Temper Tantrums | Health Eagle

Temper Tantrums

by Tom Seman MD FAAP October 11th, 2012 | Pediatrician on Call
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My two year-old daughter is starting to throw terrible tantrums. If I don’t give in to what she wants, she cries so much that she vomits. I am at my wit’s end. What can I do?

This can be a difficult situation, especially when out of the house; therefore, it needs to be tempered as quickly as possible.

Most children who vomit easily with lots of crying and screaming typically had issues with gastro-esophageal reflux (GERD) as infants. This condition typically heals itself over the first year of life, but approximately 5% continue on until older. Those adults are the target for advertisers of such antacids as Tums, Zantac, Pepcid and similar over the counter and prescriptive medications.

Other children who vomit when crying do so as a learned response to positive reinforcement. This means that at some point when they were crying and having a tantrum they vomited. Immediately the parent stopped the demands, and the child was able to continue what she was doing. Thus, teaching her that if she cries and vomits she wins. Children like most people are not necessarily thrilled about vomiting, but if it achieves a goal, then this is satisfactory since the parent will usually help the child wash the taste out of her mouth.

The child further recognizes when the parent is stressed, such as when they are out of the house.  They are at a disadvantage, because of the social codes of conduct which we follow, but young children have not learned. From a very early stage, a child’s behavior during a conflict should be monitored and handled calmly. The child should be placed in a safe spot and remain there until she quiets down.

Should the child throw or break items, vomit or defecate in the area, after he or she calms down, the child should be cleaned and if the child threw items made to help pick them up. The child should then be disciplined for performing whatever action that had to be cleaned. In public, although we need to try and create a similar safe setting, sometimes a small amount of interaction and control is necessary.

If the child is known to vomit when upset and is having a tantrum in a public place, then the child should be removed to a private area such as just outside he building. Should the child vomit, then the child and parent will clean up the mess, and if the child is not too messy, the parent and child should go back in and continue with whatever was absolutely necessary to do at that time.

Remember it is whatever is absolutely necessary. The child will then realize that her tantrums only delay the inevitable, and that she will have a sore throat or funny taste in her mouth yet still must perform whatever activity it was to begin with.

If there are some events that are known to cause the child to tantrum, choose wisely when having to do these. Inform her beforehand that she will be doing an event that she is not thrilled about, but that you will try to make it go quickly. Giving her a warning ahead of time lets her know that you care about her feelings, and you will do your best to limit the time necessary.

Thirdly, after the tantrum, remind the child that you love her and that whatever it was is necessary and that you and she will try to get through it as quickly as possible. Telling the child these things lets her know that you have heard and understand her feelings.

Remember ,tantrums can be frustrating to parents. Most can be predicted and thus somewhat lessened with the above tips. Starting early to treat tantrums appropriately with time outs allows you teach your child that there are better ways of expressing that she is unhappy allowing for better control in all types of situations.

So how do we control tantrums with time outs? The idea of a time out is not punishment. The purpose of time out is to develop self control/self discipline in the child when she is upset.

I often explain it as follows: You are in a meeting and your boss is having you do something that you do not want to do. You would like to jump up and down and scream. Instead you may close your eyes for a few moments and go to your happy place. You then open your eyes and get back into the conversation or situation or if possible and try to make the best of the situation.

In this scenario you have essentially given yourself a mini-timeout.Performing this in only a few seconds is the result of years of maturity. This is what you are trying to teach your child.

Just follow the instructions below as soon as possible, and you will be on your way to a more in control child. We have all heard that the length of time a child should be in time out is one minute per the child’s year of life. What is often overlooked is that this is one minute per year of life of continuous quiet. A two year old sitting in her time out place screaming at the top of her lungs for two minutes is not a time out. She has only been told where to have her tantrum. The purpose of having her quiet is to develop that self control that she needs to help her deal with the situation which she is finding offensive. So when a child has a tantrum.

1. Place her in the time out area.
2. Tell her that when she is quiet you will start timing her.
3. Repeat this every few minutes until she quiets down.
4. Once she stops crying immediately start timing her either by counting or setting a timer. Should she start to cry again before the time is up stop the timer reset it back to the beginning and repeat that you will start timing once she is quiet.
5. Once she remains quiet for the required length of time remind her to please not do that again, give her a big hug, tell her you love her and send her on her way.

Consistency is the most important part of handling these tantrums. Once the child realizes that you are consistent in the treatment then she will quiet down as soon as she can. Naturally she periodically challenges your resolve to handle the situation. Stay firm. She will soon be taking care of her tantrums with little fanfare.

As always,
Good Luck

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All health and medical information is provided for educational purposes and is not meant to replace the medical advice or treatment of your healthcare professional.