Toddler Lessons

Although Type 1 and Type 2 diabetes have overlapping symptoms, they’re caused by different things.

With a Blood Test. This can be either a fasting blood test or a random blood test. If a patient has one or more of the following, they’re said to have diabetes:

Insider Info: Although diabetes is a chronic, life-altering condition, it’s manageable. One of the hardest things about diabetes (especially insulin-dependent diabetes) is that there’s no day off. Kids (with their parent’s help) must be diligent about checking their glucose levels and be careful about what they eat.

Both Type 1 and Type 2 diabetics can experience acute and chronic complications of their diabetes if it’s left untreated or if their treatment regimen isn’t optimized. Get Wise about these complications below:

As mentioned above, it’s important for children with diabetes to closely monitor and regulate their blood sugar levels.

Why? Because erratic blood sugar levels can cause long-term problems (in addition to the acute problem of DKA).

Chronic issues seen with diabetes include: kidney disease, vision problems, high blood pressure, nerve damage in the feet & legs, poor growth, and erectile dysfunction (in males, later in life). Children with diabetes are, therefore, closely followed by an endocrinologist (a doctor who specializes in hormones and metabolic disorders). Endocrinologists can help optimize their patients’ treatment plans and help them stay on top of their glucose levels.

Although diabetes is rare in toddlers, it’s worth knowing about—especially if there’s a family history of Type 1 diabetes. Be mindful of the red flag signs described above (e.g. fatigue, weight loss, frequent urination, and excessive thirst) and call the doctor if your child consistently experiences one or more of them.

“Booty Call: a shout from the
bathroom letting you know it’s
time to go wipe someone’s butt.”

~@babyhellfire

And…That’s a Wrap!

ADHD is the most common “neurodevelopmental disorder” seen in kids. A “neurodevelopmental disorder” just means the brains of kids with ADHD function a bit differently than the brains of kids without ADHD. The part of the brain most impacted by ADHD is the one that controls “executive functioning”—the ability to focus, organize information, remember things, have flexible thinking, and exhibit self-control.

1. Predominantly Hyperactive-Impulsive ADHD: This is your “classic” ADHD. Kids with this form of ADHD are impulsive and hyperactive but they can focus fairly well.

2. Predominantly Inattentive ADHD: Kids with predominantly inattentive ADHD are often mistaken for “daydreamers.” They have trouble focusing but aren’t all that hyper or impulsive. Back in the day, “predominantly inattentive ADHD” was called ADD (ADHD without the H), but this term is now outdated.

3. Combined Type ADHD: This type of ADHD has all the things: the lack of focus, the poor self-regulation, and the bouncing-off-the-walls energy.

Insider Info: Boys with ADHD tend to be more hyperactive and impulsive than girls with ADHD. Girls, therefore, are more likely to be diagnosed with the “inattentive” form of ADHD than boys. They’re often seen as “spacey” rather than disruptive, making the ADHD harder to spot. This isn’t to say that girls can’t have the other types of ADHD too.

Children are born with ADHD. It’s not their fault and has nothing to do with how they’re raised or how much sugar they eat.

ADHD often runs in families and some parents don’t even realize they have ADHD until their child is diagnosed with it.

Intoeing (i.e. being pigeon-toed) is when a child’s feet turn inward (instead of pointing straight ahead) when they walk.

There are several reasons why a child might be pigeon-toed, most of which are benign and resolve on their own. They include:

Image Source: OrthoKids

Image Source (Cropped): Matthew Wagner, MD

The “other” category is the dumping ground for all other causes of intoeing, a few of which are cause for concern.

For example, when doctors see a patient with intoeing, they want to rule out a clubfoot (a pathologic foot deformity), developmental dysplasia of the hip (a hip problem), and cerebral palsy (a neurological condition that causes muscle weakness). These conditions are rare, however, when compared to the more common causes above.

Back in the day, doctors recommended corrective shoes for pigeon-toed kids. Today, corrective shoes are rarely necessary. Instead, doctors first seek to find the underlying cause of the intoeing.

Most cases of metatarsus adductus, internal tibial torsion, and femoral anteversion resolve spontaneously. If they persist longer than expected, the child will be referred to an orthopedic surgeon (the fancy name for a bone doctor).

They’re caused by a virus called the human papillomavirus (HPV).

Wait a Second, Isn’t There a Sexually Transmitted Disease Called Human Papillomavirus (HPV) and a Vaccine That Protects Against It?

Yes! There are actually many strains of HPV (150 and counting!).¹ Common warts are caused by a different strain of HPV than sexually transmitted genital warts.

Insider Info: The HPV vaccine only protects against the sexually transmitted-type of HPV.

Yes! Warts can be transmitted via skin-to-skin contact and through the sharing of towels. They can also be spread by walking barefoot around pools and locker rooms. The virus often enters the body through a small break in the skin.

Insider Info:

Common warts, though benign, can be a bit of a nuisance to get rid of. They can take a while to go away and may return after treatment. Most warts will go away on their own within 2 years. 2 years is a long time though, so many parents will seek treatment for their child’s warts before then.

The Best Way to Get Rid of Warts at Home is By Using an Over-the-Counter Wart Remover. These wart removers come in different forms (think: medicated liquids, patches, and pads) and typically contain salicylic acid.

Examples of Popular Over-the-Counter Wart Removers Include:

Manners take a while to learn, so don’t expect your toddler to say “please” and “thank you” overnight.

Note: Some of the tips might be a bit over your child’s head, but it doesn’t hurt to lay the groundwork early on.

Kids, as you know, love to mimic their parents. While you don’t have to edit everything you say around your kids (and shouldn’t), be mindful of your tone and how you talk about other people. Just because you think something, doesn’t mean you have to say it.

Make up different scenarios to practice manners and act them out. The “rude” character is always the most fun to play.

What’s That? It’s the “bubble” in our mind that houses all of the things we want to say. As your child gets older, teach them to keep “rude” thoughts inside their “thought bubble.” This will make them less likely to blurt out, “You’re fat” or “You’re old.” There’s a fine line between being honest and being hurtful. 

If you see someone being kind to someone else on the street, point this out to your child. Also point out rude behaviors so that your child knows what bad manners look like too.

Teach your child the basics of good etiquette — both the words (e.g. “please,” “thank you,” and “excuse me”) and the actions (e.g. how to look someone in the eye when they’re speaking).

To do this, you can introduce the idea of a “talking stick.” The talking stick can be a ruler, a glitter wand (my fave), or a real stick. Whoever is holding it gets to talk. Take turns and see what happens.

A Word to the Wise: Let your youngest kiddo hold the talking stick first and keep everyone else’s turn brief. Otherwise, you may end up with a tantrum on your hands.

You don’t have to berate, correct, or embarrass your child every time they say or do something rude. Pay attention to the big transgressions and let the rest slide.

You’ll often hear parents snap at their kids to “be nice” when they’re acting like jerks. Being “nice” has a slight air of inauthenticity, however, whereas being “kind” connotes a deeper, more genuine way of being.

It’s easier for children (and everyone else, for that matter) to be polite when they’re well rested.

The morning rush is often a source of stress for parents as they try to get everyone out the door on time.

Wake up earlier than your child. This gives you time to center yourself and get ready.

Most kids need a fairly robust time buffer in the morning to get everything done. If you expect your child to get dressed, brush their teeth and hair, and eat breakfast in 10 minutes, you’ll be disappointed (and late).

Do everything you can the night before to prep for the next day. Build this into the bedtime routine. You can lay out clothes, pack lunches, and get bags ready to go. As anyone with kids knows, trying to find a specific sock during the morning rush will make you want to pull your hair out.

PediaTip: Ask your child’s doctor for their take on whether your little one needs a multivitamin.

Recent studies have shown the body doesn’t absorb multivitamins as effectively as we once thought.² Therefore, popping a bunch of vitamins willy-nilly is a waste of time and money. Moreover, giving kids mega doses of vitamins can cause problems and is, therefore, not recommended.

The Bottom Line: Children who need a multivitamin can benefit from it if they’re given the correct dose.

Reality Check: Kids are usually fans of gummy vitamins. Dentists, not so much. Why? Because they stick to the teeth and increase the risk of cavities.

Even if your little one doesn’t need a full-on multivitamin, they should still take a vitamin D supplement every day. In addition, it helps to pay some attention to your child’s calcium, iron, and fiber intake.

The calcium, vitamin D, iron, and fiber requirements for kids vary by age. Here’s how it all breaks down:

Remember, milk isn’t the only source of calcium. Yogurt, cheese, green vegetables (think: spinach), and orange juice (fortified with calcium) fit the bill, as well.

Kids who refuse all forms of calcium, may need a calcium supplement

Insider Info: Calcium supplements often contain vitamin D. These combo supplements kill two birds with one stone, by covering a child’s calcium & vitamin D needs at the same time.

Vitamin D and calcium work in tandem to make sure that our kids’ bones and teeth grow properly. Our ancestors got most of their vitamin D from the sun. Because we tend to live more like vampires these days (i.e. we work and live indoors) and we’re diligent about slathering sunscreen on our bodies, the amount of vitamin D that we get from the sun is no longer sufficient.

Because a vitamin D deficiency in kids can lead to something called “rickets.” Even though rickets is more prevalent in developing countries, it’s still a problem in the U.S. Rickets leads to weakened bones, bone deformities, stunted growth, and bone pain. It can also cause tooth deformities and muscle cramps.

To prevent rickets, the AAP recommends that parents give children over 1 year extra vitamin D (in the form of a vitamin D supplement) every day.

After the 1-year mark, all kiddos need 600 international units of vitamin D supplementation per day.

Insider Info: An international unit is just a weird-sounding measurement that’s used for vitamins.

Unfortunately, large volumes of milk can lead to constipation and iron-deficiency anemia in kids. Docs, therefore, recommend limiting toddlers’ milk intake.

Specifically, the AAP recommends that 1-to-2 year-olds take no more than 16-24 ounces of whole milk per day and 2-to-3 year-olds drink no more than 16-20 ounces of milk per day.³ As a result, kids don’t end up getting enough vitamin D through their milk.

The Bottom Line: The AAP recommends that all children over 1 year take 600 IU of vitamin D per day (in the form of a supplement).

Insider Info: As mentioned above, toddlers who crush a ton of milk are more likely to develop iron deficiency anemia. You can avoid this by limiting your child’s milk intake to 2-2.5 cups per day.

Insider Info: Infants who are taking less than 32 ounces of formula per day (including those who are exclusively breastfeeding) often need a daily iron supplement from 4 months of age until they start taking solid foods (around 6 months of age). Once children start solid foods, they don’t usually need an iron supplement unless they were born prematurely or they have a known case of iron-deficiency anemia.

Note: Iron deficiency anemia is often picked up by the routine bloodwork that’s done at the 1-year and 2-year checkups.

If the pediatrician recommends that your child take an iron supplement, Get Wise about the best way to give it and about the (relatively benign) side effects associated with it.

Fiber keeps our digestive systems “regular” and reduces our risk of colon cancer, heart disease, and high cholesterol. Most Americans, however, don’t get enough fiber in their diets. Adults need about 20-35 grams of fiber per day. For kids 2-19 years, the AAP recommends calculating their daily fiber requirement this way:

*This means that a 3-year-old needs
8 grams of fiber per day.

The Bottom Line: You don’t have to obsessively count how many grams of fiber your child gets each day. Just try to incorporate the high-fiber foods listed above into their diet.

Probiotics are all the rage these days and many pediatric gastroenterologists swear by them.

To get a sense of how children develop emotional intelligence (and empathy), it’s important to understand how their view of the world (and their place in it), changes during childhood.

To help us with this, let’s turn to the 4 Stages of Cognitive Development, a theory that Jean Piaget, a Swiss psychologist, proposed in 1936. This theory suggests that children go through four stages of mental development as they mature. As kids pass through these 4 stages, they gradually build empathy & emotional intelligence and learn how to reason.

Even though toddlers are wildly egocentric, it’s never too early to flex your kiddo’s emotional intelligence muscle.

1. Prioritize It. Make empathy an important part of your family life. Talk about it and weave it into each day.

2. Say It Out Loud. If you see a person who looks sad, happy, scared, tired, etc., point them out to your child. You can say, for example, “that man on the bench looks tired. Do you see how he’s closing his eyes? I wonder if he didn’t get enough sleep last night.” You can even make a game out of reading other people’s facial expressions and body language.

3. Model It. Kids like to copy everything their parents do. If your child sees you being sensitive to other people’s feelings, they’ll probably follow suit.

4. Role-Play It. Practice empathy through role playing. Include both heroes and villains in your scenarios.

5. Draw It. Draw scenes of people being kind to one another. For example, you can draw a picture of someone crying and ask your child how they would help that person.

6. Read About It. Read books about empathy and emotional intelligence to your toddler. 

PediaWise Picks:

7. Promote Self-Care. It’s hard to be kind to others when you’re not kind to yourself. Teach your child to be their own best friend.

Now that your child is getting deeper into the toddler years and new teeth are emerging, it’s time to revisit the topic of dental health.

As mentioned in previous PediaGuide articles, humans have 20 baby (primary) teeth and 32 adult teeth. Here’s a picture comparing a child’s mouth to an adult’s mouth. (The child’s mouth, as you’ve probably already guessed, is the smaller one on the right.)

There’s a vague order in which we gain our teeth. The picture below shows the general order and timing of when teeth come in (although there’s a lot of variation among kids).

At birth, kids are assigned a “sex” based on their boy or girl parts. If a baby is born with “ambiguous genitalia,” (i.e. the private parts aren’t clearly male or female), the parents and a team of doctors use multiple factors (such as chromosome analysis and future reproductive potential) to determine the child’s sex.

While “sex” is rooted in biology, “gender” is a social construct. “Gender identity” refers to one’s internal sense of being male, female, a blend of both, or neither.

Many experts believe that kids come hardwired with a preferred gender identity.¹ It takes a bit of time, however, for a child to develop their personal sense of gender.

Note: This is what pediatricians see, on average, but everyone is different.

Sneak Peek: Over time, kids become less rigid about their views on gender. For instance, they no longer think the opposite sex has “cooties” (for the most part).

As children go through the stages above, it’s not uncommon for them to be curious about the behaviors of the “opposite sex.” This is a “normal” part of the gender identity process.

Seriously? Yup. Although certain schools can “open doors” for different students, the current research shows that adults have similar job satisfaction rates and earning potentials whether they went to an “elite” college or to a “non-elite” college.¹ Therefore, it’s more important for kids to find the “right” school (and to work hard when they get there), than to get hung up on the name of the school.

In the world of education, there are 4 principal learning styles: Visual, Auditory, Reading/Writing, and Kinesthetic (aka Tactile). Most students use a combo of these styles to learn, but each student usually has one style that works best for them.² Paying attention to your child’s learning style and putting them in a school that honors their particular style (or that “teaches to the learner”), can make all the difference.

Want to Know More About the Different Learning Styles? This checklist (courtesy of Grade Power Learning) outlines the defining characteristics of each type of learner.

Studies show that a healthy (read: limited) amount of meaningful homework each night can boost the academic achievements and test scores of middle school and high school students.³

Many experts agree that the “10-Minute Rule” can help make homework manageable. 

What’s the “10-Minute Rule?” It’s a guideline that restricts the amount of homework that a child is assigned based on their grade level. For example, when following the “10-Minute Rule” a teacher will give 1^st graders 10-minutes of homework per night, 2^nd graders 20-minutes per night, and so on. According to this rule, 12^th graders should have no more than 2 hours of homework per night.

Caveat: It’s unclear how useful any amount of homework is for elementary students.

Quality Counts Too! Not only should teachers be mindful of the quantity of the homework they assign, but they should pay attention to the quality of the homework, as well.

Translation: Useful homework is IN, busy work is OUT.

91% of millennials say they expect to switch jobs every 3 years or so. Given this mindset, researchers project the average millennial will have 15-20 jobs during their lifetime.⁴  Therefore, the goal of finding the “perfect job” out of college and staying in that job for life, is an outdated one.

Why? Because studies show that 85% of future jobs haven’t even been created yet.⁵

PediaTip: Ask kids what kind of person they want to be and what they’re interested in, instead.

Our old-fashioned notions of what it means to be “successful” and how to achieve success are being turned on their head.

This means don’t worry about getting your child into the most prestigious nursery school possible. Instead, focus on finding the “right” fit. This advice applies to elementary school, middle school, high school, and college, as well. And, if a particular school doesn’t work out, your child can always change schools.