Fussy eating, tantrums, separation anxiety and toilet training

Tantrums

What are tantrums?

Tantrums tend to start between two and three years old, although they can start earlier. During a tantrum, a child will often shout, scream and cry. They may also kick, hit or bite. Tantrums are very common and almost all young children have them - some more than others.

Why do they happen?

Tantrums occur because young children are not able to express themselves easily. Toddlers can also want independence and become frustrated when this can't or doesn't happen. Tantrums tend to decrease and/or stop after four years of age as children are better able to understand the world around them and communicate their needs and wants.

What can I do when my child is having a tantrum?

when you child is having a tantrum:

  • Try to be calm and consistent - speak slowly and quietly, don't worry about what other people may think if you are in public and don't give in to the tantrum as your child may then see this as a way of getting what they want.
  • Ignore the tantrum - ensure that your child is safe and explain that you will be there for them when they have calmed down, then carry on with what you were doing.
  • Reassure - after the tantrum, reassure your child, talk to them about their emotions and if they are old enough, talk about how they might deal with those emotions differently ("use your words if you are angry").
  • Positive reinforcement - try to make a point of noticing and commenting on good behaviours (such as "you are playing very nicely with your brother") so that your child gets attention for acting in the way you would like them to.

How can I prevent a tantrum?

Not all tantrums are preventable since this is a normal phase that toddlers go through. However, it is useful to have a predictable routine for sleeping and eating in order to prevent your child becoming overly tired or hungry. Ensuring that your child spends time outdoors being physically active can also help. Talking with your child about what you will be doing that day can prepare them for what is going to happen. Let your child make small choices about their day when this is possible. Distraction may also help if you sense that your child may be about to have a tantrum - keep a small toy nearby (in your bag) or point out something particularly interesting to your child.

What can I do if I need more help?

If you are struggling to cope with your child's behaviour, talk to your health visitor or GP.

Further information:

Separation Anxiety

What is it?

Separation anxiety in children is common and very normal. It tends to occur between the ages of six months and three years although it can crop up at other times in response to stress and change. Your child may not like being held by other people or may get upset when you leave the room. They may also cry and protest when you go to new places or leave them with other people, for example, at nursery.

Why does it happen?

Separation anxiety begins when a child starts to understand that they are dependent on their caregiver but this person/people are separate to them and can leave. This can make the child feel worried and insecure.

What can I do to help?

It is important to understand that this is a normal phase for your child. Although some children struggle with this phase more than others, it will almost certainly get better in time. Here are a few things you can try:

  • Practice separation - try leaving your child for short periods of time, let them know what is happening and when you will be back.
  • Say goodbye and go - have a short and predictable goodbye routine, make sure you leave after you have said goodbye.
  • Use a comforter - some children like to have a familiar item (cuddly toy or blanket) when they are apart from their main caregiver.

What if I need more help?

If your child is extremely distressed and this does not improve over time, contact your health visitor to discuss your concerns

For more information click here.

Sleeping

How much sleep should my child be getting?

For age specific information on sleep please click here.

below are approximate guidelines that are suitable for most children to feel rested:

Age & Sleep Requirement:

0-3 months - 14-17 hours

4-11 months - 12-15 hours

1-2 years - 11-14 hours

3-5 years - 10-13 hours

6-13 years - 9-11 hours

14-17 years - 8-10 hours

18-25 years - 7-9 hours


Why is my child not sleeping?

There are many reasons why young children may have difficulty sleeping including:

  • Sleep association (something or someone your child needs to fall asleep e.g. needing to be fed to sleep or held/rocked)
  • Separation anxiety
  • Being overtired
  • Bedtime fears (being scared of the dark)
  • Nightmares
  • Night terrors

For older children, bad sleep habits, too much caffeine, too much screen time, worries, stress and mental health problems can all contribute towards poor sleep.


What can I do to help?

  • Try to understand and address the underlying problem.
  • Having a bedtime routine - a warm bath, dim lights and a story can all be relaxing and help to signal sleeping times.
  • Have a consistent bedtime and wake time, adapting this to your child's sleep needs as they get older.
  • A comforter may help a young child settle at bedtime and if they wake during the night.
  • Avoid screen time in the hour before bed.
  • Make sure your child has a cool, quiet, dark and comfortable place to sleep.

What if I need more help?

If you need further help and support, speak with your health visitor and/or GP.

For more information:

Fussy Eating

What is fussy eating?

Many pre-school aged children can be fussy about what or how they eat. It is not uncommon for children to refuse to eat certain foods, eat a very limited range of food or refuse to eat at all.

What can I do to help?

The following things may help:

  • Try not to worry or focus too much on food - if there are no problems with your child's growth and development it's best to wait for your child to outgrow this phase.
  • Eat together as a family and eat the same meal, ensuring that your child has an appropriately sized portion and that their food does not have any added salt.
  • Keep trying with new foods and offer them in different ways (e.g. offering carrot cooked, uncooked, grated, mixed in a sauce etc.).
  • Get your child involved in preparing and cooking meals.
  • Praise your child when they try something new.
  • Aim for no more than two snacks a day.
  • Don't cook to order, if food is uneaten at the end of the meal, just take it away without comment.

What if I need more help?

If you need further help and support, speak your health visitor and/or GP.

Further information:

Bedwetting

Up to the age of 5 years, wetting the bed is normal. It usually stops happening as your child gets older without the need for any treatment:

  • up to 1 in 5 5-year-olds wet the bed
  • 1 in 20 10-year-olds wet the bed
  • about 1 in 50 teenagers wet the bed
  • about 1 in 100 teenagers continue to wet the bed into adulthood

Bedwetting happens when your child makes more pee at night than their bladder can hold; unfortunately, young children often don't wake to the feeling of a full bladder, which means that they wet their bed whilst they are sleeping. It can run in families, and boys are more likely to wet the bed than girls.

The good news is you don't need to wait until children grow out of bedwetting - treatment is now available and recommended from the age of 5 years.

What should you do?

If your child is under 5, you don't need to see your GP about their bedwetting unless:

  • it happens a lot and is upsetting them
  • they're constipated despite you changing their diet
  • they have also started wetting themselves during the day, but had been dry most days for a while
  • they go to the toilet a lot during the day (for example, every hour), they can't hold on for even a few seconds or minutes, peeing is painful, or they're peeing less than 4 times a day

Other practical tips include giving them their last drink of the day no later than 90 minutes before they go to sleep and encouraging them encourage them to pee as the last thing they do before they go to sleep. Ask you health visitor or school nurse for advice if you are worried.

For commonly asked questions and excellent practical information about the treatment of bedwetting, click here.

Toilet Training

When to start?

Most children are ready to start potty training between 18 months and 3 years of age. However, all children are different and it is important to wait until your child is ready. You might feel your child is ready to start potty training when you notice the following:

  • Your child can get on and off of the potty
  • Your child can pull their clothes and underwear down
  • Your child can follow instructions
  • Your child knows when they have a wet or dirty nappy and they tell you this
  • Your child can stay dry for an hour or two
  • Your child knows when they are doing a wee and they tell you this
  • Your child knows when they need to do a wee or a poo and they may tell you this in advance

How to start?

  • Choose a time when there are a few other big changes such as house moving or a new sibling arriving
  • Keep a potty in the bathroom (and one downstairs if the bathroom is upstairs)
  • Once you have chosen a time to start, swap nappies or pull-ups for pants
  • Encourage your child to sit on the potty regularly, particularly after meals and at any time you know your child normally does a poo
  • Encourage boys to sit down to wee - this helps them to empty their bladder properly and makes sure they can poo as well if they need to
  • Don't make a fuss if they have an accident but do praise them when they succeed

Night-time potty training

Night-time potty training might take longer than daytime potty training. If your child's nappy is dry or very nearly dry in the morning, they may be ready for night-time potty training. Make sure that your child uses the potty just before bed and then make sure it is nearby in case they need to use it overnight. Use a waterproof sheet and have clean bedding and pyjamas to hand. If things aren't going well, stick with nappies for a little longer and try again later.

What to do when there are problems?

If after you start potty training, it appears that your child was not quite ready, go back to nappies/pull-ups and try again in a few weeks. If you have any other concerns about potty training, talk to your health visitor and/or GP.

Further information:

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