Milestones Infancy to Toddler KMA

At what age does the posterior fontanel close?

2 Months

At what age does the anterior fontanel close?

18 Months

An infant’s birth weight should _________, at 6 months of age.

Double

An infant’s birth weight should _________, at 12 months of age.

Triple

An infant would have an increase length of how much?

½ to 1 inch per month

Which teeth will first erupt in infancy?

• Lower Central Incisor

• At 10 Months

• Falls off at 6 - 7 Year old

At what age, does the infant start to move their head from side to side?

Within 2 Months

At what age, does the infant start to track using their eyes? (Faces)

Within 2 Months

At what age, does the infant start to make dovelike noises? (cooing)

Within 2 Months

At what age, does the infant start to smile?

Within 2 Months

At what age, does the infant start to hold head up when on their stomach?

Within 2 Months

At what age, does the infant begins to like play?

Within 4 Months

At what age, does the infant start to transition from cooing to babbling? (Copy Noises)

Within 4 Months

At what age, does the infant start to hold and reach for toys?

Within 4 Months

At what age, does the infant start to remember faces?

Within 4 Months

At what age, does the infant start to roll over?

• Within 4 Months

  • This is the time when you want to stop swaddling.

At what age, does the infant start to sit up without support?

Within 6 Months

At what age, does the infant start to experience stranger anxiety.

Within 6 Months

At what age, does the infant start to babble with vowels.

Within 6 Months

At what age, does the infant start to recognize and respond to names?

Within 6 Months

At what age, does the infant start to have fun looking at the mirror?

Within 6 Months

At what age, does the infant start to sit up without support?

Within 8-9 Months

At what age, does the infant start to crawl?

Within 8-9 Months

At what age, does the infant start to stand and hold on onto objects (E.g. crib)?

Within 8-9 Months

At what age, does the infant start to use the pincer grasp?

Within 8-9 Months

At what age, does the infant start to move objects from hand to hand?

Within 8-9 Months

At what age, does the infant start to exhibit object permanence?

Within 8-9 Months

At what age, does the infant begins to walk?

Within 10-12 Months

At what age, does the infant start to follow very simple commmands?

Within 10-12 Months

At what age, does the infant start to take object and put them in a containers and bang them together?

Within 10-12 Months

At what age, does the infant start to say Simple Words like “Mama”?

10-12 Months

At what age, does the infant start to exhibit separation anxiety?

10-12 Months

How to avoid sudden infant death syndrome?

• Sleeping Position: On their back

• Avoid tobacco smoking

• Remove extra items in the cribs

• Don’t overdress the baby

• Don’t sleep in the same bed as the infant (Can share room)

How to avoid shaken baby syndrome?

The most important thing is to make sure that every person who cares for your child knows to never, ever shake a baby.

Infant Intervention

Younger Infants

• Trust vs Mistrust

• Respond to the baby’s cry by rocking, swaddling, etc

Older Infants

• Keep the parents near

• Keep the same nursing staff in the case of hospitalization because infants in this stage exhibits separation and stranger anxiety

Eating Plan (Infancy)

• Exclusive breastfeeding for 6 months

• With the addition of 400IU of Vitamin D

• If breastmilk is not possible, use infant formula with iron.

• Avoid cow’s milk and honey

Social Stimulation (Infancy)

• Infants are sociable but not at this stage, they wish to engage in independent play first.

• For the first 4 Months, infant’s play should involve observation (face, high contrast, items, and voices.

• After 4 months, infant start to interact with their environment, so toys are encouraged.

• In Erick Erickson’s Theory, the toddler is under what stage of development?

• At this stage, toddlers have realized that their actions influence or affects others around them.

Autonomy vs. Shame and Doubt

At what stage of development, does the child begins to speak in three word sentences?

Toddler

A child is _______ times their birth weight, when they are 2 years old.

Four

Average weight of 2 year olds;

• Male: 27.5 lbs

• Female: 26.5 lbs

Average height of a 2 year old;

33 - 34 inches

Mnemonic for the Developmental Changes in Toddlers

• Temper Tantrums

• On the Move (Safety)

• Diaper to Potty Transition

• Developmental Stage Theory

• Loves to Say “No” (Negativism)

• Eating Plan

• R’s of Toddler

Temper Tantrum “Terrible Two”, Why do they occur?

This has something to do with autonomy because at this stage of development, toddlers tend to start their independence. Since they are still young, their skills are not developed yet so they fail at their task. Leading to stress in which they throw tantrums.

Education to Parents about Temper Tantrums

• It’s normal.

• Stay Calm

• Don’t Give In or Reason

  • Giving in to their request teaches them that this works, meaning they will do it again if it were to happen.

  • Reasoning doesn’t work because toddlers doesn’t have the capacity to understanding reasoning.

• Ignore them but stay close

• Be consistent in your approach

How to prevent temper tantrums?

• Change of scenery (Distract them)

• Check for triggers

• Give them choices

• Prepare them - don’t abruptly say something that changes the scenery specially when they are enjoying it. Give them time to prepares, like when you are to leave.

On the Move “Safety” (Toddler) - DANGER

• Drowning

• Automobile Accidents

• Nose-dives (falls)

• Getting burned

• Eating toxins

• Revolvers / rifles

• Suffocate / choke

Diaper to Potty Transition

• Toddler needs to be physically and mentally ready.

• Sphincters controlled (Voluntarily)

• Night time trained takes time

  • Bed-wetting can persist for a long time, that’s why it is necessary to use diapers when nighttime.

• Trained by 3 years old

When is the external (voluntary) anal sphincters developed in Toddlers?

• 18 - 24 Months

• Potty training starts at 3 Years old

Potty Training (Toddler Milestones) - TOILET

• Two hours or more w/ dry diapers

• On/off by themselves (potty/clothing)

• Interested in potty

• Likes sitting in toilet (5 - 10 minute)

• Experiences regular bowel movements

• Tells you they have to go

Development Stage Theory (Toddler)

• In Piaget’s Model, a toddler can be in the Sensorimotor (1-2 yrs) or Preoperational Stage (2-7)

  • Toddler’s have problems seeing things in other’s point of view, so they are naturally egocentric.

  • Symbolic Thinking

  • Parallel Play - Toddler observes other play and they will play but they won’t play with other

• In Erickson’s Model,

  • Autonomy vs Shame and Doubt

  • Toddler will have confidence in completing task

• Interventions:

  • Give the toddlers opportunities to be independent

  • Give them choices

  • Give them positive feedback when they have progress

  • Avoid punishment when the toddler fails

Stages of Separation Anxiety

• Protest (Wanting you to stay)

• Despair (Crying and Withdrawing)

• Detachment (Holding until you come back)

How to prevent separation anxiety?

• Reassure the toddler that their caregiver will return

• Maintain Routines

• Encourage the child to take about their parents

Loves to Say “No” (Toddler)

• Negativism - Doing opposite of what is being asked

  • How to avoid?

  • Don’t ask questions that can have no as an answer. Give options instead.

Eating Plan (Toddlers)

• Grazers (Frequent small feeding)

• Dental Caries?

  • Avoid juices at night, visit dentist (12 months), brush teeth.

• Picky Eaters

  • How to avoid? Don’t mix foods, No new foods, Fun and colorful plates (Rituals)

R’s of Toddler

• Ritualism

• Rivalry

• Regression

• Things done the same way

  • Why? Predictable, Comfortable, and Promotes learning

  • Reduces stress

Ritualism

• Siblings, which diverts the attention to the new baby causing a change in scenery then tantrums

• How to prevent?

  • Include them in the care of the baby

  • Routines

  • Watch out for jealousy

Rivalry

• Reverts back to infancy

  • Caused by change of scenery (E.g. siblings)

• How to avoid?

  • No punishment

  • Identify stress

  • Don’t overwhelm with a new skill

  • Praise when they are doing well.

Regression.