Q: My two year-old recently picked up the biting habit. He would bite anyone whenever he doesn’t get his way. What can we do to contain this?

Counselling psychologist/marriage & family therapist Charis Wong says,

Since children at this age are only beginning to learn language and communication skills, they may engage in more primitive behaviours such as biting when frustrated. Most children eventually grow out of this bad habit, but the problem can be very distressing to parents. The debate is still on-going as to whether or not to bite back your child to show them how much biting hurts. Like corporal punishment, biting back can be an effective means of stopping this undesired behaviour, yet using aggression to respond to aggression is modelling inappropriate behaviour and can leave a lasting negative impact on the child. There are other methods that you can explore before you consider whether or not to resort to this drastic biting-back action.

Firstly, it is important to know when and exactly why your child is biting. I’d suggest you analyse his behaviour by recording what happens every time before and after each biting episode. When you say “get his way”, do you mean that is he doing this to obtain a tangible item, or to get attention, or to avoid an unwanted activity/environment? Once you know the precipitating event, you will not only be able to plan a more effective intervention but also anticipate a biting episode by watching out for the warning signs and intervene before it happen.

The moment your son starts to bite you or someone else, immediately respond by acknowledging his frustration, then firmly but calmly set a limit that, “teeth are not for biting people”. Offer a more appropriate alternative replacement behaviour for him. If he doesn’t stop, say, “Oh dear, you know that teeth are not for biting people but you continue biting. It looks like you need some cooling off time” and place your son for a time-out in a safe, but boring room long enough for him to understand that this is the consequence of his behaviour.

If you do this consistently each time he bites, he will soon get the message that biting will not give him attention but isolation! If your son is biting to get your attention, it is important that you do not give him attention, even negative attention, as this would only reinforce the undesired behavior.

Also, consider whether your son is engaging in this attention-seeking behaviour because he is not getting enough attention or is feeling bored and needs more stimulating activities. If your son is biting to avoid an unwanted activity, consider trying to pair the activity with a pleasant stimulus to increase his motivation. For example, limit cartoon time to only taking place after he completes his dinner. If your son is biting to avoid an unwanted environment (i.e. a noisy, crowded place), respond by acknowledging his frustration but reinforce the rule that teeth are not for biting. If you catch your son biting other children, immediately remove the “victim” from your son and give plenty of attention and sympathy to the “victim” while ignoring your son.

Once your son is old enough to reason with, you can talk to him about what is going on and encourage him to use his words to express his needs and emotions instead. One way to do this is to put your son’s finger into your mouth and use your teeth to put just enough pressure on his finger for him to realise that this is going to hurt if you add more pressure. Then ask him whether he’d like you to bite his finger. When he says no, ask him why not. This will lead to a conversation about biting; that biting hurts and it is not okay. Also ensure that you give your child plenty of love and attention, so that he feels safe to come to you when he is in distress.

Q: I’m 32 weeks pregnant and going away for the festive period. Do I need to do anything to prepare in case my baby comes early?

Midwife Ann Ibrahim says,

A baby born before 37 weeks gestation is considered premature. By 37 weeks, the baby’s lungs would have matured enough for breathing, the organs will have matured enough, and the baby would have the necessary strength and brain formation to suck and feed. Most premature babies who are born after 32 weeks have a high chance of surviving and growing up to be healthy. A baby whom has spent less time in the womb has less chances of being healthy and surviving well as the lungs, organs, and strength are not matured yet. These babies will need special care.

The likelihood of premature labour (baby coming early) is slim unless you have had complications or an infection. To be on the safe side, always travel with your notes from your obstetrician/midwife and bring along their contact details should they need to know about your pregnancy in an emergency. Locate the nearest clinic and hospital with neonatal and obstetric facilities and keep the numbers handy. Same goes for emergency numbers like for an ambulance and family members.

If you do go into premature labour (your waters break or you experience contractions), seek help immediately and go for a check-up with an obstetrician. In more than half of these cases, contractions will cease and the membranes may seal up on their own, but you need to assess the cause. If birth does indeed look like it’s progressing, then some medication can be given to mature the baby’s lungs and slow down the labour process. The baby will then be assessed at birth for lung and organ functions as well as ability to feed, and help given in a neonatal facility.

Q: My two-year old has been walking for about a year, but she tends to walk on his tiptoes. Why is this happening?

Consultant paediatrician Dr. Ling Shih Gang says,

Tip-toeing among toddlers is very common. This usually occurs within the first one or two years after they start walking. It can be considered normal and is usually a passing phase. Why does it happen? Nobody really knows why. Most tip-toeing children only do that intermittently. If your child has more persistent tip-toeing, it is better to consult a doctor. A small minority of tip-toeing children may actually have neurological abnormalities that cause increased tone and rigidity of the limbs, such as cerebral palsy.