Health and Nutrition

Excerpted from
Dr. Spock On Parenting: Sensible, Reassuring Advice for Today's Parent
By Benjamin Spock, M.D.

If a parent has a great fear of giving in to illness (as I was taught to have in my childhood), he will have the impulse to teach the same thing to his child: "Don't fuss, you'll feel better soon." "That doesn't hurt. Stop crying." "Don't be a baby, be brave." This may not seem a bad thing to teach. It would counteract any tendency to hypochondriasis or exaggeration of aches and pains; it should inculcate bravery and stoicism-virtues that have been prized since the days of ancient Sparta and are still admired greatly in some families.

But one trouble with an attitude of denial of illness and pain is that an individual may learn to ignore the symptoms of disease in himself until he is in very serious condition. Doctors frequently encounter patients-even patients who are physicians and should know better-who have had clear-cut symptoms of a disease such as cancer for many months and who not only did not mention them to anyone but also managed to persuade themselves that the symptoms were of no importance at all.

A more troublesome consequence of excessive stoicism about pain and discomfort in some individuals is that they eventually may come to suppress feelings of other kinds too-anxiety, sorrow, anger, or even joy. Worse still, they also may tune out the emotions of other people. They won't recognize unhappiness or worries or resentment in their spouses, children, friends, and fellow workers. They become difficult, uncomfortable people to live with.

For the only satisfactory way in which human beings can get along with one another is by communicating their feelings along with their thoughts. We all watch constantly the face, especially the eyes, of the person we are talking with, to be sure that he understands and sympathizes with what we are telling him about ourselves, or to see whether the proposal we are making pleases or irritates him. If he is the kind who conceals his feelings, we are uneasy. Or we assume that his feelings are unfriendly and then we turn unfriendly ourselves.

So the sensible balance to aim for in raising a child is to allow him to show the pain or other discomfort that seems realistic for the injury or illness he is suffering, but by reassurance or firm reminder to counteract any strong tendency he may have to exaggerate his misery.

Of course, this is a rather theoretical piece of advice because parents already have built-in attitudes that are difficult to hide. A mother who is frightened by the sight of blood, no matter how insignificant the wound, or a father who harbors a sense of shame about showing any fear is naturally going to have difficulty striking the best balance with the child. We all deviate from the average in some such respect.

Psychoanalysts believe that many worries about bodily inadequacy start from unnecessarily stern warnings about masturbation. Around one year of age, when a child is identifying all parts of his (or her) body, he explores his genitals too. It's good to realize that this is only one aspect of his curiosity and his growing sense of self and is normal. You don't need to do anything, if that suits you, or you can smile and say, "That's your penis" (or "your vulva"), or whatever you want to call it-an entirely acceptable part of one's body. Or if his handling of his genitals bothers you (as it does some parents), you can easily distract him at this age by offering a plaything or just chatting about something that interests him. The main thing is to avoid giving him the idea that a part of his body is evil or that he might injure himself by touching it.

The same consideration applies to the three-to-six-year-old period, when occasional experimentation with the genitals and sex play with other children is very common. Depending on your own feelings, you can casually ignore these signs of normal sexual development. Often just the presence of the parent is enough to interrupt the play. Or you can divert the children by suggesting another activity. Or you can tell them matter-of-factly that it's not polite to do that when there are other people around, or simply that you don t want them to do that. But it is better not to imply to your child that sex play is harmful to physical or mental health (it isn't) or that it will turn you against him.

The most efficient time to encourage toilet training is around two to two and a half years of age. There is a natural readiness then in a majority of children. Dr. T. Berry Brazelton, as a result of observing fifteen hundred consecutive children in his practice, came to several conclusions about training. It's wise to avoid any pressure or persuasion. Present the child with the kind of seal that fits over a potty on the floor and tell him that this is his very own seat. Don't mention its other purpose at this time. Leave the lid on, let him sit on it as often or as little as he wishes. After several weeks during which he has gotten used to it and developed friendly possessive feelings toward it, put a potty under it, raise the lid, and tell him that he can use his seat to go poo-poo (or make a BVI, or whatever term you use), just the way Mommy and Daddy use the big toilet. Leave off his diaper at the time he usually performs. Let him try this as little or as much as he wishes. If he sits briefly and then gets up, don't try to detain him. The idea is to let him feel not that you are trying to get his movement away from him and into the potty, which arouses possessive and balky feelings in many young children, but that using the toilet is a grown-up skill that he may want to learn by himself.

Dr. Brazelton found that children not only do learn toileting by themselves but that they learn urine and bowel control at about the same time. The most convincing result of letting the child learn by himself was an extremely small number of cases of persistent bed-wetting. This suggests that persistent bed-wetting (past three or four years) is a protest-at the unconscious level of the mind-against too much toilet-training pressure from the parents.

It's also important that children not be taught, by the parents' words or facial expressions, that the bowel movement is not only disgusting but also dangerous to touch, as if it were poisonous. Many individuals have received such impressions in early childhood, impressions that then persisted into adulthood and caused chronic worries about such matters as irregularity in the timing or amount or consistency of the bowel movements. These worries sometimes lead to frequent use of cathartics, enemas, and high colonic irrigations.

Actually there is nothing unhealthy about irregularity in movements, the amount passed is not important, and the only harm in hard movements is the discomfort. When an individual has been led to believe that the bowel movement is inherently poisonous, he is easily convinced that headaches, sallowness of the skin, bad breath, and fatigue are caused by constipation.

He may then begin to feel debilitated or ill when the timing of the passage of the movement or the amount of movement seems less than ideal. But bowel movements are not poisonous inside or outside the body. And even the disgust at their smell is something that is taught.

The common denominator in these various suggestions is that to bring up our children to have healthy altitudes toward health, we should focus our concern not on the injuries and diseases that threaten them, but on preserving their good feelings toward their bodies, toward themselves as people, and toward us as parents.