What advice should the nurse provide the parent of a toddler regarding how do you handle temper tantrums?

You're standing in the snack aisle of the supermarket. Lying at your feet is your toddler, who has just been informed (by you) that, no, they cannot have the Cinderella fruit snacks. Their face has turned a shade somewhere between red and purple. Their fists are pounding the floor in fury as they emit a shriek that can be heard in the farthest reaches of the parking lot. The other shoppers are gaping at this spectacle as you wish desperately for a hole to open in the floor and swallow you up.

Many a parent has been through a scenario like this, although the tantrum might have taken a slightly different form; crying, hitting, kicking, stomping, throwing things, and breath holding are all popular tantrum techniques.

Temper tantrums are exceedingly common in children, especially between ages 1 and 4 -- the early part of which is sometimes called the "terrible 2s" -- when kids are still learning how to communicate effectively. More than half of young children will have one or more tantrums a week as they vent their frustrations and protest their lack of control.

Although they are a normal part of the toddler repertoire, temper tantrums can be distressing to parents. When they occur infrequently, tantrums aren't a big deal and are best ignored. It's when they become regular or intense that parents need to look into what's causing them and find ways to stop them.

Tantrum Triggers

Some children are more prone to tantrums, particularly kids who are intense, hyperactive, or moody, or kids who don't adapt well to new environments. For most toddlers, tantrums are simply a way of getting out their frustration and testing limits (Will mommy buy me that toy if I scream really loud?).

The smallest things, from asking them to take a bath while they're in the middle of watching Sesame Street to requesting that they share a favorite stuffed animal with a younger sibling, can set off young children. Any situation that involves change may spawn a tantrum. Add fatigue or hunger to the equation and children, their threshold for tolerance even lower, are even more likely to throw a tantrum.

How to Stop the Screaming

The easiest way to stop a temper tantrum is to give the child what they want. Obviously, that strategy won't do you any good in the long run, because your child will constantly go into tantrum mode whenever they want something.

The first step in defusing a temper tantrum is to keep your own temper in check. You're not going to get anywhere with your child if both of you are screaming at each other. Spanking your child is also not a good option, and it will only make the tantrum worse. Take a deep breath, gain control over your emotions, and then discipline your child by calmly but firmly letting them know that tantrums are not acceptable behavior.

If your child still won't calm down and you know the tantrum is just a ploy to get your attention, don't give in. Even if you have to walk through the supermarket dragging your screaming toddler, just ignore the tantrum. It is easier said than done, but stick to your guns and eventually the duration will lessen and they will know you are serious and this is not going to work. Once your child realizes the temper tantrum isn't getting them anywhere, they'll stop screaming.

If your child is upset to the point of being inconsolable or out of control, hold them tightly to calm them down. Tell them gently that you love them but that you're not going to give them what they want. If that doesn't work, remove them from the situation and put them in a time-out for a minute or two to give them time to calm down. The general guideline for the length of a time-out is one minute per year of the child's age.

It’s also OK for you to take a break if you feel like you’re losing control. Put your baby in a safe spot, like a crib or playpen, and take a few minutes to regroup. Go into another room and listen to music, call a friend, or do something relaxing.

Tantrum Prevention Tactics

Instead of having to stop a temper tantrum after it starts, prevent it by following these tips:

• Avoid situations in which tantrums are likely to erupt. Try to keep your daily routines as consistent as possible and give your child a five-minute warning before changing activities.
• Communicate with your toddler. Don't underestimate their ability to understand what you are saying. Tell them the plan for the day and stick to your routine to minimize surprises.
• Allow your child to take a toy or food item with them while you run errands. It may help them stay occupied.
• Make sure your child is well rested and fed before you go out so they don't blow up at the slightest provocation.
• Put away off-limit temptations (for example, don't leave candy bars lying on the kitchen counter close to dinnertime) so they don't lead to battles.
• Give your toddler a little bit of control. Let your child choose which book to bring in the car or whether they want grilled cheese or peanut butter and jelly for lunch. These little choices won't make much of a difference to you, but they'll make your child feel as though they have at least some control over their own life.
• Pick your battles. Sometimes you can give in a little, especially when it comes to small things. Would you rather let your child watch 15 extra minutes of television or listen them scream for 30 minutes?
• Distract. A young child's attention is fleeting and easy to divert. When your child's face starts to crinkle and redden in that telltale way, open a book or offer to go on a walk to the park before it can escalate into a full-blown tantrum. Sometimes, humor is the best way to distract. Make a funny face, tell a joke, or start a pillow fight to get your child's mind off what's upsetting them.
• Teach your child other ways of dealing with frustration. Children who are old enough to talk can be reminded to use their words instead of screaming.

Praise your child for getting it right. When they stay cool in a situation that would normally have triggered a tantrum, tell them they did a good job of controlling their temper. Even when you discipline your baby, be sure to let them know that you love them no matter what. Positive comments help boost self-esteem.

If temper tantrums are becoming more frequent, they haven't stopped by around age 4, or your child is in danger of hurting them or others, it's time to call your child's health care provider.