I’M Sooooo Sick Lavishing Focus On Your Child’s Minor Complaints Of Illness Reinforces Their Behavior

When one of her children wakes up feeling yucky, Angela O’Mara listens closely to the complaints, then hands down her ruling. “If they just have sniffles,” O’Mara says, “I send them to school.”

And if it’s, say, fever or nausea, O’Mara and her husband, Richard Barnes, will opt to take Jonathon, 6 1/2, and twins Brandon and Briana, nearly 5, to the doctor or keep them home.

But what’s never on the agenda for minor illness is special treatment.

“We keep them comfortable watching TV and drinking lots of juices,” says O’Mara, “But I don’t do anything differently. If I spoil them, it would make them want to stay home more often.”

And, say researchers, it could also turn them into the Sick Adults From Hell.

Giving children special attention when they are sick with minor ailments increases the chances of raising hypochondriacs, research shows. Studies also suggest that many adults who drain the health-care system with minor complaints were given red-carpet treatment during childhood when sick days seemed more like holidays.

When minor ailments strike, the best approach is “to make the child as comfortable as possible,” says William E. Whitehead, a research professor at the University of North Carolina, Chapel Hill, and a specialist in the field of “illness behavior.”

Children, he says, “should have quiet time to rest, fluids and so on.” Beyond that, he cautions parents not to bestow special treats or privileges, such as fixing a favorite dessert or allowing late-night TV at the first sound of a sniffle. The no-frills approach, he says, is mentally healthy.

Gifts aren’t recommended either, says Whitehead, whose findings are based on two decades of research.

“Our feeling is that whil wellintentioned, that is not a good thing to do,” Whitehead says. “It makes the child feel like being sick is a privileged position and often has a much stronger effect on other children in the family.”

Besides that familial fallout, there could be longer-term effects. “A consistent pattern of reinforcing illness by treat foods or special privileges, especially (for) minor symptomatic complaints, is something that clearly does increase the likelihood that people will grow up to be much more aware of symptoms, much more likely to report minor symptoms and much more likely to stay home from work or to expect others to help them out,” Whitehead says.

Among his recent findings: If parents catered to children with minor symptoms such as menstrual cramps or colds by excusing them from household chores or other responsibilities, these children are more likely to miss workdays or social activities as adults when these same symptoms occur, Whitehead found in a survey of 383 women, ages 20-40. The results were published in last month’s Psychosomatic Medicine.

The goal for parents, experts caution, is both lofty and tricky. Children need to be taught to be somewhere near the middle of a health continuum that has “suppressors” on one end and “sensitizers” on the other, says Michael D. Crowell, director of the Center for Physiologic Studies at Baptist Medical Center in Oklahoma City and a frequent collaborator with Whitehead.

Suppressors, he explains, deny symptoms, while sensitizers gripe about the tiniest aches and pains.

“Suppressors are more likely to die from treatable diseases,” says Crowell, also an associate professor of biological psychology at the University of Oklahoma Health Science Center. “Sensitizers take a lot from the health-care system and their personal social system.”

Parents who learned a healthy approach to minor illness during their childhoods usually pass on the wisdom easily to their own children, experts say.

Nancy Bell-Redmond, a Hollywood Hills mother of two, takes the same approach as her parents did with her.

When her daughters — Sara, 7, and Kathleen, 10 — have minor discomfort, Bell-Redmond often makes tea with lemon or suggests they take a warm bath. “Being sick around here is not a big deal,” she says, echoing the sentiments of her husband, Lee Redmond. “We just concentrate on getting better.”

She thinks it is no coincidence that their daughters are very healthy. “My pediatrician asked me to send a picture, it’s been so long,” she says with a laugh.

Just as her parents did, Angela O’Mara encourages her children to try school if their symptoms are minor. If one of her children goes to bed at night complaining of a normally minor problem such as a stomachache, she often tells them, “You will probably feel fine when you wake up.” And they often do.

Of course, not all overly pampered sick kids grow up to be hypochondriacs, Whitehead says. Whether people become sensitizers, suppressors or somewhere in between seems to hinge, he says, on a number of factors, including stress levels and overall satisfaction with life.

And what if you’re not sure if your child’s ailments are minor or major? “I think when in doubt parents ought to take their child to a doctor to be sure they are not ignoring real (or serious) symptoms,” Whitehead says.

And when the health situation is a recurring one, or when the child has vague complaints — especially if they crop up at school test time or in the midst of peer problems — parents should also consider the possibility of sickness as an avoidance mechanism, Whitehead says.

And what of those hypochondriacs who now realize they learned it at home? Being aware of the tendency is a start, Whitehead says. Those who live with these sensitizers might reduce the complaining by giving their loved ones extra attention when they are well in hopes of reinforcing the healthy behaviors.

Even parents who have regularly bestowed junk food and gifts during cold and flu season can reverse gears.

Instead of focusing on illness as an excuse for extra attention, Crowell suggests paying more attention to another behavior such as a school project or hobby. “If you reduce the reinforcement for illness behavior,” he says, “you can extinguish the response (to symptoms).”