Toddlers

The toddler years are very important ones for developing a foundation of good health for your child.

Parenting a toddler takes a great deal of patience, a positive attitude, and a healthy sense of humour. It is a good idea to have some basic information to follow, and it’s important to remember that it is ok to ask for help. The Health Unit can support you in understanding what is going on with your toddler, so that you can respond in a healthy and positive way.

Visit the links below for tips on specific concerns in your toddler’s development.

 

Consider using the Looksee Checklist, a tool to help you keep track of your baby’s development.

The Looksee Checklist® is a developmental checklist that follows a child from one month of age to six years. It provides a snapshot in time of your child’s development, and a starting point for discussion with a health/childcare professional. Starting October 1, 2023, there will be a one-time sign-up fee.  The 18-month looksee checklist® will remain free to all families)

Resources:

Visit our breastfeeding webpage for lots of helpful information.

If you are a parent or caregiver for a toddler child (18 to 35 months), use Nutri-eSTEP® as a fast and simple way to find out if your child is a healthy eater. Nutri-eSTEP is a nutrition screening tool for toddlers and preschoolers, created in part by Dietitians of Canada.

Nutri-eSTEP® contains 17 questions about a child’s typical food choices, eating behaviours, and physical activity and growth patterns. The questionnaire takes about 10 minutes to complete and provides immediate feedback.

Learn more at Nutri-eStep.

Feeding toddlers can be challenging sometimes.

Now that your child is a toddler, they may be growing much slower than when they were an infant. Don’t be surprised if you notice some changes in the way they eat. This is all normal.

Your toddler may:

  • Seem very hungry at one meal and not at the next.
  • Eat a large amount of food one day and much less another day.
  • Not want to try new foods.
  • Have food likes and dislikes.
  • Want to be in control and may say “no” often.

Offer your toddler or preschooler a variety of foods from each food group found in Canada’s Food Guide in different flavours, textures and colours. A healthy balanced plate provides the energy and essential nutrients children need to grow, develop and be active.

Breast milk is still an important source of nutrition for your toddler until two years of age and beyond. In addition to breast milk, when your baby is between 9 to 12 months old and is eating a variety of iron-rich foods every day, you can offer homogenized (3.25% M.F.) cow’s milk. Give milk in an open cup. After the age of two, toddlers can begin to drink the same milk as the rest of the family. Learn more about transitioning your baby to cow’s milk (UnlockFood.ca).

Sometimes children are very hungry or not hungry at all. This is normal. Your job is to decide what, when and where to offer food. Your child’s job is to decide if he/she wants to eat and how much. This helps children to learn their hunger and fullness cues. Keep meal and snack times a pleasant family time. It’s also importanto to set a good example of healthy eating for your children.

  • Provide a healthy meal or snack every two to three hours. Try for three meals and two snacks every day.
  • Seat your child at the table for meals and snacks without any distractions (TV, toys, etc.).
  • Let your child feed him or her self.
  • Toddlers have very small stomachs, so offer child-sized portions; they may only eat 1/4 to 1/3 of what you might eat at a meal.
  • Give food using a child-sized plate, utensils and cup.
  • Offer the same food as the rest of the family and modify the texture as needed.
  • Do not go back to the kitchen to get different food if your child refuses to eat.
  • Give your child enough time to eat – about 20 to 30 minutes.
  • Allow your child to ask for more food or not eat at all.
  • Eat with your child as often as possible as children learn through role modelling.
  • Don’t bribe, punish, or reward your child with food, or use ‘games’ or ‘tricks’ to encourage him to eat.
  • Most children learn bowl and bladder control between the ages of two and four years old.
  • Nighttime bladder control may occur months or years after a child masters daytime bladder control.
  • The best approach to toilet training is a child-centred approach when the child is mentally, emotionally, and physical ready.
  • Signs a child might be ready to toilet train includes when they:
    • Can stay dry for several hours
    • Are able to follow instruction
    • Know when they need to go
    • Are able to walk to the potty and sit on it, and pull their pants up and down
    • Are able to ask to use the potty

When starting toilet training, it is important to prepare the child, develop a step-by step-routine, and praise the child’s progress.

Resources:

Most toddlers sleep between 10 and 13 hours in a 24-hour period.
Keep in mind these healthy sleep habits for your toddler:

  • It’s still important to keep a sleep schedule your child is familiar with. The routine you established during the first year is even more important for your toddler.
  • Avoid naps that are too late in the day, because at this age, they can affect nighttime sleeping.
  • Help your child wind down about half an hour before bedtime with stories and quiet activities.
  • Be gentle but firm if your child protests.
  • Keep the bedroom quiet, cozy, and good for sleeping, such as keeping the lights dim.
  • Soft, soothing music might be comforting.
  • Security items (such as a blanket or stuffed animal) are often important at this age.

Source: Canadian Paediatric Society – Healthy Sleep for Your Baby and Child; About Kids Health – Sleep: Benefits and Recommended Amounts

Learn more on sleeping behaviours (Encyclopedia on Early Childhood Development).

Discipline is an important part of child rearing and teaches children self-control and acceptable behaviour.

Tips for positive discipline:

  • Positive discipline is based on trust, love, support and respect.
  • The child needs to see discipline that is fair and consistent (discipline that is not consistent is confusing to the child).
  • Discipline techniques need to be appropriate for the child’s age and stage of development.
  • Ways to help a child learn good behaviour include offering regular praise, knowing what to ignore, accepting mistakes, offering realistic choices and being a good role model.
  • To manage misbehaviour, a parent can redirect to another activity, use logical consequences, encourage problem solving, or use quiet time or time out (depending on the age of the child).
  • Tantrums are a normal part of development and can often be shortened by speaking in a calm voice and acknowledging frustration and helping the child work out the problem. When tantrums do happen, a parent can ignore the behaviour, step in if the child is in danger and offer reassurance and a drink of water when it is over.

Resources:

  • Anxiety, frustration, stress, and anger can be triggered by a variety of things including new developmental challenges, life changes, stressful events, or unfamiliar or new situations.
  • Toddlers may have difficulty identifying a strong emotion and may instead act out as they are unable to have words for what they are feeling.
  • Anxiety is one of the most common mental health concerns and can affect young children.
  • Parents play a vital role in helping their children manage anxiety.
  • When coping skills and brave behaviour is rewarded in the home, children can learn to face their fears, take reasonable risks and gain confidence.
  • Anger is a normal emotion. Anger management can help a child learn better ways to cope with their feelings.
  1. Calm down before you act

When we get frustrated, we can react without thinking. If you react in ways that are hurtful, you can make the situation worse by scaring your child. Try to breathe deeply when you feel yourself getting frustrated. Wait until your body relaxes and you can think clearly before doing or saying anything.

  1. Think about what you want your child to learn in this moment

Your child will learn how to deal with frustration by watching how you deal with it. Children who are spanked are more likely to solve their own conflicts by hitting others. To teach children how to be respectful and non-violent, you need to treat them with respect and interact without violence. Show them how it is done.

  1. Consider your child’s point of view

Most of the behaviours that frustrate parents are normal reactions to hunger, tiredness, boredom, restlessness, fear, illness, pain, discouragement, frustration or stress.

  • Has your child missed her snack?
  • Was he up late last night?
  • Did she miss her nap?
  • Does he need to run outside?
  • Is she getting sick?
  • Is there stress in the family?

Ask your child if something is bothering him. When you understand the reason for your child’s behaviour, it is easier to handle the situation without losing your temper.

  1. Think about your child’s stage of development

Babies are just beginning to learn about the world. They need to know that they live in a safe place. They often cry because they do not have words to tell you how they feel or what they need. It can be hard to figure out what they are trying to tell you. Babies never cry to make you mad. They just need to be comforted and protected. They need to know that they are safe with you. You cannot spoil a baby. When your baby cries, try:

  • feeding her
  • changing his diaper
  • holding, cuddling and singing to her
  • rocking or walking with him

If your baby cannot stop crying and you are feeling stressed out, put your baby in a safe place. Spend a few minutes alone until you feel calmer. Ask for help from family, friends, a doctor or other community resources.

* Remember, never shake a baby. Shaking a baby can cause serious brain injury and death.

Toddlers learn by touching and tasting everything. This is how they get to know the world. They are little explorers who want to know what everything is and how everything works. If a child’s hand is slapped for touching things, they will be afraid to explore, so they will learn less. To keep your toddler safe while he explores:

  • Put dangerous things out of reach.
  • Distract her with a safe toy.
  • Use words like ‘hot,’ ‘sharp,’ and ‘ouch’ over and over to teach him about danger.
  • Always make sure she is in a safe place where you can watch her closely.

Preschoolers want to do things for themselves and make their own decisions. They cannot express or control their feelings very well. When they get frustrated, they often have tantrums. Their emotions take over and this can scare them. Spanking will only scare them more and make the tantrum worse. Instead, you can:

  • Stay close and keep your child safe.
  • Take deep breaths.
  • Stay calm to help your child gradually calm down.

When your child has calmed down, hold him gently and help put his feelings into words. “You were mad because I cut your apple and you wanted to eat it whole.” Show your child how to handle strong feelings without yelling or hitting. Teach her how to think of solutions to her problems. Help him to express his feelings using words. If something gets damaged, help your child learn how to fix it.

  1. Create a loving and respectful home.

Adults are important role models. Children learn from watching how adults treat each other, as well as how they treat children. Talk with your child and explain things so she can learn. Show him and tell him you appreciate his efforts. Respect her need to grow, learn and explore. Teach him about safety and distract him from things that can harm him. Respect her need for sleep and healthy food, which greatly affect her behaviour. Have a daily routine. Last but not least, have fun with your child!

Parents are always learning. All parents need ideas and support.

  1. Do not be afraid to ask for help

To find out where to find support in your community, ask:

  • your family doctor
  • your local public health department
  • your family support worker
  • child care centres
  •  family resource centres
  • child and family service agencies
  • parenting programs such as Nobody’s Perfect
  • First Nation, Inuit and Métis organizations and health programs
  • multicultural or newcomer centres
  • social media support forums

Source: Public Health Agency of Canada – Ways to Guide Your Child’s Behaviour

 Video courtesy of the City of Hamilton

From Encyclopedia on Early Child Development:

Additional resources:

Proper use of car seats helps keep children safe. Always read the manufacturer’s instructions and the child restraint section in your car owner’s manual.

Please note: As of January 2018, the Brant County Health Unit no longer holds car seat clinics.

Resources:

Free drop-in programs for parents, caregivers and their 0-6 year old children, in collaboration with EarlyON Brant. Visit EarlyOn drop-ins for times and locations.

Visit our Parenting classes page for more details about Triple P parenting classes in Brant.

What is ALTER for Child Safety?

A child safety program developed by University of Guelph professor and psychologist, Dr. Barbara Morrongiello, proven to reduce childhood injuries that occur in the home.

ALTER for Child Safety, ALTER for short, provides parents and caregivers with a tool they can use to help them problem solve safety challenges and reduce injury risk in young children.  It’s easy to use, easy to remember, and it works!

Each letter of ALTER stands for a change that parents/caregivers can make to keep their children safer and more in view. It gives parents/caregivers the autonomy to choose which changes to make and how many based on their own child’s characteristics, the environment they are in, their preferred parenting style, and family values.

Why use ALTER?

As children grow and learn new skills it is not uncommon for them to get hurt. While most of these injuries will be minor, sometimes they are not. Tragically, some children will die from their injuries. Others may experience lifelong disabilities because of their injury.

Most of us can remember an injury story either from personal experience or stories from friends, family, or things heard on the news.  These may be hard to talk about, but they also can help us better understand how vulnerable children can be to serious injuries and learn what we can do to better protect them.

Parents/caregivers may be surprised to learn that unintentional injuries, that is, injuries that happen not on purpose, are the number one cause of death for children in Canada and a leading cause of hospitalizations. The most common types of unintentional injuries during early childhood are falls, drowning, poisoning, burns, choking and strangulation. Each year in Brantford, over a thousand children between the ages of 0-4 have an injury serious enough to require a visit to the emergency department. The majority of these will happen while the child is home with their parent/caregiver.

The good news is that most of these serious injuries can be prevented.  Parents/caregivers can take steps, such as using ALTER, to help reduce child injury risk.

Who is ALTER for?

ALTER is for parents/caregivers of children 1-5 years of age but can also be used with school aged children.

As babies and children grow and develop new skills, their risk for injuries changes.  With each new skill comes new risks.  How we manage those risks also changes.

Parents know their children the best, but they too are often surprised by what their child can do! Children can be unpredictable and impulsive and, like their parents ;-), cannot always be relied on to follow the rules even if they know what they are.  They are curious and enjoy exploring their environment but don’t have a good understanding of what is dangerous yet even if they have been injured before.  Sometimes they overestimate their abilities or try to imitate what older children or adults are doing.  Due to their size, developing skills, and physical makeup, children are more prone to getting injured.

Keeping young children in view so you can act quickly to stop them if they do something unsafe is important and has been shown to work and reduce injuries. Using ALTER will give parents additional strategies to use to improve child safety.

When to use ALTER?

Parenting can be hard. It’s impossible to watch children 100% of the time but most parents and caregivers admit that they could do a bit more than they are.

Use ATLER whenever the children in your care are not in view, when something else is competing for your attention, when your gut is telling you that something might go wrong, and when you’re feeling stressed and tempted to take a shortcut with parenting.

Where to use ALTER?

Most injuries to young children happen at home with the parent/caregiver present. ALTER targets injuries that occur in the home. It can be used in the child’s home or a home where the child is visiting.

Homes are designed for adult size, convenience, and comfort. These features can make life easier for adults but can create hazards for children. Counters, electrical outlets, button batteries, water heater temperature, window screens, balconies, stairs, furniture, cabinets, drawers, TV stands, blind cords, and toilets are just a few things in a home can cause the most common types of childhood injuries: falls, burns, poisoning, choking, strangulation, or drowning.

How to Use ALTER?

ALTER gives you many ways to reduce your child’s risk of injury and the letters serve to remind you of those strategies: A-Activity, L-Location, T-Timing, E-Environment, and R-Resources. Using one or more of these strategies can increase the time your child is in view and, when they are not in view, these strategies can reduce your child’s risk of injury. Please see below for examples of how you can use ALTER to keep children safer.

———————————————————————————————————————————-

A = change your ACTIVITY or that of your child (e.g., have child help you; switch child to a low-injury risk activity if you cannot watch child continuously)

L = change your LOCATION or that of your child (e.g., fold laundry where s/he is playing; bring your phone into the bathroom so you can stay there while they take their bath)

T = change the TIMING of what you want to do (e.g., do it when your child sleeps)

E = modify the ENVIRONMENT to reduce risk of injury (e.g., secure bookcases, lock cupboards, put medicine out of sight and reach, block access to the stairs)

R = use your RESOURCES (e.g., who can help you by watching your child – a friend? partner?; visit injury prevention websites such as ALTER and Parachute for more information; safety products; home safety checklist)