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Preschooler tantrums...

How parants can beat them:

What's it really take to parent a preschooler? It's pretty simple, once you realize what kids this age can and can't do (and what sets them off and what keeps them happy!). Here are seven qualities that make it much easier to manage all that, and why they're so crucial when you've got an independent-minded, boundary-testing picky eater on your hands.

We've all heard about the terrible twos. But nobody talks about the tantrum-throwing threes or the ferocious fours. So lots of parents are surprised when their preschooler hurls himself on the floor, screaming, after not getting a colouring book at the supermarket.

Preschoolers, like toddlers, can fall apart when they're tired, hungry, or overwhelmed. We assume that because they have stronger language and reasoning skills, they'll have better control over themselves. But sometimes, they have a harder time settling down (bedtime, for example) because they think they're missing out... on something.

Fortunately, kids this age place great importance on figures of authority: teachers, doctors, and you. Use this to your advantage to set clear, firm rules, says Errika Lynch, a preschool teacher and mom of two in Groton, Massachusetts. Like any tough leader, you can't get too mired down in details.

That means no negotiation over bedtime. Being steadfast and concise is key, so they know what's expected.

Forethought

When he's 2 or so, your formerly voracious eater may become so picky you'll worry he's malnourished. Experts say you're dealing with a power struggle and a plea for independence, both playing out at the dinner table.

Suddenly, kids realize they can exert total, maddening control by refusing to eat what's in front of them. So you need to think ahead in the kitchen - but that doesn't mean making multiple meals or giving in to their demands.

It does mean having a few good choices for everyone, and leaving it at that. "Children will not willingly starve themselves," says Nori Hudson, a nutrition consultant based in Berkeley, California.

If your child's not getting the entire nutritional food pyramid every day, don't worry. He'll probably have all his nutritional needs met over the course of a week. So watch what he eats and plan accordingly: If he goes for peas one day, offer him cheese or yogurt the next. Another tactic is to get your preschooler involved before dinnertime.

Ask him to help you mix the mac and cheese so he feels like he's in control. Or at the market, let him pick out a fruit that he finds interesting-looking. "It's never too early to let kids experience a variety of textures, tastes, and colours," says Hudson.

Actors have nothing on preschoolers - or their moms. On any given day, your child will be a baby elephant, a monster alien, or a fairy ballerina. And you get to play along.

"Imagination is critical for their development," says Claire Lerner, director of parenting resources at Zero to Three, a Washington, D.C.-based children's advocacy group. Preschoolers stretch their language skills as they describe complex story plots for you to follow.

They hone their logic ("This happened, so this happened, and then this...") and develop social skills playing imaginatively with their peers - describing how to build the fort, for example, and cooperating to make it happen. "Your role is to become a facilitator," says Lerner. "Be careful not to take over their story.

The more they do, the better." Offer her ideas, like "Oh, no, there's an alligator! What are we going to do now?" Playing dress-up? Encourage her to make props out of ordinary stuff around the house (a bowl can make a very nice crown). Just remember you're the supporting actor in this play. Let her direct for now.

One of the hardest things to do as a parent is to let your child walk alone into the scary world of jungle gyms and new people. But preschool beckons, even for just a few hours a day. "I've hugged more crying parents than I have children on the first day of school," says Allyssa Lamb, a veteran preschool teacher in Berkeley.

To quell your queasiness, make sure you feel good about the person you're leaving your child with, and focus on what your child will gain from school. It gives her rules for every task, which kids this age thrive on. It makes her feel proud and independent that she can eat her own snack and throw away her own garbage.

It enables her to be away from you for a while, trust her own decisions, and, hey, have some fun. Preschool can also accomplish a lot of the stuff you're still working on, like ridding your child of her pacifier or lovey.

"I couldn't get my daughter to stop using her Binky, put her shoes on by herself, or sleep by herself," says Tressy Pelonis, a mom of 2-year-old Allison, in Long Beach, California.

"Since she started preschool, she's like a different kid!" If your child has a hard time adjusting to her new routine, comfort her but don't indulge her fears by letting her stay home or lingering at dropoff. Keep a stiff upper lip and remind her that she's a big kid. Remember, you can cry on your spouse's shoulder when she's not around.

Preschoolers know the power of words. From repeating "poop" in between uncontrollable fits of laughter to uttering the most chilling words in the English language - "I hate you" - your 3-year-old is beginning to understand that certain language elicits dramatic reactions.

That's why it's important not to overreact to potty humour or take hurtful proclamations personally. "It's another form of testing, to see how far they can go," says Lynch.

Now that kids have moved on from diapers and think about potty issues more, they sense that these topics are taboo. And taboo = hysterical. The best way to deal? Act like an English monarch, with a blase, "I am not amused" face.

The more you react - positively or negatively - the more you reinforce the behaviour. Explain that while he can engage in a little bit of toilet humour at home, it's not OK at preschool, a friend's house, or anywhere else in public. Or divert him with a nice clean joke ("What did five say to six? Seven ate nine!").

When it comes to mean words, use the same approach. Kristy Hill's 3-year-old told her to leave the room because he didn't like her. The Keller, Texas, mom says it was hard not to feel upset, but she managed to keep calm and said, "Oh, that's sad because I love you very much."

Overreacting will only let your child know that this is a good way to get your attention. As with potty humour, nonchalance is key - but you do need to make it clear (later, when he's calmer) that language intended only to hurt people is never OK.

During preschool, kids' motor skills and hand-eye coordination really take off: Witness the one-foot hop and the buttoning of shirts.

Your child learns by trying these things out - repeatedly - and it helps immeasurably to be able to see someone as skilled as yourself doing them, too. So crack your knuckles, stretch your calves, and get ready to hop, button, and more.

A slightly less tiring way to help your child's development is with crafts. Playing with clay or stringing beads is a great way to build up the small muscles in his hands and hone his hand-eye coordination.

You can also ask him to do housework with you. He can stir cake mix, plant flowers, or sort laundry by colour - he'll be improving his coordination and having fun. When my son Jack was 3, I gave him a little squirt bottle filled with water and he would "clean" stuff around the house. "This age group lives to help, because they get attention and the praise makes them feel good," says Lynch.

"They feel like they've accomplished something, like they're grown-ups."

It's not all about rules and schedules with preschoolers. As much as your child thrives on knowing what to expect, she's also just a little kid. It's hard growing up: There's potty training, a big-kid bed, maybe a new sibling.You try three (or more!) major life changes in one year.

That's why it's important to show your child you feel her pain, too. It could mean a hug and a new do when she flips over her hair being braided "all wrong." Or it might mean just understanding that it's tiring to spend a long day at preschool, remembering the rules, getting along with other kids, and generally keeping herself together. Help her decompress with a snack and a chat, and don't rush into chores or errands.

Your empathy will not only keep the both of you calmer, it's also a quality well worth modelling. And if you'd be proud to see your child mimic the things you do, then you can definitely call yourself a great mom

Parenting.com

Obesity surgery seen as potential diabetes cure

A small new study gives the strongest evidence yet that obesity surgery can cure diabetes.

Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers.

Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests.

"It's the best therapy for diabetes that we have today, and it's very low risk," said Dr. John Dixon of Monash University Medical School in Melbourne, Australia, lead author of the study, which involved 55 patients.

The surgery performed was stomach banding, a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, predominates.

Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, said Dr. David Cummings, who wrote an accompanying editorial in the journal but was not involved in the study.

"We have traditionally considered diabetes to be a chronic, progressive disease," said Cummings of the University of Washington in Seattle. "But these operations really do represent a realistic hope for curing most patients."

Diabetes experts who read the study said surgery should be considered for some obese patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said.

Experts generally agree that weight-loss surgery would never be appropriate for diabetics who are not obese, and current federal guidelines restrict the surgery to obese people.

The diabetes benefits of weight-loss surgery were known, but the Australian study in Wednesday's Journal of the American Medical Association is the first of its kind to compare diabetes in patients randomly assigned to surgery or standard care.

Scientists consider randomized studies to yield the highest-quality evidence. The study involved 55 patients, so experts will be looking for results of larger experiments under way.

"Few studies really qualify as being a landmark study. This one is," said Dr. Philip Schauer, who was not involved in the Australian research but leads a Cleveland Clinic study that is recruiting 150 obese people with diabetes to compare two types of surgery and standard medical care.

"This opens an entirely new way of thinking about diabetes."

Obesity is a major risk factor for diabetes, and researchers are furiously pursuing reasons for the link as rates for both climb. What's known is that excess fat can cause the body's normal response to insulin to go haywire.

Researchers are investigating insulin-regulating hormones released by fat and the role of fatty acids in the blood.

In the Australian study, all the patients were obese and had a diagnosis of type 2 diabetes during the previous two years. Their average age was 47.

Half the patients underwent a type of surgery called laparoscopic gastric banding, where an adjustable silicone cuff is installed around the upper stomach, limiting how much a person can eat.

Both groups lost weight over two years; the surgery patients lost 46 pounds on average, while the standard-care patients lost an average of 3 pounds.

Blood tests showed diabetes remission in 22 of the 29 surgery patients after two years. In the standard-care group, only four of the 26 patients achieved that goal. The patients who lost the most weight were the most likely to eliminate their diabetes.

Both patient groups learned about low-fat, high-fibre diets and were encouraged to exercise. Both groups could meet with a health professional every six weeks for two years.

"There is a growing body of evidence that bariatric surgery is an effective tool for managing diabetes," said Dr. John Buse of the University of North Carolina School of Medicine in Chapel Hill, the association's president for medicine and science.

"It's just a question of how effective is it, for what spectrum of patients, over what period of time and at what cost? Not all those questions have been answered yet."

Medical devices used in the study were provided by the manufacturers, but the companies had no say over the study's design or its findings, Dixon said.

CNN.com