6 pieces of old-school pediatric philosophy

1. It’s okay to be silly during a visit (eg, trying to find where a child hid his or her belly button), as long as there are no serious health problems and it fits your style and the child’s. This is particularly effective with children aged between 3 and 6 years.

2. Similarly, when an older child comes in with mild poison ivy, besides asking them how many leaves poison ivy has, I ask what it feels like. The correct answer, of course, is that you are not supposed to know what it feels like.

3. Along these lines, I carry some simple magic tricks in my bag, which can be done even by a clumsy person (or, in current medicalese, a person with dyspraxia) such as myself.

4. If you see something, say something. If the 2-year-old is chugging down a bottle of milk during a visit for fever, advise the parents that the bottle should be given up once the child is well.

5. Infants do not have sleep problems; parents do. I have never had an infant complain that his parents woke him up at night to feed him, and he wanted them to stop. Presenting it this way will show the parents that, if they want their older infant to sleep through the night, they will have to be the ones to bring this about.

6. Many parents are concerned that their normal child may have something wrong with him or her, or that they are doing something wrong, when the problem is actually due to the child’s temperament. I explain this as a matter of the child’s style, and that it is a question of personality, not pathology. There are many useful books on the subject for parents, but my shorthand description is that many children are either cats or dogs. The former, for example, are usually quieter, less demanding, and harder to read as to mood. The latter tend to be more intense, more engaging, and it is much easier to tell if they are happy/sad/excited.