Children’s Health

How do I make time-outs effective when disciplining my child?

DEAR DOCTOR K: You've mentioned time-outs as an appropriate way to discipline young children. But they don't work for my son, at least the way I'm doing them. What can I do differently?

DEAR READER: When children are young, discipline means teaching them self-control and the difference between acceptable and unacceptable behaviors. One way to do this is with a time-out.

How can I protect my middle schooler from cyberbullying?

DEAR DOCTOR K:My daughter will be starting middle school this year. How can I protect her from cyberbullying?

DEAR READER: Bullying can be particularly difficult during middle and high school, when popularity and peer acceptance feel like the most important parts of life. Adding technology to the mix makes it worse still. Cyberbullying is not simply bullying that takes place through electronic means.

What do I need to know about my son’s video games?

DEAR DOCTOR K: My son plays a lot of video games. What do I need to know about them? And how can I make sure they don't become a problem?

DEAR READER: I've yet to meet a child who doesn't like video games. But as you imply, this kind of entertainment has its downsides. I've talked with several colleagues who are pediatricians here at Harvard Medical School, and they've helped me answer your question.

My 4-year-old still mispronounces many words– Should I be worried?

DEAR DOCTOR K: My 4-year-old still mispronounces many words. Adults outside of our family have trouble understanding what he's saying. Should I be worried?

DEAR READER: Just as it took time for your child to learn his first word, it takes time for children to learn to speak clearly and correctly. To see what the latest thinking on this is, I talked to pediatrician colleagues at Harvard Medical School.

What do I need to know if my 9-month-old has another seizure due to a high fever?

DEAR DOCTOR K: My 9-month-old daughter had a seizure last time she had a high fever. The pediatrician said it could happen again. What do I need to know?

DEAR READER: The medical term for what your daughter experienced is febrile seizure. I was taught that febrile seizures are caused by a high fever or a sudden rise in body temperature. The effect of the higher body temperature makes the brain "irritable" and causes a seizure. But in the last few years, we've learned it may be more complicated than that.

I have two young children — Besides small toy parts, what are other choking hazards?

DEAR DOCTOR K: I have two young children. I know not to buy toys with small parts or keep coins within their reach. What other choking hazards should I be aware of?

DEAR READER: Your question is timely, because a large study on this topic was recently published. It provides answers that surprised me and may surprise you. I think this is information that every parent with young children needs to know.

How old can you start disciplining children?

DEAR DOCTOR K: My sister and I both have young children. She believes that toddlers are too young to discipline, but I think it's important to establish rules and consequences early. What do you think?

DEAR READER: Discipline is important for all children, including babies and toddlers. Disciplining your toddler means teaching and protecting your child, both at once. Your goal is to keep her safe by teaching her self-control and the difference between acceptable and unacceptable behaviors. Discipline does not mean punishment.

What can I do to prevent my baby developing a flat spot on the back of his head?

DEAR DOCTOR K: I know it's safer for my baby to sleep on his back, but I'm worried he'll develop flat spots on the back of his head. What can I do to prevent this?

DEAR READER: Flat spots on the head are becoming more common in babies. As you suspect, that's likely because more babies are sleeping on their backs than on their bellies. We want babies to sleep on their backs to decrease the risk of sudden infant death syndrome (SIDS).

How should I respond when my 4-year-old tells a lie?

DEAR DOCTOR K: Lately my 4-year-old has started lying to me. She'll say she didn't break a toy, or push her brother, when I know she did. How should I handle this?

DEAR READER: Almost all preschoolers will lie at one time or another -- and it's clear they know they're lying, and that they shouldn't be doing that. For example, when one child hits another and is challenged about it, here's the usual sequence of lies: "I didn't do it"; "I didn't mean it"; "It didn't hurt anyway!"