TANTRUMS AND BITING
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Temper Tantrums:
Temper tantrums are common in young children and are an immature way of expressing anger or frustration. It is important that you do not get flustered by the tantrums, and that you do not give in to your child's demands since this will just encourage her to have more tantrums.

Too many parents have tantrums themselves by screaming or in other ways losing control when their child is misbehaving. It is important that you model calm behavior even when you are upset so that your child can see that it is alright to be angry but that anger needs to be channeled properly.

Although tantrums look similar, their cause varies a lot. Frustration tantrums occur when your child is frustrated with himself; he needs comfort and encouragement with these tantrums. Attention seeking tantrums should be totally ignored because if your child gets a response, she will have these more often. If he is having a tantrum where he is refusing to do something important such as go to bed or get into the car, let him have the tantrum for 2-3 minutes before physically forcing him to follow your commands. It may help him to be warned that it is almost bedtime or almost time to get in the car.

Disruptive tantrums should be disciplined with time-out or other forms of discipline. If your child is in a rage where she could hurt herself by throwing herself on the floor, hold her for 2-3 minutes until she calms down. If it only makes her more upset you can put her down if she agrees to stop throwing herself on the ground.

Biting:
Biting is very common in young children because it is a powerful weapon that allows the child to attain what he wants from other children. It causes a lot of trouble for parents because their biting child might get expelled from a day care, have other parents become upset with them, and cause them to lose friends when their child is biting a friend's child.

Biting may start as an accidental behavior when the young child playfully bites his parent. Even if the bite does not hurt, a firm No! should be given and the child placed in a brief time-out so that he quickly discovers that this is not an acceptable behavior.

Do not bite your child back under any circumstances. Try to give him alternatives to the biting behavior such as coming to you to encourage another child to share a toy. Give him lots of praise when he avoids biting.

TELEVISION AND YOUR CHILD
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General Information:

Television has a large influence on your child's life because so many children watch so much television. While its entertainment value is high and there is benefit in your child being exposed to cultures, experiences, animals, and the world that he may never had been exposed to without television, overall television has largely negative influence on your child. Some children watch more television in their first 18 years of life than they have in their classrooms.

Harmful Aspects of Television:

1. Television displaces active types of recreation such as playing with friends, sports, art, music, and outdoor activities.
2. Television reduces social contacts and conversation with friends and family.
3. Television discourages reading and reading serves to challenge his thinking and vocabulary.
4. Excessive television viewing reduces school performance.
5. Television discourages exercise and increases tendencies towards weight gain by encouraging inactivity and snacking of high-calorie, high-fat foods.
6. Television encourages desire for material possessions that we all "deserve" according to the advertisers.
7. Television violence can increase children's fears of a violent world, may increase aggressiveness especially in young children, and may decrease sympathy for the huge number of victims murdered on television.
8. Television gives an unrealistic view on sexuality to the young. More than 90% of sex suggested on television is between single people. Seldom are the consequences of irresponsible sexual activity shown whether they be sexually transmitted diseases,  pregnancy, or mental health difficulties. Sexuality on television portrays marital sex as unfulfilling even though studies show that it is more fulfilling and safer than sex between unmarried persons.

Treatment:

1. Encourage outside play.
2. Read every day to your children when they are young.
3. Limit television to 2 hours a day or less. If your children are use to 4 or more hours you may have to wean them down over a month or so by offering many other opportunities for healthier activities.
4. Do not use television as a babysitter
5. If your child is having problems in school then limit his viewing to one-half hour a day on school nights and one hour on weekends.
6. Do not let television interfere with a regular bedtime.
7. Do not watch television during meals since this is one of the wonderful times to talk to your children and see how they are doing,
8. Turn off the television at the end of viewing a program; if he channel-surfs, your child will eventually find something that interests him.
9. Turn off shows that are excessively violent, portray irresponsible sexuality, or poor values in any other way.
10. Set a good example by limiting the amount of television that you watch. It is difficult for your child to limit her watching if you are watching television all day long.
11. Teach your children how to evaluate the goal of the commercials and show them how they use manipulative techniques to try to interest you in making a purchase.
12. Teach your children how to evaluate the message that a program is trying to bring to you and your children and how that message may be against your values and your children's values.

TESTICLE EXAMINATION
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Cancer of the testicles is less common than breast cancer, but like breast cancer occurs in a private but easily examined part of the body. Testicular cancer typically occurs in young men less than 40-years-old and occasionally in teenagers.

The cancer that occurs tends to be very aggressive and can spread quickly to other parts of the body.  However, if caught early, cancer of the testicle is quite treatable. Lance Armstrong, a world-famous cyclist who trains in Austin, was diagnosed with testicular cancer in 1996 and was successfully treated. He later went on to win the Tour de France, the most famous cycling race in the world.

How to Do the Exam:

1. The testicles are oval-shaped, firm, and tender. One testicle may be larger than the other.
2. Once a month, after a shower or while getting dressed, feel all around each testicle.
3. Above each testicle you will feel soft tissue that contains the blood vessels and sperm duct; this is normal but can increase in size if the vessels become larger.

Call Your Doctor If:

1. You feel any new growth or lump on either testicle whether it is painful or painless.
2. You experience excessive tenderness in one area that does not go away.
3. One of your testicles seems to have changed its shape somewhat.

THUMB-SUCKING AND PACIFIERS
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General Information:

Babies and young children love to suck on thumbs, fingers, and pacifiers. A security object often becomes part of the ritual.  The baby's desire to suck on the breast or bottle is important for nutrition and a full 80% or more infants suck on hands or pacifiers when they are not hungry. Sucking at that time seems to allow children to comfort themselves.

If your baby loves to suck, it is a good idea to give her an orthodontic pacifier (Nuk) by about 1 month of age so that she will not begin sucking her thumb. The pacifier does not cause the severe overbite that can result with prolonged thumb-sucking and is easier to wean your child from since it is not part of her body. Do not use home-made pacifiers such as nipples taped to bottle tops since they can come apart and choke your child.  Do not put your child's pacifier on a string around his neck that can result in choking. Rather use a pacifier that clips on part of his clothing. Do not coat the pacifier with sweets or honey since these can cause cavities or infant botulism in babies. Do not use a pacifier that has fluid in the middle of it since this can become contaminated with bacteria.  Also rinse off his pacifier each time he is finished with it or it falls on the floor. The sucking drive decreases as children age with only about 15% sucking their thumb or fingers by 4 years of age.

Treatment:

1. Thumb-sucking before 4 years of age does not usually cause any problems.
2. Occasional thumb-sucking during the day when your child is tired does not cause problems; if constant during the day encourage your child by reminding him that big boys do not suck their thumb and by showing him the callous on his finger that may hurt at times.
3. Thumb-sucking at bedtime is usually not voluntary and probably unimportant if it stops after your child falls asleep; if it is constant during the night consult your dentist to see if it is affecting her teeth.
4. If by 5- or 6-years old your child continues to suck his thumb frequently and your dentist is concerned that it is affecting the alignment of his teeth, then a bitter-tasting medicine (Stop-zit) can be applied at bedtime or a dental appliance may be placed in your child's mouth to prevent his sucking.
5. Encourage her to stop the pacifier if she is 3 or 4 years by giving her stars or marks on her hand and lots of affection when she is able to go for a short period without the pacifier. Never punish or humiliate her to give up the pacifier.

TOILET TRAINING
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Toilet training can be successfully completed as early as 18 months of age when your child has the ability to hold his urine and stool long enough to use his potty seat. However, most children are more than 2-years-old and many are more than 3-years-old. When your child completes toilet training depends mostly on his temperament.  Since your child can retain his stool for a long time, he is in control of when he goes to the potty, not you. Therefore, headstrong children tend to take longer to train than cooperative ones. Boys usually train later than girls.

Few children are toilet trained before 2 years of age and 15-30% of children are not trained until after 3 years of age. It is not a sign of failure on your part or your child's part if she has not trained by 3 years of age. Obviously, it causes more work for the parents when she delays toilet training, but that is all. No permanent problems ever result.  Toilet training is tending to occur at an older age on average now probably because better disposable diapers decrease the parental insistence on early training.

To Achieve Toilet Training at the Earliest Possible Age:

1. Relax! Toilet training always occurs eventually.
2. Buy a potty chair when he is about 18 months of age.
3. Always encourage her with praise at any steps toward success, however small.
4. Never yell or punish when he is slow to train.
5. Realize that she may have some progress and then some setbacks before final success.
6. If you have a new baby in your home or recent stress in your family, training may be delayed or a child who has previously been toilet trained may regress.
7. Boys usually train slower than girls.
8. It may help your child to see someone else of the same sex use the adult toilet.
9. Training for urine usually occurs weeks or months before success with his stool.
10. Children who are successfully toilet trained may wet the bed at night for years.

TONSIL AND ADENOID SURGERY
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General Information:

Tonsil and adenoid surgery are the most common surgeries on children in the United States other than circumcision. While as many as 30% of children in some communities will have their tonsils removed, only about 2 to 3% of these children have appropriate medical indications for such surgery.

The tonsils are a type of lymphoid tissue similar to the glands in the neck, under the arm, and in the groin. The tonsils help fight infection in the nasal and throat area and prevent spread of infection beyond these areas. Research has shown that children usually have more rather than less sore throats and colds after their tonsils are removed.  Tonsillectomy causes death of the child in 1 in 15,000 cases. About 5% of children bleed several days after surgery and may require transfusions or surgery to stop the bleeding. Occasionally, children with normal speech can develop nasally speech after surgery because the top of the back of the mouth no longer closes completely. All children have throat discomfort for several days after the surgery.

Reasons Not to Take Out the Tonsils and Adenoids:

1. Large tonsils- Your child's tonsils will likely enlarge until he is 10-12 years of age. From that  time onward the tonsils normally become progressively smaller.
2. Frequent colds and viral sore throats- Removing the tonsils does not help this problem.
3. Strep throat- An occasional episode of strep throat is not a reason to remove the tonsils.
4. Recurrent ear infections are not improved by adenoid removal unless your child has persistent nasal obstruction and mouth breathing caused by very large adenoids.
5. Tonsillectomy will not help school absence, poor appetite, hay fever, asthma, or bad breath.

Reasons to Take Out the Tonsils and Adenoids:

1. Persistent mouth breathing- Mouth breathing with colds or allergies are common, but   mouth-breathing at all times might be cause by enlarged adenoids.
2. Sometimes speech sounds can be affected by large tonsils.
3. Rarely, severe snoring, heart failure, swallowing problems, recurrent abscesses (boils) of the tonsils, and tumors may be reasons to remove the tonsils or adenoids.