16–18 Months

At this age, your child is likely to have intense emotions. He may react quickly and impulsively to them. Excitement, frustration, joy, anger, and fear are some of the feelings he has.

Help your child understand these feelings by giving them a name. When a box will not open or a car will not roll, your child may drop it in tearful frustration. Say “I know it makes you angry when your toy won’t work.” These words show your toddler that you understand his frustration. It gives him words for understanding his feelings. Showing him how the toy works or substituting another toy may help him gain control over his frustration.

It takes many years for a child to learn about and to cope with his emotions. Giving names to feelings is the first step.

What it’s like to be 16–18 months

How I grow…

·         I walk by myself.

·         I can throw a ball from a standing or sitting position.

·         I may be able to climb stairs with help.

·         I may start creeping down the stairs backward.

·         I am very good at pushing a small chair.

·         It gives me a real sense of power to test out my developing muscles.

How I talk…

·         I may be able to hum.

·         I have long babbling “conversations” with you or with my toys.

·         I can combine two words such as “go bye-bye.”

·         I may let you know when my diaper is wet or soiled.

·         I will begin to say “please” and “thank you” if I regularly hear you say them.

How I respond…

·         I am struggling to be independent and to do things by myself.

·         I depend on your help when I am in trouble.

·         I don’t understand what it means to share. I like to play near other children but not with them. When I want a toy, I can’t understand that another child may also want it.

·         I hunt for you by going from room to room.

·         When I give you something, I want to see how you like it.

·         I will play by myself for awhile but I like you nearby.

·         I may help put toys away if you show me where they belong. I can’t do it by myself. Make a game of it for me.

·         Tickling and squeezing me may be fun for you but might make me uncomfortable. If you toss me up in the air, I may get scared and the rough movement could damage my brain.

How I understand…

·         I am beginning to put things inside other things to see how they will fit.

·         I am beginning to remember where objects belong.

·         I try to copy adults.

·         I spend a lot of time staring at things, animals, and people.

·         I can understand simple directions most of the time and follow them some of the time.

·         I may go find a toy in another room if you ask me to get it.

How you help me learn…

Toddlers are curious, loving, and full of fun and laughter. They can melt your heart and lift your spirits. They can also be very demanding. They have little patience and endless energy. Toddlers have their own schedules. Just because you’re tired at the end of the day, doesn’t mean that your toddler is. Or your toddler may be exhausted yet unable to wind down when you are needing quiet time.

Talk about your frustrations to a friend, counselor, or doctor to help put things in perspective. Call The Parent Line to get support and ideas on how to cope with your active toddler.

·         I am figuring out how things work and may discover that your lipstick marks just as well as crayons. It may be difficult for you to imagine how clever I was to have made that discovery. It will be easier for both of us if you put the “no-no’s” out of my reach. I need to explore, and I need a safe place to discover how things work.

·         Play with me. One of my favorite games now is “chase-and-be-chased.” Other favorite games are “hide-and-seek” and “roll-the-ball.”

·         Give me lots of hugs and kisses.Tell me you love the way I smile, that you like my giggle, that you love my nose, my toes, and my ears. Tell me over and over again.

·         Talk to me, even though I don’t understand everything you say. Talk to me as you would talk to an adult. Listening to you will help me under stand longer sentences. Tell me what is going to happen today, where we are going, and what we will see.

·         Let me play with an old purse with a handle. I will put my treasures in it and carry it around.

·         Let me sit in a laundry basket or cut out the ends of a large box and let me practice crawling through it. Hang a towel over one end of it and I’ll hide from you.

Guidance

Anger and Tears

A toddler’s ability to handle frustration is very limited. He gets angry and upset easily. An outburst is most likely to happen when he is hungry, tired, or excited.

To help prevent outbursts:

·         Maintain your child’s routines: eating, napping, and bedtime.

·         Give your child a few minutes notice before ending an activity. This advance notice makes “changing gears” easier.

·         Take snacks, books, and small toys with you when you go places. Avoid large crowds, long waiting periods, and too many errands which may overstimulate your child.

·         If you see that a situation is upsetting him, stop or change the activity. Respond to your toddler’s tears before he loses control.

·         Make sure you are not expecting too much of your toddler by setting too many limits or using “no” too often.

When an outburst does occur:

·         Realize that it is always worse for you when it occurs in public. If you can find a quiet place to help your child calm down, it will be easier for both of you. Think about what your child must be experiencing.

·         Try not to get angry yourself. If you do, the outburst is likely to get worse instead of better. However, don’t give in to unreasonable demands.

·         Depending on the situation, if there are safety issues involved, you may need to restrain your child. Decide whether to ignore an outburst or to hold your child securely. Offer your child comfort when he has calmed down. These outbursts may continue through age five. They may be less frequent but more intense as a child grows older. It takes a long time for a child to learn self-control. He needs support, understanding, consistency, and encouragement as he learns to handle his emotions.

Choking

Your toddler can easily choke on food. To prevent choking, here are some things to remember:

·         Avoid giving food such as crack seed, arare, chips, peanut butter served from a spoon, nuts and iso peanuts, raw carrots and celery, hard pieces of fruit, gummy candies, popcorn, trail mix, marshmallows, mochi crunch, hard candies, and jelly beans.

·         Cook carrots. Cut grapes into quarters and remove the seeds. Cut hot dogs and Vienna sausages lengthwise into four strips.

·         Always watch your child when he is eating.

·         Never give him food when he is lying down.

·         Insist that he sit down to eat. Foods that cause choking are often eaten “on the run.”

·         Keep eating times relaxed. Fighting, laughing, and crying can make him catch his breath and inhale food.

Weaning From a Bottle

A toddler can usually drink from a cup quite well. However, many parents continue to give their child a bottle because they prefer giving liquids in a spill-proof container. Other parents are worried that their toddler will not get enough to eat if he doesn’t get a bottle. The bottle may also provide a lot of comfort to a child. If your toddler continues to use a bottle with milk or juice in it, problems can occur. A child may carry his bottle around sucking on it frequently during the day. At night, he may go to sleep with the bottle in his mouth. Juice or milk is in frequent and continued contact with his teeth. These liquids feed bacteria in the mouth and can cause cavities. If he sucks his bottle while lying down, there is also a chance of painful ear infections.

To prevent these problems, help your toddler gradually give up the bottle.

·         Give him milk and juice only from a cup. If he insists on having his bottle, fill it with water or allow him to have it when it is empty.

·         Be prepared for a few tough weeks of crying and whining. Look for ways to distract your child from his bottle.

·         Continue your special routines. If the bottle has been associated with cuddling and rocking, carry on these activities, but without the bottle.

·         Keep his bottle out of sight unless you intend to give it to him.

Food Choices

Your child knows when he has had enough to eat and what foods he likes. He doesn’t know what foods are needed for growth and health. That part is your job.

Offer several small servings of food from each of these groups daily:

·         Breads, cereals, rice, pasta, crackers, poi

·         Vegetables cut in small pieces

·         Fruits cut in small pieces

·         Milk, yogurt, or cheese

·         Meat, fish, poultry, egg, tofu, beans

The Parent Line Keiki Guide describes a typical child at each age. These descriptions are based on the study of many children. Because your child is unique, he may do things somewhat earlier or later.

Health

Dental Care

Schedule your child’s first visit to a dentist sometime between the ages of 1 and 2. Dentists who have special training and equipment to care for children are called pediatric dentists or pedodontists. Your own dentist may also be willing to care for your child.

This important first visit should be a pleasant experience. Prepare your child for the visit by reading him a children’s book about going to the dentist. Explain to your child that the dentist is a helper to mom and dad in caring for his teeth. Before he gets there, tell him what to expect. Playing “dentist” may also help.

During the first visit, ask your dentist how you can keep your child’s teeth strong. Ask for a lesson on how to teach your child to brush his teeth properly. Find out if you need to floss your child’s teeth. Regular brushing and flossing, the use of fluoride, regular check-ups, and a diet low in sweet foods and drinks will help reduce dental problems.

This is the time to establish good dental habits. Young children often feel very grown-up when they are given their own toothbrush and are allowed to brush and spit to their heart’s content. You will need to help your child do the actual daily brushing but toothpaste is not needed until age three.

Safety

Make your home safe for your child.

·         Plastic bags and balloons are responsible for many suffocation deaths. Tie each bag in a knot for storage or disposal.

·         Medicines, household and garden chemicals, paints and craft supplies make kitchens, bathrooms, work-shops, and garages especially dangerous. Lock up all these hazards.

·         Fluoride and vitamin pills (child or adult type) are a major cause of poisoning for children this age. Over the counter and prescription drugs (including birth control pills) are also dangerous.

·         A friend’s purse containing pills that look like candy is tempting to a curious child. A pill bottle in plain view at a grandparent’s house is a safety hazard.

·         If you suspect that your child has swallowed something dangerous, immediately call the Hawaii Poison Center or dial 911. Keep Ipecac syrup on hand and locked up. Do not use unless advised to do so by medical personnel.

·         Keep toothpicks out of reach. They can cause serious injury to eyes and ears and can be swallowed.

·         Check window openings and lanai railings to be sure a child could not slip through. Remove lightweight lanai furniture or planters that your child could push close to a lanai railing. He could climb up and over the railing. Check to see that window screens are secure and furniture is away from a window to prevent falls out of the window.

·         Put screening around your railings if the bars are too far apart.

A Parent Asks

Q – My baby is 18 months old. I am still breast-feeding him. My mother says I should have weaned him a long time ago. One of my friends breast-fed her baby until she was three years old. What do you think?

A – There is no right answer. By 18 months, children are able to drink quite well from a cup, so breast-feeding becomes a way of asking for and receiving comfort more than a way of fulfilling nutritional needs.

Some children lose interest in breast- feeding before the mother is ready to stop. Other children want to continue well into the third year. Some mothers believe that breast-feeding should continue until the child stops nursing by choice.

When you decide to wean your baby, here are some suggestions:

·         Avoid weaning when your child is faced with a stressful situation. Your return to work, a family vacation, or the excitement of a holiday could be a difficult time.

·         Wean your child gradually. First, stop the feeding that seems least important to your child. Then gradually stop other feedings one at a time. Look for other ways to respond to your child’s hunger, thirst, or his desire for attention and affection.

·         Be sure to offer your child a variety of protein-rich foods. Meat, fish, cheese, tofu, and eggs can make up for the decrease in breast milk.

·         Continue pleasant routines such as bedtime rocking and singing that your child has come to associate with his breast-feeding.

 

 

 

 

 

 

 

 

 

 

 

 

 

Feeding Your 1- to 2-Year-Old

 

Toddlers this age are moving toward a diet more like your own. Keep introducing new flavors and textures. Food preferences are set early in life, so help your child develop a taste for healthy foods now.

 

Toddlers have little tummies, so serve foods that are packed with the nutrients they need to grow healthy and strong. Avoid sweets and empty calories. Don’t give your child sugar-sweetened drinks, such as soda, juice drinks, sports drinks, and flavored milks. Limit 100% fruit juice to no more than 4 ounces a day, and serve juice in a cup, not in a bottle.

 

Your toddler will continue to explore self-feeding, first with their fingers and then with utensils at around 15–18 months of age. Give your child lots of chances to practice these skills, but lend a hand when frustrations arise. As skills develop, step back and let your little one take over.

 

Toddlers like to assert their independence, and the table is one place to give yours some sense of control. Serve a variety of healthy foods from all the food groups and let your child decide which of those foods to eat and how much.

 

 

What About Milk?

Milk is an important part of a toddler's diet because it provides calcium and vitamin D, which help build strong bones. Most kids under age 2 should drink whole milk. If a toddler is overweight or there is a family history of obesity, high cholesterol, or heart problems, your doctor might recommend switching to reduced fat (2%) milk.

 

If your child can’t drink cow’s milk, choose unsweetened soy drinks fortified with calcium and vitamin D. Other milk alternatives (such as almond, oat, rice, or coconut) have less protein and may not be fortified.

 

Kids this age don’t need special toddler milk or formulas, which contain added sugars. Toddlers can get all the nutrition they need by drinking cow’s milk or a fortified soy drink and eating a variety of solid foods.

 

When your child is 2, you can switch to low-fat or nonfat milk.

 

Between 12 and 18 months of age is a good time to move to a cup. Instead of stopping bottles all at once, slowly drop them from the feeding schedule, starting with mealtime. Offer whole milk in a cup after your child has begun the meal.

 

Why Is Iron Important?

Iron makes the red blood cells that carry oxygen throughout the body. Low iron levels can affect growth and may lead to learning and behavior problems and anemia (a low number of red blood cells).

 

After 12 months of age, toddlers may not get enough iron because they no longer drink iron-fortified formula and they may not get enough iron-rich foods in their diet.

 

To help prevent iron deficiency:

Limit your child's milk intake to 16–24 ounces (480–720 milliliters) a day.

Include iron-rich foods in your child's diet, like meat, poultry, fish, beans, and iron-fortified foods.

Continue serving iron-fortified cereal until your child is eating a variety of iron-rich foods.

Talk with your doctor if your child drinks a lot of cow's milk, isn't getting enough iron-rich foods, or if you're thinking of giving your child a multivitamin.

 

What Foods Should We Avoid?

Offer your child a variety of healthy foods. Watch for allergic reactions when trying new foods.

 

Toddlers between 12 and 24 months should avoid:

 

foods with added sugars and no-calorie sweeteners, including sugar-sweetened and diet drinks

high-sodium foods

unpasteurized juice, milk, yogurt, or cheese

foods that may cause choking, such as hot dogs, raw vegetables, grapes, hard cheese, popcorn, and nuts

Always supervise when your child is eating. Make sure your child sits up in the high chair or other safe place.

How Much Should My Toddler Eat?

Schedule three meals and two or three healthy snacks a day. But expect your toddler to sometimes eat less or skip meals. This can be hard for many parents, but kids should be allowed to respond to their own feelings of hunger and fullness. Toddlers who are full may push food away, close their mouths or turn their heads away from food, use hand gestures, or make sounds to let you know they have had enough. Don't push food on a child who's not hungry.

 

 

Early Brain Development and Health

The early years of a child’s life are very important for later health and development. One of the main reasons is how fast the brain grows starting before birth and continuing into early childhood. Although the brain continues to develop and change into adulthood, the first 8 years can build a foundation for future learning, health and life success.

How well a brain develops depends on many factors in addition to genes, such as:

1. Proper nutrition starting in pregnancy

2. Exposure to toxins or infections

3. The child’s experiences with other people and the world

Nurturing and responsive care for the child’s body and mind is the key to supporting healthy brain development. Positive or negative experiences can add up to shape a child’s development and can have lifelong effects. To nurture their child’s body and mind, parents and caregivers need support and the right resources. The right care for children, starting before birth and continuing through childhood, ensures that the child’s brain grows well and reaches its full potential. 

The importance of early childhood experiences for brain development

Children are born ready to learn, and have many skills to learn over many years. They depend on parents, family members, and other caregivers as their first teachers to develop the right skills to become independent and lead healthy and successful lives. How the brain grows is strongly affected by the child’s experiences with other people and the world. Nurturing care for the mind is critical for brain growth. Children grow and learn best in a safe environment where they are protected from neglect and from extreme or chronic stress with plenty of opportunities to play and explore.

Parents and other caregivers can support healthy brain growth by speaking to, playing with, and caring for their child. Children learn best when parents take turns when talking and playing, and build on their child’s skills and interests. Nurturing a child by understanding their needs and responding sensitively helps to protect children’s brains from stress. Speaking with children and exposing them to books, stories, and songs helps strengthen children’s language and communication, which puts them on a path towards learning and succeeding in school.

Exposure to stress and trauma can have long-term negative consequences for the child’s brain, whereas talking, reading, and playing can stimulate brain growth. Ensuring that parents, caregivers, and early childhood care providers have the resources and skills to provide safe, stable, nurturing, and stimulating care is an important public health goal.

When children are at risk, tracking children’s development and making sure they reach developmental milestones can help ensure that any problems are detected early and children can receive the intervention they may need.

key ways that parents can support their child’s healthy development:

• Responding to children in a predictable way

• Showing warmth and sensitivity

• Having routines and household rules

• Sharing books and talking with children

• Supporting health and safety

• Using appropriate discipline without harshness

A healthy start for the brain

To learn and grow appropriately, a baby’s brain has to be healthy and protected from diseases and other risks. Promoting the development of a healthy brain can start even before pregnancy. For example, a healthy diet and the right nutrients like sufficient folic acid will promote a healthy pregnancy and a healthy nervous system in the growing baby. Vaccinations can protect pregnant women from infections that can harm the brain of the unborn baby.

During pregnancy, the brain can be affected by many types of risks, such as by infectious diseases like Cytomegalovirus  or Zika virus, by exposure to toxins, including from smoking or alcohol, or when pregnant mothers experience stress, trauma, or mental health conditions like depression. Regular health care during pregnancy can help prevent complications, including premature birth, which can affect the baby’s brain. Newborn screening can detect conditions that are potentially dangerous to the child’s brain, like phenylketonuria (PKU). 

Healthy brain growth in infancy continues to depend on the right care and nutrition. Because children’s brains are still growing, they are especially vulnerable to traumatic head injuries, infections, or toxins, such as lead. Childhood vaccines, such as the measles vaccine, can protect children from dangerous complications like swelling of the brain. Ensuring that parents and caregivers have access to healthy foods and places to live and play that are healthy and safe for their child can help them provide more nurturing care.

What does CDC do to support early brain health?

CDC is committed to supporting early brain health through evidence-based programs and partnerships within communities. Below are just a few examples of CDC programs that support early brain health:

• Learn the Signs. Act Early

• Legacy for Children

• Early Hearing Detection and Intervention

• Essentials for Childhood

• Concussion Prevention

• Lead Prevention

• Fetal Alcohol Spectrum Disorder Prevention

• Childhood Immunization

• Treating for Two

• Preconception Care

• Infant and Toddler Nutrition

• Addressing Health Disparities in Early Childhood