Health Promotion of the Toddler and Family

The toddler stage of development begins at twelve months of age and ends at thirty-six months. During this stage, toddlers begin to explore the world around them as they grow and develop their social and motor skills. As the nurse, you’ll promote health of the toddler by supporting nutrition, toileting, social development, and safety.

Toddlerhood is marked by slower physical growth than infancy, yet height and weight continue to increase steadily. At the same time, their stomach increases in size allowing toddlers to eat around three meals and 2 snacks per day. To support the growth and the increased energy requirements during this period, toddlers require nutrient dense foods, including vegetables, dairy products, proteins, and whole grains.

When assessing the toddler's nutrition, keep in mind that toddlers tend to develop distinct likes and dislikes of foods, and can become fussy eaters, and this can make it challenging for caregivers to ensure they're getting all the necessary nutrients they need. So, be sure to assess for any nutritional gaps by asking caregivers about their toddler’s eating habits. Then encourage them to introduce alternative sources of nutrients, like mixing vegetables into a fruit smoothie, and providing additional nutrients, like vitamin D- and C-fortified beverages and iron-fortified cereal. Lastly, instruct caregivers to limit empty calorie products, like fruit juices and candy.

A key developmental milestone of toddlerhood is becoming toilet trained. Toilet training becomes possible as the toddler’s bladder and bowel grow to accommodate urine and stool for longer durations. During this time, toddlers can wake up dry from a nap and can stay dry for at least 2 hours during the day. In addition, they start to sense the need to void and can sit on the toilet long enough to allow bowel movements to pass.

When teaching caregivers about toilet training, reassure them that every toddler will develop this skill in their own time. Because caregivers can find toilet training challenging, encourage them to begin the process by normalizing routine use of the toilet with their toddler, creating a toileting schedule, and offering rewards and praise when they use the bathroom and perform hygiene habits, like washing their hands.

Other developmental milestones include social milestones as toddlers increase independence from their caregivers. By age three, toddlers are typically able to separate from caregivers without crying. Toddlers typically prefer parallel play, which is when they play next to their peers without interacting. They also develop possessiveness over toys and other items, often expressed by saying, “Mine!”; they can throw tantrums; and they begin to develop a need for control, often expressed by saying “No!”