The Beginner’s Guide To Taking Care of Your Toddler: 13 to 18 Months

This article was written in collaboration with Professor Daisy Chan, Chairperson, Chapter of Neonatologists.

Developmental Milestones

Developmental milestones are behavioural or physical checkpoints in the toddler’s development as they grow. In general, your toddler should exhibit a variety of behaviours after his/her first birthday:

• Movement/Physical Development - Your toddler should be able to pull himself/herself to stand and stoop down without help. He/she should also be able to walk with assistance from 12 months old and independently by 18 months.
• Cognitive Development - Your toddler should be demonstrating basic learning, thinking and problem-solving skills. He/she could be flipping pages in a book, pushing a toy car or imitating you doing chores.
• Social/Emotional Development - Your toddler should be capable of showing some affection, showing good eye contact with his/her caregivers, taking turns with them in pushing a toy car back and forth, and waving “bye-bye” when leaving. He/she should be interactive and look around occasionally, to check that their trusted caregivers are close by. Your toddler may show anxiety by crying when approached by strangers and there are no trusted caregivers around. Do consult your doctor if your toddler shows no eye contact (looking you in the eye when you are talking), does not look at something that you point to him/her, or appears to be living in his/her own world most of the time.
• Language/Communication Development - Your toddler should be saying “mama”, “papa” and at least one or two other simple words such as “bye”. By 18 months old, your toddler should be able to obey a single-step instruction (such as “bring your cup”), use 10 words meaningfully without echoing an adult, and start to join 2 words together, as in “more milk” or “mama, no”. Your toddler should also be able to point for his needs (for example, point to the cookie tin when he wants to eat).

You are encouraged to assess your child’s development using the Development Checklist within the Child Health Booklet. There is also the convenient option to use the Digital Health Booklet to electronically capture your child’s developmental milestones and immunisation schedule.

Act early and talk to a doctor if your toddler is not able to walk independently, say any meaningful single word or identify his caregivers by 18 months old. If you suspect that your toddler does not obey instructions because he/she cannot hear you, bring your toddler to see a doctor to screen his/her hearing as soon as possible.

The Growing Toddler’s Diet

At this age, your toddler’s digestive system should be mature enough for him/her to eat the same food as you, as long as the food does not contain any added salt and sugar. Here are some ways to help your toddler eat well:

Offer a Balanced Diet Using My Healthy Plate

• Offer a variety of food from the 4 food groups and encourage them to drink water instead of sugar sweetened beverages. This would ensure that your toddler receives the essential nutrients that they need for growth and development.

Foster a Positive Relationship Between Your Toddler With Food

• Offer manageable portions of nutrient-rich food. Even if your toddler does not eat much at times, every mouthful should be packed with as many nutrients as possible.
• Try presenting food in a variety of shapes, colours and textures to sustain your toddler’s interest in trying out different foods.
• Did you know you may need to offer new food as many as 10 times before your toddler expresses a willingness to try the new food? Explore alternatives and reintroduce options along the way. Do not force feed your toddler or use food as a reward.

Parents and Caregivers, Be the Example for Your Child

• Toddlers learn by watching adults, so during meal times, let your toddler wear a bib and place him/her at the dining table with you where he/she can learn to hold a spoon and self-feed by copying you. Do not force-feed your toddler and do not use any screens during meals.
• Your food preferences have an influence over your toddler’s dietary habits as well. So, remember to start forming the habit of eating healthily as early as possible with your toddler and avoid processed foods and sweetened drinks.

Read more about providing the nutrition your toddler needs.

You can also check out this guide to early childhood nutrition and recommended portions for toddlers.

Physical Play for Healthier Toddlers

Physical activity helps your toddler develop motor skills, build stronger bones and muscles, learn social and communication skills, and achieve a healthy weight. A toddler who is physically active will likely mature to be an active adult and continue leading a healthy lifestyle¹.

As soon as your toddler is mobile (e.g. crawling, walking with or without assistance), he/she is ready to have at least 180 minutes of structured and unstructured physical activity spread throughout the day in a safe, supervised environment. Where possible, engage in daily outdoor play and allow your toddler to also engage in social play and interact with other toddlers early while being active.

Provide your toddler opportunities for free movement and floor play at home:

• Refrain from keeping your toddler restrained for more than an hour at a time
• Provide your toddler with a variety of safe and age-appropriate toys to practice grasping. Examples are 2.5cm wooden/plastic blocks which your toddler can bang together or stack 2 blocks high or replace pieces into a shape-sorter.
• Place toys on the floor around your toddler to encourage crawling and reaching

Do not be afraid to experiment and allow your toddler to explore active movement in different settings as well. Encourage your toddler to:

• Experiment with different equipment at the playground with supervision
• Engage in sensory play in outdoor settings – be it playing with sand, picking up leaves or twigs, or playing with water at a shallow pool with supervision
  
• Walk on different surfaces such as sand or grass to develop their balance
• Respond to music and movement by clapping, dancing, or singing

Check out these activity ideas to get your toddler moving.

Plan for family trips to the playground, the pool or the park. Not only does this introduce the different types of physical activities for your toddler’s development but it also facilitates bonding.

Keeping Toddlers Clean and Healthy

Young toddlers can be vulnerable to infections. Besides maintaining a safe, clean and healthy environment, cultivating good personal hygiene is also vital for their well-being.

The handwashing habit should be introduced into day-to-day activities as early as possible. Your toddler should be washing his hands often enough – before meals, after sneezing, after a trip to the washroom or after an outdoor play. Parents and caregivers, set a good example by demonstrating such personal hygiene habits too.

Read about the importance of clean hands for toddlers.

Equip your toddler with toothbrushing skills and share with them the importance of teeth cleaning early. Schedule your toddler’s first oral assessment six months later from the first tooth, at about one year old.

Watch this video to learn how to brush a toddler’s teeth.

Managing Your Toddler’s Increasing Independence

Gaining independence is a natural and important part of growing up and self-discovery. You may feel sad to find that your toddler is no longer asking you for help, but take great pride and joy in watching your toddler gain confidence and achieve things on his/her own.

Provide your toddler with a safe environment to master new skills and build self-esteem. As your toddler increasingly seeks autonomy in making decisions, you will also need to introduce reasonable boundaries and start teaching them what is acceptable and unacceptable. Do not introduce screen time as a way to manage your toddler’s behaviour. It is also important that your toddler does not engage in a behavioural tantrum, just to gain access to your screen-device, such as a phone app or electronic tablet.

You can pick up simple and practical strategies to manage your toddler's behaviour by signing up for the Triple P (Positive Parenting Programme) Online programme offered by the Ministry of Social and Family Development.

Giving Your Toddler a Good Head Start in Life

As your child enters the toddler stage of life, he/she will become more active and increasingly independent. This could be a new challenge for some of you. Just as you are figuring out how best to manage your toddler, he/she is exploring the world and discovering his personality and interests as well. Find joy in the milestones, both big and small along this once in a lifetime journey. Remember, you are your child’s first influencer. During this period of tremendous growth, give your toddler a good head start in life by inculcating the right values and introducing healthy lifestyle habits.

Visit Parent Hub for more useful tips and guides to give your child a healthy start.

The article has been endorsed by the following representatives, listed in alphabetical order by institutions: A/Prof Tan Lay Kok (Obstetrics & Gynaecology, KK Women's and Children's Hospital), Dr Moira Chia Suyin (Consultant, Department of Paediatrics, KK Women’s and Children’s Hospital), Ms Adeline Kooh Seok Koon (Asst Director, Nursing (Maternity), Mount Alvernia Hospital), Dr Angelia Chua (Family Physician Consultant, National Healthcare Group Polyclinics), Prof Lee Yung Seng (Group Director, Paediatrics, National University Hospital), Ms Susan Kok (Senior Asst Director, Nursing, Gleneagles Hospital, Parkway Pantai Group), Ms Helen Cruz Espina (Senior Lactation Consultant, Raffles Hospital Pte Ltd), A/Prof Yong Tze Tein (Head & Senior Consultant, O&G, Singapore General Hospital), Ms Fonnie Lo (Asst Director, ParentCraft Centre (Clinical) and Lactation Consultant, Thomson Medical Pte. Ltd).

Reference

1. Singapore Integrated 24-Hour Activity Guidelines for children under seven years launched. KK Women’s and Children’s Hospital. https://www.kkh.com.sg/news/announcements/singapore-integrated-24-hour-activity-guidelines-for-children-under-seven-years-launched