Kids' Wellness Matters Podcast Ep. 4: Safely Integrating Babies and Dogs In The Home

For families with dogs or who spend time around them, understanding dog behavior is essential to the safety of both children and pets. Kelly Ballantyne, DVM, DACVB, a veterinary behaviorist, addresses the potential risks of having dogs in the home and offers tips for avoiding negative encounters, especially dog bites. This episode offers a comprehensive guide for families to foster a safe and harmonious environment for both their children and pets.

"Dogs are like swimming pools... They have the same kind of level of risk. How would you supervise your child around a swimming pool? We have to do the same things with dogs."

- Kelly Ballantyne, DVM, DACVB, Veterinary Behaviorist

Show Notes

  • [00:04:53] Any breed of dog can bite due to fear, frustration, or other emotions. It can be unhelpful to label some dogs as “dangerous” because it implies that other dogs might be inherently “safe.”
  • [00:05:33] Dogs often exhibit warning signs before resorting to biting, such as stiffening up, turning their head away, licking their lips, their eyes getting wide, rolling their ears back, or furrowing their brow. Learning to recognize these subtle cues can de-escalate otherwise aggressive encounters. 
  • [00:06:51] If parents observe a concerning interaction between their child and a dog, the primary recommendation is to create distance and ensure the dog has a safe space. 
  • [00:07:36] In cases where a dog has bitten a child, the cause could be underlying health issues, and for this reason, it’s a good idea to visit a primary care veterinarian to have the dog evaluated. Consulting dog behavior experts can be helpful when trying to assess child-pet dynamics in the household and improve interactions. 
  • [00:08:53] Dog trainers can be enormously helpful, but only those who use positive reinforcement training rather than corrections or punishment as a teaching tactic. Websites like the International Association of Animal Behavior Consultants and the Karen Pryor Academy can help pet owners find certified trainers. 
  • [00:10:25] For parents who are expecting, it can be helpful to familiarize oneself with dog body language ahead of time. Setting up safety measures in advance, like baby gates, for example, can be helpful. Introducing baby items to the dog can slowly acclimatize him/her to the baby, forming a graduate introduction. 
  • [00:13:10] Creating better conditions at home, such as avoiding placing dog beds in tight spaces where a dog might feel trapped and avoid surprising a resting or sleeping dog, can make an enormous difference. 
  • [00:15:35] Ballantyne offers a list of online resources, from continuing education courses to veterinarians to dog behavior specialists. 
  • [00:17:58]  Ballantyne discusses how to navigate the sad but necessary removal of an aggressive dog from a home when other remediations fail. 

Episode Transcript 

[00:00:00] Nina Alfieri, MD: Welcome to Kids’ Wellness Matters. I'm Dr. Nina Alfieri. 

[00:00:06] Rob Sanchez, MD: And I'm Dr. Rob Sanchez. We are both parents and pediatricians at the world renowned Ann and Robert H. Lurie Children's Hospital of Chicago. 

[00:00:14] Nina Alfieri, MD: On this show, we'll chat with a wide range of experts about caring for children from newborn to young adult. Because kids' wellness matters. Alright Rob, there's no skirting the topic. We are dog people.

[00:00:30] Rob Sanchez, MD: Absolutely. We have lots in common, and certainly one of the biggest things is that we both love our dogs. We're big fans of dogs. Cooper, he's a delightful black lab, probably mixed with some other stuff in there too.

[00:00:41] Nina Alfieri, MD: Aww, and I've had the pleasure of meeting Cooper. What a beautiful, wonderful dog. Our dog, Gnocchi, who's now six, he's maturing into a distinguished older man, when we first got him, he was our, baby. He was like our first baby. We named him Gnocchi because he's a little golden retriever. And when we brought him home, he looked like little potato pasta. When we brought home our daughter, we actually spent some time preparing our dog, Gnocchi, for meeting her, it's something that I started to ask about in visits because almost everybody has a dog or is around a dog.

[00:01:12] Rob Sanchez, MD: It's something that you're going to be thinking about when you're bringing a new young baby into the home making sure you're taking the right precautions and, and introducing it.

[00:01:20] Nina Alfieri, MD: Absolutely. As we were pregnant, we were realizing we had to do specific things to get ready because a lot of the things we had trained him for were not the same as walking next to a stroller, which completely kind of freaked him out or we would play the breast pumps in our living room and he would just at us like, what is this sound? So we did tighten up on some training to get him ready for her. I will say he's a little bit of a food stalker and he has some behaviors that could be a little politer.

[00:01:46] Rob Sanchez, MD: Cooper knows to be very close when my son's at the table, cause he knows there's going to be stuff on the floor that he could try and eat up, scoop up. But also just being cautious around the house, like a dog bowl placement. Those are things that we were thinking about and, making sure that our son was safe, that Cooper was safe. 

Absolutely. And in this episode, we're going to cover some of that important preventive stuff, but we're also going to hit some of the harder topics to talk about. You know, when I was in residency, and I'm sure you too, Rob, there were a lot of ER visits for dog bites. As we're suturing kids and we're giving antibiotics and we're talking with the families, I heard the same story almost every time, which is that this was a really, really good dog who'd been part of the family forever. And you know, as you uncover more about the stories, you realize how common this is. Totally agree. I think as pediatricians, but also as parents, we're super mindful and aware of it, and we want to give the opportunity to share that with other parents as well, and talk with a great expert about it.

[00:02:40] Nina Alfieri, MD: We are joined today by Dr. Kelly Ballantyne, who is an incredible veterinary behaviorist and someone who has personally helped me a lot. Thank you so much for joining us. We're really excited to have you here.

[00:02:51] Kelly Ballantyne, DVM: Thanks so much for inviting me. I'm really excited to talk to you about this very important topic.

[00:02:56] Nina Alfieri, MD: So Dr. Ballantyne, can you tell me a little bit about your background, your love for animals, what got you into your field, and generally what is the field of veterinary behavior medicine?

[00:03:06] Kelly Ballantyne, DVM: I am one of those people who like at five years of age decided I wanted to be a veterinarian and I never changed my mind. So when I was a veterinarian, I was getting a lot of questions from clients about animal behavior and it wasn't something that I got a lot in school. So I started reading a lot of textbooks on animal behavior and I was just hooked. And it was really fulfilling to be able to help clients who came to me with various issues. Most of the issues that we treat are based in fear and anxiety but sometimes with dogs and cats, it gets expressed as aggression too, such as, you know, snapping or biting. So that's now all I do as a veterinarian is I treat dogs and cats with behavioral issues.

[00:03:47] Nina Alfieri, MD: You know, in my pediatric training, I spent a lot of time working in the Lurie Children's ER, and still in my general practice today, a common issue we see is children coming in for dog bites. And these sometimes can range from scratches but can also result in really, really severe, serious injuries. And, there's also the emotional trauma of what happens during a dog attack or a dog bite that sometimes it's long lasting with children. But let's get down to the basics here. Why do dogs bite?

[00:04:17] Kelly Ballantyne, DVM: Dogs tend to bite for a few main reasons and actually one of the most important things to note is that dog bites are part of normal dog communication. It's definitely like an intense level of communication, but when dogs are biting, they're usually biting as a defensive reaction and essentially saying like, you need to leave me alone now. In other cases, I mean, dogs might bite out of play. That's also part of their normal play behavior. Those bites tend to be less intense. They usually don't leave marks, but that's not always the case.

[00:04:48] Nina Alfieri, MD: I'm going to just throw out a common myth that I hear all the time. Is there an association with dog breed and biting?

[00:04:53] Kelly Ballantyne, DVM: No, absolutely not. Any breed of dog can bite, and it's actually I think unhelpful to label some dogs as dangerous because then you're also labeling other dogs as inherently safe, right? Like if you think, oh, okay, pitbulls are dangerous, but if I get a golden doodle, I'm not going to have any problems. That's actually not true. Any breed of dog can bite and dogs are individuals. They have emotions, so a lot of times they're biting because they're scared or frustrated, and that can happen with any breed.

[00:05:23] Nina Alfieri, MD: That's helpful to know. And you mentioned that biting is a form of communication. Can you tell us a little bit about warning signs before a dog bites and other ways that dogs communicate with us?

[00:05:33] Kelly Ballantyne, DVM: This is something that we emphasize every single day in our practice because dogs have a very elaborate way of communicating with body language and facial expressions. And it's not something that we as humans are inherently born knowing. There's actually a lot of research that shows adults aren't really great at identifying the lower level signals that dogs are uncomfortable, and children are even worse at it , and tend to misinterpret their signals. So, we kind of consider bites at the top of what we call the ladder of aggression. It's like their last signal when they're saying, you really need to stop right now. But they usually use much more subtle communication before they get to that point. And those are the signals that are missed. So that might be something such as stiffening up, turning their head away , licking their lips, their eyes might get wide, they might have their ears pulled back, they might furrow their brow. These are all stuff like if you're not looking for them, you will absolutely miss them, but if you start looking for them, you can catch problems before they escalate up to that bite.

[00:06:37] Nina Alfieri, MD: And what do you recommend if a parent is noticing an interaction between a child and a dog and the dog is maybe showing some of these lower levels of concern, like stiffening up or maybe they're licking their lips or trying to move a little bit? How should an adult intervene in that situation?

[00:06:51] Kelly Ballantyne, DVM: All of those body language signals or facial expressions are all ways that our dogs are communicating, "stop, I don't like that, I need some space." So the best thing that the parent can do in that situation is to provide that space for that dog. So that might be moving the child away. That might be sending the dog to, you know, a safe space where they won't be disturbed. But creating that distance is really important.

[00:07:16] Nina Alfieri, MD: Can you talk a little bit about, for a family who comes to us and has had the really unfortunate and scary event of a dog hurting a child, what are the next steps you recommend as a veterinarian and as a behaviorist, really from the dog and from the family dynamic perspective, what can the family do to try to consider next steps and move forward?

[00:07:36] Kelly Ballantyne, DVM: So, in terms of immediate next steps, I would definitely bring the dog to the family's primary care veterinarian to get them evaluated. What we know from some of the research is that over 50% of dogs that bite, usually have an underlying health issue. So, that could be something like arthritis, or maybe an ear infection, or a skin infection that's making them feel really uncomfortable. So we wanna get them evaluated by their primary care veterinarian so that we can check for any issues that might increase their irritability and increase the likelihood that they're going to bite. And often those things are treatable. The next step is, to consult with either a veterinary behaviorist or with a certified behavior consultant to help you evaluate your home setup and your pet's behavior to see if there are ways that you can improve safety and increase positive interactions between the dog and the children in the household because a lot of dog bites are absolutely preventable.

[00:08:36] Nina Alfieri, MD: That's great to know. One thing as a dog parent that's been really overwhelming is trying to figure out what kind of a trainer to get for your dog. There are so many different kinds. As someone who is an expert in the field, what do you recommend to families for how to find a good trainer for your situation?

[00:08:53] Kelly Ballantyne, DVM: Yeah. So there are a couple of really great websites where you can actually search for trainers in your area. One of them is the International Association of Animal Behavior Consultants. Those are dog trainers that have gone through additional continuing education. They have a lot of knowledge about how animals learn and they also have standards in terms of the types of training methods that they use. The other one would be the Karen Pryor Academy, which again those trainers very well educated. And then we also want to emphasize that the trainers that are utilized are using positive reinforcement training. And you want to avoid trainers that are going to be using corrections or punishment as part of the training methodology because that, as the research shows, is very likely to increase fear and anxiety, which is what is most likely driving these behaviors in the first place.

[00:09:45] Nina Alfieri, MD: That's often a piece that as physicians, we might be missing in our counseling to families. I think a lot of times the first question is, does this dog need to be put down? And I think it's really helpful to know that there's a lot of different resources to help families take the next step forward for their kid through the medical system and the pediatrician, but also that there's an entire world to help support the dog and the family also getting along and promoting a safe environment moving forward. Let's get into my absolute favorite topic, since I'm a general pediatrician and I love prevention. Let's say, for families who are expecting a child and they've had a dog for a while, what are some ways we can help prepare the dog and the family for a new baby?

[00:10:25] Kelly Ballantyne, DVM: I love prevention too. So I'm so glad we get to talk about this. I think honestly, step number one is start learning about dog body language because getting expert at reading your dog and picking up on those subtle signs that they're uncomfortable is going to be so crucial in making sure that you have safe interactions. There are a lot of fantastic resources out there on dog body language that are very easily accessible, even some like great YouTube videos. So I would say that's Step number one. Step two is I would start to introduce some of the items that you expect that you will need when your infant is in the household and get those set up before the infant arrives, so you give your dog time to adjust because there's going to be so many changes that are going to come with this infant. So we want to make sure, we're kind of easing the dog into it. I think setting up safety measures ahead of time, such as, baby gates or pens or things of that nature to help keep your baby and your dog separated at times. Again, we want to get those into the household and set up so the dog can get used to them. You also want to make sure that the dog is comfortable being separated from you ahead of time because that's going to be a really important management strategy once your infant is actually in the house.

[00:11:37] Nina Alfieri, MD: Those are some really great things to think about during the long nine months where you're waiting for the baby to come. How about for families who already have dogs and are starting to really think about this as their kids are getting older? What are some strategies in the household or ways to supervise an interaction? 

[00:11:54] Kelly Ballantyne, DVM: I think one of the most important things is to think about your supervision. Are you actively supervising your kid and your dogs together, or is it more passive? I know one of my colleagues, she often refers to like, dogs are like swimming pools, okay? They have the same kind of level of risk. And so you want to think about, okay, how would you supervise your child around a swimming pool? You likely wouldn't leave them by the swimming pool and go check Instagram or go cook dinner. You would be there and you would be between your child and the swimming pool at all times. And then, you know, when they weren't there, you would block their access to the swimming pool. We have to do the same things with the dogs. And if anything, you know, dogs are a little bit higher risk because they're mobile, so they can move around. So we want a lot of active supervision when dogs and kids are in the same room together. So you got to be watching both of them at the same time, and if you can't, they need to be physically separated. That's number one in terms of preventing unsafe interactions between them.

[00:12:54] Nina Alfieri, MD: So, Dr. Ballantyne, you mentioned a couple of situations that might increase the risk for a bite, including if the dog's not feeling well, what are some situations families should look out for? What are some common household setups that are riskier for a dog bite event?

[00:13:09] Kelly Ballantyne, DVM: So there are a couple of just general situations that it's important to teach kids as well as just really supervise. So we really want to Avoid approaching dogs when they are resting or sleeping. Getting startled is a really high risk scenario in which a kid might get bitten so that's really just important to monitor all the time. And then just, you know, start talking to the kids about, like, when the dog is asleep, we leave them alone. When the dog's eating, we leave them alone. I also highly recommend that everybody teach their kids that if they want to interact with the dog, to invite them over rather than going to the dog and invading their space. That gives the dog choice. So if they're not feeling well, let's say, their hip hurts or their ear hurts, they're probably going to choose to be where they are, and then that's a good way to also teach kids about, consent and bodily autonomy and just, you know, everybody's got feelings, we have to respect that the dog, doesn't want to interact with us right now. I would say that those are probably the most common scenarios that we want to be really mindful of.It's also important to look at your layout and just look at, like, where the dog is tending to rest and sleep, and we want to avoid having dog beds in places where the dog's going to get trapped. We don't want the dog bed like right between the coffee table and the couch because that's a really narrow space and the dog might perceive that they actually can't get out of that space and might be more likely to bite to defend themselves. Same thing with like, we don't want dog beds under objects like the coffee table because again, the dog gets surprised, by a child's head peeking under the table. They might bite in that scenario as well.

[00:14:43] Nina Alfieri, MD: These are really great and practically useful tips. I have one more scenario I wanted to pick your brain on. So, some of our families don't have animals within the household, but when they go to parks or when their kids go to friends' houses, they interact with dogs in those environments. What advice would you give parents in terms of starting that conversation with your kids on how to approach dogs that aren't familiar to you? And whether you should.

[00:15:06] Kelly Ballantyne, DVM: Yeah, I think it goes back to that teaching kids to invite rather than going over and approaching. In most cases, if dogs aren't comfortable with an interaction, again, they try to avoid, they're doing the best that they can. So I think it's just really important that we teach kids, you know what, you can't approach every dog that you see on the street or at the park. And if you invite them over and they come over, things are most likely going to go well.

[00:15:30] Nina Alfieri, MD: Tell me a little bit about where parents can go to learn more and where we can go for help.

[00:15:35] Kelly Ballantyne, DVM: Yes, so thankfully there are a ton of great resources out there on the internet. One of those is Family Paws Parent Education. They actually have a ton of continuing education for trainers and veterinary professionals, but they also have a whole list of resources for families. And they focus it on the infant stage and then they have another focus on the toddler stage because there's different things that you got to do for each of those stages. The other one that I would highly recommend to everybody is the Dogs and Kids Course that was developed by my colleague, Dr. Emily Levine, who's a veterinary behaviorist out in New Jersey. That course is online. It's free. It is in very digestible bite sized chunks. And I can't say enough about it. It's fantastic. She also wrote a really great kids book that's targeted for kids aged two to four called Doggy Do's and Don'ts. The whole reason she wrote this book is because she had a daughter. She was reading her stories and she was actually realizing that a lot of the interactions between kids and animals taught in most children's books are kind of problematic and potentially encourage high risk behaviors. So this really focuses on teaching kids safe behaviors around dogs.

[00:16:48] Nina Alfieri, MD: Wonderful. I'm a huge believer in parents spending time reading with kids as a way to teach them about the world. So I'm definitely going to have to check that book out for my daughter too. Tell us a little bit about your clients and your families and what the most common stories that you hear are.

[00:17:03] Kelly Ballantyne, DVM: I guess I would just say, you know, we see a lot of families that are struggling and they're doing the best that they can for the pets in their lives and they love them so much. But, they don't always understand what their animals are trying to communicate and they aren't always meeting their pet's needs. Not through any fault of their own, just from, you know, lack of knowledge and understanding. A lot of what we do is education and we try to keep our recommendations practical. We try to, you know, make sure we tailor what we recommend to each individual family because everybody's different and every dog and every cat is different too.

[00:17:41] Nina Alfieri, MD: Yeah, just like in pediatrics, there's so much information on the internet that it's so overwhelming and not all of the information is actually practical or leads to a safer environment for the family. So to have someone who is an expert in dogs and in their behavior has been such a game changer for us.

[00:17:58] Kelly Ballantyne, DVM: What happens when a family gets to the point where they've tried, they've worked with professionals, and they're at the point where they're not sure if it's safe to keep the dog and the baby in the same household? How do you approach that situation when you're a little bit further down the road? There are a number of considerations. Usually when you have a bite that has happened, we're working through a risk assessment with the families to figure out if we can actually mitigate that risk to a reasonable level. If we decide that we can't, then usually what happens is we have a conversation of, is this dog suitable for rehoming or is humane euthanasia in everybody's best interest? And so we have those conversations all the time. We see a lot of severe cases, so honestly a lot of the dogs that we treat aren't suitable for re-homing for a number of reasons or would carry the same safety concerns in any home environment that they live in. So, we end up discussing humane euthanasia, which is obviously a heartbreaking decision for anybody to have to make. But I see families that have to go through that decision actually fairly frequently. I would emphasize that I see those decisions made out of love, and they're making the best decision that they can for their family and for their dog. And I do think that this is a dog welfare issue too. We don't want that dog to end up back in like, let's say, a shelter environment where they're going to get adopted and rehomed multiple times because that's not really a great quality of life for that dog either. There's no like black or white guidelines that help people come to that decision. So there's lots of things that you have to weigh on whether or not this is something that you want to try to rehabilitate the dog for or if it's just not a safe situation.

[00:19:41] Nina Alfieri, MD: Obviously, that's such a hard place to be in as a family. What are some resources or who are the main people parents can reach out to if they're considering that they're in that spot?

[00:19:51] Kelly Ballantyne, DVM: I would reach out to a veterinary behaviorist because we have a lot of information, and we have a lot of treatments that we can talk through and, really look at each individual family and try to work through the dynamics to see if it's feasible. There are some online resources like the Ohio State University vet school. They have some really fantastic resources when pet owners are at this decision making point on different things to consider before they get to the point where they think that euthanasia is the ultimate decision.

[00:20:22] Nina Alfieri, MD: It's a hard topic to talk about, like you said, this can be a decision that's made out of love and consideration for safety and for what's best for everybody in the family.So, Dr. Ballantyne, tell me what are some of the benefits of having an animal or having a child exposed to animals in their life?

[00:20:38] Kelly Ballantyne, DVM:  I think, one of the primary benefits is having another loving companion in the household, right? There's nothing greater than coming home and having a dog run up to you, like, it's the best event of their day. Usually, I don't get that level of enthusiasm from the humans that live in your household.

[00:20:56] Nina Alfieri, MD: I have to say that's true.

[00:20:58] Kelly Ballantyne, DVM: So I think the companionship, just that emotional support, can be so lovely. I also think, you know, it's teaching empathy and understanding feelings. I love when I see parents in the room, because we're often talking about fear and anxiety, so they'll have their kids with them and be talking about, you know, their dog's feelings and trying to translate for the children. So I think that's a really great benefit as well.

[00:21:21] Nina Alfieri, MD: That's amazing. And I, can say, you know, some of my best ideas are out of dog walks where my brain is just completely relaxed because I'm watching another being just enjoy being alive and sniffing things and kind of helps me go into acoustic mode in a way that the regular world doesn't really promote. If you had a couple closing tips for families, what would they be?

[00:21:45] Kelly Ballantyne, DVM:  So my closing tip for families would be to keep in mind that kids tend to mimic what we do as adults, right? Be mindful of how you interact with your dog when your kids are around. If we're trying to teach kids not to invade their dog's space, and not to approach the dog when they're resting, you wanna model those behaviors for them as well. So start practicing calling your dog over to you when you want to give them snuggles rather than going up to them and giving them a kiss.

[00:22:07] Nina Alfieri, MD: Dr. Ballantyne, I want to say a huge thank you for all of the great advice that you provided today. You really covered the gamut of prevention and learning more about dog behavior and, in general, what we can do to help keep kids and dogs safe and happy together. 

[00:22:25] Kelly Ballantyne, DVM: Thank you so much. 

[00:22:26] Rob Sanchez, MD: Thanks for listening to Kids’ Wellness Matters. 

[00:22:31] Nina Alfieri, MD: For more information on this episode and all things kids’ wellness please visit LurieChildrens.org.

 



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