I read your article regarding the child who is afraid of doctors. I have a 2 year old son who did have a traumatic experience with doctors and therefore everytime we take him he screams, just last week (son has chronic constipation)he threw his shoe at the doctor. He is fine going in but if they get close to him he will scream and cry and ask to leave. I know he needs to see the doctor for check ups but what do i do to help him not be afraid and let him know that they are trying to help?

From: Reb, Bethesda, MD

Dear Reb,

In the Q&A you refer to on fear of doctors, Dr. Ellen Hanson, director of developmental research at Children's Hospital in Boston, had some excellent suggestions, from having the doctor examine you first to bringing a bagful of toys for her to play with in the office; on the importance of being truthful ("It will hurt for a very short time.") rather than lying ("I promise it won't hurt!").

But you've got a toddler who threw a shoe at the doc! Whoa! I did some reading up and I want to take a page -- literally -- from T. Berry Brazelton's best-seller, "Touchpoints, Birth to Three (second edition)." He writes that when a toddler has a fear of a doctor it can start with a bad experience and get exacerbated by parents when they are anxious about the next visit. Kids have an uncanny way of picking up on that, so that's point #1: monitor yourselves.

His second point is that some of the responsibility lies with the ped. When there has been a bad experience, it may take time for a doctor to regain a child's trust. On page 179, he writes:

"I want the child to adapt to me again and have a trusting relationship. I explain to parents that I can help him overcome his fear if they will bring him for [these] short [non-medical] visits, inserted in between my other scheduled ones, and unpaid for, but worth it to me and to them. After I reestablish trust in the child, he will not need to scream at me or resent my attempts to talk to him or examine him on future visits. We can be friends again." And then, in the book, he goes into lots of detail on how he regains the child's trust.

I know not every pediatrician is as attuned as Brazelton to the nuances of child development -- and may not be as generous to not charge for these visits! -- but I'm betting (hoping) that if you bring this up with your doc, he/she may be willing to give it a try.

BTW, Brazelton has also written a book for children, "Going to the Doctor."

Brazelton's name is not on the lips of every parent the way once was, although he is still active and continues to lecture and train docs, but in my 20+ years of covering child development, I've never found anyone who tops him.