Teething, tantrums & diarrhoea: toddler issues tackled

Our health visitor answers all of your toddler health queries, from eczema to teething

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1) Will teething ever end?

Q. My baby’s really grizzly at the moment, and he’s constantly dribbling and biting his fingers. I know he’s teething, but when will it all end?

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A. Most babies get their first teeth around 6 months, although some are earlier. A baby’s bottom two front teeth usually come through first followed by the top two, with the next incisors either side following.

At around 12-14 months the first molars arrive, followed by the canines at 16-18 months, and finally the second molars at 18-30 months. The whole process is generally complete by the time your child is 2 to 3 years old.

Once teeth start coming through, begin using a pea-sized smear of children’s fluorinated toothpaste on the tooth. If the gum is tender, use a clean flannel to gently clean the tooth. Toothpaste should be the last thing on your tots teeth at night.

Teething can be painful and offering cooled teething rings, carrots or cucumbers can relieve sore gums. Baby paracetemol or ibuprofen will help ease the pain and inflammation.

2) My toddler holds her breath during tantrums

Q. My 2 year old has started holding her breath when she’s cross. Sometimes she goes pale and nearly passes out and it really scares me. Help!

A. Breath holding is common in toddlers – it’s one way of your toddler showing her frustration with you. However, it’s very distressing, especially if she does to the extent that she goes pale. Some toddlers even twitch and appear to fit.

However dramatic the consequences appear, the best approach is to treat it the same way as all tantrums, and ignore the behaviour. The less attention given, the less likely it is to be repeated.

Instead, have a think about what generally precedes an episode. Is she tired or hungry? Is there a certain trigger for tantrums in general? When episodes occur, make sure she’s safe, get her to lay flat (preventing accidents from falling) keep a safe distance, and ignore her as much as you can.

When the event has passed make little comment and move on. Remember to notice all the good behaviour she shows and give lots of attention for that too.

3) Toddler Diarrhoea

Q.Our GP’s diagnosed my daughter as having ‘toddler diarrhoea’. What can we do to help her?

A. Toddler diarrhoea is when children pass between three and 10 watery stools a day, often containing undigested foods such as sweetcorn or carrots, even though they’re not otherwise ill. They may suffer from tummy cramps, too. As children grow, the condition improves, and it seems to have no lasting impact. Dietary changes can help. Think in terms of the ‘three Fs’:

  • Fats – Unlike adults, children need their diet to contain around 35-40% saturated fat and those who consume less than this amount are often found to suffer from toddler diarrhoea. Ensure they’re offered full-fat milk, yogurt and dairy products as part of most meals.
  • Fluids and fruit juices – The high sugar levels in fruit drinks interfere with water absorption in the bowel, contributing to symptoms. Try to stick to water and full-fat milk for children’s drinks.
  • Fibre – This helps absorb water from the bowel, acting like blotting paper. Aim to give your child five portions of fruit and vegetables a day. See our website for some delicious ideas.

4) How do I deal with eczema?

Q: My 15 month old has been diagnosed with eczema. What can I do to keep her skin hydrated and infections at bay?

A: Eczema is a red, itchy skin rash that’s common in babies and toddlers. Having a dry skin type, changes in temperature and the chemicals in some soaps and detergents can cause it to flare up.

Let your little one soak in the bath twice a day for around 10 minutes and add a capful of bath oil that’s suitable for sensitive skin. This will help keep the skin clean and free from crusts that can lead to infection and stop it drying out too.

The water temperature should be coolish and the bathroom warm. Use a mild cleanser to bathe your little one, but wash her hair separately after bathtime to reduce irritation. Pat your tot’s skin dry and apply a good dollop of moisturiser or emollient cream that helps seal in the body’s own moisture.

5) Is she overweight?

Q. I am worried that my 2 year old is too heavy. She loves her food and milk, but I now notice that clothes for her age are much too small.

A. Probably the best place to start is by having your child weighed and measured at your local clinic.

That will help you and your health visitor decide if there is a problem.

If your child is overweight, the problem will need to be addressed – but that can be done, and done as a family. It will mean looking at lifestyle changes for you all. Exercising is a fun place to start for toddlers. Increase her family trips to the park, bike rides, swimming sessions and walks to the shop.

Replacing sugary snacks and fast food with healthy options should start to make a difference. Introduce more fruits, pitta breads, cheese and fruitcakes instead.

And examine her milk intake too. From 1 year, 500-600ml (a pint) a day is all she needs. This figure includes dairy products like yoghurts.

6) Does my child have a hearing problem?

Q. My 3 year old doesn’t always respond when we talk to her. She passed her newborn hearing test, but could there now be a problem?

A. It’s possible, and definitely worth pursuing. Passing the test that newborns have indicates your child had a range of hearing at birth. However, illness, trauma, medicines or the onset of evolving impairment can impact negatively on hearing. (For example, glue ear, where the middle ear fills with fluid that looks like glue, is common.)

In these situations you may start to notice that speech development is slower than expected, or that it starts well but then doesn’t progress. Hearing can also vary at times, so your child may have periods when she seems to ignore you or needs good eye contact before she appears to understand what’s being said.

A simple hearing test arranged via your health visitor or doctor will help her on the road to getting any problems sorted in time for her to start school in the best possible health.

7) Eczema worries

Q. Our 15 month old has been diagnosed with eczema. Any tips for how and when to bath her?

A. Frequent baths keep skin clean and free from crusts that can lead to infection – two 10 minute baths a day is ideal if possible. Always add a suitable oil to the water to stop skin drying out. The bathroom should be warm and the water coolish, to avoid sudden temperature changes that may make her itch.

Wash your little one with an aqueous cream. If applying to infected skin put some onto a saucer to avoid contaminating the container. Use a freshly washed flannel each time as sponges can retain bugs. Pat her dry to retain the moisture.

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You can wash a small baby’s scalp with aqueous cream, but older children need their hair washed separately after a bath, to lessen irritation from shampoo.

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