Promoting Safe, Secure, Nurturing Relationships

All parents want their children to succeed academically; have a safe and healthy childhood; and grow into independent adults. Positive parenting focuses on building safe, stable, and nurturing relationships between parents and children.

Positive parenting programs can help caregivers learn effective skills.

This age can be very challenging but it can help to offer praise and positive feedback. She loves to hear how she is doing well and how much you love her. Positive feedback builds her self-esteem and helps her choose the behaviors you want from her.

Resources:

• Positive Parenting Strategies webinar August 2021
• Bright Futures- Building Positive Parentings Skills Across Ages
• Triple_P Parenting.com
• Circles of Security
• Attachment Vitamins
• Mt. Sinai Parenting Center
• Resilience University

Father involvement in the early childhood years is associated with positive child development. For example, at 3 years of age father-child communication has been shown to be a predictor of advanced language development. Fathers tend to be more likely and more active play partners. Fathers engage in more active play, and their involvement in play with preschoolers predicts decreased externalizing and internalizing behavior problems and enhanced social competence. (References)

Pediatricians are often the first members of the health care team to engage fathers.

Pediatricians can be more inclusive to fathers by:

1. Welcoming fathers and express appreciation for their attendance.
2. Offering flexible hours for all caregivers to attend well child visits
3. Addressing fathers’ unique concerns regarding their children.
4. Recognizing that mothers and fathers may not always agree on how best to raise a child. Parents may disagree on the approach to discipline or positive parenting.
5. Emphasizing how children look to their fathers as role models for behavior and are likely to imitate behaviors.
6. Stressing the unique role many fathers play in encouraging age-appropriate active play and modeling physical activity
7. Promoting fathers awareness about the practicalities of breastfeeding and how to support mothers’ nursing.

You are a great playmate for your child! They love laughing with you and learning how to play from you. You can help your child build skills to get them ready for kindergarten. Games like freeze dance, Simon says, and red-light green light all build control of their bodies and asks them to pay attention-important skills for school.

Your child learns so much from you. What are some things you like to teach her?

Resources

• AAP Policy Statement, Fathers’ Roles in the Care and Development of Their Children: The Role of Pediatricians
• Childhood Looks Better When Dad is in It

Play builds brain structure and promotes executive functioning. It also supports shared communication and attunement between the child and their caregiver, supporting early relationships and protective factors.

It is helpful for parents to have strategies for engaging their child in play that is responsive and developmentally appropriate. You can share this play milestones resource with families 

Get eye level with your baby during baby time. Tummy time strengthens her head and neck muscles to get ready for crawling and sitting up. Getting eye level will give you a chance to connect, smile, and laugh together.

Playing together can be a good time to enjoy each other’s company but also give him time to share how he is feeling and thinking. You have probably noticed him acting moments of his day or interactions out during play.

Resources

• AAP Policy Statement: The Power of Play: A Pediatric Role in Enhancing Development in Young Children
• Center for Developing Child, Harvard Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence

For better or worse, young children use screen time often and regularly. With the widespread use of screens throughout our normal lives, it is expected that young children would be exposed and introduced to screens themselves. However, the concern remains how much of their time is spent in front of a screen and how early they are being introduced to a screen.

Did you know Recent studies show that 68% of children under the age of 2 use screen media in a typical day, and that average screen time was 2.05 hours per day.

Parents want what’s best for their children—but they also lead busy lives. It can be hard to work, cook, clean and get kids to bed. Many parents choose to offer screen time because they believe media content is educational. They believe their child is learning. Parents have also admitted to not limiting screen time to avoid conflict or to entertain or distract their children. All very relatable reasons for busy parents.

However, screentime has often been shown to reduce the amount and quality of interactions with caregivers and families.

Pediatricians and other providers can support families with realistic goals for reducing screen time and encouraging time for families to connect with their child. For example:

Build healthy family routines! Help families remember how much their child loves them and wants to spend time with them. More than they want to spend in front of a screen. Support families to protect their time with their child and identify a regular time for play and connecting that may work for them. Even if it isn’t everyday.

Build screentime routines and boundaries: Our habits start early! This includes screen time. Support families to identify what their boundaries should be in the early years related to media use and time in front of a screen. The AAP offers a family media plan to help families get started.

Avoid screens before bedtime: Media use before bed can affect how well a child sleeps. Suggest families avoid screen time use at least 30 minutes (confirm this #) before beginning their bed routine.

Remove screens in the bedroom: Limiting screentime can be extremely challenging for busy families. Keeping a screen out of their child’s bedroom can be a more realistic goal and a great start.

Your child loves spending time with you! They learn so much from you and want to share their day with you. What are some things you enjoy playing together?

After a busy day, a regular bedtime can be a great way for you and your child to relax. His day has been busy too! Bath, brush, book, bed is a great start.

Find more resources on the AAP media and children webpage

Family involvement in early literacy supports language development, school readiness, and social emotional development including resilience. Shared book reading offers opportunities for caregivers to model positive interactions and communicate with their child. Visit the AAP early literacy page for strategies for implementing early literacy into practice.

More than 140,000 US children have lost a primary or secondary caregiver due to the COVID-19 pandemic (NIH 2021). The death of someone close to a child has profound and lifelong effects. Pediatricians can offer assistance and support to children and families including:

• Exploring and confirming the child understand what has occurred and what death means
• Helping to identify reactions such as guilt, fear, worry, or depressive symptoms that suggest need for further services
• Reassuring children who become concerned about their own health or those of family members
• Sharing local resources
• Offering advice on funeral attendance on children

Resources:

• AAP Resilience in the face of grief and loss curriculum
• AAP Clinical Report, Supporting the Grieving Child and Family