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Ask Dr. Sears: Preschool Mood Swings

Q. My 3 ½ year-old granddaughter has such mood swings, it's almost scary. One minute she's fine  -- playing and talking normally, but then for no reason, she gets angry and starts yelling and talking back. Is this an indication of serious emotional problems?

Your granddaughter is fortunate to have you as a caring grandmother. Most children at this age have some degree of mood swings, but rather than use the old cliché of "she'll grow out of it" or "it's just a passing phase" (which it could be), I believe this is behavior that warrants concern, and should be addressed. Here are some steps you might use to help your granddaughter mellow her moods:

Identify the trigger. What sets off the mood swings? Is she tired, bored, frustrated, angry, or needing attention? Are there unsettling events in her family life (with friends or at school) that could be making her angry or unhappy? Is she a deeply sensitive child? While this is a positive quality trait, she may be bothered more by unsettling events than a child who is less sensitive. Try to identify the triggers and intervene the best you can. Ask yourself if there's some way that you can help her steady her moods.

Chart the mood swings. Are they getting more frequent and/or severe? Are they interfering with her growth and development? If the answer is no, then you don't need to worry as much, but any behavior that is escalating needs to be addressed by a professional.

Monitor her nutrition. If her mood swings are a reflection of an underlying biochemical imbalance, it could be caused by poor nutrition. I have termed this "nutritional deficit disorder" (NDD), to reflect the biochemical disturbance caused by poor nutrition. Stable moods require stable insulin levels and blood sugar  -- if her blood sugar goes up and down like a roller coaster, so will her moods. Some children are more sensitive to the effects of junk food than others. Take a trip through the kitchen and discuss eliminating troublesome foods from her diet with her parents. Foods that contain high fructose corn syrup, hydrogenated oils, and anything with a number symbol (like red #40) are a good start.

? Have her start the day with a brainy breakfast. This sets the nutritional tone of the day. If she eats a high protein, high fiber, healthy-carb breakfast, such as a bowl of oatmeal topped with yogurt and fruit, she'll begin the day with stable blood sugar.

? Have her graze on good foods. Going without food for more than a few hours can cause her blood sugar, and consequently her moods, to go out of whack. Offer snacks that are high in fiber, protein and healthy fats, such as peanut butter, fruit, and yogurt. Make homemade whole-grain cookies or muffins that are high in fiber. Above all, avoid sweetened and artificially-sweetened beverages and snacks. Eating frequent mini meals throughout the day also helps keep the body in biochemical balance.

Discover her special something. Every child needs to excel in at least one thing. Help her find her special talents, whether it be art, sports, or music. When a child is involved in one thing that she is good at and likes, this will usually carry over into her overall satisfaction with herself, and lessen mood swings.

Take inventory of her general health. Lack of sleep or exercise, as well as poor quality sleep can also be a factor. Just like vigorous exercise is good advice for adults with mood swings, it also works for children. Being active increases the level of mood-mellowing hormones.

Check her happiness factor. Your granddaughter's overall level of happiness is very important. If a child is generally unhappy, then it becomes a bigger problem that needs to be addressed as soon as possible.

Finally, determine if there is a family history of mood disorders, such as anxiety or depression. If this is the case, it would be wise to seek professional counseling, even at such a young age.