This is a hard question to answer. We don't know why some children are able to move on from having a BFRB and not be affected again, while others struggle. What we do know is that learning to pay attention to the needs of the body, even after the behavior has stopped, is the most effective way to manage. Some clinical evidence shows that toddlers or infants who have a BFRB (known as "baby trich") may stop the behavior as they grow and develop; however, this is not always the case. Usually, BFRBs which typically begin at the age of 12 are chronic disorders, that may wax and wane over time.

For Parents

Will my child be bullied?

The physical effects of BFRBs on one's appearance can lead to unpleasant interactions with classmates and other peers. Meeting with your child's teacher (if your child agrees to this; ultimately it is their decision whether to disclose their BFRB or not) before the school year starts to talk about their BFRB and discuss opportunities to educate classmates and other peers about the reasons behind their physical appearance may lessen negative interactions. Encourage your child to be proud of who they are, that they are worthy and important. Try to create peer bonds through sports, clubs, and other activities that help your child see that they have many special gifts beyond their BFRBs.

Getting connected to community also helps. It's as easy as registering for an upcoming TLC health education and community event.

Should I let them get a wig? Isn't that enabling them?

The hair loss experienced from hair pulling can impact self-esteem and self-confidence. Many BFRB community members, especially girls and teens, share that not having hair impacts their feeling of femininity and/or belonging with peers. A wig can restore their self-confidence while also helping manage their behaviors. Although a wig may not stop their hair pulling, having a wig allows them to feel more comfortable at school and in community.

How can I empower my child to manage this behavior on their own?

Knowing that this is your child's journey, clearly listening to their needs, hopes, and dreams can help you navigate best practices in empowering them to live fully into themselves. Asking gentle clarification questions like, "How can I support you?", "What would you like me to know about your BFRB?", "How can I be your best advocate?" can be a great place to start a conversation. Keep in mind that this is a journey; that means there will be good days and there will be difficult days - but through it all, focus on the person your child is first, not their behaviors. What do they need to feel safe? What do they need to feel supported? What do they need to honor themselves?

As parents, it's not always easy to take a step back and let our children guide us. Asking for help from others on this journey connects you to resources and support. Signing up for TLC's health education and community programs to learn more helps you become the best parent you can be.

How can I teach my child the best way to react and respond to negative comments about their BFRB?

First and foremost, help your child determine if the person giving the negative comment is a friend, acquaintance, or a stranger in public. When friends make negative comments, they may be lacking information.

Education is the most powerful way to react. Most negative comments are born from ignorance. Providing useful pieces of information can be very helpful. Suggest they visit TLC's website, www.bfrb.org.

Is there anything I can do to help them?

Love, love, love your child, on the good days and on the challenging days. Love your child as your child first - not their BFRB. This is your child's journey. Standing alongside them with encouragement and not judgment keeps the lines of communication open - a critical component of ensuring their emotional and physical well-being. You may not understand what drives their behaviors to pull, pick, or bite. Asking gentle clarification questions, instead of judging, may give you better awareness of what they may be experiencing before, during, and after acting on their urges. Please do not tell your child to stop pulling, picking, or biting. BFRB community members will tell you that telling them to stop their behavior only makes it worse - further inducing shame and isolation. Some say it makes them pull, pick, or bite even more.

Becoming as informed as you can about body-focused repetitive behaviors helps you become your child's best advocate. The TLC website is a great resource, as are TLC's health education and community programs. You are not alone.

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