GENDER SWAP

Q: My daughter will be three tomorrow, and for the last six months she has insisted that she is a boy. I never thought I would be concerned, but it is getting to the point where it is all she thinks about. How should I handle it?

A: It's normal for children this age to wonder and fantasize about being the opposite sex, just as it's normal for slightly older children to have imaginary friends. It's just part of an active fantasy life.

My guess is that she talks about it a lot because she can see that she gets a reaction from you. So don't worry. The next time she mentions it you might try saying something like, "What would your name be if you were a boy? And what would your name be if you were a cat?" Have fun together playing with the idea of being someone or something else. --Lawrence Kutner, PhD

NASAL CAVITY SEARCH

Q: How do I get my 2-year-old to stop picking his nose?

A: This is a tougher challenge than it appears. After all, your 2-year-old sees nothing wrong with exploring his body in this way. He's unaware of the social niceties involved in unclogging his nostrils in less direct ways.

First of all, you should mention this behavior to your child's health care provider during your next visit. That way, you can be sure that there isn't anything in her nose that's irritating him or interfering with his breathing. If his nose has a smelly discharge, make an appointment right away, as he might have put something up there (peanuts, raisins and pieces of crayon are some all-time favorites).

You can use a blunt-tipped nasal bulb with a salt water solution or a spray can with prepared saline solution to help unclog his nose if it's stuffy. (The pediatrician or a nurse can show you how.) Apply a small amount of petroleum jelly if his nose is dry, cracked, or tends to bleed.

As for breaking the habit, all the explaining in the world won't help. He may not even be aware that he's doing it. Your best bet is to try to distract him when you see him picking his nose. Don't criticize him or become upset; just find something else for his hands to do. If you do that, in most cases the problem will diminish and eventually go away. --Suzanne Dixon, M.D., M.P.H.

AS SEEN ON TV

Q: My 4-year-old daughter is starting to lie next to boys and wants to kiss them on the lips (as she has seen on TV). I've tried to tell her this is not nice. What should I do? Help!

A: First of all, don't freak out. Children's sexual behavior can be upsetting to us, but it's usually innocent exploration. She has seen people do this in the media and has had no indication that it is not acceptable behavior. Gently remind her that this is something only grown-ups do in private and that it is not for children.

This is also a good lesson for adults about the profound effects media can have on children. Look how easily her behavior was influenced by what she saw. That is why we encourage parents to limit television time and make sure programming is appropriate for the child's age.

On the other hand, when children exhibit a preoccupation with sex, it may be a red flag that there is something else going on in their lives that they are not ready to cope with. Children who are exposed to pornographic material or who have been sexually abused may behave in the way that you describe. If your daughter persists with this behavior, see your pediatrician. -- Loraine Stern, M.D.