Online Health Chat with Dr. Emma Raizman

February 24, 2012


“She hit me first.” “I didn’t do it!” “He ruined my game!” Sound familiar? If you have more than one child, you likely have experienced sibling rivalry, and you probably know how intense and hurtful it can be. Though common, sibling rivalry can be a difficult situation to manage. Many factors contribute to sibling rivalry, including birth order, developmental stages, temperament, family dynamics, and the need to define oneself as an individual.

Sibling rivalry can affect self-esteem, future friendships, and family harmony if not handled appropriately. Understanding the causes of sibling rivalry and learning basic techniques to communicate with your children can help curb competition and create a more peaceful environment for you and your family. Most likely, your children’s’ relationship will develop into a close one as they grow older and develop important skills such as cooperating and understanding each others’ point of view.

Emma Raizman, MD, is a pediatrician in the Department of Community Pediatrics at Cleveland Clinic Children’s Hospital, and she sees patients at Cleveland Clinic Brunswick Family Health Center. Dr. Raizman came to Children’s Hospital after seeing patients in private practices in Virginia and San Diego, California. She graduated from the University of Pittsburgh School of Medicine in 1998 and completed her Pediatric Residency at Children's Medical Center of Akron in 2001. She then completed a Fellowship in Child Abuse Pediatrics at Rady Children's Hospital in San Diego. Dr. Raizman served as Co-Medical Director of the Child Abuse (REACH) Center as well as an Assistant Professor of Pediatrics at Children's Medical Center of Dallas and UT Southwestern for three years before returning to private practice.

Her interests include well infant, child, and adolescent care; helping families choose the right pet for their family and helping infants and children live safely with dogs; evaluation of headache, bowel complaints, fatigue, asthma, and pre-teen issues.

Cleveland_Clinic_Host: To make an appointment with Emma Raizman, MD, or any of the pediatricians at Cleveland Clinic Children's Hospital, please call 216.444.5723. You can also visit us online at

Cleveland_Clinic_Host: Welcome to our Online Health Chat with Dr. Emma Raizman. We are thrilled to have her here today for this chat. Let’s begin with some of your questions.

Age differences

singingmommy: I have a mild-mannered 7-year-old boy and a very aggressive and big 3 1/2-year-old boy, and although they play together extremely well most times, when they fight the older one fights with words and the younger one fights with fists. I'll bet this is very common, but how can I parent so that it doesn't always sound like I'm coming down on one of them? I'm especially concerned about my older son as he is very sensitive.

Dr__Raizman: First of all, developmentally, it is very common for your younger child to want to fight physically and your older child to fight more with words. And also, it is not uncommon for your older child to have more of a sense of right and wrong and what is happening to your younger child. Typically, the best thing to do is to coach them in how to work the situation out themselves rather than you trying to resolve the situation for them. One way to do this is to sit down with both of them when they are not fighting and establish ground rules, such as no hitting, no yelling or mean words. I would say that if they fight over something in particular, like the TV or a toy, it may help to establish times that the older one gets the TV or toy and the younger one gets the TV or toy and talk about sharing. If it starts to get violent, then that is the time for you to step in and put both of them in a time out and then bring the two together to talk about the situation. You want each child to feel that he is getting your attention, rather than each child feel that he is getting punished by you. If these fights seem to be more about your attention, then the best thing for you to do is take a time out yourself and let them work things out themselves while you are in another room, so they are not doing things just to get your attention. I do want to reassure you that this is a very common situation and there may be times when one child, perhaps your 7-year-old, might need a little bit more attention because he has a different understanding of the situation. It is OK to give him the attention that he needs, just as long as you are making sure that your other son is also getting undivided attention from you so that he doesn't feel neglected.

have_not: Is it easier to stop sibling rivalry that starts when children are young versus when they are older? When my kids were younger, I had no problems. Now that they are 13 and 14, I am having big problems. Are the 'solutions' the same?

Dr__Raizman: Sibling rivalry can arise at any time. It is not unusual for it to arise in the teen years. The concepts are still the same. You want to teach them how to work it out themselves, with a little bit of guidance from you, and help them establish what their boundaries are with each other. It is also helpful to try to engage them in some non-competitive activities with each other and as a family, as well as to give them time to explore their individual interests.


lisamchil: I'd like some ideas on non-competitive activities--seems my sons can make anything competitive. ANYTHING.

Dr__Raizman: Good question! Some kids really can make anything, even a stroll in the park, competitive. I would encourage family activities, such as walking together, going to a museum, trying a new restaurant where there can be discussion as a family, rather than letting them go off and be competitive with each other. If they start to make these activities competitive, which they may, I would remind them that this is family time and that it is not the time to compete with each other. It may take constant reminders, but they will start to understand the ground rules.

lovee: My two daughters are in constant competition. If one does it, the other one has to, and if one doesn’t do it as well as the other, then there are 'big problems?' How best to get them to understand that they each are going to have their strengths and weaknesses, and that if they are not the same, it does not mean that one is better? I've tried talking to them and reasoning with them, but it doesn't seem to have an effect.

Dr__Raizman: Sometimes, actions can speak louder than words. Each of them, I am sure, has an activity that they like to do or a hobby that makes them unique. I would make sure that you are spending time doing or watching each of their individual activities or hobbies with them, even if it is just for a short time, highlighting how proud you are of them for their individual activity or hobby. This will go a long way in helping them.

soccer_mom: My kids do not argue that much at home but are close in age and play on the same soccer team. Their coach tells me they are very competitive on the field and practice with each other. How do I help when I am not there? I would prefer not to put them on separate teams.

Dr__Raizman: They should be able to be on the same team. I would talk to them about the ground rules and what you expect from them in terms of their behavior on the team. You may tell them that you expect that they should be able to work this out themselves and stay on the same team, but if they can't seem to do this, you may have to separate them. You may also want to talk to them after their games or practices and just ask if there is anything you can help them with to make things go easier. That way, you are keeping the lines of communication open.

Drawn together

lisamchil: I try to get my three sons (10, 13, 15) to give each other space when they seem like irritants to each other, but they're drawn together with some magnetic force. Do they need to fight? Is it part of their development?

Dr__Raizman: No, it is not really part of their development, but it does happen very frequently. You may have to help them establish a plan for giving each other space. Perhaps one could be doing homework while another is playing video games and another is outside, and then switch off. Or, it may be as simple as reminding them to give each other space or do another activity. The good thing is that they will outgrow it and eventually be great friends.

momoftrips: We've set parameters on fighting: no put-downs or name calling, Yet, when in the car and I cannot separate them, the boundaries are crossed. Neither negative nor positive consequences for behavior seem to make a difference. Any suggestions on how to handle?

Dr__Raizman: I would let them know that there are ground rules before getting in the car and that there will be consequences for them not following the rules. The important thing with this approach is being consistent. If you tell them there will be consequences, such as grounding or a toy being taken away, then you have to follow through. I would also reward them with praise when they are sitting quietly and not bothering each other. Lastly, I would make sure that they have things to do in the car, such as a book or iPod, or activity that they can do individually and not be involved with the other. Or, alternatively, pick a game that you can play as a family in the car, such as math facts, I Spy, etc. where everyone can interact in a positive way.

dada: My daughters (6 and 7) have to have everything the other has, even if they are not very interested in it. They get upset if they don't have the same clothes, toys, books, etc. How do I help discourage this and help them be more of individuals? I am getting tired of buying two of everything!

Dr__Raizman: I would talk to them both together and separately, and this may need to be done several times. I would keep reminding them that they are individuals and they are special and that you will always make sure that things are fair, but that you want them to celebrate who they are. That means that one may get different clothes on one day and the other may get a different toy on another day, but you promise them that you will keep things fair. If they say they don't believe you, what you can even do is keep a tally on the refrigerator so that they can see that even though one is getting one thing on one day, the other will get something on another day, and that you are being fair. Once you do this for a while, you can stop with the tallying. After a while, they will soon start appreciating their differences.


mommab: I have three children, more or less 2 years apart in age. My younger two play together all the time and play very well together. The oldest is not as imaginative as the other two (doesn't really do role play, etc. very well). He will come in and either try to play (unsuccessfully) or just try to disrupt their play. How do I handle this type of situation? I know he just doesn't want to be left out and is jealous of their compatibility.

Dr__Raizman: First things first, I would talk to the two who get along the best and let them know that you would really appreciate it if they would play with their brother and that it would be a very nice thing for them to do and possibly give them positive rewards (like stickers) for doing that. I would also talk to all of the kids about how fun it is both to play together and to do your own thing. That way, your son may take a little bit more joy with playing by himself at times and playing with his sisters at times. I would remind them that they don't need to play together all the time and that may help him to not feel so bad when he is enjoying time by himself. Perhaps there is a toy that he has that the others might be interested in playing with that might bring them to him.


koko: My son and daughter fight all the time. He constantly puts her down and teases or makes fun of her. He doesn't really do it when his father or I am around and my daughter doesn't really tell on him, but I do hear him. How best can I get this to stop?

Dr__Raizman: I would sit them down together when they have not been fighting and talk to them about being kind to each other and about the ground rules of how to interact with each other, which would be no mean words, no yelling, no hitting. I would not lay any blame, but say that you wanted to talk to them about this. I would also just remind them frequently about being nice to each other and this both reminds them to do that and also lets them know that you are somehow aware of what is going on. I might also sit down with your daughter privately and let her know that if she is really being bothered by what her brother is doing that she should talk to him and let him know, and that if it continues for her to talk to you so that you can resolve it.

linne: I'm a grandmother and my two grandchildren, 3 girl, 7 boy, visit and sleep over often. They are well brought up, but lately when they come over at some point instead of playing well together, my grandson just starts running and taunting my granddaughter. Time outs at home work, but I've only done it once and my grandson was mortified. How do I at least get them to just stop so I can talk to them? Needless to say my husband, pop, is no help and half the time becomes the third child. I only had the one daughter so I'm not used to boys and whenever I had a problem with my daughter the friend could simply be sent home if they couldn't work it out. Can't talk with my grandchildren if I can't stop them without physically picking up my granddaughter and going into another room...I don't like shutting the door so he just runs after us...and he acts cute at the same time. Two are just so different than one.

Dr__Raizman: Let me assure you, this is very common. The first thing you have to do is establish the ground rules at your house and be consistent about enforcing those. I would sit them down when they come over and let them know what the ground rules are - no hitting, no yelling, no mean words, no chasing each other, etc. I would then let them know that if this happens, you will count to 3 and if it does not stop, they get a time out. You then have to be consistent about giving them this time out, even if it mortifies them. You then need to be consistent, even when he's cute, about using the time outs when they are not behaving. It is challenging at first when establishing this routine, but the rewards are great and you will be very pleased with the results.

Stepping In

cat_woman: When do you, as a parent, step in and handle problems between two brothers (9 and 10), and when is it best to leave them alone to settle their differences?

Dr__Raizman: The time to step in is if you are concerned that a child could get physically hurt, or it seems to be escalating into a violent or dangerous situation. If the situation seems to be escalating verbally, you may want to step in to remind them of the ground rules of no hitting, no mean words, etc., but I would avoid letting it become a griping session, where each one talks about the other one in front of you. I would turn it back on them and let them know that they need to use their words and talk to each other to work this out. You can either do this while you are standing there, or if you feel that they are acting out more to get your attention, then just leave them alone.


sabaker_77: What do you do about birthday parties? My kids do not seem to understand they do not get gifts when it is the other’s birthday. I am not sure why this is because we have never bought gifts for both. Usually ends with yelling and tears on both sides.

Dr__Raizman: I would make sure that you talk to the one who is not having the birthday party before the guests get there and let him or her know that this is a special day for their brother or sister and they will be getting presents, but it does not mean that they are loved any more than you are, and that when it is your special day, you will be getting presents and your brother or sister will not be getting presents, just like you are now. It might not be a bad idea to have a little store of small gifts, like stickers or pencils, so that you can give the non-birthday child a little something of their own as well. I would also make sure that you hug them during the party and make sure that they are also getting some of the attention.


creamb: Are there guidelines that can be followed to help prevent sibling rivalry before it even starts? I have a 3-year-old daughter and am expecting a son in March.

Dr__Raizman: Setting the ground rules and setting boundaries before any interactions even start are the best way to keep the interactions positive. Having your 3-year-old practice with a baby doll and having you show her how to be nice to the baby, how to help you with the baby and show her that there are times when you are not going to want her to touch the baby will all help her to get prepared for having a new little brother. It is also very important to make sure that your daughter gets some individual attention and time from you, especially during the end of the pregnancy and during your son's infancy. If she knows that she will get attention from you without having to act out, then she is much less likely to act out.


Cleveland_Clinic_Host: I'm sorry to say that our time with Dr. Emma Raizman is now over. Thank you again, Dr. Raizman, for taking the time to answer questions about "Sibling Rivalry."

Dr__Raizman: Thank you for chatting with me today. Sibling rivalry is both common and expected, but can also be controlled chaos and end up in loving close relationships between siblings.

More Information

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