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The Checkup Dr. Perri Klass on family health.

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In March, I wrote in this column about how different babies are different assignments, some much more challenging than others. Does a difficult baby mean parents are doing something wrong? How do you know when a baby — or small child’s — behavior signals problems more serious than a challenging temperament? And when nothing major is actually “wrong,” do parents have any real reason to complain?

Many parents commented, here or by email, about the contrasts between their own children — the easy baby and the hard one; the happy, satisfied and satisfying child (“After my husband and I had our first child, we realized quickly that we were the world’s best parents,” wrote “Olderandlesswise” in the comments here) followed by the demanding impossible child. (“Turns out we totally suck as parents. Who knew?”)

A number of people described having a very difficult first child who was therefore also a last child — or having a difficult second child and thinking, if this one had come first, there would never have been a second one.

Everybody telling these stories had experienced that sense of direct parental responsibility — the bad sleeper must be a bad sleeper because of something the parents did or didn’t do. The screamer wouldn’t be a screamer, if only you had done something differently. You get credit for the happy affectionate child, you get blamed for the one who isn’t. You blame yourself, and other people blame you.

And sometimes the pediatrician says the right thing, but there are also parents who come away from the doctor’s office just feeling more shamed, more unable to meet the standards.

As a pediatrician, I need to acknowledge that your job as a parent is to love and cherish and civilize the particular child you were given — not the child you had planned on, not the child your own parents were sure you would get, not the child in any particular parenting book.

My own first child did not like to be put down, ever, under any circumstances. We bought one of those soft baby carriers and one of us wore him pretty much all the time — washing dishes, standing up and typing with the typewriter on top of a dresser — and that made him happy, and when he was happy, he was delightful.

We had a book that showed photos of someone else’s baby lying on his back and smiling. I assumed that the baby in the photos had probably been drugged. A decade later, when I had one who enjoyed being put down, I apologized mentally to the author and the photographer.

There is no one-to-one correlation between what you do and and how your baby behaves. You work it out together, you and the baby. Sometimes you can successfully intervene, and part of the pediatrician’s job is to help you find guidelines that sometimes work — sleep training, breaking bad habits and reinforcing good ones, helping a baby learn to self-soothe, dialing down tantrums. But you can only do what you can do, and there are children who specialize in chewing up the guidelines — what a pediatrician friend of mine calls, “what to not expect.”

There is always the worry that something else is wrong with a child who seems to be distressed a great deal of the time, or with a toddler whose behavior continues to be extreme. In cases of excess crying, people wrote in to blame everything from the trauma of circumcision to food allergies, from gastroesophageal reflux to autism. I want to be very clear that good pediatric practice involves searching out the source of distress when you can — and that every pediatrician worries about classifying crying as “colic” when it’s really something else. On the other hand, there are a lot of true colicky babies out there.

And sometimes, especially as a baby grows, parents find that problems go beyond temperament. My colleague Dr. Karen Hopkins, a developmental behavioral pediatrician at New York University Langone Medical Center, told me, “a typical complaint is, I can’t find anyone who will agree to babysit for him because he’s too difficult, or he’s had to change day care centers or babysitters three times because they can’t manage him.” Those children may need to be evaluated for early evidence of hyperactivity or oppositional behavior that goes even beyond the toddler norm, or for autism.

“Where the parents feel out of control, where they’re very unhappy, where they observe significant differences in a playground setting or a playroom between their child’s play and others,” Dr. Hopkins said, families may need extra help.

Every pediatrician I know is in awe of the parents who cope with medical and developmental problems, who “go to medical school the hard way” and find themselves mixing expert nursing and constant advocacy with the love and care of parenting. They are, as a group, pediatric heroes.

But acknowledging and celebrating that kind of parental heroism shouldn’t stop us from discussing and celebrating the more everyday parental dedication of coping with a challenging though healthy baby. It’s really important not to take for granted the daily toil — however joyful — of caring for young children; that would be in the long tradition of ignoring and undervaluing the work done primarily by women in this world, too easily dismissed by those who haven’t put in the effort.

Some wrote to say, well, as long as you have a healthy child, you have nothing to complain about. That’s true, in a certain sense. But you need to pay attention to your own trials, even if they aren’t mortal, and acknowledge the energy and dedication and love and good humor that get you through the difficult days of parenthood, which can be truly difficult, even when you have a lot to be thankful for.

So here’s to the everyday dedication of parenthood — that truly for-better-or-for-worse commitment. Let’s enjoy them when they’re easy — without taking undue credit, and without necessarily predicting what they will become from their infant temperaments — and let’s acknowledge that sometimes they’re really hard. Especially some of them.

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