Support Your Child’s Challenging Behaviors While Managing Hyperemesis Gravidarum (HG).
Raising and managing challenging behaviors of young children while battling Hyperemesis Gravidarum (HG) presents a unique set of demands on mothers struggling with nausea and vomiting. As a mom who experienced three pregnancies with HG, I understand the challenges of managing your health while also caring for young children. If you do “too much,” you take away the energy your body needs to raise small children. This is a balancing act that only a mom with HG can understand.
In managing the mental health of yourself and your children, it is important to first understand that children are unable to regulate their own feelings. Emotional regulation is a learned skill that parents can teach to their children. This is a process known as coregulation[1]. A child’s ability to regulate themselves is actually dependent on our ability to regulate ourselves. If parents are not feeling calm, balanced, and in control, they are unable to provide the emotional support required for coregulation.
Emotional dysregulation in young children typically appears as a challenging behavior. Challenging behaviors in young children are normal, but battling HG while parenting these behaviors is unique. As someone who battled HG while parenting young children, I understand that this can be a daily obstacle. My hope is that by learning a little more about your child’s behavior you can improve your mental health and well-being, as well as your child’s.
One thing that you can do to alleviate the stress of parenting with HG is to educate yourself on challenging behaviors.
What is a Challenging Behavior and Why is it Happening?
Some examples of challenging behaviors in young children can include screaming, hitting, biting, crying, throwing food, and, let’s not forget, my personal favorite- refusing to go to bed. Although many of these trigger frustration or feelings of defeat in adults, they are actually a form of communication. Children communicate their needs nonverbally before they are able to identify and vocalize their needs.
How can a behavior like throwing food be considered communication? Isn’t this just an excuse for “bad behavior”?
I suggest taking a step back from the behavior and asking yourself a few questions before you react.
What does this behavior mean? What is my child trying to tell me? How can I help improve my child’s ability to communicate this need? Are there things that I can do throughout the day to prevent this from happening?
Challenging Behaviors: Meltdowns vs. Tantrums
It can also be helpful to define if this behavior is a meltdown or a tantrum. This distinction is important because there are simple practices you can apply to your life to limit meltdowns. A child usually experiences a meltdown due to their loss of ability to regulate themselves, which is typically caused by hunger, understimulation, overstimulation, or tiredness.[2].
Meltdowns can usually be remedied easily by offering food, attention, a new setting, or a period of rest. They typically involve removing the child from the situation, meeting their child’s needs, and helping them soothe before reengaging in the activity. Meltdowns can also be prevented by being proactive throughout the day. If you can define the behavior as a meltdown, then you can adjust your approach and get ahead of the meltdown occurring again when you are faced with a similar situation.
Tips for preventing meltdowns:
- Maintain a schedule throughout the day. Offer periods of rest or sleep, predictable meals/snack breaks, opportunities for group and independent play.
- Control your environment by limiting toys that make noise and sounds- these can easily cause overstimulation. Decrease the amount of toys/books/activities that are accessible in your child’s play space. Play soothing music and avoid overly colorful décor.
- Keep a Mystery Box of “new” items that you can offer when you feel your child is understimulated. These are the items that I would save for the days where I was battling HG alone at home with my children. A new coloring book from the Dollar Store, a can of shaving cream to play with “snow” in the bathtub, a large box that can be colored and made into a house for your child’s stuffed animals, a new pack of stickers, even old empty water bottles that you can make into musical shakers – the possibilities are endless! You will be surprised how the excitement of a “new” item can entertain your child and promote creativity.
- Offer time outside where the child has opportunities for unstructured play. Do this daily if your health allows. This will provide your child with a sense of freedom and will provide sensory input that they will not experience from inside play.
Tantrums on the other hand are not as easily resolved. They are occurrences of frustration caused by wanting access to something, being unable to express their wants/needs, or feeling a loss of control of a difficult situation2. These require more stamina from parents and often times lead to a “teachable moment”. You will need a fully charged battery as a parent to address tantrums, but there are a few things that you can do in the moment to make them less draining.
Tips for addressing tantrums
- Check in with yourself.
- If you are feeling overwhelmed, pause and regulate yourself before addressing your child. This is the most important thing you can do in this situation.
- Remember, your child’s emotional state is linked to your own (coregulation).
- Provide transition warnings.
- Let your child know, “In five minutes we will be getting ready for a nap. It’s important that we both have time to rest during the day.” OR
- Use “First_____, then______” statements like, “First we will change your diaper and then we can stack the blocks.”
- Be sure to be consistent and follow through with these warnings or the next time you give your child a warning they will expect you to give in.
- Offer choices throughout the day.
- “Do you want to wear the pink socks or the striped socks?” “Should we play a game or color?”
- There can be a lot of unpredictability in a household battling HG, so giving the child a sense of control can alleviate some of their stress.
- Reinforce your child’s positive behavior throughout the day.
- “Wow! You said ‘Please.’ You sound very kind when you ask for things when you say ‘please.’”
- This will help your child feel validated, and they will know they can receive attention for positive behavior.
- Acknowledge your child’s feelings.
- “I understand that you are sad that we cannot go to the park today. It’s hard when we have to change our plans because mommy isn’t feeling well.” “I know it can be hard to see mommy not feeling well. Sometimes we get sick and our bodies need rest. Mommy will feel better soon.” “I know you are disappointed that mommy can’t come to watch your soccer game. Mommy is sad too. Mommy will be so excited to come watch you when she is feeling better.”
Having empathy and naming your child’s feelings for them will support coregulation.
Model how to regulate your own feelings when you are upset.
- Teach your child to take “belly breaths” by putting your hands on your stomach and feeling the stomach expand and retract. Have your child do the same. Google “Elmo belly breaths” for a great video example for your child.
- Bring your hands together and stick your two index fingers up and create “birthday candles”. Sing Happy Birthday and take turns blowing out the candles.
- Create pinwheels and watch the wheels spin as your child takes deep breaths.
Try to see your child’s behavior as a form of communication – Remember that your child’s behavior is their attempt to communicate something to you. Take time to reflect after an interaction with your child when you have had time to decompress.
What do I think my child is trying to tell me? How did I handle this moment? How was I feeling? What can I do differently next time?
Call on Support
Family and friends can also be a great resource in supporting your child’s behavior. People would often ask me how they could help me with my children, and sometimes I felt too sick to even realize where to start. Below are a few ideas of how your community can support you.
- Call a friend or family member to vent.
- Sometimes it is better to step away and process your feelings before trying to manage your child’s. “When I battled HG, I found that my child’s behavior quickly upset me. When I took a moment to process these feelings and regulated myself I could better support managing my children. This is an extremely challenging time and it is OK to feel upset or overwhelmed when parenting with HG.
- Take a break.
- Have someone come over to entertain your child so that you can rest. I would often have a family member come over so that I could sleep, or I would bring my child to their house and then nap there.
- Fill up your Mystery Box.
- Ask family or friends to add random items to your Mystery Box. This can be a great way to include family from out of town who want to support you- they can send items in the mail!
- Meals.
- Ask for help making your child’s favorite meals or snacks in advance so they are ready to serve – especially if you do not have the stamina to prepare food. If you are triggered by mealtimes, have someone feed your child for you. Having consistent meals and snacks can prevent meltdowns.
Resources to Manage or Better Understand Challenging Behaviors:
Remember that in order to successfully manage your child’s behavior, you must be in a calm state yourself (coregulation). If you are feeling like you need support, do not feel guilty for addressing your needs before your child. It is important to take care of your own mental health so that you can support the mental health of your child. If you are battling HG and while parenting, know that you are not alone and there is support from the HER Foundation.
- Find a support group that fits your needs!
- Request a peer support.
- Share our “When Your Loved One Has HG” brochure with your family.
- Share our “How to Help Her” page.
Other Resources:
- Talk to your child’s pediatrician if you feel that your child’s behavior concerns you or you feel that you do not have the skills to address them. Keep a notebook of what is happening, when it’s happening, and what happens before and after a challenging behavior occurs. These notes will be helpful for your pediatrician to reference.
- Contact your local school district or office of education and ask about local programs/agencies that offer free support.
- Familiarize yourself with some of my favorite texts:
- Whole Brained Child- 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind by Daniel J. Siegel, M.D. & Tina Payne Bryson, Ph.D.
- No Drama Discipline by Daniel J. Siegel, M.D. & Tina Payne Bryson, Ph.D.
- How to Talk so Little Kids Will Listen by Joanna Faber and Julie King
[1] Co-regulation in human services. The Administration for Children and Families. Accessed April 10, 2024. https://www.acf.hhs.gov/opre/project/co-regulation-human services#:~:text=Co%2Dregulation%20is%20the%20interactive,et%20al.%2C%202019).
[2] Siegel, DJ, Tina Payne Bryson. The Whole Brain-Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind. Scribe Publications; 2012.
Thank you the HER Foundation volunteer, Elizabeth Meyer, M.S. for writing this guide for us.
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