Whenever we (pediatricians) walk into a room with a 15, 18, or 24 month toddler waiting for us, we take a deep breath right before opening the door. The reason? Toddlers are grumpy, irritable, and very headstrong. They are also easily scared, and stranger anxiety and separation from the parent anxiety are peaking, which can make an exam very difficult. I warn parents around 12 months that the next few appointments could be rough, so that they realize this phase is normal and expected, and there is nothing wrong with their toddler. This period, much like the six-month period, is a test for parents, and a critical time to mold their child’s future temperament.
Why are they like this? My personal opinion is that they are smart enough to have strong opinions of what they want, and old enough to realize that the world can be scary sometimes. But, they are not mature enough to understand that sometimes we do things that we don’t want to do and not everything in life will be rainbows, puppies, and goldfish crackers. On top of that, their communication skills are very limited, so I can imagine how frustrating it could be, being trapped inside their little minds with very little ability to influence their world, which would make sense that those feelings often accumulate into tantrums. Tantrums are absolutely normal at this age, and for understandable reasons, but how parents respond to them will determine if normal toddler tantrums will continue into abnormal preschool tantrums. I see this often in the office, and usually these families have a few common missteps that make these later age tantrums more likely. Hopefully this article will help you avoid that fate!
Your job as a toddler’s parent isn’t to stop tantrums, it is to move them to a safe place to have them. Parents feel like they have to fix the tantrum, but the reality is, almost everything you do to stop it will function as a bribe to your toddler, and just teach them that tantrums are a good way to get a positive outcome. Think about the ways that you can stop a tantrum - give them a food treat, distract them with a video, take them away from the situation to something that is more fun, etc. All of these just teach kids that tantrums equal rewards. The other mistake I see parents make is that they believe they can talk them through the tantrum, somehow reason with them. You can’t. It doesn’t work. I love kids, but toddlers do not have the mental capability for abstract thought; they live in a black/white world based on cause and effect, much like your family dog. The dog cannot understand why he can chew up his toy football, but he can’t chew your prescription sunglasses, just like your toddler can’t understand why they can throw their toy, but not your cellphone. Talking them through it will not change the tantrum. So, what should you do? Move the tantrum to a safe place to have it. If your child starts a tantrum by the brick fireplace, that could be a disaster, so move them to somewhere with carpet and drywall and let them go to it! Toddlers can cry so hard they vomit or pass out, and that is okay. It is important for them to learn self-control, and that comes through giving them space to have that tantrum. During this time, you need to look relaxed, matter of fact, and in control. “Kiddo, I love ya, but this is ridiculous. When you are done let me know.” That’s it, and let them work it out. It could take 2 minutes or an hour, but either way at some point it will be over. Once it is done, then feel free to try to talk through what happened. Also, when your toddler’s tantrum is over, you need to be over it as well. Kids don’t hold a grudge, and they don’t let one event ruin the rest of their day, so when it is done, you need to go back to your normal routine and normal positive parenting. Parents who follow this strategy often find that tantrums end very quickly.
What are some other tips to decrease tantrums and get through the phase faster?
Don’t let your embarrassment impede your ability to deal with tantrums. When kids lose it at the grocery store, in the restaurant, at the movie theater, etc., parents will often turn to distraction (videos on their phone) to stop the tantrums, because they are embarrassed and want it to end quickly. That is the absolute worst thing you can do. Remember that anyone with kids has gone through this, so the vast majority of adults know what you are going through and know that toddlers throw tantrums. What you need to do is remove the toddler to a more private location. When we went through this with our oldest, we would take turns taking Xander out to the car to finish that tantrum while the other parent continued shopping or got to-go boxes for the meal. I think we even got to-go boxes a few times before we started the meal. (tip - during the height of tantrums I would just throw in the towel of going to restaurants because the only way to get through some of those meals is showing kids videos, which is absolutely terrible for them).
Don’t ask them if you can do something that you are going to do anyway!
Do you know what is worse than not being in control? Thinking you are in control and then finding out you are not. I see parents do this every week when it comes to shots. “Can we give you your flu shot today?” No 3 or 4 year old is going to say yes to this question. That is why they are not legal consenters for medical decisions; they cannot make informed choices. But parents will ask them, and then when the kid says no, they give them the shot. It is better to step up to the plate and just tell them matter of factly, “You are getting a shot today.”
Do offer them two choices, both of which you are happy with.
Asking a toddler what shirt they would like to wear to the Christmas party can be very overwhelming and result in a tantrum, or them picking a shirt that is not appropriate for the event. Instead, say “Would you like to wear the green shirt or the red shirt to the party?” This gives them autonomy and a feeling of pride, but without the melt down.
4. Do. Or do not. There is no try - Yoda
With toddlers this is timeless advice. When I ask parents if they are brushing their toddler’s teeth I often hear, “We try to.” Nope, you need to be the wall. A toddler should not be able to use tantrums as a way to affect your actions. If you think brushing teeth is important, then it needs to be done, 100% of the time, regardless of how your toddler protests, screams, or kicks. Be patient, persistent, and firm. And once you have told them one time that it needs to be done, stop telling them or begging them. They know what you want to do but remember, it is not a negotiation. You are lightyears ahead of your toddler’s ability to make good decisions.
5. Always remember the difference between a BRIBE and a REWARD.
A reward is telling someone they need to do something good to get a positive outcome, which fosters future desire to do good things. “When we go for your physical, if you do a good job we will have ice cream after your shot.” A bribe is telling someone if they stop doing something bad, they can get a good outcome. The problem with that approach - you have to do something bad first. In the middle of the appointment if your 3-year-old is kicking and biting the nurse trying to give his flu shot, and you say, “If you sit quietly, and stop kicking, we will get ice cream” you are just telling him it is okay to do something wrong because it gives you a chance to get something you want.
6. Pay attention to them when they are happy and doing well!
There is no more effective way for your toddler to get attention from the person they love the most than having a tantrum. And sadly, some tantrums are because they need your attention. Your goal is that they shouldn’t feel that way. When you are spending time with your child, be there. All of your attention is on them, not on the screen, your apple watch, or phone. They are very observant, and they know if you are paying attention to them or just pretending to. Make sure each parent gets quality 1:1 time weekly (daily if possible) and point out to them often when they are behaving well and making good choices.
I loved my dad without reservation, but he wasn’t exactly a child development specialist. He was raised in the great depression, when parenting was very stern, survival was not a certainty, and tantrums were often treated with a wooden spoon, but he did give me the best parenting advice I ever received and it was shockingly simple and wise. “Pay attention to your kid when they are happy, and ignore them when they are cranky” I wish I could remember his exact words, but that one sentence sums up a lot of this article and is shockingly effective.
As always, good luck parenting,
Dr. William J. Fisher, MD
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