By Claudia M. Gold, MD, December 20, 2021
Three-year-old Bella’s frequent tantrums since the birth of her baby sister Julia brought the family to my behavioral pediatrics practice. Her father Jose began our visit with an explanation. “She’s jealous and is trying to get attention.” He even had a solution. “Maria (their mother) just needs to spend more special time with Bella” and “She needs to set more firm limits.” I felt as if he had read the book; reciting the lessons I’d learned years ago in my developmental and behavioral pediatrics fellowship.
But beneath this typical framing lay a multilayered story of meaning. It emerged after about thirty minutes into an hourlong visit when we all sat together on the floor in a safe space of play and discovery. Jose had come to the United States from El Salvador as a young boy and spoke English well. Maria had joined him more recently and so relied on Jose to be her interpreter. I needed to intentionally pause to be sure that she had heard and understood my questions and responses.
We began the session with a period of observation of three-month-old Julia in Maria’s arms while Bella explored the box of toys. I noticed the delight mother and infant took in each other when Julia, in a quiet alert state, captured Maria’s gaze. I commented on how Maria supported her daughter through fussing to nursing to sleep with a calm confidence.