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Ask Dr. K: Address toddler’s biting as soon as it occurs

DEAR DOCTOR K: Today at the playground my toddler bit another child. How can I make sure she doesn’t do this again?

DEAR READER: Lots of toddlers between 1 and 3 years go through biting and/or hitting stages. Children at these ages cannot yet express in words their feelings, so they may bite or hit parents, children or caregivers to get attention or to express frustration. These young children also may bite just to see what kind of reaction it provokes.

Toddlers will try any behavior to achieve a goal — until they learn that the behavior is unacceptable. If we didn’t know it was unacceptable, we adults would probably revert to behaving like toddlers. (In fact, no surprise, we sometimes do.) And kids who know a behavior is unacceptable still will do it when the conditions are right.

A friend’s 5-year-old daughter was alone in the living room bouncing a ball. The ball knocked over a vase. When her mother heard the crash, she came into the room, saw what had happened and said to her daughter: “You know you’re not supposed to bounce a ball inside the house! Why did you do that?” Her daughter replied, “‘Cause you weren’t looking, Mom.”

Back to the biting: The reasons for this aggressive behavior may be understandable, but the behavior itself is never acceptable. Biting and hitting hurt, and children need to learn more appropriate ways to express themselves.

My pediatrician colleagues here at Harvard Medical School tell me that when your child bites or hits, it is very important to make a swift, direct response. Tell your daughter what she should not do, why she should not do it, and what the consequences will be if she does it again. State firmly and immediately: “No! Do not bite! Biting hurts! If you do it again, no TV for you tonight!” Keep your words simple and short. Children this age don’t have the attention span or developmental ability to understand long explanations.

After responding to your child’s misbehavior, try to figure out why she acted this way. If she is biting or hitting to get attention, discourage this behavior by making extra efforts to praise her when she behaves appropriately. If your child has kicked or bitten another child, pay special attention to the victim. Your child will learn that by misbehaving, her attempts to get your attention have backfired.

If she is biting to relieve teething pain, offer her something soft to chew on. If she is frustrated or angry, remove her from the situation. If she has started to talk, suggest words that she can use to express her feelings. If she is overstimulated, over-tired or hungry, address the specific need and try to anticipate it in the future.

If aggressive behaviors are properly addressed as soon as they occur, most children learn quickly that this kind of behavior is unacceptable and stop. If your child is older than 3 years and is still hitting and/or biting, your pediatrician may recommend that she see a child psychiatrist.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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