Toddler development and milestones: your 22 month old

Have you ever wished that time didn't travel so fast? In the next two months, your toddler will be two years old! Where did the time go? But wait, did you realise that part of 22 month old development and milestones would include a prelude to the terrible twos?

This month, not only will you be discovering new things about your toddler, but also this would be a time of self-discovery for your little one. In this period, he will almost decide on his dominant hand, and he might annoy you by fiddling with his body parts. But there is so much more in store for you and your toddler in his 22 month old development journey.

Also, do not forget that each child is unique and may follow his own timetable. Patience is something every parent needs to learn. But if there are any red flags, visit a doctor right away.

22 Month Old Development and Milestones: Is Your Tot on Track?

Physical Development

Did your toddler grab that toy with his right or his left hand? By now, he's developing a preferred hand! Will he be an artsy left-hander or a logic-loving right-hander? Don't worry too much, though – research has not yet shown any definite differences between right- and left-handers. The future is still wide open, whichever hand he prefers!

Don't worry too much about the other stuff he might be getting up to with his hands. He is discovering it feels nice to rootle around in his diaper, and explore his genitals. And, parents, this goes for girls too! It is completely normal for your little girl to explore down there as well.

It's all part of your child's journey of discovery. If you're in a public place or other people are present, it's easy enough to distract toddlers. Later on, you can explain that this is best left for private moments.

Some children have a full set of teeth at 1 year and 8 months, some are still growing theirs. Some toddlers are continuously asking questions, other toddlers prefer to figure things out for themselves.

At this stage, your child’s median height and weight* should be as follows:

• Boys
  – Height: 86.1 cm (33.9 inches)
  – Weight: 11.7 kg (25.9 lb)
• Girls
  – Height: 84.8 cm (33.4 inches)
  – Weight: 11.5 kg (25.4 lb)

Your child’s head circumference* should be:

• Boys: 48.0 cm (18.9 inches)
• Girls: 46.9 cm (18.5 inches)

Tips:

• Other things your toddler is discovering: building blocks! By now, he could be building towers of up to five blocks all on his own! And what is more fun than letting all those blocks tumble down again?
• He is still a little tornado, moving, dancing, jumping, throwing, making full use of everything his body is able to do! If you help him out, he can even balance on one foot for a little while. He can also throw a small ball overarm now, but make sure it is not too heavy.

When to Talk to Your Doctor:

• If you see your toddler is lethargic or less active than before
• Unable to grip things
• Prefers to walk only on tip toe, rather than having his/her entire feet on the floor
• Inability to use regular household items like spoons and forks by 15 months

Cognitive Development

Your little toddler learns by observing and playing. At this age and stage of toddler development, formal education is still miles away. He's figuring things out the experimental way, and by watching what you do. You can help him by showing how to do things, like how to stack blocks or fit a puzzle together, and by playing with him.

He also loves to touch everything, including putting things into his mouth, to find out how things feel. He uses all his senses in his explorations!

Don't worry if he seems bent on destruction. Letting things fall, throwing them, dropping food and toys on the floor, are all part of discovering how the world works. He doesn't yet realise this could damage things or hurt people. Tell him gently, but be prepared to remind him often!

Tips:

• Another favourite game at this age is putting things into each other, like bowls or filling up baskets and tipping them over. A little wheelie toy with a basket, such as a shopping cart, is perfect for him.
• It's a good idea to have a few different type of toys within easy reach so he can pick the ones he wants. But don't overwhelm him with choice. You can rotate a few toys each week, so he doesn't get bored.
• Start playing more nursery rhymes, or singing in front of him. You could also maybe read a book with him. This will not only engage him but it will also find a place in his memory, and one day, he may be able to identify it.

When to Talk to Your Doctor:

• He has started to understand and respond to things, knowing when you might say no and when to stop. But if you see that your toddler is completely ignoring you, or is not scared of anyone, or shows no interest in listening to anyone... it is best to consult a doctor.

Social and Emotional Development

Play time means mummy time to your little toddler! You are his favourite person to play with, and he can't wait for you to come through that door and get down on the floor with him. He may be curious about other people, but you and daddy are his safe haven.

At this stage of toddler development, his mind is far ahead of his skills. He understands so much more than he is able to let you know! This of course leads to frustration, because he may know what he wants, but he doesn't know how to ask for it yet. Patience is key.

Tips:

• Children thrive on predictability and routine. So regular meal and nap times, as well as morning and night rituals, make them feel secure. They might even surprise you by helping you clear the table after breakfast or getting their tooth brush after dinner!
• This predictability gives them a sense of control over the world, and your adorable little tyke might turn into a little tyrant if you try to change things. This is completely normal. A bit of warning, such as "We're leaving in three minutes," usually sorts out most of these issues.
• By now your child has not learnt to share his things with others, especially someone younger to him. But because he has started to listen to instructions, it is best to start instilling this virtue lovingly. Make them meet more kids of their age so that they start becoming more social.

When to Talk to Your Doctor:

• Your child may be scared of strangers and new people, and that is absolutely normal. Every child develops at different speeds. It is only a cause for worry when he is fearful of you or your spouse, or is not ready to move out of his comfort zone or home.

Speech and Language Development

It's time to start talking, mummy! Your little one's mind is whirling with ideas and pictures, and he wants you to put names to everything. Describing what you see is now becoming a conversation as your toddler points and waves at things.

You could also begin telling him more about the things he points at, by telling him that cars honk or that the stove is hot. This is where opposites and adjectives come in. He is also ready to understand simple processes, such as "First we get the cup, then we pour the milk, then you drink the milk."

Tips:

• The naming of body parts is a favourite game at this stage of toddler development, as well as singing songs and listening to stories. Don't worry if your little one seems to get distracted by the pictures from the story line. His inquisitive mind is busy exploring!

When to Talk to Your Doctor:

• If your child has not started talking in bi-syllables or broken simple words, then it might be a concern. Best to confirm any developmental delays with the doctor.

Health and Nutrition

By now, your little toddler has almost a full set of teeth! But that doesn't mean he can eat everything. Keep paying attention to the size of food, as he might still choke on bigger pieces. Food like candy, nuts, popcorn and lollipops require adult supervision, and grapes should be cut into quarters, not halves, to avoid choking hazards.

Typically, the calorie intake for boys and girls of this age are as follows:

• Boys: 961.3 Kcal/day
• Girls: 943.5 Kcal/day 

To meet their daily nutrition needs, it should be composed of the following:

Protein

At this stage, it's a good idea to introduce your tot to sources of protein such as poultry, seafood, dairy, beans, nuts and seeds, eggs, and tofu. As a guide, keep in mind that one serving equals one to three tablespoons of lean meat, chicken, or fish, four to five tablespoons of dry beans and peas, or one egg (in total 17.5g of protein). Introduce two servings of fish or meat 1/3 the size of your palm. 

Fruits 

Your child needs about 3 cups (100g/cup) of fruits every day. 3 cups of fruit equals 2 of fresh, frozen, or canned fruit, half cup of dried fruit and half of a large apple, cut into small pieces.

Vegetables 

It can be challenging to feed your little one vegetables, but keep on trying! Your child requires 1.5 cups (25g each) of vegetables every day. 1.5 cups of vegetables equals to 1 cup cooked mashed or finely chopped vegetables, 1/4 large tomato and/or 1/4 a medium carrot.

If your child's plate is colourful, you know you're on the right track. Aim to provide a variety of vegetables, including dark green, red and orange, beans and peas, starchy and others, each week. When selecting canned or frozen vegetables, look for options lower in sodium.

Grains 

Grains are an important source of carbohydrates, something your growing child needs plenty of. Introduce up to 3 ounces of grains in your child’s meals. One ounce of grains equals one slice of bread, one cup of ready-to-eat cereal, or half (1/2) cup of cooked pasta or cooked cereal.

Not all grains are equal though. It's a good idea to choose whole grains, such as whole-wheat bread, oatmeal, popcorn, quinoa, or brown or wild rice. Limit refined grains such as white bread, pasta and rice.

Milk/Dairy 

Breastmilk is still a good source of nutrition for your toddler. Your child should drink a minimum of 400-700ml of breastmilk. You can choose to switch it up with milk, cheese or yoghurt.

In summary, here’s what your child needs every day (refer above for what the amounts look like):

• Fruits: 3 cups for boys; 3 cups for girls 
• Vegetables: 1.5 cups for boys; 1.5 cups for girls
• Grains: 3 ounces for boys; 3 ounces for girls
• Proteins: 25g for boys; 25g for girls  
• Milk: 16 to 24 ounces for boys; 16 to 24 ounces for girls
• Water: 1200 ml for boys; 1200 ml for girls

Tips:

• Because your toddler has almost got all his teeth, the chances of decay are higher. It is very important to cultivate good oral hygiene habits and make sure he brushes his teeth once, at least before sleeping at night, if not twice a day.
• At 1 year and 10 months, your toddler would like to imitate more than follow your instructions. So if you want them to eat healthy, eat with them. Or invite kids of his age group with good eating habits and make the group eat meals together. Meal times can be made fun too!
• Your toddler may be fussy about eating, but proper balanced nutrition is very important for his growth. Limit his milk intake to a maximum of two to three times a day, around 200ml per session. Feed him at least one whole fruit a day, otherwise one big cup of mixed fruits like banana, apple, watermelon, pear, orange divided into regular intervals. In a day, limit the processed food intake to one portion – one slice of bread, one biscuit/cracker/cookie.
• Try to avoid excess salt (in packaged food) and additional sugar apart from those in natural food items, as much as possible.

When to Talk to Your Doctor:

• If your toddler has a skin reaction after eating certain food items, or starts coughing/choking/wheezing, then your toddler might be allergic to something. Best to visit a doctor and get him checked. Also notice if your toddler is not able to see clearly, holds screens/books closer while reading or is unable to identify objects from a distance. You may want to visit an ophthalmologist.

Vaccination

Around this time, nearing or completing two years, toddlers are given influenza shots. Speak to your doctor and make sure you do not miss the schedule.

To find out what vaccinations your child should have gotten up to now, and check if this schedule is up-to-date, click here. As of 18 months, these immunisations should have been introduced to your child:

• DTaP – 1st booster: Immunisation against Diphtheria, Pertussis & Tetanus
• IPV – 1st booster: Immunisation against Poliomyelitis
• Hib – 1st booster: Haemophilus influenza type b vaccine
• MMR – 2nd dose: Immunisation against Measles, Mumps & Rubella

Even with a complete vaccination record, your child might still catch colds, the flu and other common illnesses like Hand Foot and Mouth disease. If your child shows signs of severe discomfort, including vomiting, diarrhoea or very high fever (over 38°C/100.4°F), please consult a doctor.

Treating Common Illnesses

Common illnesses that are common for this age group are cold and cough, fever, measles and HFMD. Do read up about hand, foot and mouth disease. Find out what it is, and what you should do in the event your toddler has it. But don't worry, many such common illnesses help to build your child's immunity.

It’s crucial to note here that while some medications can be bought without any prescriptions, your first option of treatment for mild health issues should be simple home remedies.

To manage the three most common medical issues in kids – fever, cough, and cold – try the following:

Fever

Encourage your child to take plenty of rest. You could also apply lukewarm compresses to your child’s forehead, armpits and groin areas to help bring the temperature down. If your child’s temperature rises above 38°C (100.4°F) you should bring him/her to the doctor and follow medical advise to manage your child’s health.

When it comes to treatment of cough and cold, the The U.S. Food and Drug Administration (DFA) does not recommend over-the-counter (OTC) medicines for children younger than 2 years old. It is always advised to seek the opinion of the paediatrician.

Cough

You do not need to feed antibiotics to your child with a cough. Provide your child with extra warm fluids such as water and milk. It is important to help your child stay hydrated. Never use cough medicines or syrup for kids under 6.  Try using ½ to 1 teaspoon (2 to 5 ml) of honey as needed to ease night time coughing.

Cold

Use saline (salt water) nose drops or spray to loosen up the dried mucus. Suction and blow it in repeated intervals until the discharge is clear. As colds usually clears on their own, it helps to be patient. They usually last between one to two weeks. Prop your child's head up with a pillow or folded towel which can help him/her to breathe easier.

It’s also important to teach and encourage your child to practice good hygiene, especially hand-washing which can help prevent the spread of illnesses.

When To See a Doctor

• Your child has difficulties with breathing
• When your child is not eating or drinking, with signs of dehydration (such as decreased urination)
• Your child experiences excessive crankiness or sleepiness
• When your child experiences persistent ear pain
• If your child's cough lasts for more than three weeks

Republished with permission from TheAsianParent Singapore

Source: Toddler Development and Milestones: Your 1 Year and 10 Month Old