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Hold Them Tightly: When a child is dysregulated, it’s more important than ever for us to stay calm and strong.

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Babies and toddlers reach a point in their social and gross motor development where it is much, much easier to examine them on a parent’s lap. The timing of this transition is slightly different for each child based on temperament and mobility.

If you’re a parent, you know the stage — when changing a diaper becomes like a race car at a pit stop, one arm braced to hold the child down while the other tries to switch out the diaper. It’s like holding a wet fish as it flips and flops to get out of your grasp and back in the water.

A 3-month-old, not yet there, will smile and coo at me while I listen to her heart, no stranger anxiety to let her know that I am not someone from her inner circle. Willing to let almost anyone in.

A 13-month-old with two older siblings will bravely sit on the exam table, trying to prove to himself and his siblings that he is big like his sisters. A people-pleasing 2-year-old will sit up there as well, digging deeply to be brave and face the otoscope speculum in her ears.

One 4-year-old, sometimes already aware that she is about to get her pre-kindergarten shots, will choose to be examined in a parent’s lap. We have steps leading up to our exam tables, and another 4-year-old will go up on the table for the sheer pleasure of climbing the stairs.

Kids sometimes need the comfort of a parent’s arms. And sometimes they need to venture as far away as they are able to establish some independence. Parenting is a dance of knowing when to hold them tightly, and knowing when to back off.

Almost all 5-year-olds and above are able to be checked on the table. By that age, they are confident to be separated from their parents across the room while I ask them about any health concerns they might have about their bodies.

By this age, they will tell me about their summers (splashing the dog with the water hose); their shoes (they light up when I stomp); and their necklaces (my cousin made it for me). A child this Spring made up an entire children’s book adventure when I asked him if the T Rex on his shirt could come to life and be in the room with us.

When it comes time for something hard, though, the mood in the room can change like a fast-moving storm. Time for your shots. Time for your strep test. Time to test your blood.

In a pediatric office, when it’s time for hard things with young children, sometimes the hard thing happens more easily and quickly on a parent’s lap. As a child starts to panic, the parent’s ability to stay calm helps dictate how the rest of the visit goes.

In life, this is also true.

Ironically, when I need to do an ear exam in a kid that does not want her ears checked; or look at a throat in a baby who is refusing to open her mouth, what helps from the parent is counter-intuitive.

My inclination, for example, when my kids have to do hard things is to comfort and console, or even bargain with them. Sometimes I try to remove the uncomfortable task so they don’t have to experience it. But it’s better if they can instead borrow some of my calm energy and strength. If I’m emotionally spinning, they will always out-spin me.

In a moment of distress for the child, when it is necessary for the child to do something he does not want to do on the parent’s lap, the parent’s arms cannot go slack. If they do, the child will writhe and wiggle away, and the misery will be prolonged. The toddler will slide down the lap onto the floor, screaming all the way.

In a moment of distress, what helps the child through the unpleasant experience efficiently is when the parent is a strong and forceful holder. Sitting on the lap, holding the child closely and firmly, parental biceps and forearms flexed, thighs pressed together to pin the legs so they can’t kick.

It is the parent holding the child tightly, not letting them move, that gets the unpleasant experience over with quickly. Giving them a boundary makes the misery over in seconds instead of minutes.

“I know you don’t want to do this. I’m going to hold you so we can get it done. I am here.”

Mostly we want our kids to get through life without unpleasant experiences. Wouldn’t that be great? It would be such a smooth life if none of us had to do things we don’t want to do. But that’s not the way life works, for my kids or for me.

As my children grow up, they are increasingly independent. I am not there for every moment — every awkward lunchroom experience, every success or failure, each dirty joke or heartbreak. I’m definitely not there for every adolescent misstep.

But I want to parent in a way that they know the following: whatever they go through in life, when life gets hard, my arms are there. I will be there to hold them tightly. And I believe they can do what they have to do.

In those moments — whether it’s a toddler having a meltdown at the grocery store; a 4-year-old looking me in the eye as she does what I just asked her not to do; or a teenager stomping around the house because every other 15-year-old is allowed to do what I just said he can’t — the pattern is set.

No matter what you do, child. No matter how big your tantrum, I am here to hold you. We will get through this unpleasantry together.

With my arms firm and my grip secure, your resistance and tantrums won’t phase me. Your tears don’t scare me. I am strong enough to handle your despair and let you feel it. I will not lessen my grip. Whatever you have to go through, no matter how hard it is, I am your parent. I will be here.

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