Wednesday, April 28, 2010

Big Ol' Bald Spot

Ethan is definitely not an easy toddler. He was a breeze as a baby, but we're paying for it tenfold now that he's in the thick of his terrible twos. Here's his latest behavior: pulling out his own hair. He started this when we were on our trip to Washington, D.C., and would mainly pull out his hair during a tantrum. It makes sense - his schedule was off, he was away from his daddy for the first time, and he heard "no" way more than he wanted to during our flights. I only saw him do it a few times during our vacation, but it's really picked up now that we're back.

As soon as I noticed that his hair was thinning out, I called the pediatrician. She was not at all concerned, and let me know that it's very normal. I asked if there was anything I should be on the lookout for - warning signs that would let me know to bring him in to be checked out. She said that unless I see damage to his scalp (from scratching or picking) that there's no need to bring him in. It's a phase, and he'll grow out of it.

The hardest thing about this (other than looking at a GIANT patch of emptiness where his beautiful hair used to be) - he only pulls when he's in his crib. Where he quietly babbles. Or sleeps. But never screams. So what do I make of that? The behavior has now become a way for him to self-soothe. It's like sucking his thumb. He probably doesn't even realize that he's doing it. And since I can't catch him doing it, I can't address it. I've started documenting the damage on my camera phone, so that I can objectively compare over time to determine whether or not the spot is getting bigger. Today was photo #1.

Here's the bald spot:

Here's what we've tried:
- More calming routines at bedtime (bathing, rocking, singing, etc.)
- Tiring him out before we put him down so that he falls asleep quickly instead of crying or playing in his crib
- Keeping his schedule ├╝ber-consistent (As opposed to our super INconsistent vacation schedule)
- Talking to him about his bald spot ("Owie! No pull - be gentle. *help Ethan softly pat his head* That's right, gentle. No pull, be gentle.")

Here's what we've got left to try:
- Shave his head

That's about it. I really can't think of anything else I can do that will be effective. I need to break the habit, and without being able to give him a replacement behavior for the hair pulling, I'm out of luck. Unless I take away his hair. No hair = no pulling. He'll be forced to kick his habit, cold turkey. By the time his hair grows back to pulling length, he should be over it. Hopefully.

With family visiting soon for Ryan's upcoming grad school graduation, we're holding off a bit longer before we pull out the clippers. That leaves enough time for all of you to share your brilliant ideas for how to solve this little problem of ours. Or to leave a supportive comment, encouraging me that all will be well.

Fix this, please - I'm dying over here!


Adrien said...

I am so incredibly sorry that you are dealing with this. I am sure it is sad to watch and frustrating to deal with. I have no experience with this at all, so feel free to completely ignore my ideas. However, would he be willing to wear special bedtime gloves or would he just take them right off? You could let him help you pick them out and make a big deal about how special and cool they are. Maybe the gloves would make it more difficult to pull out his hair. Or, could you put special band-aids on his thumbs and/or fingers at night that might make it more difficult? (Of course, if he removed the band-aids, could they be a choking hazard?) Do you let him take a special toy or stuffed bear to bed with him to make sure he has something else to touch and play with as a distraction?

Adrien said...

I probably should have added that Shade went through a phase of head-butting, hitting, kicking, and biting all at the same time. I tried everything I could think of and was feeling hopeless and confused. The doctor said it was normal and to just ignore it and give it time. After a few months, with very little intervention, it DID stop. Most likely, as crazy difficult as it is now, it will end and everything will be okay! =)

alicia said...

Wow. That's a tough one. I say shave it and then maybe he'll forget by the time it grows back. I've heard of this sort of thing, but never knew anyone who dealt with it.

Good luck.

Sarah said...

Thanks so much, Adrien! Those are really great ideas - I appreciate each and every one of them! Ethan tends to throw everything out of his crib almost immediately, and we haven't had much luck getting him to wear gloves (or hats, for that matter!). He has a little dragon that he loves, but that also gets thrown from the crib almost right away. I'm glad to hear that Shade grew out of his difficult phase. It's so hard to watch them going through something and feel like your hands are tied! Thanks for the encouragement!!!

Sarah said...

Thanks, Alicia... I'm thinking that's the route we'll probably have to go. I am taking him to the doctor tomorrow, and will ask for a referral to a specialist. I'm worried that it's Trichotillomania, and want to be sure that we nip it in the bud right away before it develops into a full-blown behavioral pattern.

He's been waking up screaming lately, which makes me think he's doing it in his sleep. I'm also not finding any hair, which makes me think he could be eating it (which, according to my very scientific internet research is not uncommon). Hopefully I'll get some answers tomorrow, or at least be one more step along the path!

Emily Q. said...

Only a behaviorist would jump to Trichotillomania. Hee hee. *hugs* I know this can't be fun to tackle. Lyla went through a phase where she pulled her hair and hit herself in the head when she was angry, but we were able to replace it pretty quickly with clenched fists and "I'm mad!" fortunately before any serious damage. Of course, I jumped straight to worries about SIB and autism. Kids are weird!
I was going to suggest maybe a hat with a chin strap, but I imagine he could still get it off if he didn't want to wear it. What about something tactile that doesn't appeal to him, like Vaseline? So when he reached for his spot, he felt something icky. I know it would be greasy and gross, but you could switch bath time to morning, maybe, and if it worked probably fade it out pretty quickly...
I'll keep brainstorming ideas and ask our school psych!
*hugs* again!!

Sarah said...

Oh, Emily, don't think I wasn't mentally going through the DSM-IV and checking things off the list! I did briefly let my mind drift to the autism checklist, but not with any basis, just out of worry. But I did go there! ;) He did the hit himself in the head thing a few months ago, but we just ignored it and it quickly went away. No other SIBs observed - thank goodness!

I thought about Vaseline, and my neighbor suggested olive oil. That's a great idea! We'd probably have to wash his sheets a lot, but it would be worth it! Maybe I'll try that tonight! Chin strap hat would probably make him really angry, and he'd just scream and scream until we took it off. But it's a thought to keep in mind, for sure.

Thanks for the ideas and double hugs!!!!

Adrien said...

I agree that it is definitely too early to worry about Trichotillomania. However, I would be concerned about him eating the hair since that can cause problems. I love the vaseline or olive oil idea. If you think toys would work as a distraction in the crib, we only put toys that are attached to the crib and he can't throw out. We have the Ocean Wonders Aqarium (which he loves) and the K's Kids Hungry Pelican. I sincerely hope that this is just a phase that passes very soon. I will be thinking about you, Ryan, and Ethan and will put you all in my prayers. Bald spot or not, Ethan is ridiculously adorable!

Laurie B. said...

Hey! Wow. yeah. So of course all parents have different ways of dealing with "undesired" behavior, but I think generally we all are thinking or talking about undesired behavior that we are witnessing. I can honestly say I've never had to deal with a behavior that I couldn't see (or couldn't find the evidence for, for that matter), and my heart totally goes out to you.

The only 2 things that I can think of are that.... 1) if he was eating it, you would be able to tell based on his diapers. I'm sorry that I know that, but, have you seen my dog? Have you seen my floor. Enough said.

and 2) my vote is for shaving, or cutting it very short. I think I would definitely want to stop that immediately and the only sensible way for his age (and based on the fact that he isn't doing it around you guys) is to make it impossible for him to do it. It either means cutting off the hands or cuttting the hair right? Less permanent damage with the second option I think.

;-) sorry again, and all of my sympathies and "venting" at your disposal!

Sarah said...

Adrien - great suggestion! I set up the video camera on night vision and recorded Ethan tonight after I put him to bed. I snuck in and grabbed it (it stopped recording after 23 minutes for some reason), and just watched the clip. It wasn't as helpful as I had hoped, mainly because I had the camera aimed too low to see his head when he was standing up, and the night vision setting creates a sort of strobe effect, so I couldn't really tell what he was doing. What I did see, though, is him pacing back and forth in his crib and throwing everything out. Maybe if he had a toy that he couldn't throw he'd sit and play happily until he couldn't keep his eyes open anymore.

Laurie - Ewwww! ;) I haven't been checking his diapers. Will put that on my list of things to watch out for! I'm definitely more of a fan of cutting off his hair than his hands, though it makes me sad to think of him with a baby buzz cut! It's better than a bald spot, though, and I do want to stop this ASAP. I'll call you tomorrow after I hear from the doc.

*Katie* said...

Oh. That is a tough one! How frustrating to not know what the correct answer is. When my son was 3 he would pick at his skin during bedtime of course, his dad and I freaked and we talked with him about it constantly. We did two things. First, we stopped talking to him about it because we thought that maybe he liked the attention we were giving him when we were trying to snuggle and cuddle him out of it. Second, I gave him a piece of a small towel that was SUPER pilly that he could only have at bedtime. I told him I needed him to pick the little fuzzy pills off for me and he did at bedtime. (he loved picking them off and throwing them on the floor) he would pick at that and fall asleep.
He was a bit older than your little guy but maybe he needs some sort of special distraction?
I HOPE that this is a phase that he passes through quickly for his wellbeing AND for yours!

Sarah said...

Katie, that pilly towel was a great idea! I love creative parenting solutions. It's amazing what we'll come up with, isn't it? We buzzed Ethan's hair tonight, and have a referral to a specialist to check everything out and make sure he's okay. I'm feeling better about things now that we have a plan in place. Thanks for the well wishes! I hope this passes quickly, too!

Kristy said...

My fear is that if he doesn't have hair (if you shave) then he will find some other way to do the same thing (eyebrows, eyelashes). Can you try replacing the soothing technique? Give him something he can rub or pull that he takes in the crib??

Sarah said...

I was definitely worried about the same thing, Kristy. I tried a bunch of things that I thought would give him the same soothing input that he was getting from the hair pulling. Nothing worked. :( As much as I try to encourage a lovey, he throws everything out of his crib as soon as I leave his room at night. We ended up giving him a buzz cut. So far, so good - no eyelash or eyebrow pulling as of yet. Keeping an eye on it, though! Thanks for the thoughts!!! :)