1-2 years - Thriving under 5 - Plunket
1 to 2 years
Care of the First Teeth
Baby’s first teeth are important as they help baby to eat and speak properly. They also guide the development of their second teeth. By about one year you can use a small soft bristle toothbrush to brush your child’s teeth. You might like to teach your child to clean his teeth in the morning and before going to bed at night. He will learn how to clean his teeth by copying you brushing your teeth. Your child needs help to clean his teeth until he is able to clean them well. Be very gentle when helping. Only a very small smear of fluoride or junior toothpaste on the toothbrush is needed. Do this for him, as he does not have the skills to only put a little bit on. Children will swallow the toothpaste for a while, before learning to spit it out. Using too much toothpaste or letting your child eat toothpaste can cause white speckles on their developing second teeth. Fluoride helps prevent tooth decay and strengthens their teeth. It is naturally occurring in some water supplies and is added to others. Some areas have no fluoride in the water. Fluoride tablets are not advised for young children even if your water is not fluoridated. Use a fluoride toothpaste when cleaning teeth instead. Natural and added sugars in food and drinks can cause holes in teeth (dental decay) because bacteria in the plaque on teeth use the sugars to make acid which begins to dissolve the surface of the teeth. In between eating, the saliva in the mouth hardens the teeth again. Holes are caused by the amount of sugar children have and also how often they have sugary drinks or food.
Holes can be caused by:
• frequently falling asleep with a bottle of milk or juice in the mouth. This leaves the teeth coated in fruit acids and sugar while they are asleep.
• frequently drinking small amounts of fruit juice or sugary drinks throughout the day. This causes the teeth to be bathed in fruit acids and sugar over a long time.
• eating biscuits, muesli bars, dried fruit and sweets coating their teeth in sticky sugar. Keep these for occasional special treats. Water is the best drink to give children apart from milk. If you want to give fruit juice, dilute it with lots of water (one part juice to 10 parts water). The best time to eat sweet foods is at the end of a meal. Keep snacks between meals sugar-free. Check your child’s teeth regularly. If you notice any brown areas on his teeth you need to see a dentist or dental therapist. It is important to enrol your child at the local dental clinic. It is a free service. Plunket staff or other Well Child Health Providers can tell you how to contact your local dental clinic.
Food and Nutrition
• It is ideal for children to breastfeed until one year old or longer.
• After one year, most children can drink cow’s milk.
• Children need to drink about 3 cups of milk a day (500 – 600mls). Too much milk can reduce how much they eat. Offer milk at the end of meals and water between meals.
• Homogenised (standard) milk is the best type of cow’s milk for them.
• Reduced-fat milk does not have enough fat and fat soluble vitamins for your child’s needs. It is not recommended until 2 years of age.
• Flavoured milks, milo, fruit juice and fizzy drinks are best for treats only, they are high in sugar and can cause holes in your child’s teeth.
• If your child refuses to drink milk out of a cup, he can get calcium and nutrients from cheese, yoghurt, custards, milk on his cereals or calcium enriched milk substitutes (e.g. soy) instead.
• Encourage your child to drink water. If using fruit juice, add plenty of water (i.e. one part juice to 10 parts water). Drink water yourself, as children copy what they see others do.
• Your child may enjoy drinking water or milk from a feeding cup or with a straw.
• Tea and coffee or cola drinks should not be given to children (these drinks reduce how much iron the body absorbs and can make children anaemic).
• Do not give alcohol to children. Their bodies cannot cope with it and it can seriously harm them.
When your child is around 1 year old, try giving him the same food as the rest of the family. Children need to be offered a variety of food for energy and growth, including fruit and vegetables, bread, cereal, legumes, meat, fish or vegetarian foods and dairy products. Children need fat in their diet for energy and growth. Low fat diets do not provide enough fat. High fibre foods such as wholegrain brown bread and bran can prevent your child from getting the goodness from other foods and are best left until at least 2 years old. Offer your child small amounts of a variety of foods and then let him choose what he wants to eat. Try to ignore food left on the plate and tell him you are pleased with what he has eaten. Some toddlers will drink and eat everything they are offered, while others will have firm likes and dislikes. They may now refuse food they used to happily eat. Even the best eaters are fussy at times. You may notice your child does not eat as much as he used to eat. Don’t worry, this is normal behaviour. Healthy children do not starve themselves, they will eat when they are hungry. Growth rates slow down at around 9 months to a year so they do not need as much to eat. Fussy eating can be worrying for parents. Parents are sometimes tempted to offer sugary, fatty, salty foods or more milk, but if they eat too many of these foods, children are less likely to eat healthy, family foods. Parents can also sometimes be tempted to offer food and drinks often. This means their child never gets the chance to get hungry. If snacks and drinks are sweet they may also cause tooth decay. Children are often happier having three small meals and a healthy snack between meals during the day. They have small stomachs and use lots of energy during their busy day. Avoid offering snacks before meals, as a gap without eating may make him hungry and he may eat his meal better. Some examples of healthy snacks are: small sandwiches, yoghurt, cheese, crackers, pieces of fruit. Keep offering him small amounts of the foods he refuses and new food as it may take time for him to try it and learn to like it. Your child may want to start to feed himself. He can do this either with a spoon or his fingers. At first the spoon may be taken to his mouth upside down and empty. He will soon learn how to get the food into his mouth. To help prevent choking on food, avoid small hard foods (e.g. nuts, popcorn) and teach him to sit down when eating and drinking. To prevent your child getting sick, teach him to wash his hands before eating
Many toddlers continue with a daytime sleep until they are three to four years old. Others have outgrown it by 18 months. Sometimes, even if your toddler doesn’t sleep, giving him a rest time can give you both a quiet, peaceful time during the day. Books, toys, a story or music tape may keep him amused.
Your toddler may wake at night needing your care and comfort when he is unwell or teething, but should soon settle back to normal when he is feeling better. Separation anxiety is common again around 18 months of age. This may make him difficult to settle and more clingy. A night light and a calm soothing approach may help him settle. It is common for toddlers to be attached to objects in bed (e.g. teddy, blanket). These can help him feel safe, calm and relaxed for sleep. Ensure the object is safe, not too small or with pieces that can be pulled off and cause choking or so large that they may smother or strangle him. Regular bedtime routines (e.g. bath, story, quiet cuddle, bed) may help your child settle to sleep at night. If your toddler wakes in the night, try not to rush in straight away. He may settle himself back to sleep. When you move your toddler out of his cot you may find he starts coming out of the bedroom. For ideas on managing this see the 2-5 year section on sleep on page 96. Children are not being naughty when they wake at night. If your toddler’s waking is becoming a problem for you, he may need some help to learn about going to sleep. You may want to discuss helpful ideas about sleep with Plunket staff. You may also find books in your library to help with his sleep problem.
The bath can be one of the best play times of the day. Toddlers love playing with lots of things, (e.g. empty drink bottles, plastic cups or jugs, boats and any toys that float or can be filled with water). To avoid drowning, stay with your children when they are in the bath. Watch them while the bath is filling and empty the water as soon as the bath is finished Some children take a strong dislike to the bath. These fears often do not last long. You can help by taking a gentle gradual approach to bathtime. Some parents have found it helpful to stand their toddler in an empty bath and sponge them with warm water. Each night gradually increase the amount of water in the bath. Your toddler may prefer to have a bath or shower with an adult, brother, or sister.
At 15 months, immunisations for MMR (measles, mumps, rubella) and Hib (haemophilus influenza type b vaccine) are given. These immunisations are free to all children and help protect your child against these diseases.
In New Zealand, most people choose to immunise their children. However,outbreaks of diseases like measles, mumps, rubella and whooping cough still occur because not enough people are fully immunised. Having an appointment early in the day so he is not tired, planning a calm day, taking a favourite toy, talking to him calmly and distracting him at the time of the injection may help him cope. The injections can make some children unsettled. Your doctor may recommend giving liquid Paracetamol for this. Check the right dose for your child’s age and weight with your health professional. A relaxing bath can also help if your child is unsettled. Some children may get a rash or fever about 6 – 7 days following the measles injection and it can last for several days.. If you are concerned about your child, contact a doctor. For further information on immunisations refer to the First 6 Weeks section, your Well Child Tamariki Ora Health Book or phone 0800 immune / 0800 466 863
Children are ready to learn to use the toilet at different ages, usually any time between 18 months and 4 years. At about 18 months to 2 years, your toddler may start to notice he has a wet or dirty nappy. Over the coming months he will become aware of the urge to go to the toilet. He may become able to hold on long enough to make it to the toilet in time.
Growing and Learning
As babies grow into toddlers, they become more independent wanting to do things by themselves, in their own way and when they want to. Toddlers often seem to have lots of energy and make a lot of mess as they play,
moving quickly from one thing to another. By 2 years, you can expect your toddler to start to:
• walk and run. Some children start walking before a year, while others don’t walk until 18-months, or older
• begin to climb
• know the names of body parts, (e.g. eyes, nose, ears)
• follow simple requests
• try to touch everything
• at times refuse to do what you ask
• become easily frustrated
• feed himself
• repeat games over and over
• enjoy copying you doing household activities
• learn by playing with things they can push, pull and bang.
Toddlers seem to have so much energy and are constantly on the move. They also have a lot of fun. They develop new skills and learn about the world around them through play. Play teaches them to think and discover how things work (e.g. through touching, feeling, and moving things). Children learn by doing things themselves and by being praised for their efforts. They will often play with things for only a short time and then move on to new things.
Some activities your toddler may enjoy are:
• talking with you. This helps him to learn about ideas, feelings and things around him.
• playing with water at the bench and sink while you prepare meals. It may help to have some things to play with handy, (e.g. plastic cups, spoons, jugs). To keep him safe protect him from the stove and hot taps.
• copying you and helping you around the house and outside (e.g. sweeping, washing dishes at the sink with you). Children learn by doing what they see others doing. It also gives them a feeling of importance and belonging.
• looking at books and reading with you. This encourages him to turn pages, name and point to pictures, and repeat words. You may like to join the public library. They lend a wide range of books for children.
• playing with toys he can push and pull
• toys that can be put inside one another, (e.g. blocks and coloured pegs inside an ice cream container)
• stacking toys and blocks to help him learn balance and building skills
• playing with pots and pans with wooden or plastic spoons
• playing with play dough
• painting and drawing
• climbing and playing in large cardboard boxes
• playing with balls, and other outdoor equipment like buckets and spades
• playing with you, other children and family. This also helps their social skills.
• exploring and trying things for himself
• going out for walks and drives
• dressing up; this encourages his imagination and interaction
• dancing and playing with musical instruments.
Parenting 1 to 2 year olds can be a fun time. Each day your child will learn something new. However, being a parent is not an easy job. It takes a lot of time and patience. It is very normal to feel unable to cope at times. Parents, caregivers and children all have good and bad days. His behaviour may seem worse if either of you are tired, unwell, or you are in a hurry. Every child is a unique and special person and reacts to situations in their own way. Some may become noisy and active, others quiet and less active.
By 2 years, your toddler may be saying and repeating several words, and starting to join words. He will also chat away to himself in his own baby language. First words are usually names of important people (e.g. Mum and Dad), or familiar objects (e.g. cup, ball). He will understand a lot more than he can say. He may be starting to learn colours and shapes. Children who grow up in families hearing two or more languages enjoy learning these languages.
Ideas that may help develop your child’s language include:
• talking about what he is doing, what you are doing and the world around him
• reading stories and talking about the pictures in the book
• repeating words he says
• encouraging him when he says words or tries a new word
• expanding what your toddler has said. For example, if he says “baby cry” you could reply “yes the baby is crying, because she is hungry”.
• talking about shape, size and colour, for example if he says “ball” you could expand it by saying “yes, it is a small blue ball”.
• talking about sounds your toddler can hear, for example the sound of planes. You can talk to your Plunket nurse, other Well Child Health Provider, doctor or a speech language therapist, if you are concerned about your child’s speech or he is not saying any words by 18 months.
By 2 years most toddlers will:
• watch everything going on around them
• notice things at a distance, for example birds and planes
• reach for and pick up small objects with finger and thumb.
By 2 years you can expect your child to:
• listen when people talk
• repeat words, start to join words
• point to pictures
• know several words
• have a name for himself
• like music
• use his voice in a variety of ways to make lots of different sounds
• follow simple directions.
If you are concerned about your child’s hearing or eyesight, talk to your Plunket nurse or other Well Child Health Provider or doctor.
It is very common for toddlers to want to be independent and make choices for themselves that are different to what you want them to do. For example, they may refuse to be dressed, not get into their car seat, not want to leave the park or may run away from you at the shops. It is common for toddlers and preschoolers to have temper tantrums. These often occur because your child cannot say what is upsetting him, is angry, upset or frustrated. Any behaviour, good or bad, that is rewarded with attention is likely to be repeated. For example, a tantrum at the supermarket over a sweet, often stops as soon as the ‘reward’ of a sweet is given. The child then has a tantrum at the next visit until he gets another sweet. He has learned that a tantrum is a very good way of getting what he wants! Children are not deliberately naughty. Remember that frustration and anger are normal human feelings. He needs your support and help to learn how to behave well. You have not ‘failed’ if your child has a tantrum or is not behaving well.
Some of the following ideas may help your parenting. Spending Time Together.
• Children love to be cuddled, played with and talked with.
• He may enjoy helping with simple jobs like taking things to the table. This will teach him skills, make him feel helpful and can also be fun.
• Toddlers are busy, loveable and messy. They don’t stay at one activity for long. Having different activities available can help keep him occupied. Try not to worry about the mess. You could make a game
with him to help clean up.
• If you are busy, taking a break to play with your child will make him happy, then you can go back to what you were doing.
• Reading to your child will give him a quiet calm time, some special time together, and help him learn.
• Sometimes going out or doing something you enjoy can turn a busy or difficult day into fun, e.g. a walk or a trip to the park.
• Play groups can be a great way for your toddler to use some of his energy and play with other children.
Telling your child when you’re pleased with him.
• Telling him when he is being good and encouraging him when he is trying something new will make him happy and more likely to be good and try new things.
• Try to avoid saying “don’t” and “no” as much as possible because your child may focus on behaviour you do not like and is likely to do it again to get your attention.
• Children love attention. Any behaviour that is rewarded with attention is likely to be repeated. Try to notice good behaviour and give positive statements like “well done, I like the way you shared your toy. That was very kind of you.” “You’re being really helpful. Thank you for bringing me your cup.”
• It makes children happy and feel important when they know you love them and enjoy their company.
Comforting him when he is hurt, sad or needing your support.
• You can do this by giving him a quiet cuddle, holding him and talking to him in an understanding way.
Giving your child choices.
• At this age, it is normal for children to say “NO” when asked a question. Giving choices may help your child feel he has some say in decisions and make him less likely to say “no”. For example, instead of saying “would you like an apple?” try “would you like a banana or an apple?” Giving choices helps him feel involved and helps him learn. For example, in the supermarket he may like to choose the blue or yellow soap.
Being prepared to change your day.
• You might need to change the times or ways you do things if he has become over tired, frustrated or bored (e.g. you may decide to alter meal times if he has become too tired to eat).
• If you know you will be out for a long time, taking a small lunch box of food and drink with you and some favourite toys or books is helpful.
• Giving him a sleep or rest so he doesn’t get too tired. You may find he has more tantrums if he is tired.
Setting clear boundaries/family rules.
• It is important for you, as the adult, to be very clear about which behaviour you accept and which you do not. If you have decided that you will not buy your child a sweet each time you go to the shop, then make that clear to the child. Perhaps take something else for him to eat (e.g. a banana or other food item).
• The important thing is for you to have decided what you will do, not letting your child make the decisions by having tantrums.
• Children feel more secure with clear rules, even though they may not like them all.
• Children need to know what is okay and not okay in your family. Clear rules about not hitting, biting or yelling can help.
• The boundaries need to be realistic for his age. Sometimes the behaviour is a normal part of their development or you may be expecting too much from him.
Talking to him in positive clear language.
• Children often cannot understand an adult’s rules. Using words he can understand to explain what you would like him to do, helps him to know how to please you.
• Try telling him what you want him to do rather than what you don’t want him to do (e.g. “Can you give me the book”, rather than “Don’t throw the book” or “Show me how well you can hold my hand when we are in the car park”).
• If you are unhappy with his behaviour, it may help to tell him why you are unhappy and what you want.
Trying to keep calm and in control.
• Using a calm quiet voice is best, even if you feel like yelling.
• If he is doing something you do not like, try not to become stressed and angry with him. If you become angry it can make the situation worse and make you feel less in control.
• Trying to involve your child in your activities as much as possible is helpful. If he feels needed and important, he is much less likely to be demanding.
• Children can sense when you are stressed and become upset. Avoiding rushing him when you are busy, stressed or tired may help.
Avoid smacking because:
• A child learns by copying and may think it is okay to hit others.