I Have a Lot of Hills I’ll Die On

There’s a trend online where people share the “hills they’ll die on,” the opinions they hold without wavering.

For me, these aren’t hot takes. They’re beliefs shaped and stress tested over more than a decade as a board-certified pediatrician and a mom. They come from caring for thousands of kids, years of ongoing learning, and seeing what actually helps families in real life, not just on the internet.

When I started thinking about mine as a pediatrician, parenting educator, and mom, I realized something fast: I have a lot of them.

These aren’t ideas I picked up from a headline or a comment section. They come from years of listening to parents in exam rooms, reading the research, watching what helps families feel steadier, and what quietly makes things harder. They’re shaped by the tension parents feel between doing their best and being told they’re never doing enough.

So this is my list, and it’s not short. It reflects what keeps coming up, over and over again, in real conversations with parents.

You don’t have to agree with every hill. That’s not the goal. My hope is that reading them helps you feel a little more grounded in what actually supports kids and the adults raising them.

Parental mental health is child health.

You can’t separate how a parent is doing from how a child is doing. I know this not just as a pediatrician, but because I have been there myself, living through anxiety and depression. When parents feel supported and steady, kids tend to do better emotionally and behaviorally. When parents are burned out, stretched thin, or constantly questioning themselves, that stress shows up at home. Not because anyone is failing, but because families are connected systems.

And this is where the conversation often gets oversimplified. It is not always as easy as “just get help.” For many families, the barriers are real, lack of access, lack of time, lack of affordable resources, and a system that makes support hard to reach. The first step is awareness, naming that parental mental health matters. The next step is treating it like the priority it is, at home, in healthcare, and at a policy level. Supporting parents is supporting children.

You can love your child deeply and still need space from them.

You can love your child deeply and still need space from them.

When I solo parent for a weekend or even a full week, it is very natural for me to want to tap out when my husband walks back through the door. Not because I do not adore my kids, I truly do, but because caregiving is tiring. Being “on” all day, every day, making decisions, managing emotions, meeting needs, it adds up.

Caregiving, especially in the early years, is intense. Wanting time alone, quiet, or a moment where no one needs you does not cancel out love. It does not mean you are not cut out for parenting. In fact, many parents are more patient, more present, and more regulated because they allow themselves breaks instead of pushing through exhaustion and resentment. Taking space is not a failure. It is part of sustainable parenting.

If you don’t model it, don’t expect it.

Parents often feel frustrated about things like, my kid won’t eat vegetables, they want screens all the time, they melt down over small things, they don’t listen, they won’t rest. And those frustrations are real. But modeling matters more than we like to admit.

We can’t expect kids to eat vegetables if they are rarely offered, or if we openly avoid them ourselves. We can’t set screen time limits for school age kids and older kids if we are constantly on our phones, scrolling through dinner, zoning out whenever things feel hard. Kids notice that disconnect fast. Rules make more sense to them when they see adults living by them too.

The same goes for emotional skills. If we want kids to handle frustration, we have to show what that looks like. If we want them to rest, we have to allow ourselves to rest without guilt. If we want them to take responsibility after mistakes, we have to model repair instead of defensiveness.

Kids are always watching. Daily behavior teaches regulation, boundaries, and values far more effectively than lectures ever will. Modeling is not about being perfect. It is about being intentional, consistent, and honest in how we show up.

Cry methods of sleep training do not harm secure attachment.

Attachment is not built in one night or one moment. It is built over time through many everyday interactions. Feeding your child, comforting them when they are hurt, playing together, listening to their feelings, and showing up consistently. A few nights of learning how to fall asleep does not erase all of that.

In a home where a child is loved, cared for, and responded to during the day, sleep training does not break attachment. Kids still know their caregiver is there for them. They are learning a new skill, how to fall asleep on their own, not being abandoned.

Many families actually notice the opposite. When sleep improves, parents are more rested. Kids are more regulated. There is more patience, more connection, and fewer emotional blowups. Chronic lack of sleep, for both kids and adults, can make everyone more irritable, overwhelmed, and less able to cope.

Sleep training is not about ignoring a child’s needs forever. It is about supporting sleep in a way that works for the family. In a loving, responsive home, secure attachment stays strong.

(If you want a deeper dive into the research on sleep training and attachment, the PedsDocTalk Newsletter: Is Sleep Training Helpful or Harmful breaks it all down.)

Sleep and sleep boundaries matter for everyone.

This does not mean being rigid or obsessive to the point where sleep itself becomes stressful. It means being intentional. Having a predictable routine. Helping your child understand that sleep is a basic health need, just like food and water.

Talk about it out loud. Let your kids hear you say that sleep helps your body feel better, especially when you are sick or run down. That sleep helps your brain think clearly and your mood stay steadier. When kids understand why sleep matters, not just that it is a rule, they are more likely to buy in as they get older.

Celebrate good sleep too. Not in a pressure filled way, but in a normal, positive way. “You slept well and your body got what it needed.” That reinforces the message that sleep supports how we feel and function.

Sleep impacts nearly everything, behavior, mood, attention, learning, and coping. When kids are not sleeping, parents are not either. Exhaustion makes small stressors feel huge. Sleep is not a luxury. It is a health need.

Being a pro sleep family is about balance. Consistent routines, clear boundaries, shared values around rest, and flexibility when life happens. That foundation supports everyone in the home.

(If you’re tired of searching for sleep help, this PedsDocTalk Newsletter has every resource you need in one place, from babies to toddlers.)

You cannot out-supplement a lifestyle problem.

It is January, which means supplements are everywhere. Powders, gummies, drops, promises to fix sleep, focus, immunity, mood, all of it. And to be clear, some supplements are useful or even needed for certain kids and families. And sometimes families are already doing the basics well, so a supplement truly is a supplement, not a stand in.

But a lot of what parents are trying to “fix” with supplements is really rooted in routines and environment. Inconsistent sleep. High stress. Limited movement. Busy schedules that crowd out play, connection, and time outside.

Kids need consistent sleep, a variety of real foods, movement, play, social connection, and fresh air. Those foundations do not come in a bottle. No powder can replace rest. No gummy can undo chronic stress or lack of downtime.

Supplements can have a role, but they should add to a healthy base, not replace it. When the basics are supported first, everything else works better, including the supplements that are actually indicated.

For more on my thoughts about supplements, watch this video and subscribe while you’re there.

Food morality harms kids.

When foods are labeled “good” or “bad,” kids are not just learning about food, they are learning to judge themselves. Eating a “bad” food can turn into feeling bad. That is how guilt and shame creep in. Over time, food becomes stressful instead of flexible and neutral.

Labeling foods also puts them on pedestals. The more a food is restricted or talked about as “bad,” the more powerful and tempting it becomes. Kids may fixate on those foods, overeat them when they get access, or feel out of control around them. Meanwhile, the foods labeled “good” can start to feel like a chore or a rule instead of just food.

This approach also disconnects kids from their body’s cues. Instead of noticing hunger, fullness, and satisfaction, they are trying to follow food rules.

What to do instead.
Use neutral language:  Some foods help our bodies grow and feel good for longer. Some foods are mostly for taste and enjoyment. Both can exist. Offer a variety of foods consistently, including vegetables, proteins, fruits, and fun foods, without pressure or bribing. When foods are not moralized or restricted, they lose their power.

A calm, predictable food environment helps kids build trust with their bodies and a healthier relationship with eating over time.

For more on labeling foods–check out and download this podcast episode.

Vaccines are well-studied, where benefits outweigh risks.

It is January and somehow we are already watching Health and Human Services overhaul a vaccine schedule that was working. Changing this without strong evidence is not a neutral move. It is a risky one, and it will do more harm than good.

When I talk about vaccines, I talk about benefit versus risk. That is how medicine works. No medical choice is zero risk, including taking Tylenol or driving to school. The question is always, does the benefit clearly outweigh the risk. For childhood vaccines, the answer is yes. Over and over again. Across decades of data.

Vaccines are among the most studied tools in pediatric medicine. They lower the risk of severe disease, hospitalization, and death. They also protect babies, grandparents, and medically fragile people who depend on community protection. The risks are real but rare. The benefits are large and well documented.

Good medicine is not about fear or politics. It is about evidence, outcomes, and protecting health. And the science on vaccines has been very clear for a very long time.

(If you want a full resource, the PedsDocTalk Complete Vaccine Guide walks through each vaccine from birth to adolescence, plus RSV, COVID-19, flu, along with myth-busting and Q&A. I will need to update it to allude to current recs changing that differ from what most pediatricians would recommend.)

Parenting advice that ignores development is incomplete.

Many “behavior problems” are really developmental realities. Kids are not being difficult, they are being young. Emotional regulation takes time. Impulse control develops slowly. Transitions are genuinely hard for developing brains.

And development is not just about age. Neurodiversity matters too. Kids with ADHD, anxiety, sensory differences, learning differences, or other neurodevelopmental profiles may experience the world very differently. What works beautifully for one child may completely miss the mark for another, even at the same age.

This is why parenting can feel so hard. There is no true one size fits all solution for behavior concerns. Advice that ignores development and neurodiversity often leaves parents feeling like they are doing something wrong, when the real issue is a mismatch between expectations and a child’s capacity.

Understanding this is key, not just for parents, but for educators and caregivers too. When we align expectations with how kids actually grow and process the world, we move away from shame and toward clarity, compassion, and strategies that truly help kids succeed.

Constantly rescuing kids from discomfort creates more anxiety, not less.

There is a balance here. Supporting kids does not mean leaving them alone with hard things, and it does not mean jumping in at the first sign of struggle. It starts with autonomy, giving kids space to try, while knowing an adult is close and available.

Struggle is part of learning how to cope. When kids are protected from every moment of frustration or uncertainty, they lose opportunities to build confidence in their own ability to handle hard things. Especially when they are young, they will need more support and quicker intervention to stay safe and regulated. But even then, the goal is not to remove all discomfort. It is to guide them through it while still allowing effort, frustration, and trying again.

As kids grow, that space becomes even more important. Support often looks like staying close, offering calm reassurance or a few guiding words, and resisting the urge to fix it right away. That balance, autonomy with thoughtful intervention, helps kids build resilience, confidence, and trust in themselves. More on autonomy and then intervention here.

Fear of big feelings leads parents to flex on important boundaries.

Big emotions can be uncomfortable for adults. When a child melts down, yells, cries, or protests loudly, it can feel easier to give in than to hold the line. For example, a parent says no more screen time, the tears start, and suddenly the boundary shifts to “just five more minutes.” Not because the limit was wrong, but because the feelings felt big.

In the moment, that flexibility feels soothing. In the long run, it creates more uncertainty for kids. Children feel safer when boundaries are calm and predictable, even when they hate them, and yes, even when they protest loudly. A steady limit tells them, “I can handle your feelings, and I am still in charge.”

Big feelings are not a sign you are doing it wrong. They are often a sign the boundary matters.

And honestly, boundaries come up so much in parenting that maybe one day I will write a whole book about them 👀

Gentle parenting without boundaries is permissive parenting with better branding.

A lot of families have slipped into permissive territory because gentle parenting is often misunderstood. Validation became the focus, but the transition and the limit got lost. Empathy turned into endless explaining, negotiating, and waiting for a child to feel ready, even when the boundary was necessary.

Yes, warmth and validation matter. Kids deserve to have their feelings seen and named. But validation is not the same as agreement, and empathy is not the same as giving in. Children also need leadership. They need adults who can say, “I see you’re upset, and this is still the limit,” and then help them move through it.

When boundaries disappear, kids often become more dysregulated, not more at ease. Too much flexibility can feel confusing and overwhelming for developing brains. Gentle parenting works best when empathy is paired with clear, consistent limits and a confident transition forward.

More on the GOAT parenting style authoritative parenting on this youtube video.

We expect children to cope in environments that adults would struggle in.

There is still an old idea floating around that kids should be “seen and not heard.” That is not how children are wired, and it never really was. Kids need to move, talk, ask questions, make noise, and release energy. Expecting them to sit still, stay quiet, and hold it together for long stretches would be hard for most adults too.

Many kids are moving through long days with little downtime, lots of structure, and high expectations. School, activities, transitions, rules, screens, homework. That is a lot for a developing brain and body. When a child “falls apart,” it is often a signal of overload, not misbehavior.

This is where time and place matter. Kids are more likely to listen and regulate when their needs for movement, connection, and expression are met earlier in the day. Giving them space to talk, move, and be kids makes it easier for them to show restraint and focus when it is truly needed.

Before assuming something is wrong with the child, it is worth looking at their day, their schedule, and their developmental stage. Often the environment needs adjusting, not the child.

Instant gratification is making us more irritable and less patient.

If I ever did a TED talk, it might be about this. About the quiet ways instant gratification has reshaped how we cope, how we wait, and how we tolerate discomfort. So much of modern life is built around speed, efficiency, and convenience. We get answers instantly. Food shows up fast. Entertainment is always available. Discomfort is something we expect to disappear quickly.

The problem is not convenience itself. It is what we lose when waiting disappears. Waiting teaches patience. Boredom creates creativity. Not getting something right away helps build frustration tolerance. When everything is immediate, even small delays can feel unbearable, for kids and adults alike.

Many of us grew up in the 80s or 90s, where waiting was part of childhood. Waiting for a show to come on. Waiting for a ride. Waiting while being bored. Those moments were not glamorous, but they gave us space to imagine, problem solve, and just be kids.

Patience and frustration tolerance are still essential life skills. They just take more intentional practice now. Making room for waiting, simplicity, and discomfort in small, everyday ways helps kids build resilience in a world that rarely asks them to slow down.

Insurance company priorities drive much of modern healthcare, leaving families underserved and clinicians burned out.

Insurance companies largely control how care is delivered. They decide what gets covered, how long visits can be, what requires prior authorization, and how much clinicians are paid. Their priority is cost control, not relationship based care. That pushes healthcare toward volume, speed, and documentation instead of listening, prevention, and trust. Families feel rushed. Clinicians feel squeezed. Everyone feels frustrated.

Private equity adds another layer. When healthcare systems are bought and run like businesses focused on short term returns, pressure increases to see more patients in less time, cut staffing, and maximize billing. That model is not built for thoughtful care, especially in pediatrics, where reassurance, education, and prevention matter deeply.

Many of the gaps families experience are not because doctors do not care. They are because the system is designed this way. Parents feel unheard. Clinicians feel burned out. And real health outcomes suffer.

This is one of the reasons I created PedsDocTalk. To give families the time, education, and clarity that the current system often makes hard to access.

The U.S. loves kids in theory and abandons them and families in policy.

We talk a lot about valuing children, but our policies often say otherwise. Limited paid leave. Childcare that costs as much as a mortgage. Healthcare tied to employment. Weak mental health access. Little protection for parents when life happens. None of this is child centric.

Where you live matters far too much. Your state can determine whether you have paid leave, affordable childcare options, school funding, Medicaid access, and mental health support. That means a child’s well being depends on their zip code, not their needs. That is not fair, and it creates real disparities we already see and will continue to see widen.

When families struggle under these pressures, the blame often lands on parents instead of policy. But supporting children has always meant supporting the adults raising them. Without basic federal standards that create a floor of support for all families, kids will keep paying the price for where they happen to be born.

One last thing

None of these hills are about doing parenting “right.” They come from watching parents work incredibly hard inside systems that often make things harder than they need to be. Systems that limit time, access, rest, and support, then quietly ask parents to carry the weight anyway.

Parenting does not happen in isolation, and neither does child health. When we name what actually supports families, and where things are breaking down, we loosen the grip of self blame. We stop asking parents to fix structural problems with more effort and more guilt.

My hope is not that you agree with every hill. It is that you walk away feeling a little less alone, a little more grounded, and a little clearer about what truly matters. Support was never meant to be a solo job, and neither is raising kids.

On The Podcast

You are never wrong for being worried about your child. You are allowed to ask questions, ask for help, and ask for another set of eyes. Advocacy is not confrontation, it is care. And the doctors caring for your family are human too, carrying both expertise and emotion into every room they enter.

In this episode, I sit down with pediatric ER physician and creator Dr. Beachgem for a wide-ranging, honest conversation about what families often misunderstand about emergency care, how to advocate for yourself and your child in the hospital, and what it really looks like to practice medicine on both sides of the stretcher.

And yes, we also talk about The Pitt, why it resonates so deeply with healthcare workers, and why humanizing medicine matters more than ever.

In this episode, I break down the three core needs every child has to feel secure, confident, and connected with their parents: safety, respect, and connection.

These are not soft ideas or permissive parenting. They are the foundation of authoritative parenting and the reason kids are more likely to listen, trust, and stay connected to us as they grow.

Ask Dr. Mona

An opportunity for YOU to ask Dr. Mona your parenting questions!

Dr. Mona will answer these questions in a future Sunday Morning Q&A email. Chances are if you have a parenting concern or question, another parent can relate. So let's figure this out together!