What Is ADHD? 

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder ⁽¹⁾ . People who experience it have difficulties paying attention, and/or controlling their impulses and regulating their behaviour.  

Children ⁽²⁾ with ADHD are more likely to:  

• Have academic problems 

• Have problems in their social relations (e.g., family and friends) 

• Suffer physical injuries 

• Do drugs and alcohol 

• Have low self-esteem 

• Have problems finding and keeping a job when they grow up 

ADHD is the most common neurodevelopmental disorder with an estimated prevalence ⁽³⁾ of 5%. It usually continues into adulthood although for some people, symptoms lessen with age. Others never completely outgrow ADHD, but they learn to manage it using different strategies.  

Do Toddlers Have ADHD? 

ADHD seems to be a condition we are born with. So, it is possible for toddlers to have ADHD. The issue is that toddlers cannot be diagnosed until they are older. It is not possible to get toddlers diagnosed because toddler behaviour and ADHD symptoms often overlap.  

Toddlers ⁽⁴⁾ usually find it difficult to pay attention, control their impulses and they tend to be quite hyperactive. These three characteristics are typical of children with ADHD. Those children who reach primary school and still find it difficult to develop these abilities may be referred to a specialist to determine if they have ADHD. 

How Is ADHD Usually Noticed? 

Children with ADHD tend to be identified when they are in primary school during middle childhood. Very often these children have trouble with their schoolwork as well as with other children ⁽⁵⁾.   

How Is ADHD Diagnosed? 

ADHD must be diagnosed by a paediatrician, or by a mental health professional, like a psychologist or a psychiatrist. 

Diagnosing ADHD is a process with a few steps. It is a complex process because there is not a single test to diagnose ADHD. Other problems, such as anxiety, sleep disorders, or other type of neurodivergent conditions, have similar symptoms to ADHD.  

The American Association of Paediatrics (AAP) has guidelines to diagnose and treat ADHD in children between the ages of 4 and 6 years old. It does not have guidelines aimed at younger children.  

Healthcare professionals diagnose ADHD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The DSM-V states that there are three types of ADHD: 

Hyperactivity-impulsivity: 

• Often fidgets with or tap hands or feet, or squirms in seat 

• Often leaves seat in situations when remaining seated is expected 

• Often runs about or climbs in situations where it is not appropriate  

• Often unable to play or take part in leisure activities quietly 

• Is often ‘on the go’ acting as if ‘driven by a motor’ 

• Often talks excessively 

• Often blurts out an answer before a question has been completed 

• Often has trouble waiting for their turn 

• Often interrupts or intrudes on others 

Inattention: 

• Often fails to pay close attention to details or makes careless mistakes in schoolwork, at work, or with other activities. 

• Often has trouble holding attention on tasks or play activities 

• Often does not seem to listen when spoken to directly 

• Often does not follow through instructions and fails to finish schoolwork, chores, or duties in the workplace  

• Often has trouble organizing tasks and activities 

• Often avoids, dislikes or is reluctant to do tasks that require mental effort over a long period of time 

• Often loses things necessary for tasks and activities 

• Is often easily distracted 

• Is often forgetful in daily activities 

Combined:

A child with combined ADHD has symptoms of both inattentive and hyperactive-impulsive ADHD.  

Children are diagnosed with ADHD when they: 

• Have symptoms for at least six months.  

• Have symptoms in two or more settings (e.g., home, school, social setting). 

• Have symptoms that impact their ability to function successfully in school, at home, and in other social contexts.  

• The symptoms are not better explained by another mental disorder 

It is important to note that your child might show one or many of these characteristics without having ADHD.  

How Is ADHD Treated? 

ADHD cannot be cured but the correct treatment can help manage the symptoms. The American Academy of Paediatrics recommends that: 

• Children younger than six years old: parents to receive behaviour management before medication is tried.  

• Children 6 years-old and older: they should receive medication (e.g., stimulants or non-stimulants) and behaviour therapy. For children under 12, it is also recommended that their parents receive training in behaviour management.  

A good treatment plan should be closely monitored, and changes should be made along the way to adapt to the child’s development. It is also important that parents, teachers, and health professionals work together to best support the child.  

Why Is it Important to Diagnose ADHD as Early as Possible? 

Early diagnosis and treatment can make a big difference. This is why, researchers are examining how it could be diagnosed earlier. The latest research is examining the links between ADHD and children having a difficult temperament from birth ⁽⁶⁾. Researchers are also examining links between ADHD and toddlers struggling to achieve motor and language milestones, as well as toddlers being very active ⁽⁷⁾.   

Finally 

Please remember that whatever people may say there is nothing you have done to cause your child’s ADHD. ADHD is a neurodevelopmental disorder.  

If you suspect your toddler may have ADHD, discuss it with your doctor but do not forget that ADHD cannot be diagnosed when children are this young.  

If you have any questions regarding ADHD, please do not hesitate to get in touch with me.  

Love,  

Ana 

Dr Ana Aznar 

References 

⁽¹⁾ Nikkelen, S. W. C., Valkenburg, P. M., Huizinga, M., & Bushman, B. J. (2014). Media use and ADHD-related behaviors in children and adolescents: A meta-analysis. Developmental Psychology, 50(9), 2228-2241. https://doi.org/10.1037/a0037318 

⁽²⁾ Barkley, R. A. (2014). ADHD and injuries: Accidental and self-inflicted. The ADHD Report, 22(2), 1-8. https://doi.org/10.1521/adhd.2014.22.2.1 

⁽³⁾ Polanczyk, G., De Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American journal of psychiatry, 164(6), 942-948. https://doi.org/10.1176/ajp.2007.164.6.942 

⁽⁴⁾ Nigg, J. T., Sibley, M. H., Thapar, A., & Karalunas, S. L. (2020). Development of ADHD: Etiology, heterogeneity, and early life course. Annual review of developmental psychology, 2(1), 559-583. https://doi.org/10.1146/annurev-devpsych-060320-093413 

⁽⁵⁾ McGoey, K. E., Eckert, T. L., & Dupaul, G. J. (2002). Early intervention for preschool-age children with ADHD: A literature review. Journal of Emotional and Behavioral Disorders, 10(1), 14-28. https://doi.org/10.1177/106342660201000103 

⁽⁶⁾ Nigg, J. T., Blaskey, L. G., Stawicki, J. A., & Sachek, J. (2004). Evaluating the endophenotype model of ADHD neuropsychological deficit: results for parents and siblings of children with ADHD combined and inattentive subtypes. Journal of abnormal psychology, 113(4), 614. https://psycnet.apa.org/doi/10.1037/0021-843X.113.4.614 

⁽⁷⁾ Miller, C. J. (2023). Mindfulness Interventions for ADHD. In Clinical Handbook of ADHD Assessment and Treatment Across the Lifespan (pp. 631-647). Cham: Springer International Publishing. 

Over the last few years, parental alienation has been discussed in the media quite a lot. But do you know what parental alienation really means? Do you know that there is huge controversy amongst professionals because they don’t even agree if parental alienation is really a thing? Keep reading to find out what’s all about.  

What Is Parental Alienation? 

Parental alienation ⁽¹⁾ is a mental condition in which a child allies strongly with one parent (the alienating or favoured parent) and refuses to have a relationship with the other parent (the alienated or target parent). The alienated parent is rejected without any justifiable reason, such as physical or emotional abuse, or neglect.  

The idea of parental alienation was first quoted by Dr Richard Gardner in 1992. 

The most common cause ⁽²⁾ is that the child is manipulated by the other parent. As a result, the child ends up disliking or being afraid of the alienated parent. Parental alienation usually happens when parents are going through a very conflictive separation or divorce. However, it can also happen in intact families. Especially, if the couple is going through a rough patch or have a very difficult relationship.  

The result of parental alienation is the breakdown of the relationship between the targeted parent and the child.  

Alienation may be done by mothers and fathers ⁽³⁾. 

A Word of Caution 

Before we dive into the research on parental alienation, let me tell you that this is a highly controversial topic. Even though researchers have been examining it for the past 30 years, some of them do not even agree that parental alienation is a thing.  

On one hand, there are researchers who argue that parental alienation is based on junk science ⁽⁴⁾ and it is only a justified dislike for a parent, similar to estrangement. According to them, parental alienation is ambiguous, and impossible to diagnose.  These researchers also argue that parental alienation is a legal strategy used by abusive parents to get custody of their children ⁽⁵⁾.  

In contrast, other researchers ⁽⁶⁾ believe that there is enough evidence to support the concept of parental alienation. They believe that parental alienation is a thing.  

Let’s explore what the research says, while keeping in mind this word of caution. 

Signs of Parental Alienation in Parents 

The alienating parent may… 

• Criticize and humiliate the target parent in front of the child.  

• Convince family members and friends that the target parent does not deserve their love and should not be in touch with the children 

• Impede or make it very difficult for the child to spend time with the target parent  

• Do campaigns of denigration against the other parent 

• Disapprove of the child showing affection towards the target parent 

Signs of Parental Alienation in Children 

Children who are victims of alienation may… 

• Criticize the alienated parent strongly and with no cause 

• Show unconditional support for the favoured parent. Everything the favoured parent does is right and everything the alienated parent does is wrong 

• Experience hatred or fear towards the alienated parent 

• Not care about the feelings of the target parent  

It is important to keep in mind that having negative feelings towards a parent is not always evidence of parental alienation.  

What Are the Consequences of Parental Alienation? 

Some mental health professionals use the term parental alienation syndrome (PAS) to describe the effects on parents and children. Other professionals have stopped using the term ‘PAS’ and instead they refer to ‘parental alienation’, ‘alienation’, ‘implacable hostility’ and ‘child resistance or refusal’. These terms are also questioned by some practitioners and researchers because they claim there is no scientific evidence to support them.   

Children may experience short-term and long-term effects, such as depressive symptoms, lower quality of life, and difficulties communicating with the target parent ⁽⁷⁾. They may also find school difficult, have problems sleeping, and develop low self-esteem ⁽⁸⁾.  

The target parent ⁽⁹⁾ may experience depression, anxiety, frustration, feelings of loss, fear, and helplessness. However, note that there is not much research examining the experiences of alienated parents. 

Is PAS a Diagnosable Mental Disorder? 

PAS is not recognized as a diagnosable mental disorder. It is not included in the two major mental health diagnostic systems that practitioners use around the world. These are the DSM-V of the American Psychiatric Association (APA) and the ICD-11 of the World Health Organization (WHO).  

It is important to note that the WHO and the APA consider that parental alienation can be considered a ‘Caregiver-Child Relationship Problem’. This category is included in both diagnostic manuals, but it is not recognized as a mental health disorder. The WHO considers that parental alienation is relevant in some judicial contexts, but they argue that there is a lack of evidence to consider it a mental syndrome. 

The fact that PAS is not considered a mental disorder does not mean that it will never be. Diagnostic systems, like the DSM-V and the ICD-11, are not set in stone. They have included disorders that have later been eliminated (e.g., homosexuality) and added others that were not included before (e.g., Disruptive Mood Dysregulation Disorder, DMDD).  

What Is the Difference Between Parental Alienation and Estrangement? 

Estrangement involves a child rejecting a parent with a reasonable justification, such as abuse or neglect ⁽¹⁰⁾. Alienation involves rejecting a parent with no clear reason. 

Estrangement is also not considered a diagnosable mental disorder by the DSM-V or the ICD-11.  

Is Parental Alienation Abuse? 

No. Domestic abuse is a crime whereas parental alienation is not.  

Why Is It Important Whether Parental Alienation Syndrome Is Really a Thing? 

Whether PAS is really a thing or not is important because it could have huge implications in child custody decisions, abuse cases, and children’s welfare.  

If PAS was to be recognized as a mental disorder, children’s testimonies would be evaluated with scepticism, particularly in cases of abuse or neglect. Judges might question whether children’s statements are their own or influenced by the alienating parent.  

Family courts would have to rely more on expert witnesses, such as psychologists, to determine if the child really has PAS or not.  

Finally… 

As we have seen, parental alienation is a really complex issue. If you are going through a difficult patch with your partner or your children and you want to discuss it, do not hesitate to get in touch with me.  

Regards,  

Ana 

Dr Ana Aznar  

References 

⁽¹⁾ Bernet, W. (2023). Recurrent misinformation regarding parental alienation theory. The American Journal of Family Therapy, 51(4), 334-355. https://doi.org/10.1080/01926187.2021.1972494 

⁽²⁾ Bernet, W. (2020). Parental alienation and misinformation proliferation. Family Court Review, 58(2), 293-307. https://doi.org/10.1111/fcre.12473 

⁽³⁾ Lowenstein, L. F. (2013). Is the Concept of Parental Alienation a Meaningful One? Journal of Divorce & Remarriage, 54(8), 658–667. https://doi.org/10.1080/10502556.2013.810980 

⁽⁴⁾ Joyanna Silberg & Stephanie Dallam (2019) Abusers gaining custody in family courts: A case series of over turned decisions, Journal of Child Custody, 16:2, 140-169, DOI: 10.1080/15379418.2019.1613204 

⁽⁵⁾ Meier, Joan S. and Dickson, Sean and O’Sullivan, Chris and Rosen, Leora and Hayes, Jeffrey, United States Child Custody Outcomes in Cases Involving Parental Alienation and Abuse Allegations: What do the Data Show? (January 01, 2020). GWU Law School Public Law Research Paper No. 2019-56, GWU Legal Studies Research Paper No. 2019-56, Available at SSRN: https://ssrn.com/abstract=3448062 or http://dx.doi.org/10.2139/ssrn.3448062 

⁽⁶⁾ Baker, A.J.L. (2018). Reliability and validity of the four-factor model of parental alienation. Journal of Family Therapy, 42, (1), 100-118. https://doi.org/10.1111/1467-6427.12253 

⁽⁷⁾ Tavares, A., Crespo, C. & Ribeiro, M.T. What Does it Mean to be a Targeted Parent? Parents’ Experiences in the Context of Parental Alienation. J Child Fam Stud 30, 1370–1380 (2021). https://doi.org/10.1007/s10826-021-01914-6 

⁽⁸⁾ Harman, J. J., Kruk, E., & Hines, D. A. (2018). Parental alienating behaviors: An unacknowledged form of family violence. Psychological Bulletin, 144(12), 1275–1299. https://doi.org/10.1037/bul0000175 

⁽⁹⁾ Baker, A., & Andre, K. (2008). Working with alienated children and their targeted parents. Annals of the American Psychotherapy Association, 11, (2), 10-.  

_⁽¹⁰⁾ Garber, B. D. (2011). Parental alienation and the dynamics of the enmeshed parent–child dyad: Adultification, parentification, and infantilization. Family Court Review, 49(2), 322-335. 

To track or not to track… That is the question parents face. For some parents tracking their child’s phone is an absolute must, and they don’t see what the problem is. For others, it is an intrusion of their children’s privacy.  

So, what does the research say? Let’s have a look.  

What Does the Research Say? 

Truth to be told, there is not much research on this topic. There is one study ⁽¹⁾ published in 2024 examining parents’ phone tracking of their teenagers. They found that teenagers who were tracked by their parents were more likely to have issues like anxiety or depression, and to drink alcohol. But this study cannot answer an important question: Are parents tracking their teenagers because they are doing things that they should not be doing or are teenagers doing things that should not be doing because their parents are too controlling? In other words: What comes first? The tracking or the misbehaving? This is not something that so far research examining phone tracking can answer.  

Tracking a child 24/7 means that that child is being constantly watched and supervised. And we don’t really know how that affects children. 

One way to understand how tracking children’s phones may influence them is to rely on the research examining the effects of parental control on children. After all, tracking your child’s phone is a way of controlling them.  

Should We Control Our Children? 

Rather than controlling our children, we need to know our children. Knowledge ⁽²⁾ about who their friends are, the things they do when they go out, how they are doing at school, the things they like, what worries them, and whether they are OK. Why is knowledge important? Because when parents know about their children’s life, their children tend to engage in less risky behaviours and tend to have better mental health. 

There are two ways to get that knowledge about your children: 

• By controlling them: when we control our children, we control the amount of freedom children have to do things without us, asking their friends for information, spying on them, surveilling them. 

• By monitoring them: and the best way to monitor ⁽³⁾ them is by having a good relationship with them so they want to tell you what is going on in their life.  

There is a clear difference between getting information about your child by controlling ⁽⁴⁾ or by having a good relationship with them. Knowing a lot about your child because you keep spying on him is very different to knowing about your child because he wants you to know. Children of parents who control very tightly tend to do worse than children whose parents monitor them effectively.  

So, instead of trying to control our children, we need to think about monitoring them properly. The best way to monitor our children is by developing a strong bond with them.  

What Is the Problem with Tracking Children? 

There are a few issues that concerns psychologists: 

• It may be a controlling parental behaviour. As we have just seen, parental control is linked with negative outcomes for children.  

• Children who are being constantly tracked may not develop responsibility and autonomy, and it may increase their anxiety.  

• Children may get the idea that the world is a dangerous place. Why would you track 24/7 your child if there is not danger around each corner? 

• Children may develop a false sense of safety, thinking that you will always be able to know if they are in danger. As part of normal development, teenagers must develop an understanding of their own safety, and what they need to do to keep themselves safe. 

Is Everyone Tracking their Kids? 

As far as I know, there are only two studies examining the number of parents that track their children. Both studies have been conducted in the US. One examined, parents of children aged 5-11 in 2020 ⁽⁵⁾ and found that 1/3 of parents tracked their children. The other one, examined parents of adolescents in 2024 and found that about half of parents tracked their children’s. Fourteen per cent of parents were tracking their kids without them knowing about it.  

It is also worth mentioning that girls were more likely to be tracked than boys. This may be because parents are more worried about girls’ safety when out and about. 

What To Do? 

Before making a decision, ask yourself who will benefit from the tracking. Will it benefit you because it will bring you peace of mind? If so, what makes you so worried about child being out unsupervised? Or will it benefit your child? If so, how? 

It is also important to consider your child’s age. Tracking teenagers can be particularly tricky because teenagers need to have a sense of privacy and independence. It is part of them growing up. When teenagers feel that their parents are going too far in their parental duties, they may rebel. This may lead the teenagers to resent their parents, and their relationship will suffer. Many teenagers will turn their phones off, let their battery go dead, or stop answering texts. 

If you track your child, tell them you are doing it. Your relationship with your child should be based on trust and respect. If your child discovers that you have been tracking them without them knowing, your relationship will suffer. Especially, the older they get.  

Consider also the information you receive. You will only know your child’s location but not what he is doing or who he is with.  

What Happens with the Data that Tracking Apps Collect? 

This is a concern for many experts. In 2020, Life360 App made $16 million from selling location data. Who buys them? Insurance companies and any other company that finds value in having that data.  

There are many other control apps. Apps such as Find My or Google Maps can be used to see the real-time location of your child’s device.  

On Android phones, Location Sharing allows your child to share their real-time location. On iPhone, you can know where your child is through the Find My App.  

Final Words 

At the end of the day, it is entirely up to you whether you track your child’s phone. If your child sees it as a way for you to control him and invading their privacy, it will probably not be good for your relationship. In contrast, if your child thinks that the tracking is out of concern and care and/or they want you to track them because they feel safe that way, then it won’t harm your relationship. I would recommend that if you do track them, you do it for safety and open communication and not to police and punish your child.  

If you have any questions or comments, get in touch with me!

Love,

Ana

Dr Ana Aznar

References 

⁽¹⁾ Burnell K, Andrade FC, Kwiatek SM, Hoyle RH. Digital location tracking: A preliminary investigation of parents’ use of digital technology to monitor their adolescent’s location. J Fam Psychol. 2023 Jun;37(4):561-567. doi: 10.1037/fam0001067. Epub 2023 Mar 6. PMID: 36877491; PMCID: PMC10238636. 

⁽²) Racz, S.J., McMahon, R.J. The Relationship Between Parental Knowledge and Monitoring and Child and Adolescent Conduct Problems: A 10-Year Update. Clin Child Fam Psychol Rev 14, 377–398 (2011). https://doi.org/10.1007/s10567-011-0099-y 

⁽³⁾ Kerr, M., Stattin, H., & Burk, W. J. (2010). A reinterpretation of parental monitoring in longitudinal perspective. Journal of research on Adolescence, 20(1), 39-64. https://doi.org/10.1111/j.1532-7795.2009.00623.x 

⁽⁴⁾ Kakihara, F., Tilton-Weaver, L., Kerr, M., & Stattin, H. (2010). The relationship of parental control to youth adjustment: Do youths’ feelings about their parents play a role?. Journal of youth and adolescence, 39, 1442-1456. DOI 10.1007/s10964-009-9479-8 

⁽⁵⁾ Auxier, B., Anderson, M., Perrin, A., & Turner, E. (2020). Parenting approaches and concerns related to digital devices. Pew Research Center. 

“Hello, i would like to know your opinion on how to teach respect to a twelve yr old girl. My daughter is an A student and is liked in school by friends and mothers and teachers, however when she is home she has episodes of rudeness to her mother and me and my answer would be soap in the mouth like my dad would have done to me, back then. I know we cant do that but controlling my feelings is difficult when she is so quick to answer back in a rude way to her parents who do everything for her, please help, thank you, Mark“

Dear Mark,  

Many thanks for getting in touch. I have four teenagers, so I totally get you! Coping with rude tweens and teenagers is tough. 

Your daughter is entering adolescence, and this means that she has started a process called ‘individuation’. This means that she is separating from you while getting closer to her friends. This doesn’t mean that she doesn’t love you or that she doesn’t need you anymore. What it means is that sometimes she finds it difficult to manage this new stage of her life. Don’t take it personally. Her rudeness is not about you. It’s about her finding it difficult to manage her emotions. 

Being rude during adolescence is ‘normal’, which doesn’t mean that it’s OK! Your role as parents is to teach her that it is not ok to be rude to you. Whenever she is rude, count to five and calmly say something like:  

• “I just want to help you. Please say that again in a polite way so I can respond”  

•  “I am sure that you don’t want to be rude but the way it came out was really rude, can you think about it for a minute and say it in a nicer way?”.  

• “The way you just talked to me was quite rude, shall we start this conversation again?’ 

It is very important that you say this in a calm and respectful manner. Think that you cannot ask for respect if you don’t respect her. Behave with her exactly how you want her to behave towards you. Doing this will not stop rudeness overnight but it will set the tone that you want to have in your house. If you are consistent and keep saying this every time she speaks to you in a rude way, she will change her tone. 

You mention that your first reaction would be to wash her mouth with soap as your dad did to you. I totally get your point because it is difficult to break the patterns we grew up with, even if we know they are not right. But think that the important thing is not to escalate the situation and the best way to do so is to calmly but firmly, ask her to rephrase whatever she has said in a polite manner.  

It is sometimes difficult as parents to keep our cool with our children. If you find yourself stuck in this situation, do get in touch with me. This is something we can work on in a few sessions.  

I hope you find this information useful. I wish you and your family all the very best, Mark! 

Ana 

Dr Ana Aznar 

Here are the six parenting trends I believe we are going to be seeing during this coming year:

1. The decline of gentle parenting: 

Parents are realising that gentle parenting is exhausting. Gentle parenting puts impossible pressure on parents, demanding that children’s needs are always placed first. Read more about gentle parenting.
 

2. The decline of sharenting: 

Parents are becoming more aware of the dangers of sharenting and the fact that we have no right to expose our children. Read more about sharenting.
 

3. The delaying of children using technology:  

Children’s use of technology is one of parents’ top concerns. Communities of parents are getting together to delay their children’s access to technology. This trend was fueled in 2024 by Jonathan Haidt’s book: The Anxious Generation. Read more about children and technology.

 
4. The rise of personalised and flexible education: 

Parents are moving away from one-size-fits-all education and are looking for education options that suit their child and their family. From after-school activities, flexi-boarding, to hybrid homeschooling, parents are looking for a more tailored approach to their children’s education.  

 
5. The rise of lighthouse parenting: 

Outside the four main parenting styles (authoritative, authoritarian, permissive and neglectful), I do not like parenting labels because I do not think they are particularly useful. No matter how I feel about it, lighthouse parenting is gaining traction amongst parents, and I think we are going to be hearing a lot about it during 2025.  

Lighthouse parenting was first quoted in 2014 by pediatrician Kenneth Ginsburg. Lighthouse parenting is somewhat in the middle between helicopter parenting and free-range parenting. Lighthouse parents provide firm boundaries and emotional support while letting their children navigate their own challenges.  

It is important to note that while many aspects of lighthouse parenting are positive for children, there is no research examining lighthouse parenting as a single parenting construct.  
 

6. The integration of technology in parenting: 

Parents are relying more and more on apps and devices. Whether it is through smart baby monitors or AI powered educational tools, parents are relying on technology to make parenting more efficient and informed. The question is whether all these tools are trustworthy and the long-term impact they will have on child rearing practices.  
 

What do you think? Any other predictions? We will see if I was right with my parenting trends at the end of this year… I would love to hear your thoughts. Do post your comments in the comment box below or send me an email.  

Love,  

Ana 

Dr Ana Aznar  
 

Have you ever noticed how babies go from being quite uncoordinated to becoming coordinated toddlers? This happens because babies are born with very little control of their body.  As they grow, they learn to control their own body through a long and complicated process ⁽¹⁾. To achieve control of their own bodies, babies must master two types of motor skills: gross and fine motor skills.  

Types of Motor Skills: 

• Gross motor skills use larger muscles and muscles groups. They include locomotor, object control and balance skills, such as walking, rolling, and crawling. 

• Fine motor skills ⁽²⁾ involve the ability to control small muscle movements requiring close eye-hand coordination. Examples of fine motor skills are writing, using scissors, or tracing.  

Why Are Fine Motor Skills Important? 

• We need them to do everyday skills, such as eating, getting dressed or manipulating objects.  

• We need them to do well in school. Children who have issues with fine motor skills tend to have issues with their handwriting, as you can imagine, this has a negative impact in their academic achievement. In fact, research ⁽³⁾  shows that fine motor skills during preschool, and more precisely, manual dexterity, are a strong predictor of cognitive and academic skills during primary school. There are also a few studies suggesting that fine motor skills play a role in early reading, although it is not yet understood how.  

How Do Fine Motor Skills Develop? 

Fine motor skills develop a bit later than gross motor skills. This is because there is a sequence in developing muscles. First, we master the movement of the larger ones, and then we start controlling the smaller ones, and the coordination between muscles and organs (e.g., eye-hand coordination).  

Children develop their fine motor skills in the following sequence ⁽⁴⁾:  

1. Control their whole arm: they strengthen and refine the muscles in their arms. 

2. Control their whole hand: They strengthen and use their hands. 

3. Do the ‘pincher’: This is the ability to press the thumb and index finger together.  

4. Do the ‘pincer’: This is the final stage of fine motor development. Children can properly grasp a pencil and are able to engage in proper writing activities.   

How Can I Know if my Child Has Trouble with Fine Motor Skills? 

Each child is different, and their motor development is also different. This means that not all children master their motor skills at exactly the same time. If you think your child struggles with these skills, talk to your doctor and with their teachers.  

Children who struggle to acquire fine motor skills generally do occupational therapy ⁽⁵⁾. The role of the occupational therapist is to support the child when their needs cannot be met solely by the teaching team. Occupational therapy services include self-care skills, assistance with play and social relations, and academic support.  

In the same way that there are individual differences in the ages at which children acquire fine motor skills, there are also very important cultural differences. These cultural differences are caused because child rearing practices are different across the world. Let me give you an example. In the Western world, the guidelines state that babies should be sitting on their own between the ages of 5 and 7 months. Babies who sit before or after this period, are labelled as precocious or delayed. But what happens when we examine babies across six different cultures?  A recent study ⁽⁶⁾ found that at 5 months no baby that was examined in Italy could sit independently, whereas 92% of babies in Cameroon could sit on their own. These differences in development happen because culture matters when raising children. Children growing up in cultures that allow and encourage them to sit independently tend to sit quicker than children in cultures who are not giving the chance to practice sitting. This is the case for every single skill you can think of. If a child is not given the chance to practice it, he will acquire it later or never. The opportunities given to children and when those opportunities are given, are greatly determined by the culture they live in.  

How Can I Help My Child Develop Their Fine Motor Skills? 

The best way to help your child develop their fine motor skills is by providing an environment that allows them to practice large and small movements.  

For babies: 

• Give them things to grasp, squash, grip, and poke such as wooden spoons, pans, and pots 

• Tear wrinkly paper 

• Clap to music 

• Finger play songs such as ‘Wheels on the Bus’ 

• Tummy time while they need to grasp a toy  

• Play with pom poms 

• Shaking a rattle or a toy that makes noise or sound 

For older children:  

• Cut with scissors 

• Put together puzzles 

• Cook  

• Set the dinner table 

• Play board games where they have to roll a dice and manipulate small pieces 

• Finger painting  

• Build Legos 

• Play with play dough 

• Pouring water from one container to another 

• Clipping clothespins on a plastic cup 

• Stringing beads 

• Kick a ball 

Learning to master their fine motor skills can be frustrating for many children (e.g., learning to tie your shoelaces is not an easy feat!) and it can be equally frustrating for parents (e.g., yes, tying your shoelaces can take  20 minutes). Try to be patient and do not just do it yourself because it is quicker. Remember that children need to be allowed to practice new skills so they can learn them. 

As you can tell, there is no need to buy specific fine motor skills toys, you only need what you have around the house.  

Is Screen Use Negative for the Development of Fine Motor Skills? 

There is not much research examining this issue. It has been argued that the use of tablets may encourage the development of fine motor skills because it requires children to swipe and press buttons. However, others argue that the use of this type of media only requires children to perform repetitive and limited actions, not really benefiting the development of fine motor skills.  

A recent study ⁽⁷⁾ found that media use was negative for the development of fine motor skills during early childhood. However, it is not clear if children with lower fine motor skills are more drawn to screens or if on the contrary, screen use is negative for the development of fine motor skills.  

To conclude 

The more you let your child practice their fine motor skills, the better! 

If you have any questions or comment, please do get in touch with me.  

Love,  

Ana 

Dr Ana Aznar 

References 

⁽¹⁾  Adolph, K. E., & Hoch, J. E. (2019). Motor development: Embodied, embedded, enculturated, and enabling. Annual review of psychology, 70(1), 141-164. https://doi.org/10.1146/annurev-psych-010418-102836 

⁽²⁾ Bondi, D., Robazza, C., Lange‐Küttner, C., & Pietrangelo, T. (2022). Fine motor skills and motor control networking in developmental age. American Journal of Human Biology, 34(8), e23758. https://doi.org/10.1002/ajhb.23758 

⁽³⁾ Suggate, S., Pufke, E., & Stoeger, H. (2019). Children’s fine motor skills in kindergarten predict reading in grade 1. Early childhood research quarterly, 47, 248-258. https://doi.org/10.1016/j.ecresq.2018.12.015 

⁽⁴⁾ Carvell, N.R. 2006. Language Enrichment Activities Program (LEAP), vol. 1. Dallas, TX: Southern Methodist University. 

⁽⁵⁾ Salazar Rivera, J., Alsaadi, N., Parra-Esquivel, E., Morris, C., & Boyle, C. (2024) A Scoping Review of Interventions Delivered by Occupational Therapists in School Settings, Journal of Occupational Therapy, Schools, & Early Intervention, 17:3, 510-534, DOI: 10.1080/19411243.2023.2232806 

⁽⁶⁾ Karasik, L. B., Tamis-LeMonda, C. S., Adolph, K. E., & Bornstein, M. H. (2015). Places and postures: A cross-cultural comparison of sitting in 5-month-olds. Journal of Cross-Cultural Psychology, 46(8), 1023-1038. 10.1177/0022022115593803 

⁽⁷⁾ Martzog, P., & Suggate, S. P. (2022). Screen media are associated with fine motor skill development in preschool children. Early Childhood Research Quarterly, 60, 363-373. https://doi.org/10.1016/j.ecresq.2022.03.010 

“My son he is 5 years 6 months old. He has problem in academics and he forgot his stuff at school” 

Dr Ana Aznar

“My daughter with mental disorders has no interest in passing junior year, keeping grades up and isn’t concerned about her future. How do I help and avoid truancy?” 

I am sorry that you are going through this. If I am not mistaken, junior year means that your daughter is 16 or 17, right? 

In my experience, very few teenagers don’t really care about their grades. You mention that your daughter has mental disorders, so this could be playing a part. Have issues such as ADHD, dyslexia, dysgraphia…been ruled out? In addition, perhaps she has lost her self-confidence or she feels overwhelmed because she has fallen really far behind and doesn’t know how to get back on track. 

The most important question is: Why is she getting bad grades? Students typically have poor grades because:  

• They don’t understand the content.  

• They lack the executive function skills needed to succeed at school (e.g., planning, organization…).  

• There is something going on in his life impeding him to focus on schoolwork.  

• They have mental health issues.  

Have a chat with her and try to understand what is going on: Is she unhappy at school or at home?; Is she OK with his friends?; Does she feel supported? Did her bad grades started suddenly or did they develop over time? For this conversation to work you really need to make her feel that whatever she says you won’t get angry, that you are on her side, and that you want to help her.  

You also need to talk with her teachers and include her in the conversations. It is important to include her because she needs to take an active role in her learning.  

 Also, with her teachers and with her, discuss her behaviour at school. Does she pay attention in class?; Does he do his homework?; Is she accepted in the peer group?; Are there any patterns on the feedback he gets from his teachers? (e.g., perhaps they all comment on their lack of understanding of concepts, or his poor writing skills….). It is also very important that with her and her teachers, you discuss the executive skills needed to do well in school. These skills involve planning, organization, being able to pay attention, or short-term memory. As you can tell, these skills are fundamental to succeed at school but very often teenagers don’t have them well established and may need support.  You may find useful this article on executive function skills. With her teachers and her also discuss the truancy. Why is she missing school and what consequences can be established whenever this happens.  

Also, you mention the mental health issues, so possibly she is seeing a mental health professional regularly? If this is the case, do have a chat with them and ideally set up a meeting between you, the teachers, and the mental health professional to devise a plan to best support your daughter. This plan should have very specific goals, be measurable, and be revised periodically.   

I wish there was a recipe I could give that would sort it all out but sadly, things are never that simple. One important thing I want you to know is that your daughter’s poor grades are not a reflection of you as a mother. Do not measure your success based on your child’s achievements. It is also important that you take care of your own mental health. If you want further support, please do not hesitate to get in touch with me.   

Love, 

Ana

Dr Ana Aznar

“I have a 13YR. old grandson living with me. I am struggling with getting him to school. There doesn’t seem to be an issues at school like bullying, at bedtime he says he is going but the next morning he won’t get up to go. He goes to bed at a good time but doesn’t always sleep well. There have been trauma issues but overall, it seems that he is doing good. There is something I recently came across called Failure to Launch. This seems to describe part of his behavior.” 

I am sorry to hear you and your grandson are going through this.  

First of all, I would recommend that you have a chat with him (maybe you have already done this) to try to understand what is going on. Is he struggling with schoolwork?; Is he OK with his friends?; Does he feel safe at school?; Why is he not sleeping well?…  

I would also talk to his teachers to get a better understanding of what is going on. Does he look happy at school?; Does he have friends?; Is he doing well academically?; Is he paying attention in class?; Is he doing his homework? 

Together with the school, you should devise a support plan for your grandson. For this plan to work, you may need to include an educational psychologist, a school counsellor or other health professionals that the school and you consider relevant.  

Remember that to take care of your grandson you need to take care of yourself as well. If you want some 1:1 support, please do not hesitate to get in touch with me. We are here to help you.  

Finally, you may find want to read more about this topic in this article by Lorraine Quinlan, one of our REC Parenting therapists.  

I hope this helps. 

Love,  

Ana 

Dr Ana Aznar

What Are Developmental Milestones? 

Developmental milestones ⁽¹⁾ are things most children (75% or more) can do by a certain age. Skills such as taking a first step, waving, or smiling for the first time are examples of developmental milestones.  

The most important reason for monitoring your child’s development is to determine whether they are on track. Most children reach developmental milestones at or about the same age. However, some children will reach the milestones sooner and others a bit later. The fact that your child may be reaching a milestone a bit later, does not necessarily mean that there is something wrong.  

Developmental Milestones Most Children Reach at 2-Years-Old 

Movement and Physical Milestones 

• Walks (not climbs) up a few stairs with or without help 

• Runs 

• Eats with a spoon 

• Kicks a ball 

Cognitive Milestones (Learning, Thinking, and Problem-Solving) 

• Tries to use buttons, knobs, or switches on a toy 

• Plays with more than one toy at the same time (e.g., putting toy food on a toy plate) 

• Holds something in one hand while using the other hand; for example, holding a cup and taking the lid off 

Language and Communication Milestones 

• Says at least two words together (e.g., ‘more water’).  

• Points to things in a book when you ask (e.g., “Where is the car?”) 

• Points at least two body parts when you ask him to show you 

• Uses more gestures than just pointing and waving, like nodding yes or waving goodbye 

Social and Emotional Milestones 

• Looks at your face to see how you react in a new situation 

• Notices when others are upset or hurt, like stopping or looking sad when someone is crying 

Are You Worried About Your Child’s Development? 

If your child is not meeting one or more milestones, has lost skills they once had, or you have any other worries, reach out to your doctor. Have a chat with them and ask for your child to have a developmental screening.  

The American Academy of Paediatrics (AAP) recommends that children are screened using standardized validated tools at 9, 18, and 30 months or whenever a parent or provider is worried. It is also recommended that children are screened at 18 and 24 months for autism.  

How Common Are Developmental Delays? 

Developmental delays ⁽²⁾ are quite common. In the US, it is estimated that one in six children experience a developmental delay. A delay alone does not mean that there is anything wrong with the child. However, when there is an issue, intervening as early as possible can make a big difference.  

We generally talk about developmental delays being specific or global: 

• Specific: A child may have a delay in only one area, such as motor skills or language.  

• Global: A child may have delays in many areas of development, such as motor skills and language at the same time.  

The Sooner My Child Hits Developmental Milestones, the Better? 

It is important to remember that childhood is not a race. Developmental milestones are designed to be helpful, not anxiety-inducing. Parents should think of developmental milestones as way to get information about their child but not as predictor, or as a competitive indicator of their ability. Childhood is not a competition! 

Having said this, children need to be stimulated, receive attention, and love to fulfil their genetic potential. There is some evidence that hitting some developmental milestones early could indicate a high level of academic achievement or intelligence later in life. 

What Activities Can You Do with Your 2-Year-Old? 

• Involve them in household chores. They usually love to help! They can help setting the table, putting the laundry into the washing machine, and cleaning a floor.  

• Help your child to share, take turns and deal with conflicts during playdates or with their siblings.  

• Help your child to sounds words correctly.  

A Note for Parents of Preterm Babies 

Children born prematurely ⁽³⁾ (even those born in the late preterm period) have a higher risk of experiencing developmental delays. They are more likely to experience delays in language, motor, socioemotional, and cognitive domains.  

The same tests ⁽⁴⁾ that are used to test children born to term are used to test children born preterm. The only difference is that when examining performance of preterm children to developmental norms, the age from their due date rather than birth date is generally used.  

Many preterm children who experience some delays, catch up by the age of two or three years.  

If you have a preterm child is a good idea to keep a close eye on their developmental milestones. Always talk to your doctor if you are concerned.  

How Do I Keep Track of my Child’s Development? 

The Center for Disease and Control Prevention (CDC) in the US has a very good milestone tracker app that you may find useful. It tracks your child’s milestones from age 2 months to 5 years.  

How Are Developmental Milestones Decided? 

The CDC, the World Health Organization, and the American Academic of Paediatrics (AAP) develop these guidelines ⁽⁵⁾ based on scientific research, large-scale studies, and clinical observations of child development.  

Every so often, the checklists are reviewed and updated. This is why developmental milestones can change. For example, crawling used to be a developmental milestone at 9 months, but it is no longer considered one because many children never crawl, and it does not affect their development.  

Finally… 

I hope this information helps. The key message to remember is to keep an eye on your child’s developmental milestones while remembering that childhood is not a race! Milestones are meant to be informative and not to create anxiety. If you think that your child is not hitting a milestone, talk to your doctor.  

If you have any questions or comments, do get in touch!  

Love, 

Ana 

Dr Ana Aznar

References 

⁽¹⁾ Scharf, R. J., Scharf, G. J., & Stroustrup, A. (2016). Developmental milestones. Pediatrics in review, 37(1), 25-38. 

⁽²⁾ De Moura, D. R., Costa, J. C., Santos, I. S., Barros, A. J. D., Matijasevich, A., Halpern, R., … & Barros, F. C. (2010). Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort. Paediatric and perinatal epidemiology, 24(3), 211-221. DOI: 10.1056/NEJM199402173300708 

⁽³⁾ Bucher, H., Killer, C., Ochsner, Y., Vaihinger, S., & Fauchère, J. C. (2002). Growth, developmental milestones and health problems in the first 2 years in very preterm infants compared with term infants: a population based study. European journal of pediatrics, 161, 151-156. https://doi.org/10.1007/s00431-001-0898-0 

⁽⁴⁾ Brothers, K. B., Glascoe, F. P., & Robertshaw, N. S. (2008). PEDS: developmental milestones—an accurate brief tool for surveillance and screening. Clinical pediatrics, 47(3), 271-279. https://doi.org/10.1177/0009922807309419 

⁽⁵⁾ Sheldrick, R. C., Schlichting, L. E., Berger, B., Clyne, A., Ni, P., Perrin, E. C., & Vivier, P. M. (2019). Establishing new norms for developmental milestones. Pediatrics, 144(6). https://doi.org/10.1542/peds.2019-0374 

The first few months of your baby’s life are fascinating. You will watch them change day by day. We have rounded ten simple infant activities that will help the development of your baby’s motor skills, language skills, and that will strengthen your bond.   

1. Tummy Time

Tummy time ⁽¹⁾ refers to placing the baby on their stomach while they are awake and somebody is watching them.  

Tummy time is important because: 

• It strengthens the baby’s neck, shoulders, and arms, in time allowing the baby to hold their head, sit up, crawl and walk.  

• It improves the baby’s general coordination.  

• It helps prevent flat spots on the back of the baby’s head.  

You can start tummy time almost from birth. At the beginning you can place your baby on your chest. While your baby is on your chest, you can try singing, talking and touching him. As he grows you can place him on the floor. Get down to their level while you sing and talk to him. Place toys in view and encourage your baby to get them.  

Babies benefit from having two or three short (3 to 5 minutes) tummy time session each day. By the age of three months, babies can have 15 to 30 minutes of tummy time each day. 

Many babies hate being on their tummies. If this the case of yours, start by placing them on their tummies for very short periods, and gradually increase the time. And try to make it as fun as possible! 

Remember not do tummy time just after a feed!  

2. Mirror Play

Mirror play helps build self-awareness. Place yourself and your baby in front of the mirror. Pull silly faces, make facial expressions and name them (e.g., “Look, mummy is happy”), point and name body parts (e.g., “Where is your nose?”), and play peekaboo (e.g., “Where is the baby?”).  

3. Peekaboo

Developmental psychologist, Dr Caspar Addyman conducted a study with around 1,500 parents and they found that peekaboo (alongside tickling) is the number one activity that makes babies laugh. Peekaboo is all about human connection. In peekaboo you are having a conversation with your baby. Your baby is learning to have a conversation with you. They are practicing their social skills, and they just love it. They love to have your undivided attention.  

4. Finger Plays

Sing to your baby favourite old time songs such as “Wheels on the Bus”, “Bah, Bah, Blacksheep”, “Patty Cake” or “Where Is Thumbkin”. They all have hand and finger motions that go along with the song. Your baby will start copying those motions as soon as he is able to. Doing so, will help his motor skills, hand eye coordination, and language skills.  

5. Reading

You can start reading to your baby almost from birth. Early reading dictates later vocabulary ^(2). The more words a baby hears, the more words he learns. When you read to your baby, not only they are learning new vocabulary, but you are also strengthening your bond and giving him your undivided attention. Infants like touch and feel books, chunky board books, and vinyl bath books.  

6. Dance and Listen to Lullaby Songs

Research shows that listening to lullabies ⁽³⁾ helps babies to regulate their emotions, create a bedtime routine, and it promotes language development. Listening to lullabies also helps develop a bond between the parent and the baby and it passes on cultural traditions.  

7. Water Fun

Most babies love being in the water. Whether they are having a bath or they are in a pool, use the time to play with water toys. Name body parts, demonstrate pouring, or the concept of ‘dry’ and ‘wet’. Add a mirror, read a bath book, or bring on the bubbles.  

Never ever leave a baby unsupervised in the water. Babies drown very fast in a very small amount of water.  

8. Explore Household Items

Everything is new for a baby, and this is why they love to explore the world. Anything from a muffin tin, a wooden spoon, a plastic cup, a laundry basket, or a piece of coloured paper, may be totally fascinating for them. Name the objects that your baby is playing with.  

Tracking objects: Babies develop the ability to track objects ⁽⁴⁾ between two and six months of age. Their ability to track objects depend on the speed and the size of the object. Babies always prefer to look at human faces than to objects, so the more you and the rest of the family are around your baby, the better!  

9. Baby Massage

The American Academy of Pediatrics (AAP) claims that physical touch is essential for a baby’s emotional and health development. Baby massage ⁽⁵⁾ can reduce babies’ levels of stress hormones, encourage flexibility in their arms and legs, improve their sleep, and increase their body awareness. Massaging your baby after they have their bath, will help you to bond and will leave them feeling relaxed and loved. And if you do it while singing or talking to him, even better! 

How Many Toys Does my Baby Need?  

Not many! Consider that everything is new for a baby, so they will be equally fascinated by a muffin tin or a wooden spoon than by a shiny new toy. Do not feel the pressure to buy expensive new toys, because your baby does not really need them.  

Will Screen Time Help my Baby’s Development? 

Not really. Babies need human contact to thrive. There is no substitute for it. Research shows that neither the TV, an iPad, or an app, substitute human interactions. Human interactions are always better.  

Is it OK for my Baby to Play While the TV Is On? 

Background television ⁽⁶⁾ is not brilliant for children. It is best to avoid ‘technoference’ which is technology getting in the way of human interactions.  

These are some things for infants to do. Do you have others that your baby love? Let us know which ones!  

Love, 

Ana 

Dr Ana Aznar 

References 

⁽¹⁾ Hewitt, L., Kerr, E., Stanley, R. M., & Okely, A. D. (2020). Tummy time and infant health outcomes: a systematic review. Pediatrics, 145(6). https://doi.org/10.1542/peds.2019-2168 

⁽²⁾ J., & Braungart-Rieker, J.M. (2005). Effects of shared parent-infant reading on early language acquisition. Journal of Applied Developmental Psychology, 26, 2, 133-148 doi.org/10.1016/j.appdev.2004.12.003 

⁽³⁾ Sá, E., & Torres, A, (2019). The Effect of Lullabies on the Mother and on Copyright © 2019 Eduardo Sá and Ana Torres. Her Relationship with the Baby: an Exploratory Study. OA J Behavioural Sci Psych2019, 2(1): 180010. 

⁽⁴⁾ Chiang, W. C., & Wynn, K. (2000). Infants’ tracking of objects and collections. Cognition, 77(3), 169-195. https://doi.org/10.1016/S0010-0277(00)00091-3 

⁽⁵⁾ Savage, S. (2005). The benefits of infant massage: a critical review. Community Practitioner, 78(3), 98-102. 

⁽⁶⁾ Nichols, D.L. The context of background TV exposure and children’s executive functioning. Pediatr Res 92, 1168–1174 (2022). https://doi.org/10.1038/s41390-021-01916-6 

A parent is struggling with their 15-year-old daughter’s unkind behavior, lack of apology, and issues like vaping and self-harm. They’ve tried counseling and are seeking practical advice but feel overwhelmed and fearful.

I am very sorry to hear you are going through such a difficult situation. I would like first to focus on you. Understandably, you are finding it very difficult to cope with. Therefore, I would strongly recommend that you have some counselling yourself and if your partner is up to it, you could do it together. A therapist will help you deal with your own emotions and thoughts, keep a strong co-parenting team, and they will work with you to create guidelines to manage your relationship with your daughter. 

It is really good that your daughter is seeing the school counsellor every week. It would be a good idea for the counsellor to keep you informed about the progress she is making. If perhaps, the feeling is that your daughter needs further support, the counsellor could talk with her, given that they seem to have established a rapport. If there are concerns about her being autistic, perhaps the counsellor could discuss it with her, so she gets screened. The important thing is that your daughter works through the emotions she is experiencing. Remember that very often, the self-harm is not the problem, the problem is that she is not able to deal with her emotions. Understanding why she is feeling the way she does, and then teaching her to regulate those emotions in a healthy is very important.  

I imagine that your daughter’s teachers know about what is going on at home. I would also encourage you to have regular meetings with her teacher, counsellor and your daughter to devise a plan to best support her. Ideally, you want to create a strong support system around her.  

Finally, I know that it is incredibly hard for us when our kids say things to hurt us. Try to remember that those hurtful words your daughter is using are not about you at all. Teenagers often say those kinds of things when they have feelings they don’t know how to cope with. Whenever she says something hurtful, try not to give her a strong reaction and remain firm in your position.  

I am very sorry that you are going through this and from here I send you love. At REC Parenting, we have wonderful therapists to support you through this situation. If you want, get in touch with me and we will start supporting you from day one.  

I wish you and your family all the very best,  

Ana 

A parent asked: “My son is failing his subjects, he had to repeat grade 9 because he made low CGPA. Please assist as he doesn’t seem to be bothered.“

I am sorry to hear about this. It is not an easy situation to handle.  

In my experience, very few teenagers don’t really care about their grades. What looks like ‘not being bothered’ may be his way of coping with the situation. Perhaps he has lost his self-confidence, feels overwhelmed because he has fallen really far behind and doesn’t know how to get back on track, or maybe he is depressed.  

So, the most important question is: Why is he getting bad grades? Students typically have poor grades because: 

• They don’t understand the content. 

• They lack the executive function skills needed to succeed at school (e.g., planning, organization…). 

• There is something going on in his life impeding him to focus on schoolwork. 

First, have a chat with him and try to understand what is going on: Is he unhappy at school or at home?; Is he OK with his friends?; Is his mental health, OK?; Did his bad grades started suddenly or did they develop over time?; May he be experiencing bullying? For this conversation to work you really need to make him feel that whatever he says you won’t get angry, that you are on his side, and that you want to help him. 

You also need to talk with his teachers and include him in the conversations. It is important to include him because if he doesn’t take an active role in his learning, nothing that you do, will work.  

With his teachers, you need to rule out any potential learning disabilities (e.g., dyslexia, dyscalculia, dysgraphia), or any other conditions (e.g., ADHD). If there are any doubts, it is definitely worth asking for him to be screened. If this screening reveals any issues, you need to work on a support plan with his doctors and the school. 

Also, with his teachers and with him, discuss his behaviour at school. Does he pay attention in class?; Does he do his homework?; Is he accepted in the peer group?; Are there any patterns on the feedback he gets from his teachers? (e.g., perhaps they all comment on their lack of understanding of concepts, or his poor writing skills….). It is also very important that with him and his teachers, you discuss the executive skills needed to do well in school. These skills involve planning, organization, being able to pay attention, or short-term memory. As you can tell, these skills are fundamental to succeed at school but very often teenagers don’t have them well established and may need support.  

You may find useful this article on executive function skills.  

Once you all identify the issues that he may be struggling with, you all need to devise a support plan. If he is struggling to grasp new content, he may need a tutor or a homework club. If he is struggling with executive function skills, he may benefit from having a coach. If he is struggling with emotions or mental health, he may need a psychologist. This plan should have very specific goals, be measurable, and be revised periodically.  

I wish there was a recipe I could give that would sort it all out but sadly, things are never that simple. One important thing I want you to know is that your son’s poor grades are not a reflection of you as a mother. Do not measure your success based on your child’s achievements. It is also important that you take care of your own mental health. If you want further support, please do not hesitate to get in touch with me.  

I wish you and son all the best of luck. 

Ana 

Dr Ana Aznar

For many people, parenthood comes as a huge shift (understatement!). However, some of us can find the transition to parenthood – from pregnancy, through the post-natal period and beyond into parenting – more challenging than others. 

This can be a difficult and unsettling experience if we don’t have an understanding of why we seem to be finding things harder than those around us. However, many of us are starting to realise that there might be a good reason why we have found the parenting journey particularly challenging – and it’s not because we are “bad parents”. 

Diagnoses such as autism, ADHD, dyslexia, and other parts of the neurodivergent umbrella are much more common than previously thought, and many people are beginning to self-identify or seek diagnosis later in life. This is often prompted by the experience of parenthood – either through searching for answers to explain how we are feeling, or perhaps because our child themselves receives a diagnosis.

Many parents ⁽¹⁾ find the realisation that they are neurodivergent can help lift the weight of guilt or shame that they may have around their parenting journey, help them make sense of what they have experienced, and begin to embrace the joys of neurodivergent parenting.

So, What Is the Experience of Neurodivergent Parents, and Why Might It Be Different?

Parenthood begins long before the baby arrives, often with a complex mix of planning, adapting, and navigating social expectations. For neurodivergent parents, pregnancy can heighten sensory sensitivities, amplify emotional challenges, and disrupt established routines ⁽²⁾. Coping with sensory overload from physical changes, hormonal shifts, and medical appointments can be tough. Healthcare providers may not always have neuroinclusive practices, but this can be compounded by the fact that many pregnant people may not yet realise they are neurodivergent.  

Birth brings a moment of joy but also potential difficulty. It is not always possible to follow a birth plan and neurodivergent parents and their partners may find it more difficult to advocate for their needs at this time. Feeling out of control can be a trigger for any new parent, but may be especially challenging for autistic parents ⁽³⁾. The post-natal ward may be challenging from a sensory point of view, with overwhelming sounds, lights, and smells, plus midwifes and nurses helping with intimate care or breastfeeding who may not be aware of the need for explicit consent around touch.

Similarly, the transition to early parenthood is marked by sleepless nights, emotional highs and lows, and the need to adapt quickly. Neurodivergent parents may find the sensory demands of caring for a newborn—crying, feeding, and frequent touch—particularly intense ⁽⁴⁾. Executive functioning challenges, like managing time or balancing multiple tasks, can also become more pronounced.

For some, societal pressures to “parent perfectly” may lead to masking—suppressing neurodivergent traits to meet perceived expectations. This can contribute to emotional exhaustion and hinder the development of an authentic parenting style. This pressure can be exacerbated if we also have a neurodivergent child – which is likely, given the heritability of neurodivergence – because our child may not fit neatly into the boxes provided by society’s expectations.

So What Helps?

Embracing Strengths and Joys of Neurodivergent Parenting

Neurodivergent parents often develop unique parenting styles that may differ from mainstream narratives. Neurodivergent people tend to bring adaptability and creativity to their parenting, and may feel less constrained by society’s norms. Giving yourself permission to do what is right for YOU and your child can be incredibly liberating, particularly for parents who have spent a lifetime masking their differences and trying to “fit in”.

Parents may find they are able to tune into their child’s needs more sensitively and empathically. This means neurodivergent parents can be wonderful advocates for their child, and are also able to connect with their child’s joy in a special way. Many parents find they are more able to encourage intense interests, for example, or “stimming” behaviours (such as flicking fingers or pacing) that their child finds soothing or enjoyable. Neurodivergent parents who understand their own triggers as well as their child’s may, for example, have more insight into how best to create a sensory-friendly environment at home that meets everyone’s needs.

Sharing these wins with other people, especially other neurodivergent parents, can be hugely validating and comforting, and can form the basis of greater self-compassion in parenting.

The Importance of Community

One of the most powerful tools for neurodivergent parents is community support. Shared experiences and mutual understanding can lift feelings of isolation and provide a platform for practical lived-experience advice and emotional validation. Feeling understood can make all the difference to neurodivergent parents, who may often feel misunderstood or lacking in support. Neurodivergent parent communities can offer a safe space to exchange strategies, celebrate milestones, and address challenges without fear of judgment or a need to camouflage or mask. 

Being part of a neurodivergent community can also be essential for parents learning to embrace a “neuroaffirmative” mindset – seeing neurodivergence as difference rather than deficit, and celebrating human diversity. Feeling confident in the value of all neurotypes can help parents model this stance to their children, too.

Examples of neurodivergent community support could include:

• Online forums or local meet-ups for neurodivergent parents.

• Parent-and-baby groups that are neurodivergent-inclusive.

• Advocacy groups that offer resources tailored to neurodivergent families.

Access to Evidence-Based Information

Parenthood comes with an avalanche of advice, from well-meaning friends to parenting books and social media influencers. For neurodivergent parents, finding trustworthy, evidence-based information is especially important. The volume of conflicting opinions can be overwhelming, making it difficult to determine what works best for each individual family.

Key topics neurodivergent parents may seek information on often include managing competing sensory needs in the family; managing executive functioning challenges while parenting; emotional regulation both for parent and child; and understanding and supporting neurodivergent children.

Parents feel more confident if they can access reliable, neuroaffirmative resources—whether through neurodivergent-affirming professionals, well-researched articles, or specialist parenting programmes. These resources should always respect the individuality of each parent-child relationship, offering flexibility and validation rather than rigid guidelines. Armed with trustworthy information, neurodivergent parents often feel they are more able to advocate for their own needs where necessary, as well as for their child.

What Neurodivergent Parents Need from Society

Neurodivergent parents thrive when supported by an environment that validates their experiences and embraces their differences. Partners, families, and healthcare professionals play a crucial role in creating this environment by:

• Listening without judgment and validating the parent’s perspective on their family’s unique needs.  

• Adapting communication styles and providing clear, concise, and actionable information. 

• Encouraging self-compassion and challenging societal expectations that contribute to masking or self-doubt.  

• Providing practical help to reduce stress and avoid burnout.  

Finally

Parenthood is not about perfection, or “getting it right”. It’s about building a nurturing and loving relationship with our child, and neurodivergent parents embrace this like any other parent. Diversity in parenting styles enriches our families and creates a world that celebrates difference. Through understanding ourselves, offering ourselves self-compassion and playing to our strengths, seeking tailored resources, and building supportive communities, neurodivergent parents can thrive on this wild ride we call parenting.

About the Author

Dr Jo Mueller is a Clinical Psychologist with over 15 years’ experience specialising in work with parents and neurodiversity. She co-founded The Neurodiversity Practice alongside Drs Lauren Breese and Siobhan Higgins in order to provide trustworthy, authentic support for neurodivergent people. She hosts The Neurodivergent Parent Space, an online community for parents who want to Find Their People alongside evidence-based resources that can lighten the parenting load. The Neurodiversity Practice also run monthly webinars for neurodivergent (or wondering) parents on a variety of topics, and offer free downloadable resources. Find out more here: https://www.theneurodiversitypractice.com/parents

References

⁽¹⁾ Elliott J. K. et al. The neurodivergent perinatal experience — A systematic literature review on autism and attention deficit hyperactivity disorder. Women and Birth 37, 6 (2024)

⁽²⁾ Pohl, A.L., Crockford, S.K., Blakemore, M. et al. A comparative study of autistic and non-autistic women’s experience of motherhood. Molecular Autism 11, 3 (2020).

⁽³⁾ Talcer, M.C., Duffy, O. & Pedlow, K. A Qualitative Exploration into the Sensory Experiences of Autistic Mothers. J Autism Dev Disord 53, 834–849 (2023).

⁽⁴⁾ Westgate, V., Sewell, O., Caramaschi, D. et al. Autistic Women’s Experiences of the Perinatal Period: A Systematic Mixed Methods Review. Rev J Autism Dev Disord (2024).

“On how to help my son with his social skills and talking to him about sex”

This is an important topic, and it is brilliant that you want to support your son.  

It is never too early (nor too late) to talk about sex with our children. Rather than having ‘the talk’, it is better to have lots of little talks over time. Having regular conversations about it also sends the message that this topic is important and that it is a normal part of life.  

Each child is different so I cannot hand you a set script. What I can tell you is that the most important thing is for your son to know that he can ask you or tell you anything and you won’t get angry or judge him.  

When discussing sex with your son, focus on a.) explaining the biology of it (e.g., vaginal sex, oral sex…), and b.) your own values around it (e.g., how a healthy romantic relationship looks like, consent, respect, intimacy…).  

Be open and listen to him. Don’t judge him. Give him your opinion based on your own values and ask him if he agrees with you. If he doesn’t, be respectful. Let him know that you value his opinion, even it is different from yours. Whatever he says, try not to overreact.  

You don’t need to get everything right and you don’t need to know all the answers. What matters is to open the conversation. If you feel uncomfortable discussing sex, do it while going for a walk, driving, or cooking, that way you don’t have to make direct eye contact.  

There are some resources you may find useful. We have two REC Parenting masterclasses around this topic:  

• Teen Dating Violence with Dr. Kirsty Lee 

• How to Have Difficult Conversations with your Teenager with Dr. Tara Porter 

There is also a book I really like called: “This is So Awkward: Modern Puberty Explained” by Cara Natterson and Vanessa Kroll Bennett. 

Now on how to help your son with his social skills. We aren’t born with our social skills; they need to be taught. Our children learn social skills by observing how we behave (e.g., how we greet others, how we worry about others, how we listen to others). And they also learn these skills, when we explicitly teach them (e.g., “You need to look people in the eye when you talk to them”).  

There are 10 social skills that I think are important to explicitly teach your son: 

• Make eye contact. 

• The ability to listen, not just hear. 

• Talk to different people in different ways: we don’t talk in the same way to a teacher, an elderly person, or a friend.  

• Respect everyone even if we don’t particularly like them or they have different values.  

• Reading non-verbal communication: it is estimated that as much as 60% of communication is non-verbal, therefore the better we can understand it, the better we are able to communicate with others.  

• How to communicate assertively but politely: this is the ability to express their feelings, act in their own interests, and stand up for themselves without being aggressive.  

• Self-regulation: when we self-regulate well, we are able to react appropriately in every social situation we encounter. Research shows that children and teenagers prefer to be around those who can self-regulate well.  

• Pay attention to how others react to you. 

• Keep a conversation going.  

• Find a balance between online and in-person socializing. 

I hope this helps. Please do not hesitate to get in touch with me if you want further support. I wish you and your son all the very best.  

Ana

Dr Ana Aznar

“If I was unaware of being pregnant, but still had alcohol on two separate occasions, what is the likelihood of that affecting the baby?”

Congratulations on your pregnancy! You are not the only one that has drunk before finding out  you were pregnant (for what is worth- it happened to me also). Think that nearly half of all pregnancies in the US are unplanned, so there are lots of people that have been in your situation. 

There is little reason to panic if you had some drinks. The American College of Obstetricians and Gynaecologists and the UK Royal College of Obstetricians and Gynaecologists both say harm from having a little alcohol before you were pregnant is unlikely.  

The important thing is that now you know you are pregnant, that you stop drinking alcohol. There is no known safe amount of alcohol use during pregnancy so it is better not to have any at all. If you want more information, check the US Center for Disease Control and Prevention (CDC) guidelines and the advice from the NHS in the UK.  

Try not to dwell in the past and enjoy your pregnancy.  I wish you all the very best!  

Ana

Dr Ana Aznar

Perhaps you have been adopting your scout elf for a few years. Perhaps you are not sure what the Elf of the Shelf is about. Discover if this family tradition is for you. 

Where Does the Elf on the Shelf Come From?

Elf on the Shelf is a Christmas tradition started by Carol Aebersold and her daughters, Chanda Bell and Christa Pitts. It started as a family tradition but in 2005 Carol and her daughters published a book and elf kit, “Elf on the Shelf: A Christmas Tradition”. In 2007, actress Jennifer Garner, was seen carrying the book. Soon after, The Today Show featured the book. The Elf on the Shelf went viral. Millions of kits have been sold and the line has expanded to include clothing, accessories, animals, and more. 

The story goes that Santa’s Scout Elves return to the north pole each night of December to report back to Santa who is being nice and who is being naughty. The elves then fly back and hide in a new spot for the children to find them the next morning. Some elves like to stir up mischief each night before finding their new hiding spot.

The official elf wears a solid red suit with a white collar. He also wears white mittens, and a red hat with a white brim. 

What Are the Rules?

• Children cannot touch the elf, or he will lose his magic.

• The elf’s magic can be restored.  

• The elf does not move or speak while the children are awake. 

• The elf hears everything.

• The elf needs a name. Names tend to be something silly and cute, like Buddy, Snowflake, Bing, or Chippey. 

• The elf matches the personality of their family.

At What Age Can You Start the Elf on the Shelf Tradition?

You can start it at any age but usually parents start when their children are around 2 or 3 years-old. 

When Does the Elf on the Shelf Makes His First Appearance?

Usually, he appears between the 24^th of November and the 1^st of December, so he is around for a month until his return to the North pole on Christmas Eve. It will keep you busy during the holiday season!

Elf on the Shelf Ideas

• The Christmas Tree

• In the pantry

• Living room spot

• Inside the holiday wreath

• On the mantel

• In the stocking

• In the fridge

• By the door

• On the staircase

• In the blanket

• In a plant

• On a bookshelf

• In a drawer

Is It Good or Bad for Children to Believe in the Elf on the Shelf?

In the past few years some psychologists ⁽¹⁾ have voiced their concerns against parents promoting their children to believe in traditions, such as Santa or the Elf on the Shelf. Why? Because they believe that when parents lie to their children, children may stop trusting them when they find out the truth. 

What Does the Research Say about the Elf on the Shelf?

As far as I know there is no research looking specifically at the Elf on the Shelf but we can rely on the research on other imaginary characters, like Santa.  

Evidence shows that it is not negative for children to believe in imaginary characters like Santa ⁽²⁾, the Tooth Fairy, or the Easter Bunny. Magical thinking is part of children’s development specially between the ages of 5 and 8. During these ages, many children have an imaginary friend and believe in monsters and flying carpets. Blurring the lines between reality and fantasy is part of childhood. 

When Do Children Find the Truth About the Elf on the Shelf?

Research shows that around age 8, children start to figure out that Santa and the Tooth Fairy are not real. Most children come to this conclusion ⁽³⁾ on their own when they realize that the story is physically impossible. 

Is It Better to Tell Children the Truth or To Let Them Be?

Children report feeling better when they managed to find the truth by themselves. So, even if you think your child is too old not to know the truth, let them be! 

Sometimes your child may know but they choose not to tell you because they want to keep the magic going or because they think you will be sad once you know they know. 

By the time your child comes to you to discuss it ⁽⁴⁾, they usually have given it plenty of thought and are ready to face reality. Follow your child’s lead. Use their questions to assess where to take the conversation and what they are ready to discuss and understand. 

One important thing to tell them once they find out is not to spoil the fun for other kids: “Once you know, your job is to keep the magic going for other kids”. 

Finally

Whether you do the Elf on the Shelf or not, we wish you and your family a wonderful Christmas! If you have any questions or comments, please get in touch with me.

Love,

Ana

Dr Ana Aznar

References

⁽¹⁾ Boyle, C., & McKay, K. (2016). A wonderful lie. The Lancet Psychiatry, 3(12), 1110-1111.

⁽²⁾ Goldstein, T.R. & Woolley, J. (2016). Ho! Ho! Who? Parent promotion of belief in and live encounters with Santa Claus. Cognitive Development, 39, 113-127. https://doi.org/10.1016/j.cogdev.2016.04.002

⁽³⁾ Anderson, C.J., Prentice, N.M. Encounter with reality: Children’s reactions on discovering the Santa Claus myth. Child Psych Hum Dev 25, 67–84 (1994). https://doi.org/10.1007/BF02253287

⁽⁴⁾ Mills, C. M., Goldstein, T. R., Kanumuru, P., Monroe, A. J., & Quintero, N. B. (2024). Debunking the Santa myth: The process and aftermath of becoming skeptical about Santa. Developmental Psychology, 60(1), 1–16. https://doi.org/10.1037/dev0001662

In my therapy room, I often hear parent couples ask, “What happened to us? We used to be so relaxed and carefree!” Even the most solid relationships often struggle with the seismic shift that comes with introducing a baby into the family ⁽¹⁾. From practical challenges like getting enough sleep and navigating childcare, to differing expectations of each other now as partners. 

Maybe we shouldn’t be surprised that relationship satisfaction can decrease after having children ⁽²⁾. As new parents we have far less access to the protective relationship factors that keep us feeling closely connected (think: time to chat, time to chill, time to have sex!) ⁽³⁾.

Regardless of how normal it is to find the transition from romantic couple to parent couple challenging, it is still a rarely spoken phenomenon. Social media is awash with lots of ways to compare yourself, and naturally we only see the smiling, happy family and couple photos. We know that if parents feel isolated and ashamed about their difficulties, they are less likely to seek help – which can make relationship challenges even worse. 

It has been said that nourishing your relationship alongside parenting reduces stress in the family ⁽⁴⁾. Relationships can endure higher levels of stress when they are fortified with mutual support and attention. 

But what does that mutual support and attention actually look like in the months and years of early parenthood?

Communicating Well

Good communication as a couple is essential. Whether this is coming together to make a game plan to tackle your baby’s new sleep schedule or taking time and space to really hear about what an experience has been like for your partner. Often, we can forget about how important the skill of listening is in communication. Good listening helps you to understand things from your partner’s point of view and is a solid predictor of relationship satisfaction ⁽⁵⁾. It might seem obvious, but to really be listening we often need to stop what we are doing and pay full attention to our partner’s words and body language. It’s easy to fall into the trap of half-listening while thinking about what you’ll say next, but true listening requires full attention.

The words we use also shape how we communicate. Using “I” statements helps prevent defensiveness and opens the door to understanding. Rather than blaming, describe how you feel and what you experience from your perspective.

Managing Conflict

Conflict is inevitable in relationships, and parenting adds new layers to it. Maybe you have different ideas about a parenting challenge or feel upset about an uneven share of household chores.

Research separates out destructive and constructive conflict ⁽⁶⁾. Destructive conflict typically involves personal attacks, a lack of resolution and resulting emotional distress. These are the fights when everyone feels hurt, and probably regrets something uttered in the heat of the moment. Constructive conflict, on the other hand, focuses on the issue at hand, shows mutual respect, and aims to solve the problem through compromise or collaboration. So, it is possible to argue well, but it’s not always easy to do so in the heat of the moment. A tip towards more constructive conflict is to always try to focus on the issue, not the person. 

Accepting Relationship Changes

I encourage parents to look at their lives as a couple as being in seasons. This introduces a way of accepting relationship changes (just like we accept the moving of seasons) and acknowledges that something that feels difficult now, will likely shift and change. 

It takes trust and a sense of vulnerability to open up to your partner about some of the ways that your relationship might have shifted since becoming parents. Trust can be harder to come by if we feel as though we are not on the same team. 

For some couples, it might be that discussing with an impartial professional such as in couples therapy is the right answer, for others improving communication and openness with each other bit by bit makes the difference. 

Rebuilding Protective Factors

Communication, intimacy and quality time together all take a hit when a baby is born, and it may feel like that ease of being with each other has gone out of the window. We tend to think about intimacy in relation to sexual intimacy, and of course that does play a role, but intimacy and sex are different things. 

Physical connection can come in many forms, like hugs or kisses, and small gestures—like buying your partner’s favourite treat—can keep emotional closeness alive.

It can be really difficult between nappy changes and other care commitments to communicate about how you are feeling. This can add to a feeling of distance between each other. It can be helpful to set aside time to talk, share an activity and connect ⁽⁷⁾ . If a “date night” just feels too out of reach at the moment, I often suggest that couples commit to just one moment in the week (a quiet evening cooking dinner, Saturday afternoon walk with the buggy) where they can commit to talking and listening to each other. 

About the Author

Dr. Naomi is a Clinical Psychologist with over 12 years experience of working in mental health settings. She works in private practice in Amsterdam supporting parents in the ‘perinatal period’- from pregnancy to childbirth and all aspects of the transition to parenthood.  She is particularly interested in the ways that couple relationships shift and change (for better or worse!) once kids come along, and recently launched Stick Together- Conversation Cards for New Parents, which are a set of 40 beautifully designed question cards crafted to bring partners closer together, as they navigate parenthood. Buy them now!

References

^{(1) Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2009). The effect of the transition to parenthood on relationship quality: An 8-year prospective study. Journal of Personality and Social Psychology, 96(3), 601–619. https://doi.org/10.1037/a0013969}

^{(2) Karimi, R., Bakhitoyari, M., Arani, A. M. (2019). Protective factors of marital stability in long-term marriage globally: a systematic review. Epidemiol Health. doi: 10.4178/epih.e2019023}

⁽³⁾ Twenge, J. M., Campbell, W. K., & Foster, C. A. (2003). Parenthood and Marital Satisfaction: A Meta-Analytic Review. Journal of Marriage and Family, 65(3), 574–583. https://doi.org/10.1111/j.1741-3737.2003.00574.x

⁽⁴⁾ Gottman, J., & Gottman, J. (2008). And Baby Makes Three:The Six-Step Plan for Preserving Marital Intimacy and Rekindling Romance after Baby Arrives. New York: Harmony Press

⁽⁵⁾ Walker, S.A., Pinkus, R.T., Olderbak, S. et al. People with higher relationship satisfaction use more humor, valuing, and receptive listening to regulate their partners’ emotions. Curr Psychol 43, 2348–2356 (2024). https://doi.org/10.1007/s12144-023-04432-4

⁽⁶⁾ Gao, M., Du, H., Davies, P.T. and Cummings, E.M. (2019), Marital Conflict Behaviors and Parenting: Dyadic Links Over Time. Fam Relat, 68: 135-149. https://doi.org/10.1111/fare.12322

⁽⁷⁾ Anderson, S. A., Russell, C. S., & Schumm, W. R. (1983). Perceived marital quality and family life-cycle categories: A further analysis. Journal of Marriage and Family, 45(1), 127–139. https://doi.org/10.2307/351301

If you are in social media and follow ‘mumfluencers’ or any parenting accounts, for sure you must have heard of gentle parenting. You may swear by it, you may hate it, or you may not be sure about what it really means.  

Whatever your feelings towards this popular parenting style, do you really know what the research says about it?  

We explain everything you need to know about gentle parenting.  

Who Came Up with Gentle Parenting? 

British author Sarah Ockwell-Smith introduced the term ‘gentle parenting’ in 2015. Since then, gentle parenting took a life of its own on social media and You Tube, fuelled by ‘parenting experts’ and ‘mumfluencers’.  

At the time of writing this article, a Google search on ‘gentle parenting’ generates 1.68 million hits and around 850,000 hits in Instagram.  

Do you know how many scientific articles are there on gentle parenting? One. Just one.  

So, I wonder… All this advice that parents are getting is based on… what evidence exactly?  

From a theoretical point of view, it is not clear what parents understand by ‘gentle parenting’ and moreover, it is not clear if it is really a distinct parenting style. Furthermore, there are no studies, and I mean no studies, that have examined whether gentle parenting is good or bad for children.  

What Does Gentle Parenting Mean? 

Gentle parenting does not really have an official doctrine. Ockwell-Smith defines it as a ‘mindset’ and a ‘way of being’ with an ‘emphasis on your child’s feelings’. 

These are considered its four main tenets: 

1. Empathy: Parents should always acknowledge their children’s feelings.  

2. Respect: Children deserve the same respect as adults.  

3. Understanding: Parents’ expectations of their children should be in line with their children’s developmental stage. 

4. Boundaries: Parents should establish boundaries to foster a stable, healthy, and loving environment for their children.  

In terms of discipline, a gentle parent never uses rewards and punishments. Instead, they validate their children’s feelings. They always try to understand their child’s motivations when they misbehave.   

You may be thinking: “What’s not to like about this? I agree with those four points”. As a principle, I agree too. But parenting is not that easy. Let me explain my reservations about gentle parenting.  

There Is No Scientific Research on Gentle Parenting  

I cannot emphasize enough that there is no scientific research examining this parenting philosophy. Researchers have not examined how children raised by gentle parenting do in comparison with children who are not raised by gentle parents.  

At the time of writing this article (November 2024) there is only one study examining gentle parenting. This study ⁽¹⁾ examined 100 parents in the US with at least one child aged between 2 and 7 years old. Almost half of them (N = 49), identified themselves as gentle parents. They reported high levels of parenting satisfaction and felt competent to raise their children. However, some of them were very critical of themselves and did not feel as competent. One third of those who identified as gentle parents, reported high levels of parenting uncertainty and burnout.  

What does this study tell us? That whereas some parents are doing OK following the gentle parenting guidelines (although it is not clear what this means), other parents may be finding this parenting philosophy too demanding.  

In sum, we cannot really conclude if gentle parenting is good or bad for children because no studies have examined it. And we cannot really conclude if approach to parenting is good or bad for parents because we only have one study examining it. There is simply no data.  

Most parenting styles (e.g., gentle parenting, lighthouse parenting, dolphin parenting, tiger parenting, conscious parenting…) are not based on scientific evidence. They are created by influencers, social media, and the press.  

In contrast, there is plenty of research on the four traditional parenting styles: Authoritative, authoritarian, permissive, and neglectful. There is also decent research on helicopter parenting.  

I Have More Reservations on Gentle Parenting 

I find it incredibly judgemental.

Gentle parenting followers advocate that theirs is the only way to raise emotionally competent children. Really?  What about the millions of emotionally competent people who were not raised by ‘gentle parents?’.  Moreover, no one wants to be defined as ‘ungentle’, right? So, by default If I say that I am not a gentle parent, does this mean that I am so kind of unsensitive, harsh mother?  

It Is a Form of Intensive Parenting.

We do not generally consider gentle parenting as a form of intensive parenting but from my perspective, we should. Why? Because it considers that parents have a lot of influence on how children turn out to be, it is very much child-centred, and it ignores parents’ needs (more on this later). 

Advocates of gentle parenting argue that when our child is misbehaving, throwing a tantrum or needs us, we must always be there for them. This sounds fantastic in an ideal world, but I don’t think is neither realistic nor a valuable lesson for our children. First, you are giving your child the idea that everything revolves around them. Not true. Second, when we drop everything whenever our children need us, we are not teaching them to wait or to self-regulate. Finally, intensive parenting is negative for parents’ mental health ⁽²⁾. 

Is Gentle Parenting Really Helpful?

Gentle parenting tells you how to react to your child’s behaviour. (e.g., “I understand you don’t want to put your shoes on, but we need to go to school. I know you are finding it hard.”). What if my child doesn’t change his behaviour at that time? If my child doesn’t choose to put his shoes on, what do I do then? Do I keep repeating the same line, over and over? Am I meant not to take him to school?  

It Seems that Parents Go from Gentle Parenting to Permissive Parenting.

Probably because it is difficult to discipline children following the gentle parenting advice, it seems that parents may end up not enforcing clear rules to their children.  

It Makes All Emotions Equally Important.

Gentle parenting dictates that we should always discuss and validate our children’s feelings. The issue is that when we validate every single feeling that our child is having, we are making them equally important. I am not saying that you should ignore your child’s emotions. I am totally up for discussing my kids’ emotions when they come back from school being upset or when they are lashing out at their sibling constantly.  What I am saying is that discussing for 15 minutes in the morning why your child does not want to put their shoes on, may be going too far. Sometimes, children need to do things because that is how life works.  

My Main Concern Has to Do with How Gentle Parenting Relates to Parents’ Own Wellbeing 

Given that there is no data on how gentle parenting relates to parents’ wellbeing, we can only rely on anecdotal evidence. Based on what parents are saying on social media and the press, it seems that gentle parenting sets unrealistic expectations for parents, especially for those who take it to the extreme.  

I totally agree with gentle parenting telling not to use any forms of physical discipline with their children. There is a lot of research showing that physical discipline is not beneficial for children. However, expecting parents never to lose their cool, never to yell in frustration when they have asked their children 33 times to brush their teeth is totally unrealistic. Moreover, research shows that occasional yelling is not linked with negative outcomes for children.  

Even more, modelling to our children that we should never lose our cool, that we never yell, that we are always composed, is giving them an unrealistic view of how people behave. Our role as parents is to teach our children how to deal with their own negative emotions and with the negative emotions of those around them. We fail to do that when we never show them that we also get it wrong, that we make mistakes, and that we sometimes lose our cool.  

If There Is No Scientific Evidence, Why Do Parents Adopt the Gentle Parenting Approach? 

It is not clear, but it has been speculated that gentle parenting is a reaction to the way many parents themselves were raised. Millennial parents were raised in a more authoritarian manner, and they practice gentle parenting as a reaction. Indeed, in a 2023 Pew Research Center report ⁽³⁾, 44% of parents said they wanted to raise their children differently to how they were raised. They wanted to be less punitive and more gentle.  

Gentle parenting may simply be a rejection of the parenting styles of previous generations. This is not new. Through generations, parents have gone from being told to treat their kids like adults (Watson in the 1920s), to move away from harsh parenting (Dr Spock in the 1940s) to the very intensive way we are raising our kids these days. The difference is that until recently, parenting advice always came from scholarship. New parenting styles, like gentle parenting and the others we have already mentioned, seem to come from the media.  

A Final Word 

In general, I don’t like labelling parenting styles. Other than the four traditional parenting styles, I don’t think they are useful.  

Ultimately, we must remember that parenting is not about ‘producing’ a child. Our focus when raising our children, should be to create a strong, solid relationship with them. That is the most important predictor for our children’s wellbeing. Any parenting style, such as gentle parenting, that completely ignores parents’ needs and focuses solely on the needs of the child, is doing parents and children a disservice.  

And please, try as hard as you can to ignore Instagram posts promoting gentle parenting. They are usually high on shame induction and low on nuance.  

I hope you find this article useful. If you have questions or comments, please do get in touch with me.

Love,

Ana

Dr Ana Aznar

References 

⁽¹⁾ Pezalla AE, Davidson AJ (2024) “Trying to remain calm. . .but I do reach my limit sometimes”: An exploration of the meaning of gentle parenting. PLoS ONE 19(7): e0307492. https://doi.org/ 10.1371/journal.pone.0307492  

⁽²⁾ Rizzo, K.M., Schiffrin, H.H. & Liss, M. Insight into the Parenthood Paradox: Mental Health Outcomes of Intensive Mothering. J Child Fam Stud 22, 614–620 (2013). https://doi.org/10.1007/s10826-012-9615-z 

⁽³⁾ Minkin R, Horowitz JM. Parenting in America Today. 

We have created the ultimate baby registry checklist, so you don’t need to worry.  

Friends and family will be eager to pick out presents for your baby, so to avoid ending up with 20 onesies, putting together a baby registry list is definitely a good idea. Not sure where to start? You don’t need to worry because we have created the ultimate baby registry list for you.  

What Is a Baby Registry? 

A baby registry is a wish list of products that you would like to get in preparation for your baby’s arrival. You can then share your baby registry with your friends and family. Many parents do this before the baby shower. You can either create one registry including products from different shops or you can register with only one store (e.g., amazon baby registry).  

When to Register for Your Baby 

This is up to you, but it is a good idea to start doing your research towards the end of the first trimester. You can add items to your registry as and when you have the time.  

Baby Registry Checklist 

It is up to you to decide what to include in your registry but below we list the items that we consider essential for any new parent.  

Baby Gear 

• Infant car seat 

• Stroller 

• Baby carrier or sling (optional) 

• Baby swing or bouncer (optional) 

Nursery Items 

• Baby monitor. 

• Crib, carrycot or Moses basket.  

• Mattress. 

• A waterproof cover for the mattress.  

• 2-4 fitted crib sheets 

• Nursing chair 

• Nightlight 

• Changing table or cushioned changing pad 

• Mobile 

Baby Clothes 

• 2 sleeping bags 

• 4-8 bodysuits 

• 4-8 onesies 

• 4-8 one-piece pyjamas 

• 1-3 sweaters or jackets 

• 1-3 rompers of other dress-up outfits 

• 1-3 socks or booties 

• 2 hats 

• Bunting bag or fleece suit for a winter baby 

• 2 shawls or blankets to wrap the baby in 

Diapering  

• Cloth diapers or disposable newborn- size diapers 

• Baby wipes 

• Diaper rash cream 

• Diaper bag 

• Diaper genie or diaper pail (optional) 

Feeding  

If you plan to breastfeed: 

• Breast pump 

• Nursing pads 

• Breastfeeding pillow 

• Breast milk storage bags (if you plan to pump) 

• 4 bottles and nipples 

• 4 bibs 

• Burp clothes 

• Bottle steriliser (optional) 

• Bottle warmer (optional) 

• Bottle brush 

If you plan to bottle-feed: 

• Formula 

For later: 

• High chair 

• 2 baby spoons 

• 2 baby bowls 

• 3 sippy cups 

Bath Items 

• 2 hooded towels 

• Infant tub 

• Bath set or inflatable tub-within-a-tub (after 6 monts) 

• Baby bath wash and shampoo 

• Baby lotion 

• Baby comb and brush 

Health Products 

• 2-4 dummies 

• Baby nail scissors 

• Thermometer 

• Nasal aspirator 

Safety Products 

• Safety gates 

• Childproofing gates 

Baby Toys 

• Play mat 

• Activity center 

• Bath toys 

Postpartum Items 

• 3-4 nursing bras 

• 2 nursing gowns 

• Disposable postpartum underwear 

• Pads and liners 

Things You Can Do Without 

• Wipe warmer: Absolutely unnecessary. If you think the wipe is chilly, simply hold it between your hands to heat it out.  

• Nappy stacker 

• Neck floaters: The CPSC has warned that parents using against them , following an infant death. The FDA also recommends parents not to use them because they can cause neck strain and injury, especially in babies with special needs.  

• Weighted blankets or swaddles: the AAP advises that they are not safe to use for babies younger than one.  According to the CPSC, at least one baby died while wearing a weighted sleep sack and another died while wearing a weighted swaddle.  

• AI assisted baby monitor: The first weeks of a baby’s life can be stressful, especially when we try to understand why the baby is crying: “Is he hungry? Sleepy? Why is he crying now? I’ve done everything I was meant to do!”. Therefore, many parents love the idea of an AI assisted baby monitor that promises to decode your baby’s cries, may sound like music to your ears. It is meant to tell you if the baby sounds gassy, hungry, fussy, sleepy, or agitated. Sounds great, right? It does but I have two concerns. One, is that AI is only as good as the data it trains on. The data is essentially based on a sample of adults decoding a sample of babies’ cries. Are these adults reliable? Two, your baby needs to be attuned to you, they need to get to know you, and for you to get to know them. Will using an AI baby monitor impede or promote you being attuned with your baby? 

• White noise machine: new research is showing that long-term exposure to white noise at high volumes can cause hearing loss or experience learning setbacks.  

• Pillow, loose bedding, blankets or cot bumper: All of these items are dangerous because they increase the risk of Sudden Infant Death Syndrome (SIDS). It is really important that follow the safe sleep guidelines for infants.

• Baby walker: the AAP states that baby walkers are never safe to use, even with an adult close by. Contrary to what many parents think, they won’t help your kid to learn to walk. Even more they can delay when a child starts to walk.  

• A baby-size robe: a total nightmare to put on! 

• Shoes: babies don’t need shoes. Booties or socks will do until your baby starts walking.  

• A baby-food marker: a regular blender or food processor will do.  

An Important Note  

• Don’t assume that because a baby product is safe just because it is being sold. For example, in the U.S. it us up to the manufacturers who make the products to self-test, self-regulate, and self-report their own safety and compliance.  

• You can buy second-hand many of the things in this list or you can inherit them from friends or family. However, keep in mind that it is not recommended to get a second-hand infant car seat. The reason for this is that you cannot be certain of its history. It could have been involved in a crash and the damage could not be visible or it could be missing its labels. Also, car seats have expiration dates for their restraints.  

I hope you find this checklist useful. If you have any questions, please do get in touch with us. 

We wish you and your baby all the very best! 

Love,  

Ana 

Dr Ana Aznar  

When you are breastfeeding, knowing if your baby is hungry or not, or whether he is getting enough milk, can seem like an impossible task ⁽¹⁾! And if your baby is cluster feeding, then your confusion can go through the roof. In this article, we give you the clues to deal with cluster feeding. 

What is Cluster Feeding?

Cluster feeding is when infants want to feed more frequently (sometimes all the time) than usual. They want to feed in clusters throughout the day. 

A newborn baby usually needs a minimum of eight feeding sessions in a 24-hour span. Each nursing session usually ranges from 10 to 30 minutes. But newborns usually don’t follow a clear schedule. Many newborns want to be fed more often than this and will group or cluster many feedings in a shorter period of time. 

Is Cluster Feeding Normal? 

Yes, it is absolutely fine. Cluster feeding does not mean that there is anything wrong with your baby nor with your breast milk supply ⁽²⁾. 

There is no need to worry, as long as your baby is:

• Gaining weight.

• Content between feeds. 

• Having a lot of dirty and wet nappies. After the first five days, around six or more heavy wet diapers and three or more poopy nappies every 24 hours is a good sign that your baby is feeding enough. 

Having said this, yes, cluster feeding can be exhausting and frustrating for you. 

Why Do Babies Cluster Feed?

We don’t really know why some babies cluster feed. There are several theories:

• It may happen when the baby goes through a growth spurt ⁽³⁾. In the first few months, growth spurts can happen every few days. Growth spurts can mean that your baby is putting on weight and getting taller, but they also happen when they develop new skills. 

• Some babies may cluster feed to soothe themselves when they are teething or when they feel unwell.

• Some babies may cluster feed in the ‘witching hour’. This is the name the early evening receives, when many babies become irritable, and cry a lot. 

When Do Babies Cluster Feed?

The most common times are: 

• Right after birth.

• At 2 weeks of age.

• At 1 month of age.

Having said this, remember that every baby is different. There is no way of knowing when or if cluster feeding will happen or how long it will last. 

Signs of Cluster Feeding

These are some common signs: 

• Being irritable when they are awake but not at the breast.

• Eating in short and frequent spurts close together.

• Feeding normally and fully and wanting another feed 30 to 60 minutes later.

• Wanting to be fed very often in the early evening and at night. Although it can happen at any time of the day. A baby that usually feeds every 2-3 hours, might nurse every 30 minutes for a few hours in a row. 

• Getting frustrated when the breast is just in front of them and latching on and off. 

How Long Does Cluster Feeding Last?

The good news is that it usually only lasts a few days to stop cluster feeding. 

Is It Cluster Feeding or Colic?

Colic ⁽⁴⁾ is like cluster feeding in that it often happens in the evening and can come on suddenly. However, whereas a cluster feeding baby will get soothed while feeding, a colicky baby is not soothed even when feeding. 

Will I Produce Enough Milk to Feed my Baby While Cluster Feeding?

Yes. Usually, babies feeding stimulates breast milk production. In most cases, your body will increase milk production to keep up with the demand. 

Do Formula-Fed Babies Cluster Feed?

Yes, they do. Bottle-fed babies usually feed less often than breastfed babies because formula is digested slower than breast milk. However, formula-fed babies may want to feed more often, or they may want to feed for longer. 

Challenges of Cluster Feeding

Cluster feeding can be physically and emotionally draining for parents. Very often, parents think that they are doing something wrong or that they are failing when their baby wants to feed non-stop. This happens because they have an idea of what ‘normal’ feeding looks like and they think that cluster feeding is not normal. But remember, cluster feeding is a normal part of development. Exhausting, absolutely, but it does not mean that you are doing anything wrong. 

In general, research shows that breastfeeding tends to be good for mothers’ mental health. However, when mothers’ expectations about breastfeeding are very different to their actual experience , their mental health may suffer. It is therefore important that you understand how breastfeeding works. 

It Is Important to Take Care of Yourself When Dealing with Cluster Feeding

• Stay hydrated if you are breastfeeding.

• Take steps to avoid sore nipples. 

• Keep snacks and water next to you while you breastfeed.

• Set a comfortable area for you to breastfeed that allows you to listen to podcasts or audio books, watch TV, read a book, or talk to your partner or friends. 

• Change breastfeeding positions often to avoid feeling sore. 

• Eat well.

• Ask others to help you with other tasks. 

• Rest as much as you can.

• Try to sleep when you can. 

• Understand ⁽⁵⁾ it is normal and that it will pass.

Final Message

Cluster feeding is part of normal development for many babies but this does not mean that it is easy for you. If you are feeling exhausted or need one-to-one support, get in touch with us, we will put you in contact with a lactation consultant or with a therapist, depending on what your needs are. 

We also have a fantastic REC Parenting masterclass with registered midwife and International Board Certified Lactation Consultant, Dee Bell, that you will find useful. 

Love, 

Ana 

Dr Ana Aznar

References

⁽¹⁾ Kehinde, J., O’Donnell, C., & Grealish, A. (2023). The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery, 118, 103579.https://doi.org/10.1016/j.midw.2022.103579

⁽²⁾ Kent, J. C., Prime, D. K., & Garbin, C. P. (2012). Principles for maintaining or increasing breast milk production. Journal of Obstetric, Gynecologic & Neonatal Nursing, 41(1), 114-121. https://doi.org/10.1016/j.jmwh.2007.04.007

⁽³⁾ Deshpande, W. (2008). Exclusive breastfeeding for the first six months. Community Practitioner, 81(5), 34.

⁽⁴⁾ Hjern, A., Lindblom, K., Reuter, A., & Silfverdal, S. A. (2020). A systematic review of prevention and treatment of infantile colic. Acta Paediatrica, 109(9), 1733-1744. https://doi.org/10.1111/apa.15247

⁽⁵⁾ Yuen, M., Hall, O. J., Masters, G. A., Nephew, B. C., Carr, C., Leung, K., … & Moore Simas, T. A. (2022). The effects of breastfeeding on maternal mental health: a systematic review. Journal of women’s health, 31(6), 787-807.https://doi.org/10.1089/jwh.2021.0504

Few topics are as controversial as Shaken Baby Syndrome (SBS). Whereas some medical experts defend that there is enough evidence to support it, others question the diagnosis. Keep reading to discover what shaken baby syndrome is, how to prevent it, and what the controversy is all about. 

What Is Shaken Baby Syndrome?

Shaken Baby Syndrome ⁽¹⁾ is a serious brain injury that occurs when a parent or a caregiver violently shakes a baby. As the baby’s brain, neck, and skull are still immature, violent shaking can cause swelling, bruising, and bleeding in the brain. As a result, the brain can be permanently damaged, impairing the baby’s future development or even killing them. 

SBS is also known as whiplash shaken infant syndrome, inflicted head injury, shaken impact syndrome, or abusive head trauma. 

The National Center on Shaken Baby Syndrome (NCSBS) in the US estimates that there are between 600 and 1400 cases of shaken baby syndrome a year. It is the leading cause of death from physical child abuse in the U.S. 

Shaken Baby Syndrome Symptoms  

Symptoms ⁽²⁾ vary a lot and are caused by generalized brain swelling. They may appear immediately after the shaking and tend to reach a peak within 4 to 6 hours. Often, there is no obvious physical sign of violence or injury, therefore parents and caregivers may not be aware of what has happened to the baby. As a result, they may think that the baby is fussy because they have a virus or a cold. 

These signs and symptoms may indicate shaken baby syndrome:

• Brain swelling, bleeding in the eyes, and blood in a protective layer that sits between the brain and the skull, called the dura. These three symptoms are typically referred to as the triad. 

• Vomiting.

• Poor feeding.

• Dilated pupils that do not respond to light.

• Breathing problems and irregularities.

• Cardiac arrest.  

• Seizures or convulsions. 

• Decrease/increase in tone. 

• Lethargy.

• Irritability.

• Coma.

• Fractures in the femur, humerus, or ribs, depending on how the infant was held. 

• Death.

How Is Shaken Baby Syndrome Diagnosed?

• Baby’s medical history ⁽³⁾.

• Exam for retinal haemorrhages.

• X-rays.

• Magnetic resonance imaging (MRI) scans.

• Computed tomography (CT) scans.

• Skeletal survey.

• Drug screening. 

• Blood sample.

• A thorough medical, forensic, and social investigation that excludes alternative diagnoses, underlying disease, and accidental trauma. 

How Is Shaken Baby Syndrome Treated?

It is treated ⁽⁴⁾ in the same way as any cranial haemorrhage. Typically, the brain is drained using a surgical procedure. 

It is important that parents disclose the incident as soon as possible to prevent further damage to the baby’s physical and mental health. 

Prognosis of Shaken Baby Syndrome

Although each case of SBS is different, the prognosis is poor ⁽⁵⁾ in most cases. It is a common cause of severe traumatic lesions and mortality in infants. 

Common disabilities include: 

• Speech delays.

• Developmental delays.

• Learning disabilities.

• Paralysis.

• Seizures.

• Epilepsy.

• Cerebral palsy. 

• Permanent hearing loss.

• Vision loss. 

• Blindness.

Mortality rate is approximately 15-25%. For those who survive, 80% suffer long term disabilities. Around 5-10% are left in a vegetative state, 30-40% suffer visual impairment, 30-50% experience paralysis or developmental retardation, and 30% suffer epileptic episodes. 

Until What Age Can Shaken Baby Syndrome Happen?

It can be seen in children up to 5 years old, but it is more likely during the first year of life ⁽⁶⁾. It occurs most often in babies younger than six months old. 

Who Is More Likely to Do This To A Baby?

• Ethnicity, race, or socio-economic status do not play a significant role in SBS ⁽⁷⁾.

• A factor that plays a role is the psychological state of the parent or caregiver.

• Men are more likely to violently shake their babies. 

Are Some Babies at Higher Risk than Others?

Yes, babies ⁽¹⁾ who are:

• Premature at birth (they tend to be more restless and more prone to crying)

• Male.

• Younger than 4 months

• Have pathologies (they require more complex parental care)

How Can Parents and Caregivers Prevent Shaken Baby Syndrome?

The number one trigger for SBS is frustration when a baby won’t stop crying. All babies cry, however, some cry more than others, may it more difficult for parents and caregivers to keep their cool. Typically, babies cry for 4 or 5 hours a day, peaking at 6-8 weeks of life. From around 3 months of age, most babies start crying a bit less. 

This means that SBS is totally preventable and that efforts must be made to educate parents about normal infant crying and how to prevent SBS. There is a program called the “Period of Purple Crying” that has been developed by the National Center of Shaken Baby Syndrome, that is being quite successful. 

‘Purple’ is an acronym of:

• Peak of crying: Your baby may cry more each week, the most in month 2, then less in months 3-5.

• Unexpected: Crying can come and go, and you don’t know why.

• Resists soothing: Your baby may not stop crying no matter what you try.

• Pain like face: A crying baby may look like they are in pain, even when they are not. 

• Long lasting: Crying can last as much as 5 hours a day, or more.

• Evening: Your baby may cry more in the late afternoon and evening.

Can Tossing a Baby in the Air or Rough Play Cause Shaken Baby Syndrome?

No. The force required to cause shaken baby syndrome makes it very unlikely to happen by accident. 

SBS injuries are not caused by:

• Tossing a baby in the air.

• Bouncing a baby on your knee. 

• Falling off a couch or other furniture.

• Sudden stops in a car or driving over bumps.

• Jogging or cycling with your baby.

Controversy Among Medical Experts 

The view of most medical experts, police forces, and prosecutors is that when the triad of symptoms (brain swelling, bleeding in the eyes, and blood in the dura) is found, it is very likely that violent shaking has taken place. Even when there are no other physical signs of abuse, such as bruising, fractures, or neck injuries. They argue that although the presence of the triad is not absolutely diagnostic of child abuse, it is highly suggestive of the diagnosis, particularly if there are no other impact injuries. The absence of an alternative obvious explanation warrants an investigation to determine if the child ⁽⁸⁾ has been subject to abuse. 

On the other hand, during the past few decades a growing number of sceptics have questioned if there is ever enough evidence to link the triad with a shaken baby. They claim that SBS can never be diagnosed with absolute certainty. 

The implications of this debate are incredibly important. Sometimes, abused babies are left at the mercy of their abusers when their parents are not found guilty. On the other hand, parents may be wrongly accused of abusing their children, they may be wrongly convicted, and their children may be unfairly removed from the home. 

The term ‘Shaken Baby Syndrome’ was first quoted in 1972 by British paediatrician neurosurgeon Norman Guthkelch. Based on a few cases, he introduced the hypothesis that shaking a baby backwards and forwards in whiplash-like manner might cause the triad of symptoms. However, Guthkelch became worried ⁽⁹⁾ that injustices were taking place and later in his life became a campaigner against the ‘dogmatic thinking’ of triad believers. 

Finally…

Much remains to be understood about SBS. What is clear is that our main priority should always be to protect our children. Therefore, educating parents to know how to deal with a crying baby and the dangers of shaking, is of paramount importance. 

At REC Parenting, our aim is to give you the tools to manage those moments when the baby won’t stop crying. If you have any questions on this topic, or you would like 1-2-1 support, please do get in touch with me. We are here to help! 

Love,

Ana

Dr Ana Aznar

References

⁽¹⁾ Latino, A. L., Miglioranzi, P., Coppo, E., & Giannotta, F. (2024). Knowing, recognizing, and preventing shaken baby syndrome: The role of primary care pediatrician. Global Pediatrics, 9, 100206.https://doi.org/10.1016/j.gpeds.2024.100206

⁽²⁾ Ludwig, S., & Warman, M. (1984). Shaken baby syndrome: a review of 20 cases. Annals of emergency medicine, 13(2), 104-107. https://doi.org/10.1016/S0196-0644(84)80571-5

⁽³⁾ Saunders D, Raissaki M, Servaes S et al (2017) Throwing the baby out with the bath water — response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking. Pediatr Radiol 47: 1386–1389

⁽⁴⁾ Mian, M., Shah, J., Dalpiaz, A., Schwamb, R., Miao, Y., Warren, K., & Khan, S. (2015). Shaken baby syndrome: a review. Fetal and pediatric pathology, 34(3), 169-175. DOI: 10.3109/15513815.2014.999394 

⁽⁵⁾ Antonietti, J., Resseguier, N., Dubus, J. C., Scavarda, D., Girard, N., Chabrol, B., & Bosdure, E. (2019). The medical and social outcome in 2016 of infants who were victims of shaken baby syndrome between 2005 and 2013. Archives de Pédiatrie, 26(1), 21-29. https://doi.org/10.1016/j.arcped.2018.10.002

⁽⁶⁾ Lee, C., Barr, R. G., Catherine, N., & Wicks, A. (2007). Age-related incidence of publicly reported shaken baby syndrome cases: is crying a trigger for shaking?. Journal of Developmental & Behavioral Pediatrics, 28(4), 288-293.10.1097/DBP.0b013e3180327b55

⁽⁷⁾ Sinal, S. H., Petree, A. R., Herman-Giddens, M., Rogers, M. K., Enand, C., & DuRant, R. H. (2000). Is race or ethnicity a predictive factor in shaken baby syndrome?. Child abuse & neglect, 24(9), 1241-1246.https://doi.org/10.1016/S0145-2134(00)00177-0

⁽⁸⁾ Vinchon M (2017) Shaken baby syndrome: what certainty do we have? Childs Nerv Syst 33:1721–1733. https://doi.org/10.1007/s00381-017-3517-8

⁽⁹⁾ Guthkelch AN. Problems of infant retino-dural hemorrhage with minimal external injury. Houston J Health Law Policy 2012; 201–8, ISSN 1534-7907, http://bit.ly/29b5qqn. 

Have you ever wondered why your baby is fascinated with tags? What makes these little pieces of satin fabric that detail garment care or label a toy capture your baby’s attention so well – and sometimes even better than the toy itself?

When my eldest daughter was about 5 months old, I noticed her interest in tags and bought her a Taggies toy: a soft fleece blanket with small loops of satin ribbon in all the colors of the rainbow sewn around it. Can you guess which color my baby liked best? None of them. She went straight for the product tag hiding in between!

I’ve since learned that tags have several properties that make them particularly interesting to babies. Exploring what these properties are can offer us a glimpse into how babies learn about the world around them.

The Mystery of Labels and Tags

Tags Are Usually Attached to the Edges of Objects

During the first weeks of life, babies tend to first look at the edges, or outer contours, of a new object as they figure out its shape – and that’s where the tags are usually found. As your baby scans the perimeter of a new toy, he will likely pause at the ‘irregularity’ created by the tag.

Tags Are a Common Feature Between Different Objects

Tags are present on many objects your baby notices in and outside your home, making them an interesting phenomenon for baby to categorize. Just like scientists, babies learn by figuring out patterns in the world around them: they place objects and events they repeatedly observe into categories, and then use these categories to predict the outcomes of future events. For example, by about 5 months a baby usually learns that when she drops something, it falls down; it’ll take a few years before she learns the term ‘gravity’, but she’s already discovered a pattern: objects tend to fall without support ⁽¹⁾. She will begin understanding that liquids and solids behave differently ⁽²⁾ around 6 months and gain a sense of object transparency ⁽³⁾ around 8-9 months. When a baby sees a new object or event that fits into a category she’s already figured out, she doesn’t pay extra attention to it. For example, when an older baby drops a ball and it falls down, she is not surprised: her brain sees this predicted experience as “usual”. But when the experience is unusual — say, she sees a helium balloon floating in the air — she cannot easily fit this observation into her existing knowledge, so her brain pays special attention. This is why tags present an interesting challenge: they are a common feature between different objects, but they look and feel a little different each time!

Tags Offer High Contrasts

On most tags, the text is printed against a contrasting background for ease of readability. Newborns cannot see very well yet; it takes a typically developing baby a few months ⁽⁴⁾ to be able to detect all colors. Even then, more intense and contrasting colors are still easier for babies to spot – and so high-contrast tags draw their attention.

Tags Are Easy to Grasp and Manipulate

As your baby’s fine motor skills progress, he learns to intentionally reach for, grasp, and manipulate objects – and tags are perfect for practicing these newfound skills. The tags themselves tend to be quite small; standalone objects of this size aren’t safe for babies to play with due to risk of choking. However, when securely attached to a larger, safe-to-play-with objects, tags can be explored safely. Feeling the tag’s texture, flipping it over, and noticing the small details can be interesting and calming for babies. It can also be intriguing for babies to feel the difference in texture between the tag itself and the items it’s attached to.

This is why my baby went straight for the product tag instead of exploring the colorful ribbon loops: the product tag likely looked like something she’d seen before, there was only one tag of this type, and the text stood out against the light background, capturing her attention.

Should You Let Your Baby Play with Tags?

I’ve seen parents express concern over their baby’s fascination with labels and tags, wondering if such ‘tag obsession’ is normal. As you can see, it’s very normal and, in fact, can be a sign of learning and growing. 

Before you let your baby play with a clothing or toy tags, always check that tags are securely sewn in and won’t come loose (a loose tag could become a choking hazard due to its small size). Make sure the tags your baby plays with are made of soft, smooth materials that won’t hurt your baby’s fingers or gums and don’t have any loose threads that could wrap around baby’s fingers or toes.

And what if your baby is not interested in tags? I wouldn’t worry. She may not have discovered them yet or is simply focusing on other patterns and textures around her.

Sensitive Observation

Whether your baby is interested in tags or not, she is learning incredibly fast. One way to really notice what she’s working on is to simply be with your baby, without the distraction of screens or the pressure to do something, even for just a few minutes every day. Hold your baby or lie down next to her and watch her quietly. Try not to think about what you want her to do or what the charts say she’s supposed to be doing at this age; see her in the moment, as she is. Notice what she’s looking at, what she’s working on, what captures her attention most, and what might be challenging for her. Sensitive observation like this will help you figure out what play objects your baby might enjoy most at this stage – and, more importantly, help you get to know your baby as a unique, special little person.

About the Author

Anya Dunham, PhD, is a research scientist studying ecology, a mom to three young kids, and the author of Baby Ecology, an award-winning book that brings together insights from hundreds of scientific studies to help parents understand babies’ biological needs and create the environment for feeding, sleep, and play that suits their unique baby best. Connect with Anya at https://www.kidecology.com/

References

⁽¹⁾ Needham A, Baillargeon R. Intuitions about support in 4.5-month-old infants. Cognition. 1993 May;47(2):121-48. doi: 10.1016/0010-0277(93)90002-d. PMID: 8324998.

⁽²⁾ Hespos SJ, Ferry AL, Anderson EM, Hollenbeck EN, Rips LJ. Five-Month-Old Infants Have General Knowledge of How Nonsolid Substances Behave and Interact. Psychol Sci. 2016 Feb;27(2):244-56. doi: 10.1177/0956797615617897. Epub 2016 Jan 7. PMID: 26744069.

⁽³⁾ Luo Y, Baillargeon R. When the ordinary seems unexpected: evidence for incremental physical knowledge in young infants. Cognition. 2005 Apr;95(3):297-328. doi: 10.1016/j.cognition.2004.01.010. Epub 2005 Jan 7. PMID: 15788161; PMCID: PMC3351380.

⁽⁴⁾ Skelton, A.E., Maule, J., & Franklin, A. (2022). Infant color perception: Insight into perceptual development. Child Development Perspectives, 16, 2, 90-95. https://doi.org/10.1111/cdep.12447

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All of us parents know that parenthood is both a joyful and a challenging experience, and that we can feel totally stressed out at times.  But what happens if you experience too much stress, for too long, and don’t have the resources to cope with it? That’s when we can develop something called ‘parental burnout’ – when chronic parenting stress leaves us feeling exhausted, disconnected from our children and not being the parent we’d like to be ⁽¹⁾.

The term ‘parental burnout’ has been around since the 1980s but there wasn’t any significant research into it until the last few years and that takes time to tickle down into the public conscience. So, despite it being a relatively common condition (5% of parents worldwide are suffering from burnout) ⁽²⁾, it’s not yet widely talked about or understood. 

Given how distressing parental burnout can be for both parents and children, it’s really important that we raise awareness of it.  A great place to start is Dr. Ana Aznar’s helpful overview article, and in this article, we’re going to bust some of the most common myths about parental burnout.

Myth #1: It Only Affects Mothers

The most common myth is that parental burnout only affects mothers, but that’s absolutely not the case – there’s a reason we call it ‘parental’ and not ‘maternal burnout’. Mothers might be most at risk as they often have the most contact with children and carry a disproportionate amount of the mental load, but fathers can, and do, burn out too.

In fact, some studies suggest that fathers may be even more vulnerable to parental burnout ⁽³⁾, perhaps because traditional gender roles have left fathers less prepared for the challenges of childcare and men may feel less able to seek emotional and practical support. Research also suggests that the consequences of parental burnout, such as withdrawing from your child or having escape fantasies, are also found to be more severe in fathers than in mothers.

Myth #2: It Only Affects Parents with Young Children

While it can be exhausting to be frequently managing tantrums, picky eating, and sleepless nights, parental burnout doesn’t just affect parents of young children – it can happen at any stage of parenting when a parent’s coping resources aren’t enough to cover the stress they’re under.

Parents of older children can be under just as much stress when their hands on, physical care isn’t needed.  The tasks of parenthood change as children grow – parents of teens are dealing with more emotional and psychological challenges like mood swings, peer difficulties, risky behavior, and school issues. Not surprisingly, parents of older children and teens report feeling more emotional than physical forms of burnout.

Myth #3: It Only Affects Parents of Children with Special Needs

While it’s true that having a child with special needs is a risk factor for increased parental stress and burnout, no single risk factor is enough to trigger burnout on its own. Often, the most impactful risk factors have more to do with the parent or family system than the children such as parental perfectionism, difficulties with emotional regulation, lack of social support or household disorganization.

And this is good news – these are factors that are likely to be much more amenable to change and can be addressed with a therapist or coach.

Myth #4: It’s Not Real; It’s Just ‘Millennial Snowflakes’ Complaining

Millennials didn’t invent the term “parental burnout”. In fact, the earliest book I’ve read on parental burnout is from 1983; a time when the oldest millennials were just babies. 

It’s likely that we’re hearing the term now because of two things – arguably the pressures on parents have increased in the last 40 years as the dominant parenting culture has become more ‘child-centred, expert-guided, emotionally absorbing, labour-intensive and financially expensive’ ⁽⁴⁾ which has made parental burnout more common.  

And secondly, because we’re more aware of, and open to talking about, emotional and mental health than we were in previous generations.  The stigma around talking about parental burnout really declined during the Covid-19 lockdowns when most parents felt exhausted by parenthood. One silver lining of that time was that the research literature on parental burnout rapidly grew with so many of us experiencing parental burnout and that will hopefully lead to better support for parents in future.

Myth #5: It Only Affects Single Parents

As we discovered with Myth #3, a single risk factor isn’t enough to cause parental burnout. It’s about the balance of stressors and resources you have. Not having a co-parenting partner is definitely a challenge, but that doesn’t mean having a co-parent makes life easier. In fact, in one study, single mothers were found to be less emotionally exhausted than partnered mothers who rated their partner as unavailable or only moderately available ⁽⁵⁾.

Single parents can be more vulnerable to burnout, not purely because of their single status, but because they are more likely to experience related risk factors such as lack of downtime, less financial security, and increased mental load. However, a single parent with a good support system and coping strategies is not necessarily more likely to burn out than a parent with a co-parenting partner.

Myth #6: It’s More Common in Disadvantaged Parents

We commonly see social and economic disadvantage as a causal factor in many mental health conditions but that’s not what we find with parental burnout. On the contrary, research shows that it tends to happen more in well-educated, affluent families ⁽⁶⁾.

We need more research to fully understand why this is the case. It might be related to personality traits – these parents could be more achievement-focused and perfectionistic, putting undue pressure on themselves and their children, or being hyper-aware of all the parenting advice and trying to execute it perfectly. Or it could be that these families are more likely to have moved away from their families of origin and hometowns for work and are more isolated.

Myth #7: It’s More Common in Parents Who Work Long Hours

Perhaps you thought about those affluent parents and wondered whether they’re more stressed because they work long hours. But this might surprise you – parents who work part-time or stay at home are actually more likely to burn out than those who work full-time ⁽¹⁾.

These parents often spend more time with their children and take on more of the parental responsibilities, which means they’re more exposed to the stressors of childcare and less exposed to the rewards of work – like accomplishment, adult company, and financial independence. Their balance of stressors and resources is therefore more likely to be unbalanced, and their risk of developing parental burnout increased.

Conclusion

Parental burnout doesn’t fit neatly into one box – there’s no single “type” of burned out parent or a specific risk factor that causes burnout. Any parent can experience burnout if they face more stress than they have the resources to cope with. It’s not a personal failing.

The good news? Burnout can be managed. By addressing the balance between stressors and resources, research shows that the symptoms of parental burnout can improve, along with the associated stress hormone levels ⁽⁷⁾. So, if you’re feeling exhausted and overwhelmed, don’t hesitate to reach out to a trusted friend, family member, or a professional and get the support you need so you can get back to enjoying family life.

About the Author

Dr. Katy Hill is a clinical psychologist with over 20 years’ experience of working across a variety of different NHS and university psychology departments. She was the first UK clinical psychologist to qualify as a certified parental burnout practitioner with the Training Institute of Parental Burnout in 2022. As a mum of three herself, Dr. Katy is passionate about supporting parents to reduce their stress levels, manage difficult emotions and improve relationships with their children, and themselves.  You can find her at www.drkatyhill.com or on Instagram @theparentalstresspsychologist.

References

⁽¹⁾ Mikolajczak, M., Aunola, K., Sorkkila, M., & Roskam, I. (2023). 15 years of parental burnout research: Systematic review and agenda. Current Directions in Psychological Science, 32(4), 276-283.https://doi.org/10.1177/09637214221142777

⁽²⁾ Roskam, I., & Mikolajczak, M. (2021). The slippery slope of parental exhaustion: A process model of parental burnout. Journal of Applied Developmental Psychology, 77, 101354.https://doi.org/10.1016/j.appdev.2021.101354

⁽³⁾ Roskam, I., & Mikolajczak, M. (2020). Gender differences in the nature, antecedents and consequences of parental burnout. Sex Roles, 83(7), 485-498. https://doi.org/10.1007/s11199-020-01121-5

⁽⁴⁾ Hays, S. (1998). The fallacious assumptions and unrealistic prescriptions of attachment theory: A comment on” Parents’ Socioemotional Investment in Children”. Journal of Marriage and Family, 60(3), 782-790. https://doi.org/10.2307/353546

⁽⁵⁾ Lebert-Charron, A., Dorard, G., Wendland, J., & Boujut, E. (2021). Who are and are not the burnout moms? A cluster analysis study of French-speaking mothers. Journal of Affective Disorders Reports, 4, 100091. https://doi.org/10.1016/j.jadr.2021.100091

⁽⁶⁾ Mikolajczak, M., Brianda, M. E., Avalosse, H., & Roskam, I. (2018). Consequences of parental burnout: Its specific effect on child neglect and violence. Child abuse & neglect, 80, 134-145.https://doi.org/10.1016/j.chiabu.2018.03.025

⁽⁷⁾ Brianda, M. E., Roskam, I., & Mikolajczak, M. (2020). Hair cortisol concentration as a biomarker of parental burnout. Psychoneuroendocrinology, 117, 104681.https://doi.org/10.1016/j.psyneuen.2020.104681