Toddler development Q&As with our health visitor

Potty training, talking and food problems – our health visitor answers your development worries…

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Q: I’m worried about my toddler’s speech – he’s 2 ½ and mainly communicates through nodding and pointing and lets his brothers talk on his behalf. What should I do about it?

A: At 2 years old, most toddlers have around 50 single words and can link two words together. They can also generally follow simple commands, such as ‘Find your shoes’ and ‘Put the toy back’. As your toddler has found a way to make his wishes clear by pointing and nodding it looks like he does understand, which is important as it helps him with the next stage of telling people what he wants. Although it’s great that he has such helpful brothers, they can interrupt his need and motivation to speak for himself, so this will need tackling. You could try taking him to playgroups and activities without his brothers, giving him the opportunity to play and interact by himself. Give him your full attention when chattering together, making it easy for him by using simple language and keeping sentences short.

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Q: Our 3 year old has been stammering for months and it’s not getting better. How can I help him?

A: When learning to talk, it’s not unusual for a child to struggle as he gets to grips with new vocabulary. It should pass, so when it’s been around for a few months or there’s a family history of stammering, it’s important that your son sees a speech therapist, who can advise you on what to do. Have a chat with your doctor or health visitor first. In the meantime, some of the following may help:

  • Give him your full attention when he’s talking, and make eye contact.
  • Avoid getting him to repeat words, slow down, or say them properly, as he’s worked hard enough to say them already.
  • Slow down your own speech. Take a second before you reply to him, which will show him how to have relaxed conversation.
  • Keep daily life as rush-free as possible. Children who stammer respond well to regular routines and predictability at home and nursery.

Q. Since she was unwell for a few days, my little one has been refusing milk drinks and is very fussy with her food. How can I get her back to normal eating?

A. It’s not unusual for feeding patterns to change even after your toddler has got over an illness. Sometimes it just takes time for her to regain her appetite and feel herself again. Try offering smaller, more regular, amounts of food, as this can be less daunting. But if she eats a restricted diet for a while it won’t do any harm, so try not to worry.

Offer her normal milky drinks, but as it’s important to keep drinking fluids, let her have water too, if she prefers. If you haven’t already started, give her drinks in beakers and cups, as that might encourage her to try again.

Also give her a daily vitamin supplement of vitamin A, for healthy eyesight and skin, C, for muscles, body tissue and skin healing and D, for healthy bones, to keep her on track.

Q: My toddler started off well with potty training, but now won’t poo. He ends up constipated and crying so I put his nappy back on. Help!

A: Lots of toddlers go through a phase where they’re reluctant to poo, leading to a cycle of constipation and painful bowel movements. As with most things, your tot needs a calm, reassuring approach. Start by giving him plenty of fibre in his diet by leaving skins on fruit and veggies, choosing wholemeal products and offering him plenty of drinks. Keep him busy and active too, as exercise stimulates the bowel. This should ease his constipation, which will help him get over his fear of pain when he does a poo.

It’s fine to put a nappy on him at first. The next step is to get him to sit on the toilet with his nappy on while he does a poo. Then try cutting a whole in the nappy, before moving on to sitting on the loo with no nappy. Gentle rocking back and forward can help, so sing “Row, row, row the boat” or pop a book under his feet to bring his knees up. It’ll take time, but he’ll get there.

Q: Do you have any tips on potty training when you’re out and about? I’m about to start but not sure how I’ll cope.

A: As with potty training at home, accidents will happen, probably when you’re out at the shops or park where there are distractions. The same rules apply – ignoring slip-ups and being positive when your tot gets it right.

Be prepared and carry spare clothes and wipes to keep your little one clean and dry, and also bring a bag to pop wet clothes in. Carry a portable potty, letting your child know you have it with you, and how it works. But don’t be shy to use it wherever you are if he needs to go quickly, although regular loo breaks may help prevent you having to whip the potty out in the street. For car journeys, place a protective liner in your child’s car seat, it’ll be quicker to clear up little accidents.

Q: When should my toddler be out of nappies at night time?

A: Most toddlers become dry at night between 18 months and 3 years. Night-time dryness usually follows sometime before his fifth birthday, but this can vary. The best way to tackle the transition from night-time nappies is to wait until your little one’s confidently dry during the day, happily using the toilet and his early morning nappy is dry at least four times a week.

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Other signs that he’s ready to move to pants are if he’s waking up early because he needs a wee or you notice him having an early morning wee in his nappy. If the timing’s right then buy a waterproof cover or your child’s bed and see how he gets on. If he’s still in nappies at 5, have a chat with the school nurse who can offer support in the enuresis (bedwetting) clinic.

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