Article

How to handle toddler tantrums, from a pediatrician of 45 years

What is actually happening inside your toddler's brain when they melt down on the kitchen floor, and exactly what to do in the moment. No shame. No magic. Just what works.

If you have a toddler, you have lived through a tantrum. Probably this week. Possibly today. After 45 years in pediatrics, I have sat with thousands of parents who quietly wondered if their child was the only one who lost it that hard, that often, that publicly. Your child is not unusual. Tantrums are one of the most normal experiences in early childhood. Understanding what is actually happening makes them far easier to handle.

The neuroscience, in plain language

A toddler's brain is not a small adult brain. The emotional centers, especially the amygdala, are fully online from very early in life. The prefrontal cortex, the part of the brain responsible for impulse control, planning, and regulating big feelings, is barely under construction. It will not finish developing until well into adulthood. What this means in practice is that when your two-year-old is overwhelmed, the alarm system is firing at full volume, and the brakes are not yet installed.

Asking a toddler in a tantrum to calm down and use their words is a little like asking someone with a broken leg to please stop limping. They cannot. Not yet. They need an adult to be their prefrontal cortex until their own grows in.

The two kinds of tantrums

There are two distinct kinds of tantrums, and they call for slightly different responses.

1. 1

   Distress tantrums

   These happen when a child is genuinely overwhelmed: tired, hungry, overstimulated, scared, or hit by an emotion they cannot yet handle. They are not goal-directed. The child is not trying to get something. They are flooded. Your job is to be calm and close.
2. 2

   Manipulation tantrums

   These are not bad faith. They are a young child experimenting with the world: if I scream loud enough at the store, will I get the candy? Your job here is to stay warm but not give in. Otherwise the experiment confirms that screaming works.

5 things to do during a tantrum

1. 1

   Get down low and stay calm

   Drop to your child's eye level. Take a slow breath. Your nervous system is contagious. If you stay calm, theirs will eventually settle. If you escalate, theirs will escalate further.
2. 2

   Keep them safe, then wait

   If they are flailing, move them gently to a safe spot. Then wait. The peak of a tantrum usually lasts only a few minutes. Trying to reason or lecture during it does not work.
3. 3

   Name what you see

   Quiet, simple words. 'You really wanted that.' 'You are so mad.' Naming the feeling, without fixing it, helps the brain start to process it.
4. 4

   Hold the limit, kindly

   If the answer was no, the answer is still no. Tantrums are not a reason to flip your decision. The kindness is in your tone, not in changing your mind.
5. 5

   Reconnect afterward

   Once the storm passes, offer a hug. Talk briefly, in toddler-sized words, about what happened. The repair after a tantrum is where the long-term learning lives.

3 things that make tantrums worse

When to be a little curious

Most tantrums are normal. A few patterns are worth a calm second look from a pediatrician. If your child has very frequent, very long tantrums well past age four or five. If tantrums are paired with sensory sensitivities like extreme reactions to sound, texture, or light. If your child is not yet using words you would expect for their age, and that seems to be driving the frustration. None of these are cause for panic. They are simply worth a conversation.

Frequently asked

Related reading: discipline without punishment and how to raise an emotionally intelligent child. Want help with your specific child? Book an online consultation.

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