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The Checkup Dr. Perri Klass on family health.

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I got my good sleeper second. My oldest child, my first darling baby, did not reliably sleep through the night till he was well past 2. Since he is now an adult, I can skip right over all the questions of whether we could have trained him to self-soothe and stop calling for us in the night — we tried; we failed; we eventually gave up.

The good sleeper was a good sleeper right from the beginning. She followed the timeline in the books, slept longer and longer between feedings, till she was reliably giving us a real night while she was still an infant and she never looked back. Had we matured as parents, become less anxious, more willing to let her learn how to soothe herself? Were our lives calmer? Well, no. In fact, kind of the opposite. We just got dealt two very different babies.

I supervise pediatric residents as they learn to provide primary care, to offer guidance to parents as they struggle with all the complexities of baby and toddler sleep, eating, potty training, discipline and tantrums. All of the stuff that shapes your daily life with a small child, and I’m talking about an essentially healthy, normally developing small child. And the hardest thing to teach, especially to people who haven’t yet done any child-rearing, is how different those healthy, normal babies can be, right from the beginning.

So we review our sensible pediatric rubrics that deal with these questions, from establishing good sleep patterns to setting limits to encouraging a healthy varied diet. But sometimes it seems that these rubrics work best with the children and families who need them least.

Every child is a different assignment — and we can all pay lip service to that cheerfully enough. But the hard thing to believe is how different the assignments can be. Within the range of developmentally normal children, some parents have a much, much harder job than others: more drudge work, less gratification, more public shaming. It sometimes feels like the great undiscussed secret of pediatrics — and of parenting. Babies and children are different, assignments are different, and we spend a lot of time patting ourselves on the back — as parents and as pediatricians — when the easy babies and toddlers behave like themselves, and a lot of time agonizing and assigning blame when the more difficult kids run true to form.

We talk a lot about temperament in my line of work. We look at where a child — or an adult — falls along a set of axes. High activity to low activity. Adapts easily to adapts with difficulty. Intensity, mood, attention span. And while no one would argue that these are fixed and immutable traits, it’s also true that — again, as every parent and teacher knows all too well — you can’t possibly make child A into child B. You work with the temperament you’re given — it’s the assignment. And some assignments are harder than others.

We talk about “goodness of fit,” and certainly, it can be helpful to think about how one child’s temperament might be less problematic in another family — the high-energy child who is driving two somewhat sedentary, somewhat older parents crazy might be an easier assignment for two younger, more active parents.

I have had a mother explain to me why one twin was the angel child and the other the devil child. And then she started to cry. I have had a father ask me if I ever knew a couple to get divorced because their baby didn’t sleep through the night. And sure, some of those struggles reflect parental practices and habits and the way those children have been reared and how their parents reacted to earlier iterations of the behavior. But ask any parent who has brought up two children of wildly different temperaments — some of it is just the kid you get dealt.

As a pediatrician, I feel this in the exam room all the time — respect for parents who are coping good-naturedly with the cranky and the colicky. Sympathy for parents who break down when they describe public tantrums and the judgments passed by onlookers who assume that a crying baby must automatically reflect either a too-indulgent or a too-neglectful parent — or both at once.

There are children whose level of activity, or rigidity, or shyness, crosses over into the pathological, and will actually complicate their lives far beyond the variations of normal temperament. As a pediatrician, I want to start by making sure that nothing is really wrong — but when nothing is really wrong, I want to acknowledge that the job of rearing one healthy, normal child can be much more challenging than the job of rearing the one who came before — or who will come after.

My good sleeper was actually my challenging child. I’m telling you this with her full consent — like her brother, the bad sleeper, she’s now grown up. She was what we like to call a “spirited” child: unbelievably stubborn, ready to battle to the death over any small choice, and subject to periodic, and generally very public, melt-downs which I sometimes thought would get me arrested. And yes, now that she’s an adult, I can see that many of these same traits translate into determination, and strength of character. But looking back, I’m not sure any of us would have made it through, if we hadn’t been, at the very least, well rested.

Well, of course we would have made it through. As a pediatrician, you try to help and encourage; even the crankiest can be soothed; even the children most averse to new experiences can start to sample the world. Sooner or later, almost everyone accepts potty training, gives up the pacifier, sleeps through the night. And given a longer distance — years stretching into decades — most of us, parents and children, do find it possible to look back and smile.

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