Nighttime Fears

It is very normal for kids 2-4yrs to have fears at nighttime…the dark, the shadows, the boogeyman, etc.  And little kids can be very creative in their fears!  My younger brother used to be afraid of trains coming in through his window!  I remember being afraid that my raincoat hanging on a hook in my room turned into a little girl who would come closer to me, to get me when I closed my eyes.  And my father confessed to being afraid of Captain Hook’s crocodile who swallowed the clock… he couldn’t stand any ticking sounds until he was about 10!  Knowing that times haven’t changed much, kids who watch Disney movies might be afraid of a particular villain living in their closet or visiting them in their dreams.  And lots of kids are afraid of alligators or monsters under the bed.

These things are totally normal.  But when the fears start interrupting “normal” sleeping habits, it is time to take action.  If you can intervene early, you often stave off fears getting worse.  However, be prepared that many fears don’t go away overnight.  They are largely outgrown with time.  But there are things you can do to manage nighttime fears.  Being practical and creative is the key.

1.  Adjust lighting. Some kids do well with nightlights, others don’t because the light creates more shadows which are scary.  Ask them.  Some kids like having a flashlight by their bed, which makes them feel powerful in the dark.  Or, get an energy efficient lamp and let them sleep with the light on.  Don’t be afraid that they’ll need it forever; when they’ve clearly outgrown the problem, they’ll probably want it off themselves.

2.  Add soothing music. Many stereos can be set on “repeat” and this is something to take advantage of if your child wakes up a lot during the night.  Lullabyes, some classical music, or kids songs CDs can be a distraction from fear when a child opens their eyes in the dark… they don’t hear funny sounds outside, and they tune into the words instead of letting their imaginations run wild.

3.  Add to the bedtime routine. For my brother who was afraid of trains coming in through his window (for no logical reason whatsoever), my mom invented the “Train Vanishing Spray” with a simple spray bottle and water.  She used to go around and spritz his window every night saying, “Trains, go away!”, before bedtime–even letting my brother do it.  A little bit of “magic” plus kid’s control can go a long way in making fears leave.  Try the “Vanishing Spray” for alligators under the bed, villains in the closet, or other things which are irrational.  If your child is trustworthy, you can even leave the bottle with them overnight to use if they wake up scared (most two year olds can’t handle this, but a 4 or 5 year old can).  Other things which work at the bedtime routine include saying a special prayer or chant, reading a “vanishing” story each night (you can make one up yourself that incorporates the child’s actual fear and conquering hero), or having Dad play “ghostbuster” for a couple minutes (with a special tool, or superhero complete with cape).  A prayer or chant works well because the child has something to say and try when they wake up by themselves in the middle of the night.  If you believe in God, tell the child that God is more powerful than any other bad guy on earth, and to ask God for help if they wake up scared.

4.   Add a stuffed animal or prop. Lots of kids start appreciating a stuffed animal friend at this age, if they are scared.  Maybe even a couple.  If you can play it up, that the animals will protect them and keep them safe, it can really work.  Try a stuffed lion or bear (that is big and looks cute).  Or you can employ a “magic” protection charm, like a flag over their bed, a canopy or bed tent, or a new monster-proof blanket on their bed.  Even magic PJs or underwear can make them feel safe.  These things have the added bonus of keeping little kids IN their bed because they think it’s the “home base” where they’re safe.  You want to make their environment cozy and personal.

5.  Add a person. If you have multiple siblings and are open to the idea, move someone else into your child’s room.  Even a baby can make them feel safer because lots of kids are just afraid of being alone when they wake up.  If the baby wakes the other child up a lot, it’s annoying but this can actually have a de-mystifying effect on nighttime… it seems like daytime, not so scary.  If you do not have  a sibling you can move in, consider reading in their room for 10 minutes while they try to fall asleep (don’t stay forever, though).  Then you can come in and visit them, kiss them, before you go to bed yourself.  We have found that our kids really enjoy these late night visits.  Sometimes they don’t even wake up, but sometimes they do and so they know Mommy and Daddy are still watching out for them at nighttime.  You can even put a picture of you and Daddy in their room, which is often very comforting.  Just your “presence” wards off the monsters.

6.  Evict all scary stuff out of their “diet.” I am so amazed at how little kids’ culture (even for 1-4yr olds!) is entrenched with fear elements–monsters, ghosts, witches.  Like it is supposed to be fun and healthy.  In reality, it is setting them up for bad dreams and fears because preschoolers may know (when they’re awake) that they are just pretend, but in the nighttime, that isn’t convincing.  And I promise you that they can’t be afraid about things they’ve never seen.  But how many kids can go through toddlerhood without being exposed to every kind of scary stuff?  And little kids are so visual—anything that looks scary on the screen or page can bother them.  This is attacking a sacred cow for some, but if your child is scared about something it is best to eliminate it even if it is inconvenient.  This includes favorite movies, shows, books, and characters.  Even the Halloween party, birthday clown, or visiting Santa if necessary.  A lot of moms and dads feel their kids need cultural icons, but I can promise you that taking even seemingly innocuous things out of my kids’ diet went a LOOOONG way towards keeping the bedtime fears low.  Now you can’t prevent a wild imagination (like trains through the window), but you can take out easy sources of fear: witches, dragons, ghosts, wizards, villains (even the beloved Nemo or Wall-E videos, who have scary elements), snakes, sharks, wolves, alligators, pirates, big fires, and “bad guys.”  Tons of kids shows have heroes with “bad guys” but if this is making your child insecure (i.e. they are having bad dreams), it might be worth taking it out for awhile.  Be protective.  Guard your child’s sensitivity.  They have lots of years in the future to enjoy media and make-believe.  Even if you think there is only a small chance that something is scaring your child, take it out until you are sure they can handle it.   There are plenty of friendly alternatives like Dora and Wonderpets to get addicted to =)

7.  Rehearse victory during the day. Have your child practice victory over their fears during the day.  This may include role-playing the superhero who can conquer ghosts and boogeymen.  Or it can include doing a room inspection (for your realists) and examining things that look scary in the dark.  Have them adjust things that seem creepy, like a hook on the wall or picture frame that casts a long shadow.  If your child has more phobic fears (i.e. non-imaginative, like the vacuum, trains, toilet), you can work on these during the day too.  But be aware that confronting their fears might cause worse bedtime experience.  Lots of kids’ nighttime experiences are related to their daytime experiences, even if the connection seems fuzzy.  But the more secure the child is during the day, the better that will translate over to nighttime.   It’s best not to rush it– it depends on whether you feel like confrontation will help your child or just make it worse.

8.  Examine other possible sources of stress. Again, children aren’t so linear that stress is contained… lifestyle stress can definitely be encouraging nighttime problems.  “Stress” for a toddler or preschooler is relative, though, so be sure to account for things which are objectively stressful (Mommy is struggling, Daddy lost his job, parents are fighting, etc) and subjectively stressful (child is having trouble toilet-training, preschool is difficult, he or she was forced to eat vegetables tonight).  By having an open mind and thinking about what a little child could be stressed about, you may be able to pinpoint strategies that will help reduce it… postpone the toilet, talk to the preschool teacher, skip the force feeding.  Some little children are very precocious and pick up on their parents’ stresses, so don’t be beyond having “adult” talk in private or putting on a happy face for awhile.  I am not saying to neglect your own health; I am saying that an astute 3-yr old can sense when things aren’t right.  A lot of times this precociousness shows in your preschooler asking big questions: “What happens when we die?”  “Are you going to go away, Mommy?” etc.  And watch the TV shows you are watching around your kids… even Oprah or the news can be causing illogical stress for a little one.  Sometimes they see or hear just one tiny bit which is disturbing.  Tape it and watch it later.

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Now these tips are just things for normal nighttime fears.  If your child has a bigger problem like night terrors or sleepwalking, consult a professional.  But the majority of things can be managed with a little patience and practicality!  Don’t let accommodations rule your life (i.e. moving the child back into your bed), but do make accommodations and worry about weaning off props later.  A year or two of sensitivity–especially during the ages of 3 and 4–will pay tremendous dividends.

Rotavirus

Ah, the week of the stomach flu… I have just gone through one, so I am thinking about it. It’s my fourth time in five years, so that means almost each year it hits. I hate this week. I hate it every time it comes. But since it is largely the same, I thought I’d post about it just in case it helps someone.

Rotavirus is the most common cause of a week or two of family “stomach flu.” It is very common with babies and young children, and despite what the websites tell you, it usually passes on to the adults in the house! I don’t know why they say adults usually don’t get it, or as severely, because that’s not true. The bigger the adult, usually the more violent it is.

Anyway, rotavirus usually starts very suddenly with your child fine and eating, and then randomly after some meal, just vomiting everything up. Sometimes several times. If you try and give them Pedialyte, they will most likely vomit that up too. So despite what the websites say, save your money and don’t try that right away. Wait a day or two. The vomiting may last for awhile, it depends on the child. Usually the child will vomit until the stomach is all the way empty, and will stop once it is. If you give them cheerios or whatever the next mealtime, or liquids too soon, they probably will vomit that too. In my limited experience, it has usually taken 24 hours for my little children to hold anything in their stomachs. Sometimes closer to 48.  And usually it is only a graham cracker or something very small. Once they can hold it down, they are usually crampy and don’t have much appetite anyway for awhile… cheerios or saltines are as ambitious as they get.

The other main symptom of rotavirus is diarrhea. And it is nasty–explosive, watery, smelly. I could always tell when my child’s diarrhea was stomach virus versus something else because it was so pungent. Sometimes my child got diarrhea right away with the first vomiting. Danger on both ends! A plastic high chair is a good place for a young child to be at these times because it is easy to clean up. Other times, the diarrhea follows after the vomiting stage is over, like 24-48 hrs later. The child might even be hungry and eating, but the diarrhea continues… usually directly after eating, and sometimes several bouts quickly before it stops. In my toddlers, they were usually fine when they weren’t eating, and I could put them down for a nap in between meals without worrying they’d mess the crib. But the sad thing is that the diarrhea can last a long time, even 7 days or more. In these cases, you really have a situation because the child might be back to “normal” but you have to watch them like a hawk for those bowel movements… they can really make a mess. Be prepared to have a lot of bleach, pairs of pants (jeans are the best), and a lot of laundry on hand for awhile. (And a face mask, for you!) As bad as it is, it is easier to deal with toddlers in diapers than preschoolers in underwear. You may want to consider putting a preschooler back in diapers or disposable swimmies, just for this situation. It’s embarrassing for them, but most preschoolers have trouble making it to the toilet in time, every time, when it comes quickly or often.  You can have them wear plastic pants over their undies, but the elastic around the legs often makes it hard and messy to get off. Definitely avoid socks and sneakers if you can, since they will get messed. Stick with bare feet and plastic shoes like Crocs or sandals.

The main risk of Rotavirus is dehydration, and it is not totally uncommon for children or adults to have to go to the hospital for a rehydrating IV. Definitely if the patient cannot keep water down for more than a day, or passes out from the vomiting, you should take them to the ER so they can IV and monitor. But it is not uncommon to vomit seemingly forever, even turning pretty white, and just have to stick it out in your own bathroom until you can keep fluids down. If you have an infant, keep feeding and give Pedialyte in small doses (1 tsp) regularly after the vomiting stops. Some websites recommend soy formula rather than lactose-based for the recovery (because of the protein and easier digestion), although some infants can’t tolerate the soy even when they’re healthy!

The good news is, the worst of the rotavirus usually is over in 48 hrs–per person.  But by then it has usually passed on to someone else!  Then the 48 hrs begins for them.  Usually the major vomiting stops within that time period, but don’t make the mistake of drinking/feeding too much, too early. Go slow or the vomiting can return and you’re back to step 1.  Websites will say to offer food 6hrs after vomiting has stopped, but I find that is too early.  Websites say not to stick to the BRAT diet necessarily, but I find that to be misleading… toast and crackers really are the first foods for an upset system, and I wouldn’t venture beyond that until those are happily digested.  And websites today often say milk products are not as bad as people thought. But I have found (through experience) to stay away from dairy products for a week or more. .. until the diarrhea is gone.  Stay on carbs, but make sure they are always getting enough water and Gatorade. Small doses throughout the day. Gatorade is dissed by experts, and so is water, for not having the right balance of salts.  But I find that diluted juice aggravates my kids’ diarrhea whereas the sports drinks (watered down too) didn’t.  I guess you should experiment for yourself.

The morale will probably come back to your child before all the symptoms abate, like 2 to 4 days later. Very low morale is a sign of dehydration, so supervise carefully in this stage, and watch for dry lips and eyes.   One of my preschoolers stayed in bed for five days this past week, but my kindergartner was hopping around only two days later!  So everyone is different =)  Don’t take anyone to a playdate or nursery once their morale is back because rotavirus is extremely contagious. It usually appears about 24-48 hours after first contact, and it is contagious for 3 days following inception. If the child’s underwear or diaper leaks during the playdate, just even a tiny amount of stool can infect the other children… rotavirus in the stool lives for up to 4 weeks. Make sure you follow the child everywhere with bleach because that is the only thing that will kill it. We use hand sanitizers, disinfecting spray, and Clorox wipes in the house, but bleach is the only thing that is documented as true killer. So that’s your best friend while the secretions are flowing.

Obviously wash everyone’s hands as much as possible.

But the SADDEST part about rotavirus is that you can’t get immune to it.  You can get it again.  I don’t know if this is because there are multiple variations of rotavirus out there, but it is not uncommon for some families to get the bug a couple times within the same season.  It is more common in the wintertime, and I believe there are some charts out there about the geographical spread of the virus–Southwest USA getting the most cases in Nov/Dec, Midwest peaking in Jan/Feb, and Northeast by Mar/Apr.  Of course these are just approximations, but I do believe epidemiologists have noticed trends.  So super-clean your whole house after everyone’s well (especially bathrooms) and be vigilant about spreading in your local area.  Hibernate for awhile, especially from nurseries and public transportation, if you notice people dropping like flies =)  It will pay off, even if you’re bored for awhile, to not get it again.

Coping strategies I came across this week (and we’re not done yet!) are…

1. For the vomiting stage, make sure the child’s bed has a waterproof cover on the mattress and on the pillow. Strip the sheets and lay a towel on there instead. When they throw up in the bed, you can just pull off the towel and pillowcase, wipe down the waterproof covers, and put a new towel and pillowcase back down. This is MUCH, MUCH better than cleaning continuous vomity sheets, blankets, etc.

You can also put a towel on the floor right by the child’s bed, if you are worried about carpets. Pull beds away from the walls if possible because it is hard to clean vomity walls/cracks.

2. For the diarrhea stage, give your kids a Pepto-Bismol before naps and bedtimes. The doctors will tell you not to, but it is terrible to have diarrhea while sleeping if you can avoid it. Especially if you have a baby because they might lay in it all night or get it in their mouths. It is worth taking a little Pepto (or Immodium, as I used on some of my kids this week) to keep sanity. Anti-diarrheals don’t always prevent diarrhea in this situation, but they can at least decrease the amount.

3. For any stage that is still messy, fill up your washer to soak with hot water, bleach, and laundry detergent. Then you can throw messy pants or linens in there throughout the day as they accumulate, and run when it gets full. Bleach will not take the color out of most kids’ clothing unless it is poured directly on the fabric, so it is a safe place to store messy clothing for a couple hours throughout the day.

Throw away any clothing that is too soiled to clean, or hose it down in the yard or laundry tub before soaking. Make sure you resanitize the laundry tub with bleach afterwards.

4. Try to keep little children who are still messing in areas without carpets. Put little babies in Pack N Plays, which are plastic and easier to clean. My three year old took a nap on the Pack N Play mattress, on the kitchen floor, with a blanket on top during his vomiting day. Much easier to clean than sheets and bedroom carpets. During the diarrhea stage, if children are playing on couches or carpets, or you have to take them in the carseat, have them take a plastic placemat with them to put under their bum so they don’t have accidents on the fabric. Portable seat cushion! Totally worth the reminders to take it everywhere.

5. You can teach older kids to vomit in a bucket or bowl, but most little kids can’t do this. Try keeping them in the bathroom or bathtub, or in the kitchen, or in their plastic-covered beds while things are bad. Definitely keep extra buckets or plastic trash cans in rooms and bathrooms. There are times when mess is coming out both ends, or by total surprise, that you need extra bins around!

6. Assuming they can keep at least water down, don’t worry how long it takes for your child’s appetite to return. Hold back kids who think they’re ok and want to wolf things down just because they’re not throwing up anymore. And let a child who is reluctant to eat be reluctant… they’ll eat when they are ready. Watch the pallor of the face, and the hydration most (lips, eyes, mouth, tears), and as long as it’s ok, it’s no big deal if they don’t eat for a week. They’ll be tired, but no need to fear that fasting–even for a toddler–is the end of the world. It is only a big deal for an infant, who cannot be allowed to fast. For the infant, keep nursing or bottle-feeding even though they can’t keep much in there, and consult your doctor as often as needed.

7. Do not rely on Rota-Teq, the vaccine. My two-year old had that last year and she was still sick this year.