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Toddler Health
Health
Sleep and teeth problems can cause as much disruption in the toddler years as the baby ones, but at least now your toddler is easier to comfort.
Teething
The first molars, which usually come through at 12–15 months, and the second molars, which appear towards the end of the second year, are big teeth. They are often slow to come through, too, so may cause your child some pain or make her miserable and irritable. Just as when she was a baby, something cold to bite on may help. Children’s paracetamol or liquid ibuprofen may also ease any inflammation. Never give aspirin to a child under 16 years old.

Sleep
Your toddler still needs almost as much sleep as she did when she was younger; usually around 11 hours at night until the age of two. At 12 months, your toddler probably also has two naps a day, but by 18 months she may have just one sleep in the afternoon. This afternoon nap might last until she’s around four or five.
If you’re still being woken at night, or you have difficulty settling your toddler to sleep, you’re not alone. Many parents have problems with their child’s sleep that last well beyond the first year.
Strategies to improve the situation are those that you might have used when your child was younger, and they’ll still work now:
  • make sure she follows a bedtime routine – toddlers enjoy knowing what’s going to happen when and in which order; it makes them feel secure
  • stick to the same bedtime and naptimes each day; if your child knows when sleepy-time is, she’s more likely to fall asleep on cue
  • let your child fall asleep on her own; if you lie down with her each night, or sing her to sleep, she’ll need you to do the same when she wakes in the night, and will call for you to do so.
If your toddler has become used to you settling her to sleep, teaching her to fall asleep on her own may not be easy. Many parents try a structured approach – when you leave the room and she starts to protest, you wait five minutes before going back in, then ten minutes, and so on. The aim is to reassure her that you are still there, but that sleeping is something she can do all by herself. Toddlers have more staying power than babies, so it may take a few nights. Get support from other parents or a sympathetic relative if you do this; unhappy evenings can be a strain. But it will work… and the whole family will sleep much better for it.

Feet
Tight shoes, socks and even bedclothes can bend the soft bones in your child’s feet out of shape and cause long term damage. Your toddler doesn’t need shoes until she is walking outdoors, and even then they can be taken off indoors. Toddler feet grow fast – check your child’s feet regularly; she may need the next shoe size up within 6–8 weeks.
When buying shoes, check that:
  • they fit; feet should be measured every time, and shoes fitted to the largest foot
  • there is growing space at the toe
  • they will stay on when your toddler walks or runs
  • they are comfortable
  • they are flat, to support your child’s feet
  • the shoes aren’t too heavy.
Remember, canvas shoes are just as good as expensive leather ones!

Immunisations
At around 13 months, your baby will be offered the MMR immunisation that protects against measles, mumps and rubella. She will also be offered the PCV which protects against pneumococcal infection. This is a very dangerous illness causing blood poisoning, meningitis and pneumonia. Later, booster doses of other immunisations will help to make sure she has the best protection against some serious diseases before starting school. Your child will be offered these vaccines three years after completing the baby immunisations she had at two, three and four months old. They are:
  • DTaP/IPV an injection to protect against diphtheria, tetanus, acellular pertussis (whooping cough) and polio
  • MMR to protect against measles, mumps and rubella. If your child has not had the first dose of the MMR at 13 months, it can be given now, with the booster dose three months later.
Eggs are used to prepare the MMR vaccine. If your child has a severe allergy to eggs, tell your doctor or practice nurse so that they can make special arrangements to give your child the vaccine safely.
Although parents worry, the risk of complications from the MMR vaccine is tiny, but the risks from the diseases themselves are lifethreatening for a child who has not been immunised.

Speech worries
If you are worried that your child is not talking as early or as well as other children, particularly if she isn’t talking at all by twoand- a-half, it’s worth checking that she can hear properly – ask your GP or health visitor for a hearing test. If your child cannot be clearly understood by the age of three, she may be referred to a speech therapist for help before she starts school.
The best way to encourage your child to talk is to talk to her about everything you do and see. Speak directly to your child, repeat words and explain things. Let her match what you say to what she can see, to what you’re doing, or to your facial expression. Avoid the use of dummies, as they can delay speech development. If English is not your first language, just use the language you know best. Children can learn to speak in two languages at once.

Walking
All children develop at their own pace, and some don’t walk until they’re even older than 15 months. They seem quite happy continuing to cruise or crawl, and they’re probably concentrating on developing other skills like talking and thinking. Children will walk when they’re ready. Don’t get drawn into ‘competitions’ with other mums about whose child is doing what first, just enjoy these months at your child’s pace.

For the next Your Toddler Guide Chapter, Holidays, Click here arrow

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