daughter has NEVER EVER EVER successfully taken medicine. As an infant with fever she would spit up her tempra. Last summer, she swallowed almost none of the antibiotic she was prescribed for an infected mosquito bite. We wasted most of it unsuccessfully hiding it in ice cream. Tonight, she was prescribed antibiotic for another infected bite, though this time it is very close to her eye, and so more concerning.
Her father and I took her out to dinner after the doctor’s appointment, and asked her if she was going to take her medicine, to which she excitedly replied yes. She’s still nursing, and asked if she could nurse, and I said she could after she took her medicine. When we got home, she started immediately moaning and groaning with anxiety. I asked her respectfully what kind of cup she would like it in, but she was too whiny to respond. After a half-hour of positive encouragement, her father told her he was going to squirt it in her mouth if she didn’t drink it. She said she would, but just kept asking for more time( 4 more minutes, then after that, 5 more minutes, etc.) So eventually, against my judgment, we restrained her and forced it in her mouth. She swallowed it, but was so traumatized that she threw it up, along with her supper. We cuddled her, tried to calm her down, and then poured another dose (a little over a tablespoon) into her cup. I spent another hour sitting and waiting for her to take it of her own accord. I kindly explained that if she doesn’t take it she’ll need to get a needle. She just kept saying “I’m not ready yet.” I tried to explain that being brave means doing something BEFORE you feel ready, not WHEN you feel ready. I explained that conquering your fears feels really good, and tried to come up with examples of her conquering her fears in the past. She eventually fell asleep without taking her medicine (or having milk). I’m pretty sure I just heard her say “No, I’m not ready yet” in her sleep.
I believe my daughter might be prone to more anxiety than the average child. If this is the case, I wonder how much treating her with respect can overcome it?
I just want to say, I found this after desperately googling while crying, thinking i was traumatizing my 2 1/2 year old trying to give Motrin for his 103 fever. I had tried everything – putting it in ice cream, waiting him out until he was “ready”, etc. – until finally holding him down and trying to force him, which left us both in tears.
I put him in his room to regroup and read this, about leaving it in his room. I thought it couldn’t hurt to try. I placed the cup of medicine in his room and told him he could come out as soon as he took the medicine. Within ONE MINUTE that little weasel drank it on his own. THANK YOU THANK YOU THANK YOU.
Hooray! That’s great news, Jennelle! Thank you for sharing.
I’ve been having a tough time with oral medicine. My 5 year was recently diagnosed with cancer, and there are a few medications he absolutely must take that taste bad. Trying to disguise them in food is not helpful, he can still taste them and sometimes throws them up. I do not want to get into a battle with him over it. I hope giving him some choices as suggested above will help. Thank you.
What about nose drops for pre-verbal babies around 6 months (with strong opinions/preferences)? Part of my question is the pure fidgeting that makes it harder and the other part is the discomfort and fear/anxiety/fight against being messed with.
I don’t know if related but my baby was on a respirator briefly after a traumatic birth and I always imagined that having stuff and hands around your face against your will could be extra stressful.
Thanks in advance for ideas or keywords to search around for more ideas!