"The newborn's fine but her sister's a mess!"

Lula, the newborn's three-year-old sister, nearly pulls her mother's sagging maternity pants down as she clings to Mom's leg and whines for attention. The mother's lovely face clouds over as she yanks her britches back up to her waist and sets the infant's car seat on the exam table.

"Well, how has it been going?" seems like a silly and thoughtless question from me as I prepare to do the two-week-old visit on Liz, the baby sister.

"Taking care of little Liz is a breeze. But do you know someone who might like a three-year-old?!"

Ms. Jones goes on to explain the newest "adventure" at home since the birth of the baby. Lula has been toilet trained for a year. This week she pooped in her pants during nap time and used the poop for creative art work on her bedroom wall. Mom is horrified! "This is sick! I just don't know what do do!"

Lula has taken sibling rivalry to a very high level. It seems an understatement to say, "She must be feeling a little left out since the birth of the baby."

When I consider all the questions first-time mothers have about their babies, it's always interesting to see that most questions after the second child's birth center around caring for the behavior of the older child.

I've developed a three-pronged approach to the common anxious and agitated regression of an older brother or sister. First, I explain how sibling rivalry is normal and a sign of a child being immensely loved. "After all, if your husband came home one day and said, 'You are such a great wife, I think I'll get another,' you might be equally upset."

Second, though Mom is trying to spend private time with Lula, it helps to "name the time." The idea is to have "special time" for 10 minutes a day. During the day Mom can further empower this time with statements like, "I can't wait until our special time this afternoon. I wonder what we will do?" It's like planning a date--the planning can be half the fun. Use a timer and express great sadness when "the timer says our special time is over." Make plans for special time the next day.

Third, start "baby time." This is a playful invitation for the older child to regress. She is regressing anyway, but encouraging regressing in a playful way really works. I encourage Mom to put Lula on her lap and pat her head and rock her, cooing words like "You are my tiny baby!" Most three-year-olds feign resistance at first, but they really love this game and quickly play along. After a few days this game may seem boring and the child will no longer want to play it. However, my experience is that by this time this child's behavior will have significantly improved.

Implementing these three easy ideas made a world of difference for Ms. Jones and her family. Lula stopped her poop foolishness in just a few days and became her gleeful and delightful self again. Mom promised to keep up steps two and three. Remembering the recent "art work", Ms. Jones didn't need to hear that suggestion a second time!