$Unique_ID{PAR00220} $Pretitle{} $Title{1 Year to 2 1/2 Years: Daily Care Basics} $Subtitle{} $Author{ Editors of Consumer Guide Mendelson, Robert A Mendelson, Lottie M Meyerhoff, Michael K Ames, Louise Bates} $Subject{1 Year to 2 1/2 Years Daily Care toilet training toddler toddlers bowel control bladder autonomy independence bathtub bath tub bathe bathing showering mess messy clean cleaning hygiene wash washing laundry detergent irritated skin irritation teething nap naps bedtime crib climbing separation anxiety nightmares night terrors exercise chores DENTAL HYGIENE teeth toothbrush toothpaste} $Log{ A toddler's constant activity almost always provides enough exercise*0060101.tif Toddlers are busy all the time--exploring, probing, and playing*0053101.tif} The New Parents' Question & Answer Book 1 Year to 2 1/2 Years: Daily Care Basics Is it too early to start toilet training my toddler? Starting toilet training prior to the end of this period generally is not a good idea. Although the essential physiological requirement--that the toddler be able to control her bowel and bladder muscles--is usually fulfilled by two years of age, there are many other important parts to the process. A toddler must be able to recognize and communicate her needs effectively. She must also be able to handle unbuttoning, untying, or otherwise removing her clothing efficiently. In addition, she must be able to understand and carry out certain hygienic procedures like washing her hands. Even if a toddler is capable of all of the above by two years of age or so, there is a good chance that she still will be in her negativistic phase. Since toilet training requires that she comply with instructions and accede to requests, trying to start the process during this phase can cause nothing but trouble. Starting toilet training too soon can cause disappointment and frustration in parents, and fear and loss of self-esteem in toddlers. It may also delay the time at which a toddler actually starts using the toilet independently. Therefore, it is suggested that parents be as patient as possible and wait until later when their child will be considerably more cooperative, will have greater physical and mental capacities, and will be extremely interested in imitating grown-up behavior (see the "Daily Care Basics" section in the following age group for a list of signs that indicate when a child is ready to begin toilet training). My two and a half year old refuses to let me wash her hands. Although she gets them fairly clean herself, I worry about germs. Should I keep trying to wash them for her? Of course she'd rather do it herself. It's normal for her to demand some autonomy and prefer to wash without you. There will be many such occasions when, as a parent, it will be easier, quicker, and more efficient to do something for your toddler rather than to encourage her to do it herself. You should try, however, to refrain from taking over the task yourself whenever possible. Your toddler won't learn how to wash her own hands unless she has opportunities to try it herself. She needs practice to develop skills in all areas. This is also how she practices independence and develops autonomy. Encourage her to do her best hand washing before meals, and then, don't worry about it. Praise her when she does a good job. If you're not thrilled with the job she's doing, suggest that you wash each others hands together so she can learn from you. You might also present her with her very own nail brush to see if this helps her to stay at the task longer and do a more thorough job. On occasion, you might even suggest that she give her dolls or toys a bath in the sink (under your supervision); this is likely to get both her toys and her hands clean. Do I still need to hold my toddler when she's in the bathtub? Toddlers always need to be watched while they're in the tub. While some still need a hand on them, others can manage well without. You definitely need to be close enough to grab her if she should stand up or slip so that you can prevent her from falling or having her face go under the water. No-slip rubber mats can make it easier for her to keep her balance but you'll still need to wash her and supervise her in the bathtub for some time. You'll also need to continue to be careful about the temperature and the height of the water in the tub. A couple inches of water is enough. The water should feel pleasantly warm to the sensitive skin on the inner point of your elbow. All water heaters should be turned down to 120 degrees Fahrenheit. Cold water should be turned off last, and all faucets should be covered. For your own comfort, find a position that allows you to keep your eyes and a hand on your toddler without putting too much strain on your body. Kneeling next to the tub and having both hands free for washing and playing is ideal if the bathtub isn't too large or too tall. Some parents sit on a small stool or low chair to make it easier on their knees. Experiment to find the position that works best for you. My toddler loves her bath and would play for hours if I let her. How frequently should I bathe her and how long is long enough? Playing in the tub can be fun for a toddler, but it can also be very drying to her skin. Ten to 15 minutes is a nice long bath and, depending on how dry her skin is, less time is probably better. You'll want to limit baths to two or three times a week. On days when you don't bathe her, use a wet washcloth to clean her face, hands, diaper area, and any other areas that need it. When bathing her, avoid using bubble baths or similar products since they can be irritating to your toddler's skin and can sometimes cause vaginal or urinary tract infections in little girls. Since soap left on the skin can cause irritation and additional drying, it's preferable to avoid letting children sit in soapy water for any length of time. For the same reason, showering instead of bathing children is preferable whenever practical because it helps to remove soap residue. Rubber shower heads that fit onto the tub faucet are especially helpful for rinsing off soap and for washing and rinsing hair. My toddler used to love baths, but now all of a sudden she seems to be afraid of the water. What happened, and how can I get her to enjoy her bath again? Sometimes getting soap or shampoo in the eyes or inhaling water can be traumatic enough to turn a toddler off to bathing. Likewise, slipping and getting her head under water can also make a toddler fearful of a bath. While you'd probably be aware if one of these unpleasant experiences occurred, your toddler may not have reacted very much at the time. Another possibility is that the bathwater was a little too warm or cool for her last time. To make bathing more pleasant, take special care when testing her bathwater. It should feel warm to your wrist or elbow, but probably cooler than you'd prefer for your own bath. Put just a couple of inches of water in the tub; less water may be more comforting. Give her a favorite toy and encourage some playtime before you wash her. Keep your hands on her if she's truly afraid, and talk to her throughout the process. You might try playing a naming game by pointing to her nose, ears, eyes, belly button, and tummy and allowing her to name them first if she can. Let her try doing some of the washing, too. You might also try bathing or showering with her. Be sure to get into the tub or shower first and then lift her in. When it's time to get out, either hand her to a helper for drying or lift her out onto a towel first and then get yourself out. If your toddler won't even go near the bathtub, she may still be small enough to fit into the sink. If so, you can try bathing her there until she gets over her fright. My toddler always looks a mess. I give her a bath every evening, but how can I keep her clean during the day? Being a toddler and learning new skills is a messy business. Toddlers have to run, fall, climb, roll, crawl, put everything into their mouths, and wipe their dirty or sticky hands on their clothes. Eating is messy too. A successful meal is one in which she gets at least some of the meal into her mouth while the rest goes on the floor, on her face, on her clothes, and in her hair. Therefore, you shouldn't be overly concerned about her looking squeaky clean all the time. You're very likely to drive yourself up the wall if you do. Of course, you'll want to wash her hands and face before and after meals and before bedtime for hygiene purposes and to prevent her from putting her sticky fingers everywhere. Giving her a daily bath is not recommended, however, since it can be very drying to her skin. If you feel you must bathe her daily, make it a brief bath and use as little soap as possible. Remember, it's her job to explore, touch, play, and learn--not to keep clean. Should I still wash my toddler's clothing separately from the rest of the family's wash? Baby clothing is washed separately and double rinsed to help prevent irritation of the baby's more sensitive skin. The detergent used for the family wash is generally stronger and, therefore, more likely to have an irritative effect than the pure mild soap used to wash baby clothing. Although your toddler's skin is still susceptible to irritation, it's no longer necessary to wash her clothes separately. There are some fabric softeners that may bother her, but even that's less likely now. However, you'll probably still want to continue washing her diapers separately for aesthetic reasons and because they still need to be washed in hot water and double rinsed. How can I make my teething toddler more comfortable? To make your teething toddler more comfortable, you can offer her cool liquids to drink and crackers or teething biscuits to gnaw on. Sucking on a pacifier, especially the one-piece variety that can be refrigerated or frozen, may also bring some relief. Some professionals recommend rubbing ice on the toddler's gums as a temporary pain reliever, but do this only if your toddler is willing. If your pediatrician agrees, you might also try to relieve teething pain by giving your toddler an appropriate amount of acetaminophen. While teething can make your toddler uncomfortable and cranky, it will not make her ill. She may develop a low-grade fever of up to 100.4 degrees Fahrenheit the day or two before a tooth erupts, but her temperature will return to normal after the tooth erupts. Should I insist that my two year old take a nap? Most two year olds still need a nap (or even two) every day. Some toddlers skip them from time to time or prefer to go without, but not many. Chances are, when your toddler is tired, she will take her blanket and head for her bed, tell you that she wants a nap, or simply stop what she's doing and fall asleep. In such cases, you should let her nap. If, on the other hand, she's happily and busily playing, you can probably let her skip the nap. If you find that she's unbearably cranky for the rest of the day, that she is so tired later on that she can't fall to sleep for the night, or that you simply need some quiet time for yourself, you could try to encourage her to take a nap the next time. If she's not sleepy, you could encourage some quiet playtime--with or without you--instead. My toddler has been taking long naps, then I have trouble getting her to go to sleep at night. Is it okay to wake her from her naps or cut out one nap altogether? It's definitely wise to experiment with shortening or skipping one or both nap times if you're having trouble getting her to sleep on time at night or getting her to sleep through the night. The problem is that, at this age, little ones will be cranky if they're not getting enough rest. What's more, if she's truly sleepy, she'll fall to sleep no matter how you try to keep her awake. If you find that shortening or dropping a nap makes her too cranky, there's another strategy you could try. When it's time for her to go to bed for the night, put her in her crib, bed, or room, and allow her to play quietly until she falls asleep. If you try this approach, however, you will have to emphasize to her that once you put her to bed at night, she's to stay there until morning, whether she spends the whole time sleeping or not. How can I get my toddler to settle down before bedtime? It's hard, and sometimes nearly impossible, to keep a toddler from running, jumping, giggling and otherwise expending energy. To help your toddler settle down for the night, however, you'll have to give it your best shot. Be sure to avoid any rough-and-tumble play for an hour or more before your toddler's usual bedtime. Instead, set up and follow a bedtime ritual. This ritual can include giving your toddler a snack, a cup of milk, or a bottle (for a young toddler); brushing her teeth; giving her a bath (two or three times a week, not every night); changing her diaper, and getting her into her pajamas. Do your best to keep any and all of these steps from becoming battles. To top off the nightly ritual, read her a book, tell her a story, sing her a lullaby, and/or say prayers together. When you're finished, tuck her in and kiss her good night. She may not fall asleep right away, but be sure she stays in her bed. To help her drift off to sleep once you have left the room, you might wind up a music box or musical toy that plays soothing music. Whatever the bedtime ritual, try to stick to it whenever possible. My toddler has been climbing out of her crib at night. Now what do I do? First, check to see if you are keeping anything in the crib that she has been using as a stepping stool to make climbing out easier. If she is clearly climbing out on her own, try adjusting the mattress to its lowest level. If it's already at its lowest level, there are a few choices. If it's clear that your toddler can get in and out of her crib without hurting herself, you may be able to let her sleep in it for now. Be sure to leave the crib rail down, however, and put padding or carpeting on the floor at the side of the crib where she gets out. If you think there's still a chance she could fall as she's climbing out, you can move the crib mattress to the floor and let her sleep there. Junior beds are nice but not really necessary. While a junior bed with a rail may help define the sleeping area and keep her from rolling off the bed, it won't be enough to actually keep her in the bed if she wants out. A regular mattress, with or without a frame, that is low to the floor will do just as well. Keep in mind that a toddler who is no longer confined in her crib is capable of getting up in the middle of the night and roaming about the house unsupervised. So if she no longer stays in her crib, make sure that she cannot expose herself to harm (see the following question), and make sure that her room is and continues to remain safe for her even when you're not in there with her. By the way, some parents move their toddler out of the crib and into a bed as soon as another baby comes along and needs the crib. Although this practice may be economical, it is not advisable--a toddler should not have to make this move before she's ready. Buy, rent, or borrow another crib for the new little one, instead. I'm afraid my toddler will roam around the house while I'm sleeping. What can I do? Safety remains the most important factor. A toddler is still too young to be roaming freely about the house while her parents are sleeping. If she can climb out of her crib, you will have to keep her from hurting herself. What you do will depend in part on the layout of your home and the abilities of your child. You can keep her in her room by putting a safety gate at her door or by using a piece of flexible material (like a stocking) to attach the doorknob to the doorjamb so she can't leave her room but can call out if she needs you. Another possibility is to use a commercial safety net that attaches to the top of the crib and prevents her from getting out. Some professionals fear that such devices make the crib or room seem like a prison, however, and others worry that they can be hazardous in an emergency. (If you do use such a device, you might want to use a room monitor so you can hear her if she should become ill). Alternately, you could close off all areas that you don't want your toddler to enter at night. For rooms such as the bathroom, you can use high hook latches on the doors to keep your toddler out without inconveniencing the rest of the family. Hallway safety gates can prevent her from entering open areas. Safety gates should remain in place at stairways, and all doors leading outside should be securely locked. In addition, you need to teach her that nighttime is for sleeping and that her bed is where she sleeps. When you put her in her room for the night, tell her you expect her to stay there until morning--whether she sleeps or not. If she wanders out to you at night, send her back, or if you have to, take her hand and lead her back. Carrying her, making a big fuss, or allowing her to stay with you reinforces her determination to seek attention at night. My toddler had been sleeping through the night for many months, but recently she has begun waking up and crying in the middle of the night. I can't find anything wrong, but it can take as long as an hour to get her back to sleep. How should I handle this? Sometimes toddlers experience separation anxiety; they need to check and see if you're really there. They can also have nightmares or night terrors that cause them to be anxious and frightened when they wake up alone. These unhappy awakenings will eventually stop. In the meantime, however, for your own well-being as well as your toddler's, you need to shorten the amount of time you spend with her when she does wake up, especially if these awakenings occur every night. The next time she wakes up crying, comfort her and make certain that there's nothing bothering her physically (such as a wet or dirty diaper, a cold room, or an empty stomach). Be sure there's a night-light in her room and that any transitional object (such as a favorite toy or blanket) is within her reach. If she awakens again, go to her but don't pick her up; leave her in her crib as you pat her and tell her that everyone else is sleeping. If she continues to wake you up, comfort her from the doorway of her room; let her see you, and tell her that everything is fine but that it's time for sleeping. Finally, if it continues, just call to her from your room and reassure her that everything is alright. Eventually she will learn that while you love her and care about her, it's time for sleeping. Don't give up, and by all means, don't bring her back to your bed with you; once you do, she'll demand such treatment in the future. How can I be sure that my toddler is getting enough exercise? Toddlers usually wear themselves out with their running, jumping, exploring, probing, walking, and playing. They're busy all the time, and this constant activity almost always provides enough exercise. There are, of course, exercise classes that you can join with your toddler. Such classes can be a healthy and enjoyable diversion for both you and your toddler and can give you a chance to socialize with other parents. Still, these formal classes are by no means necessary for proper development or even for physical fitness. You and your toddler can get plenty of exercise by playing "hide-and-seek" or "follow-the-leader," by taking walks, and by chasing each other around the yard or park. As long as your child is growing and developing normally and sleeping well, she's probably getting enough exercise. If you are worried about her weight, stature, or development, however, consult your pediatrician. I try to take care of household chores when my toddler is napping, but sometimes I can't fit them all in. How can I involve her in my chores or otherwise keep her occupied while I get my work done? First of all, if the remaining chores involve the use of hazardous materials, tools, or appliances, you should use a playpen or a play area closed off with a gate to keep your toddler out of harm's way. You can keep a couple of special toys on the side to be used in just such situations. Be sure to praise her for her cooperation and to give her some special one-to-one interaction time with you when you're done. If your chores do not pose a hazard to your toddler, then you should give her some choices of ways to keep herself occupied. She can either play nearby or she can help you. Toddlers like to feel helpful. Keep in mind, however, that while her skills and concentration will be increasing dramatically during this period, she still has a relatively short attention span and is still easily frustrated. So, offer her simple tasks. Ask her to bring the dirty cups from the table over to the sink so that you can wash them or to bring her blanket over so that you can put it into the hamper. If you're going to vacuum, encourage her to get her toy vacuum and "help" you. If you'll be dusting, give her a small dust rag, too, so that she can join in. When you put dishes away, let her put the spoons away. If you need to set the table, let her put the napkins out. And, if you're baking, let her help put ingredients in the bowl or let her have her own piece of dough to make a miniature cookie, cake, or pie (be careful to keep her away from the oven, however). I dread taking my two year old to her grandparents' home because I constantly have to hold her and keep her from touching things. What can I do in this situation? One solution would be to invite her grandparents over to your home instead. If it's not always feasible, you might consider discussing your baby's needs and your parenting philosophy with your parents. Ask them if they'd mind removing some "untouchables" and safety proofing at least one room with your guidance. Remind them that toddlers need a play area or at least a small room where they can touch things without hurting themselves or anything else. Chances are, her grandparents will be more than willing to help make their granddaughter's visits enjoyable and safe. Another option is to plan very short visits and carry along a portable playpen or a bag of special toys. Some grandparents have special toys and things for their grandchild to play with. These are kept at the grandparents' house and brought out for her when she visits. When your little one becomes bored with her special toys or with her playpen and wants to explore, go for a family walk or take her out in her stroller. When you run out of comfortable time, take her home. DENTAL HYGIENE Your toddler's teeth need to be cleaned at least twice a day, especially after meals. For a young toddler, you may continue to use gauze wrapped around your finger to wipe her teeth and gumline. Once she's willing, however, you should introduce a small, soft toothbrush (with or without a small amount of toothpaste). Gently brush her teeth using an up-and-down motion. After brushing, floss her teeth by gently sliding the dental floss along the side of each tooth, massaging slightly down and a little bit under the tooth. Let her watch you as you brush your teeth, and be sure to give her a chance to try brushing her own teeth, too. Increasingly during this period, she will want to imitate you and attempt to do some things herself. Although you'll still need to make sure you get her teeth clean, allowing her to try brushing can help her get into the habit of taking good care of her teeth. Most pediatric dentists suggest that children have their initial visit at age two or three. It is best to make the first appointment once all 20 of the deciduous (baby) teeth have erupted. Of course, if you have a concern or see a problem before then, consult your pediatrician and/or pediatric dentist.