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My 2.5-year-old daughter has an ear infection. She has been really healthy her entire life, and this is the first time she's gotten sick enough she needs to take any medicine in a strict schedule. However, ever since she first got sick, she refuses to take the medicine in any form or medium we offer it to her. We have tried mixing it up with water, all types of juices, candy-flavored pills, etc., and she is onto us. Now, whenever we approach her with anything she thinks is medicine, she starts to cover her mouth.

She had a high fever, so we took her to the emergency ward, and the nurse kinda forced her to take the medicine, and we have been doing the same since because we don't want her fever to get too high.

The problem is she is this tiny 2.5-year-old kid and I am close to 200 lbs, and I don't like using strength or force to do things. I am afraid to cause fear or trauma on my little one. Are there ways to make this any less traumatic for my girl? I am really sad every time I give her medicine and she starts screaming "all done! all done!" or similar phrases. This is breaking my heart, and I am afraid it will cause future issues with my daughter. Any advice is appreciated.

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    In my area suppositories are common for toddlers, because they do not understand the importance of medicine and you can give it to them when they are asleep too. In such a case like OP describes, suppositories are much more spare the nerves of all involved. – Allerleirauh Sep 9 at 11:32
  • Where I am from suppositories are also very popular among toddlers for the same reasons. I am not sure why they are not as popular in the US. Thanks for your advice. – Hanlet Escaño Sep 9 at 13:21
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    Couldn't you let your child choose from two alternatives: the medicine vs a pip of chocolate/peanut butter (which includes the medicine)? Works everytime for me in cases like this or similar cases like broccoli vs cauliflower. People like choices. – Quora Feans Sep 10 at 16:37
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I don't like using strength or force to do things, and I am afraid to cause fear or trauma on my little one

This dislike of using force speaks for you. However, in this case, it might be the only thing that is guaranteed to be sucessfull in getting her to take her medicine, and it's in her interest, even if she doesn't understand it. This is what parents are for. Sometimes acting in a child's best interest means acting against what they want; this can be emotionally draining, but it's necessary. Don't be too afraid of causing trauma. You're not abusing her, you're not being mean, and you have to trust that your relationship with your daughter is built on a solid, loving foundation that will survive these times of conflict.

That said, maybe there are some things you can try so that in the future you won't have to resort to force any more. I think the most important thing in that respect is to be consistent so she knows exactly what she can expect.

First, don't argue or discuss with her when it's time to take her medicine. She needs to take it. There is no way around that, and you should make that clear to her. Arguing with her, discussing it with her, trying to reason with her etc will give her the impression that taking the medicine is negotiable. Provide her with just two options: Either she takes the medicine willingly, or you'll force her to take it. When she doesn't take it willingly, follow through immediately. There really aren't any other options, and it's better to have a horrible 30 seconds than dragging it out to a horrible ten minutes.

Once she's taken / been forced to take the medicine, soothe her. It goes without saying that if she's taken it without being forced, you praise her (@Pere suggests to praise her in any case, to reinforce the positive aspect of taking the medicine - I haven't tried this myself, though).

Second, find out whether there is something you can do to make the taking of the medicine less difficult for her. Talk to her about it when it is not time to take it. Giving her as much control as possible might help. For example, maybe you can give her control about the time when to take it. (Before a meal? After a meal?) Suggest some things you think might make it easier, like offering that she holds the spoon with the medicine herself, that she takes it in multiple small doses (if that's possible and allowed) or, if she's like me, in one big gulp so it's over quickly, or that she gets to eat a banana right after swallowing it, or that you tell her a story right afterwards (but again, make it very clear that there is no way around taking the medicine - that's a given). It's possible, though, that giving her some control over the process won't work because she simply doesn't care about any of that.

Third (because this is beyond your control), maybe there is a product with an identical active ingredient that tastes different. It's worth a shot to check.

To summarize: Offer her some control over the means and context, but remain firm and unshakable about your requirement that she takes the medicine. Kids are very good at learning patterns. Once she understands there really isn't a way around the horrible medicine, she might be more open to the question of how she takes it.

I hope you won't have to resort to force for much longer.

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    @Hanlet: you say you've tried mixing the medicine with juices and candy flavored pills, so I'm not that surprised she'll suspect treats are medicine. I expect being upfront that you're giving her medicine but you hope this new one won't taste as bad is a different thing entirely, if you can get the idea across. – David Hedlund Sep 8 at 21:16
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    @Pascal - As a user who happens to be a physician, I just love this answer! Rewards for doing the unpleasant are fine. – anongoodnurse Sep 9 at 2:25
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    I had the exact same situation with my 2 year old daughter when she got a tonsillectomy. She was in great pain at the hospital and the nurse was unable to get her to take the painkiller. She spat out three doses and cried and cried. I took the spoon, pushed it in until she gagged just a bit. Swallow and done. She was asleep in fifteen minutes. When she woke up she was fine. Children that young just can't be "reasoned" with when they make up their minds, offering a reward wouldn't have helped. With a five year old, yes, but not at two. – Francine DeGrood Taylor Sep 9 at 15:39
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    I tried a few things from your post, as well as a few other suggestions in here, but this is what has worked best so far. She is also feeling better overall, so she is not crying so much anymore when I try to give her her medicine. Thank you all of the great help. This is something that nobody prepares you for. – Hanlet Escaño Sep 9 at 16:31
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    +1 - I only would add, after "if she's taken it without being forced, you praise her", that if she's taken it being forced, praise her anyway for taking it willingly. It's a bit ironic but makes it clear what is right and focuses in the important and positive part (taking the medicine) instead of the unimportant part that should be forgotten and hoppefully avoided next time (the fight). – Pere Sep 9 at 17:23
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Let her moan, cry, and delay the inevitable, showing respect for her feelings, but set a timer for these activities. When the timer goes off, it's time to take the medicine.

Refusing medicine necessary to get better is not an option, just like playing in traffic is not an option. But respecting her feelings about it is an option.

The following is a very valuable experience I had as a resident on a Pediatric cancer ward. Twice a day, a 5 year old patient had to have an intramuscular injection of a chemotherapeutic agent. It wasn't an option; she had to have it. On my shift, I would walk in and it would begin: the pleading, the mourning, the objection, the cries. It would take about 20 minutes of (very valuable) time to let her come to the point of letting me give her the injection.

One day, I walked in and she was fast asleep. I thought, "Oh, I can just give it to her without all the anguish; It will be over as she wakes up."

So, while she slept, I prepped her thigh and gave her the injection. Once I did, she woke up. "All done!" I said.

The little girl never spoke to me again. She died a few months later, never uttering another word to me, a person who had profoundly betrayed her. Almost four decades later, I still remember the look on her face.

So, respect her feelings and give her time to grieve, but set a limit after which she will have to take the medicine. I like the suggestions in @Pascal's answer. A story afterwards, a small reward, something precious to her (stickers of her favorite character? a small bowl of ice cream? Whatever rocks her world.)

But do not feel guilty at making her take her medicine. It's your job.

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    I would argue that a resident on a paediatric cancer ward has better reasons not to spend the 20 minutes twice a day on a single child than a parent ever has. It's wonderful that you did anyway, and my interpretation of that story is that to her, you became not just a physician, but a trusted person, and that's why she felt betrayed. A parent should always work on being seen as a trusted person, not a physician. I agree that making her take her medicine is a parent's job, but it's not their only job. I say do the job, but it's ok to feel guilty if doing it conflicts with other aspects of it. – David Hedlund Sep 9 at 5:45
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    I like the timer idea. I wish I'd tried that (not with taking medicine, which was seldom a problem, but with a few other things that were non-negotiable). It gets the point across very clearly that the end result is clear from the beginning, and doesn't lead the child into thinking that he/she can argue/cry his/her way out of it, but it gives the child a chance to voice displeasure, which my solution lacks. – Pascal Sep 9 at 10:01
  • Timers work great for many things, something about a loud, identifiable sound just works. We use it for going to bed, for leaving the park, pretty much anything that meets opposition. When the timer sounds, it's time, no more negotiation. – GreySage Sep 9 at 21:46
  • I am horrified. It was futile. – Joshua Sep 10 at 2:06
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    @Joshua - Ah. It was not futile in that, in her last months of life, there were people who let her express her fears. We didn't expect her to die; we expected to discharge her. But other things happen, like infections. Many cancer patients die of infections. – anongoodnurse Sep 10 at 2:21
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Parent: "It's time to take your medicine."

Kid: "Charlie should not take medicine."

Parent: "No it's time to take medicine. First we'll take the medicine, then we can go do < fun activity>."

Kid: "Charlie should not."

Parent: "You can take your medicine, or you can go to time out."

Kid: "No medicine, no time out."

Parent: "Okay, time-out it is. Wait for 2 minutes in the corner."

Kid: Screaming

This is the script I usually follow with my 2.5 year old. Usually the "first difficult thing then fun thing" method works. After 2 minutes of boredom he's always been compliant, but I imagine I would send him back for another 2 minutes until he was ready to play ball.

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    To me, this just reiterates what OP says he is not content with, albeit replacing physical display of power with a psychological one. Here are some of the things that are problematic with timeouts. I think nothing is gained by switching to this technique. I can't say that as a kid, this would make me feel less violated than had I been physically held down, I'm actually leaning towards the other way around. – David Hedlund Sep 9 at 13:58
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    @lazarusL: Timeout teach that in exactly the way that physically holding a child down does, in this example, and I think "my way or I administer a punishment" is not really teaching kids anything more than that their will doesn't matter. As an aside, I think that psychological isolation seems like a crueler punishment than just forcing the medicine, but that's not my main point here. I understand that enforcing your will against the childs is sometimes the only outcome, but it is the undesirable outcome that OP wants to find tools to avoid. This script seems to just accept it and move on. – David Hedlund Sep 9 at 14:35
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    @DavidHedlund I see. We just have a slightly different philosophical outlook. We both agree that autonomy is good and try to preserve it, but you elevate it to a sacred level above all else. I can respect that position without agreeing with it. – lazarusL Sep 9 at 14:56
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    @DavidHedlund: "..but the take home message must be that I have heard the child....": This is easy to resolve, simply state it clearly: "You have to take this medication. I know you don't want to, I know you hate it. I'd probably hate it too if I were you. Even so, you still have to take it so your ear can get better. I'm sorry, but that's the only way." – Pascal Sep 9 at 15:09
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    @Brondahl I think timeouts are a good tool if used appropriately, for example when the child needs an opportunity to calm down, if they're having a tantrum or are really upset over something small, after which they can go on with their lives and play. However, in this case their feelings are a pretty natural reaction to having to do something unpleasant, and after this timeout they still have to face the medicine. So the timeout doesn't really have a purpose at all. Why calm down if you know the medicine is coming anyway? You may as well just use force and be done with it. – Stacey Sep 10 at 20:47
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I had similar with 2 sons... and yes I am 110kg...

Around 5 &3 they had to have injections at the docs. Oldest refused, hating needles while youngest sat and was so easy - they were in the room together... The youngest, after the first one in the left arm, turned and offered the right arm for the next injection... The nurse laughed with him and said "it's only one today"...

Doctor, nurses & Mum all tried for the oldest and I ended up hugging him so they could do it. He was ok with me after ...

He still hates needles ( now 18) but can just about keep himself composed so they can do it. If he didn’t you would not succeed - he is nearly same size as me and strong as an ox... shooting him with a dart gun might be an option... hmm wonder what the doc would say... :)

Persevere, and give a treat after - ice cream or chocolate bun at the cafe etc But it’s always a tough moment as a parent...

Wasn't long after that I had to take the oldest to hospital for a fractured upper arm. He was scared of the x-ray machine (big, never seen one etc) So he agreed to sit on my lap (we both got lead aprons...) Notably, this was not a challenge - he easily agreed to my "company" for the x-ray, so things do change...

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My eldest has a chronic medical condition (cerebral palsy), for which we have given her literally thousands of doses of medicine (through a tube directly into her stomach), not to mention some much more painful things like physical therapy, so perhaps my perspective is different, but I have always been a fan of the "no big deal, it's over already" approach both for her and my other kids.

Kids take a lot of their cues from their parents. Yes, taking medicine is unpleasant, but parents can make it worse by reinforcing that "it's a bad thing I'm trying to protect you from and trying to hide from you."

My answer to that is to not prolong the suffering. Just cheerfully say, "Time for your medicine," then give it to her. By the time she is able to complain, it's already over. When things are non-negotiable, don't negotiate.

The fascinating thing I've found by taking this approach is around age 4 or 5 kids will start asking for accommodations for the next dose, and those requests will be very reasonable. For example, my kids have asked for accommodations like sitting down first, or having a drink ready to go afterward, or having a few more seconds to catch their breath between squirts, or to have a hand on the syringe to help aim it, or when they're a few more years older, to administer the medicine themselves.

These are all requests that are very easy to grant. It shows me that the kids have accepted the things that are non-negotiable, and helps them assert control over the things that are okay for them to control. Yes, we still have complaints, even crying. The difference is, the crying is over in 10 seconds instead of 10 minutes.

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    Interesting take on being cheerful instead of apologetic. Wish I'd tried that, +1. The rest of your answer matches what I experienced with my kids. – Pascal Sep 10 at 20:06
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When my daughter was four years old she refused to take her antibiotics. As it happened, I also had to take antibiotics, so we would take our pills together. It has never been so easy to give a child her medication as it was that time.

I think part of why it worked that time was not just shared pain, but also because it became a game for us, to take the pills together. Maybe there is a way for you to get your daughter to cooperate by creating a game around taking the medicin?

  • Fun solution! Might I add that m&m's make excellent placebos! – anongoodnurse Sep 10 at 15:27
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    Another approach to try - +1 for the idea, though I think this will work better when the kids are a bit older and they like to compete and win against you (like your daughter at 4) - I envision a "who can swallow the horrible pill faster?"-game. I can just imagine my boys at that age wanting to win more than not wanting to swallow the pill. – Pascal Sep 10 at 15:43
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    Yes, this; I scheduled some of my jabs so we could have them at the same time, at the same doctor. No whinges at all. And for the tablets, she got to put mine in my mouth, then I put hers in her mouth, and we both swallowed. I could mess around and pull a face, and she'd say, "now don't be a baby." – RedSonja Sep 11 at 6:47
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My daughter's a similar age and has had to take antibiotics fairly regularly for a large portion of her life and there are a couple of things I'd like to add that I don't see here mentioned.

1) Experiment first!

Antibiotics are horrible to take. I experimented with adding them to chocolate sauce, mixing them into fruit puree, a bit of her breakfast porridge, pretty much anything.

Also consider changing where you give her the medicine (kitchen/sitting room/outside even), and in her chair vs standing. I found my daughter would associate a situation with medicine, and would resist even when we knew she didn't mind the taste. One day I literally took her to my bedroom and sat on my bed with her and bought a brand new bright orange syringe for her to play with, and then gave her her meds with it, just to break the kitchen+highchair association.

2) Be respectful of her even when using force.

When I had to resort to force, I did my best to respect her and her autonomy as best as possible.

  • I explained why I had to do this even though I didn't want to.
  • I held her securely in my arms and only resisted her struggles, I didn't apply any additional force of my own.
  • I waited until she opened her mouth a teensy bit to get the syringe in (even if it was because she was crying, I didn't pry her mouth open), and quickly injected into the side of her mouth.
  • I gave her an opportunity to swallow, and water in between if it was a larger dose.

Even though she was doing something she didn't want to do, I did everything in my power to show her that I was there and I cared for her.

Afterwards, she got a treat for being so brave and some extra cuddles, and I tried a different recipe at the next dose.

3) Ask your medical provider for help.

I spoke to my local nurse and she gave really helpful suggestions, like using a syringe, aiming it into the side of her mouth, and suggested using chocolate sauce to try first.

The next time she took antibiotics, I asked for a different option. I learned very quickly that my daughter hates that fake banana flavour, but will actually tolerate strawberry/chocolate fairly well.

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and I am afraid to cause fear or trauma on my little one.

Sometimes force is needed to save someone's life or prevent brain damage. Those are the gray areas of life. A high enough fever for long enough can lead to brain damage.

Have you tried mixing the meds in apple sauce? My mom would crush tablets and mix it in applesauce, but it was still bitter and I needed a big glass of water with it too.

Or do the suppository approach. But not all meds will come as a suppository. You may need to get this custom made, and in the US it will likely not be covered by insurance.

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This post has been heavily reworded following a lengthy debate which has since been moved to chat.

The problem is she is this tiny 2.5-year-old kid and I am close to 200 lbs, and I don't like using strength or force to do things.

I realize this may come across as a non-answer at first glance, but as most answers seem to be variations of a you've gotta do what you've gotta do attitude towards use of force, let me first establish this:

I think you should absolutely refrain from use of force to any extent possible

This ought to be the first rule of parenting. Do not use violence on your children. The wording to any extent possible is a big caveat granting you the option to say medication is still non-negotiable, and if you fail to administer it without resorting to force, you still get to have that as your fall back. Be that as it may, you should at least acknowledge that it is a failure. And failing as a parent has to be OK. We all do that. But it's not in itself a reason to lower our standards.

Brushing teeth, sitting down while eating, finishing one's meal and dressing appropriately for the weather outside are all things that are arguably in your child's best interest, that your child will more or less frequently challenge you on. To an even greater extent, I believe, the lower her perceived autonomy in these matters. Going beyond arguments of best interest, saying "thank you" after a meal, or not ruining your clothes, and a vast array of preferences unrelated to health may for some parents be up there on the non-negotiable list. Resigning to the idea that force is acceptable when the outcome is non-negotiable is, I think, embarking on a path towards a violent parent-child relationship.

What to do instead, then?
Others have contributed great suggestions in this thread on how to make the medication more agreeable to the child. For a 2.5 year old, I would put my money on the tips that pertain to gamifying the experience. I have a daughter that age, and probably several times a day we have a conversation that follows the same script:

  • Me: Time to do X
  • Her: No, not yet / I don't want to
  • Me: OK, I guess that means I'll get to do it first then
  • Her: No me first! (Rushes to toilet/bed/washing hands, whatever was initially refused)

If the medicine is sufficiently unpleasant, your mileage may of course vary, with any approach. My main suggestion is simply hang in there. Persevere. If you know how important this medicine is, then I fully expect you will be able to be more stubborn than her.

And this is the part that comes across as just removing an option (use of force) without really bringing anything new to the table, but that's missing the magic that happens in this very interaction. Of course you'll explain why the medicine is important, perhaps let her know what might happen if she doesn't get it, remind her of how quickly you can get back to a more appealing activity once this is over with, and perhaps bribe her with a reward if she follows through. I bet you've tried all that.

But most importantly, you listen to her, you hug her and comfort her, you acknowledge and validate her feelings, you confirm that "yes, I know how unpleasant this is to you". I'm sure you've tried that as well, and that may also appear not to be working, but you are showing clearly that you respect her autonomy, and that her reluctance matters to you, and is taken into consideration. Whenever you resort to force - and to a greater extent the earlier you do - your daughter will feel that her opinion doesn't matter. She will feel that it's her job to fight for being heard. For all the work you put into validating her feelings, she will gain confidence that you act the way you do while taking her feelings into consideration. That even if you do in the end use force, it was not because your opinion is more important, but because the tradeoff of her opinion and the importance of the medicine still favors the medicine. That's not something you can simply assert. Kids that age don't pay much attention to what we say, they attend to how we act. That's hard earned trust.

My original post seemed to raise more questions than it answered, and I think those comments has had great value in teasing out the details of my argument, where I may have been unclear, so I have included some of the counter arguments below, that I believe have helped clarify my point.

It's a parent's job to look after the child's best interest. You shouldn't feel guilty about doing what you have to do
That is absolutely the parent's responsibility, but it's not their sole responsibility. An analogy I'll happily steal from paediatrician Lars Gustafsson: think of the child's life as a ship. You're not the captain of that ship, the child is. You're only the pilot. You know the narrow path the ship will have to follow to navigate through the harbour. You know all of the hazards that are not immediately visible. Crucially, your job is not to take control over the ship, but to navigate it safely into open water.

Yes, you have to give the medicine, but I think a bit of guilt is absolutely appropriate if in getting there you have to take actions that conflict with other aspects of your job as a parent.

Won't a prolonged discussion give the child a false impression that the outcome is debatable?
I believe not. You can be clear from the outset what's going to happen, even if you never invite use of force as an option. The child may search for openings, but you never have to grant that. You only need to validate the child's feelings.

That's fine if you can win her over, but it seems OP can't. If after all that disucssion you still have to use force, wouldn't it have been better to rip the band aid sooner?
Emphatically no. This is key. It is the work put into respecting her autonomy that matters. If after a full hour of debate you still forcibly give the medicine, she knows that her opinion was so important to you that you spent a full hour to avoid that outcome. The shorter the route to use of force, the less she will be inclined to believe you take her feelings into account. The more she will fight to be heard.

And what's more, if you grant yourself that you have to resort to force too quickly, you will never know whether the tenth time of having that same discussion you would've won her over. That's opportunity lost, and I would argue the opportunity is very real, because all that hassle you conveniently skip is the grunt work of building the trust that can persuade her to yield part of her autonomy to you.

But I have 4 kids, I simply wouldn't have the time for that
Be that as it may. If we've established that use of force is greatly undesirable, I think that medication, at least in OP's example, is a rare and critical enough event that you should at least use up all the time you do have. So your failure rate may be higher, but that's still no excuse to jump to forceful conclusions, and no excuse not to write it down as a failure.

OK, say I do have the time. Isn't this time spent agonising the child? Again, rip the band aid
That may be the case. I don't see it that way. I think spending time emphatically listening to your child is a valuable experience in its own right. Depending on the situation, this counter argument may well be valid, but I don't think it outweighs the benefits of my suggestion.

Your use of the term 'violence' is unfair, nobody has an intent to do harm here
That wording was very much intentional. I am aware that the dictionary definition of violence contains an element of intent, but I am also aware that many organizations that work with violence prevention try not to stress that aspect. Benevolent intent is a small comfort to the victim. Parents with worse judgments could do even worse things with a good intention. The child will still feel violated.

But shouldn't aversion to medication be nipped in the bud? You're inviting an unhealthy relationship to medicine that may prove harmful later
I think the opposite is true. If the medication is unpleasant, I think forcefully holding a child down and administering the medicine against her will is going to be a great deal more unpleasant, and run a far greater risk of such long term consequences.

I get all this if we were talking about older children, do you think this still holds true at 2.5?
Well, my oldest child is that age, so that's my main frame of refernce in writing this. I think small children are generally capable of more than we give them credit for, and crucially, we will never find out that we're in the wrong, if we persistently jump too eagerly to enforcing our own parental authority.

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