Q&A: helping a toddler understand that Mommy is sick

Sevin writes:

"I have a spirited 21 month old daughter. I work during the day and she has a wonderful babysitter whom she adores. In the mornings, I used to get up with her at 7-7:30 feed her her breakfast, play with her until the babysitter came and then leave for work. She would wave me bye bye and go back to playing. At night, we always had the same routine. I prepared dinner while my husband played with her and then while he cleared up the dishes I gave her a bath. We would both read her stories and say goodnight and tuck her into bed, turn off the light and she would go to sleep on her own (most nights, some nights she wanted some company in the room while she fell asleep).

Well, about 5 weeks ago, I found out I am pregnant with our second baby. A few days after I found out, I was hit with the first trimester fatigue, but also with nausea like I have never known before. I was diagnosed with hyperemesis gravidarum; I could not even keep water down, I lost 8 lbs in 3 weeks and needless to say, I became very incapacitated. So the above routine was disrupted, she still had a similar routine, but my husband had to do it all. I am now on nausea medication that takes the edge off, so I can function a little, but I feel sick quite often still and I just have 5% of the energy I used to have. To top it all off, I was put on bedrest for a threatened miscarriage and I am not allowed to pick her or anything heavy up.  So over the last 5 weeks, I have been spending a lot less time with her, appearing and disappearing from the family room (usually to rush to the bathroom), unable to play certain games with her and unable to pick her up. Her bedtime routine has gotten longer, because my husband has to do everything himself, rather than the parallel fashion we accomplished these tasks. So she ends up going to bed an hour later and having trouble falling asleep on her own and calling for me. When she sees me, she is extremely clingy and does not want her father or the babysitter to even touch her. She has huge fits when I leave the house or even the room. My husband is convinced it's terrible two tantrums and we should ignore her and let it blow over, but my instinct tells me that she is scared of the fact that she does not see me much, is anxious about me not being around, knows something is different but cannot comprehend or express her fears and hence has "anxiety tantrums" rather than the "manipulative 2-year old tantrums". I am trying to be more comforting and lenient during these times, but my husband says I am simply spoiling her.

What is your take on the situation? Any advice to survive this pregnancy without causing her huge anxiety? What can I do to help her ?  How do sick parents with small kids deal with situations like this?"

Congratulations on your pregnancy.

It seems pretty clear to me that she's upset and anxious because you're sick and she doesn't have as much access to you as she used to. She's probably scared and worried and can't express it except by clinging to you and throwing tantrums. Add that to the fact that she's two, and there's no way she can be calm about it.

The good thing about 2-year-olds is that they have great receptive language. Even if she can't tell you how she feels, she can understand a whole lot. So I'd start by talking to her about how you're feeling very sick right now and can't spend as much time with her and can't put her to bed, but you'll feel better in a few weeks.

You could even describe exactly how you feel, so it's not mysterious. Pretend to throw up, and let her pretend with you if she wants to. Laugh about it and make it seem not as scary. She needs to know that you can't pick her up and do all the things you used to, but not be afraid that there's something so wrong that you'll never get better. Try to give her as much time as you can, even if it's just snuggling together on the couch or in bed.

And ask her specifically to help Daddy get her to bed on time. You may have to cut out a bunch of steps and order in food and skip some baths. It's important to stick to her normal sleep schedule, because being sleep deprived by even an hour can make her mood and behavior lots worse. This is a temporary crisis, so go on lockdown and only do what's necessary. It might also help if you put a chair in her room and sat in it while she went to sleep. This wouldn't be too much physical activity for you, and it would help her feel like you were really there for her when she was trying to go to sleep and scared that you wouldn't be there when she woke up.

I would definitely not connect your feeling bad with the new baby (you don't want her to blame the baby for hurting you). And I wouldn't ignore her tantrums. She's asking you for reassurance the only way she knows how. It's clumsy and counterproductive, but it's all she's got. You may end up with a shadow until you start to feel better and can resume taking care of her more, so if you just have to hole up on the couch hugging her for half an hour every day, that will help her better than anything else you can do.

Make sure she understands that you are going to get better, and that it's not her fault. You'll all get through this together. Encourage your husband to take some breaks for himself. He's got to be stretched emotionally and physically from all of this, too. Poor guy. (And have you tried acupuncture and/or vitamin therapy for the hyperemesis?)