toddler

• Toddler period


  Spans years 1 to 3
• Toddlers


  • Become more independent, active, and curious
  • Begin to show defiant behavior
  • Start imitating the behavior of others, especially adults and older children
• The toddler period can be quite a challenging time for parents
• Growth


  Physical changes in height, weight, and the appearance of the body
• Development


  Acquisition of complex motor, cognitive, and social skills, such as walking, speaking, turning a page in a book, or smiling at familiar faces
• Compared to infancy, both physical growth and acquisition of new motor skills slows down, with the most dramatic changes occurring in bodily proportions
• Head growth during toddlerhood

  Slows down from 2 cm in the second year alone to 2 to 3 cm over the next ten years
• Height and weight increase during toddlerhood

  1. Occur in spurts rather than in a linear fashion

  2. Average weight gain is around 1.3 to 2.3 kg per year

  3. Average height increase is 7.5 cm per year
• Developmental milestones


  Markers of how the toddler is developing that are typically checked periodically throughout infancy and childhood
• Types of developmental milestones

  • Motor
  • Cognitive
  • Social
  • Psychosocial
  • Moral and spiritual
• Motor milestones at 18 months

  1. Start running

  2. Carry toys while walking

  3. Walk up stairs while holding the rail
• Motor milestones at 2 years

  1. Try jumping on both feet

  2. Prefer one hand over the other

  3. Use a fork
• Motor milestones at 3 years

  1. Start riding a bike

  2. Get undressed by themselves

  3. Walk up and down stairs with alternating feet
• Fine motor skills developed during toddlerhood

  • Building tall tower blocks
  • Fitting a puzzle piece
  • Turning pages in a book
  • Scribbling and painting
• Sensorimotor stage (Piaget)


  Toddlers learn about themselves and the world around them by using their senses and manipulating objects
• Cognitive milestones at 18 months


  1. Use 10 to 25 words

  2. Name familiar objects like clothing items or food

  3. Play with dolls or teddy bears
• Cognitive milestones at 2 years

  1. Follow 2-step commands

  2. Use more than fifty words and form intelligible 2-word phrases

  3. Understand the difference between pronouns and plural and singular

  4. Develop new problem-solving strategies
• Cognitive milestones at 3 years

  1. Follow 3-step commands

  2. Use more than 200 words and predominantly intelligible 3-4 word phrases

  3. State their full name, age, and gender

  4. Know how to phrase questions

  5. Develop time concepts, identify shapes, compare two items, and count to three
• Social milestones at 18 months

  1. Increasingly independent from caregivers

  2. Prefer parallel play
• Social milestones at 2 years

  1. Throw tantrums

  2. Develop a need for control and a sense of egocentrism
• Social milestones at 3 years

  1. Easily separate from parents, though separation anxiety may reemerge

  2. Learn to share toys

  3. Show empathy

  4. Play with others
• Autonomy vs shame and doubt (Erikson)


  Toddlers begin to explore their environment and learn independence and self-care. If unable to achieve autonomy, shame and doubt can result.
• Preconventional level of morality (Kohlberg)


  Toddlers begin to develop a sense of right and wrong, with actions based on avoiding punishment and the attainment of pleasure
• Brain growth during toddlerhood

  1. Rapid growth, reaching 90% of adult size by age 2

  2. Myelination of the brain and spinal cord continues, improving coordination, language skills, and protective reflexes
• Respiratory system changes during toddlerhood

  1. Number of alveoli in the lungs continues to increase, but won't reach adult level until age 7

  2. Trachea and lower airways continue to grow but remain small compared to adults

  3. Eustachian tube is short and straight, increasing risk of middle ear infections
• Musculoskeletal system changes during toddlerhood

  1. Bones elongate and muscles become much stronger

  2. Posture becomes more erect, developing a longer, leaner, and stronger appearance

  3. Abdominal muscles remain relatively weak, contributing to pot-bellied appearance
• Genitourinary system changes during toddlerhood

  1. Urinary bladder volume increases, allowing longer urine retention

  2. Toilet training becomes possible as systems mature

  3. By age 3, can recognize urge to urinate/defecate, sit on toilet for over 5 minutes, and stay dry for at least 2 hours
• Gastrointestinal system changes during toddlerhood

  1. Stomach size increases, allowing 3 regular meals per day

  2. Small bowel length increases, decreasing stool frequency

  3. Stool color may vary depending on diet

  4. Immature intestines can pass whole pieces of difficult-to-digest foods
• MyPlate food guide


  Recommends vegetables and fruits to make up over half the plate, with grains and proteins occupying the other half, and grains taking a slightly larger portion
• Toddler diet supplements


  • Iron-fortified cereals
  • Vitamin D and C fortified juice
  • Fluoride if water is not fluoridated
• Toddler vaccines


  • Chickenpox or varicella
  • DTaP (Diphtheria, tetanus, pertussis)
  • Hib (Haemophilus influenzae type b disease)
  • MMR (Measles, Mumps, Rubella)
  • IPV (Polio)
  • PCV13 (Pneumococcus)
  • HepA (Hepatitis A)
  • HepB (Hepatitis B)
  • Yearly influenza (flu)
• Car seat safety for toddlers

  1. Always secured in an appropriately sized car seat

  2. Remain in rear-facing car seat in the backseat until at least 2 years old or maximum height/weight
• Home safety checklist for toddlers

  1. Remove choking hazards

  2. Install gates at top and bottom of stairs

  3. Secure medications and household chemicals

  4. Ensure all furniture and TVs are safely secured to walls

  5. Keep pot handles on stove turned inward and out of reach

  6. Set water heater to 120°F/49°C or lower to prevent scalding

  7. Never leave toddler unattended near water
• Toddler nutritional needs


  Around 1300 calories per day, divided into 3 meals and 2 snacks
• Healthy food options for toddlers

  • Fruits
  • Vegetables
  • Lean meats
  • Whole grains
  • Dairy products like milk, yogurt, and cheese
• Limit fruit juice, soda, and foods high in sugar and saturated fat for toddlers
• Avoid foods that pose a risk for aspiration like seeds, grapes, and popcorn for toddlers
• Ensure toddler is up to date on vaccinations