Guidelines for toddlers: eating behavior, toilet, public place, dressing

Positive parenting

Positive parenting is the process helping the child and adolescent to grow and develop in an atmosphere of love and understanding. It is not permissive. It is based on acceptance and effective discipline. It aids the learning process of the child by the use of effective discipline.

There are certain guidelines for being an effective parent. These guidelines hold true for that parent that desires to be a positive parent.

Positive parenting is a challenge. The result of being a positive parent is to have a child that has a greater capability of becoming an effective, independent, and capable adult.

Positive guidelines for living with children

  • “Catch them being good”.
  • Frequently monitor your children.
  • Let them help you.
  • Listen to your child. Every child has a special time to be heard.
  • Discipline and enforcement of discipline should be as matter of fact as possible.
  • Lectures belong in lecture halls, not in homes. Talking with your child is important.
  • Show brief sympathy when you discipline, but don’t give in.

It is important to show your child or children that you can handle problem situations without losing your cool.

Be a parent, not a martyr. Find a good babysitter — not as an escape but as a breather.

Parents are teachers: what you DO is much more important than what you say.

Eating Behavior Guidelines for Toddlers

Eating behavior disorder during early childhood is a common pediatric problem. Many terminologies have been used interchangeably to describe this condition, hindering implementation of therapy and confusing a common problem. The eating process is of importance for survival and health. Early life diet and feeding behaviors play an important role in establishing healthy food preferences and behaviors and preventing childhood overweight and obesity. Eating disorders have been adequately addressed and discussed in adults and adolescents with many randomized controlled trials and systematic reviews. The term eating behavior disorders of early childhood is meant to be the umbrella under which all problems of eating are listed at this specific age.

Diagnostic features are proposed and a difference from the DSM5 classification of “Avoidant/Restrictive Food Intake Disorder: 307.59” is shown. Detailed history taking from parents and a thorough clinical examination by the health care worker are essential. A classification of severity is proposed to separate children with meal-time abnormal behavior only from those who have associated risk, or actual consequences, of growth disturbance and micro-nutrient deficiencies. Following staging, therapy, although required to be tailored to children and families, should incorporate dietary and behavioral education and/or therapy. Nutritional supplements are a useful but transient addition to the management of such a condition.

Eating Behavior Guidelines for Toddlers with Special Needs

The goal is to teach your child how to enjoy meals with his/her family while maintaining adequate weight gains. In order to do this, you will have to follow very specific procedures. You have to understand that your child will not eat if she/he is not hungry or if you offer him/her too much food at any one meal.

The three basic parts of this program are:

  • Management of Your Child’s Eating Behavior
  • Offering of Specific Foods
  • Follow the Program for One Month

It is extremely important that you follow these procedures for every bite of food that your child takes for at least the next month.

nutritious snacks

Between Meals

Encourage and praise good behavior.

See that your child participates in active play.

In order to give your child a good appetite, he/she must get an adequate amount of exercise. If he/she is not hungry, then he/she will not eat.

Exercise is one of the main ways to help to give your child a good appetite.

Offer only nutritious snacks (such as fruit).

Do not give any food or liquids during the hour prior to a meal.

Mealtimes

  • Mealtimes should be as pleasant as possible family times.
  • The meal should not start until the child is quiet. Begin the meal by praising your child for sitting quietly.
  • Offer only nutritious food. Follow the meal plans prescribed by your nutritionist. Do not offer foods that are not on the plan without discussing it with the nutritionist.
  • Separate each food item on a plate or use a sectioned dish.
  • Do not allow any play or games during the meal or snack.
  • Fasten the high chair strap to keep your child in place

Do not allow your child to feed him/her until the feeding problem is under control.

Choose a preferred food for the first bite offered.

The length of the meal should be no longer than 30 minutes.

Do not place food on the tray on the high chair until your child is consistently accepting all of the food offered. Instead, place a chair or table beside you and put the food on it.

Until the feeding problem is under control, place the food on a table beside the high chair.

  • Praise your child’s good behavior throughout the meal.
  • Touch your child after each bite that has been eaten correctly.
  • If your child turns his/her head away, closes his/her mouth or pushes the spoon away, say, “No!” and turn away until your child has been quiet for one minute.
  • If your child throws up, wait for a full minute of quiet before cleaning it up.
  • End the meal (within 30 minutes) with a bite of the item that she/he likes.
  • If the child is taking insulin injections, talk with your doctor as to how much to decrease the insulin dosage until the child is eating correctly.

Key points

  • Mealtimes should be as pleasant as possible.
  • Discuss things that you know will interest the child.
  • Start by giving your child very small portions.
  • Praise your child for eating correctly.
eating behavior

Dressing Behavior Guidelines

Poking and Stalling

Poking and stalling are not completing a task within a reasonable time.

1. Determine that the child has learned the skill to dress him/her.

2. Teach your child a morning routine. Suggested routine:

a. get up

b. go to the bathroom

c. wash face, hands and teeth

d. get dressed

e. make the bed

f. eat breakfast

Start a timer at the beginning of the routine (30 minutes) or at the start of getting dressed (20 minutes).

  • Frequently praise the child for dressing.
  • Ignore stalling – don’t nag.
  • Use the time-out chair for each tantrum.
  • The child is not to eat or have the TV on until being completely dressed.
  • Check on your child every 2 to 5 minutes.
  • Breakfast should be ready after the 20 minute dressing time.

Remember to praise any good dressing behavior often. If your child is completely dressed by the time the timer rings, praise the behavior and have the child go eat breakfast.

Reward her/him with 10 – 15 minutes of your time doing whatever he/she would like to do (play a game, read a story, etc. after he/she gets home from school or immediately if your child is a pre-schooled.

Reward your child with “special time” after school or, for a pre-schooled, immediately.

If your child is not finished dressing when the timer goes off or is not finished by 5 to 10 minutes before time to leave, dress the child.

Do not talk except to give instructions.

Guidelines for toddlers: eating behavior, toilet, public place, dressing

Guidelines for Problems in Public Place

Start your child’s education into stores and restaurants by “training trips”.

Trips should be no longer than 15 minutes.

Choose a time when the store or restaurant is not very busy.

Trips should be made for teaching, not shopping or eating.

Rules should be stated before leaving the house or apartment.

Rules should be restated immediately before entering the “training area”. Some suggested rules include:

a. Stay with Mom or Dad.

b. Do not walk away alone.

c. Do not pick up or touch things without permission from Mom or Dad

d. Nothing will be purchased on the trip

Praise your child’s behavior often (at least once every minute or two). Example: “You’re staying right next to Mommy.”

  • Maintain frequent physical contact with your child (every minute or two). Example: Touch him/her gently on the back, rough up his/her hair or give him/her a hug.
  • Involve your child in the store as much as possible. Example: Have him/her get groceries for you or place groceries in the cart for you saying “please” and “thank you” when it is appropriate.
  • Tell/Teach your child what you are doing. Example: “Mommy is going to make sloppy joys with this meat. You really like sloppy joys, don’t you?”
toilet paper

Toilet Training Guidelines

Parents play a key role in toilet training. Parents need to provide their child with direction, motivation, and reinforcement. They need to set aside time for and have patience with the toilet training process. Before you begin toilet training, have your child examined by his or her health care provider. During your child’s check-up, talk with the health care provider about the child’s developmental readiness and temperament.

Your health care provider can help you determine whether your child is ready to begin toilet training and help you plan your approach. Parents can encourage their child to be independent and allow their child to master each step at his or her own pace. Long before training is begun, parents can teach readiness skills in a graduated fashion such as dressing. Children can also be taught to follow one-and two-stage directions and appropriate language about toileting. The understanding and expression of language greatly facilitates the training process.

Training should probably not begin before a child is 24 months of age. Children over 24 months of age are more easily and quickly trained than children under 24 months. The efforts necessary to train a younger child cancel out any potential benefit and may create unnecessary conflict.

Children learn much by observing and imitating their parents. Children can occasionally accompany their parents to the bathroom. Parents can use their own preferred toileting vocabulary to describe the elimination process. The child will begin to associate his own elimination process with the appropriate location for that process to occur.

Children should not be required to sit on the potty for extended periods of time. Five to ten minutes is sufficient. Adults do not eliminate on command and this should not be expected of children.

  • Children can be placed on the potty at times when elimination is likely to occur, such as after a meal.
  • As much as possible the training process needs to be pleasant for both children and parents.
  • Physical punishment definitely has no place in the training process. Punishment does not teach and the resulting negative side effects can create unnecessary parent-child conflicts.
  • Praise for appropriate toileting can help to motivate the child.

Guidelines for Bedtime Problem

Crying at Bedtime

1. Decide the time the child is to go to bed.

2. put your child to bed at that time every time.

3. About 30 minutes prior to bedtime, start “quiet time” during which your child should engage

in quiet activities rather than roughhousing, etc.

4. Have regular bedtime routines (bedtime story, drinks, kisses, bathroom, etc.)

5. Tell your child goodnight and that you will see them in the morning.

Turn off the light and leave the room. DO NOT GO BACK INTO THE ROOM! (Until the child is asleep) If the child is taking insulin, the dosage may need to be lowered until this problem is under control. Don’t get discouraged…it only takes a few nights.

To keep bedtime problems from recurring:

  • Do not talk to your child after he/she is down for the night.
  • Check diapers, etc., as quickly as possible. If everything is okay, leave the room without saying a word.

Bedwetting

The usual time children stay dry at night is around three years of age. If bedwetting does occur, after a period of time, more often it represents just a symptom and rarely a problem. The time when there is a greater chance of bedwetting occurring is when the child is ill. Bed-wetting is not something a child does on purpose. If persistent, you should check with your physician.

Just to put bedwetting in perspective, recognize that more boy than girls wet their beds. It has been found that bed-wetting may run in families but usually stops by puberty. Surprisingly, approximately 15% of children wet the bed after 3 years of age.

Some things to consider

  • Bed-wetting could signal a urinary tract infection or the presence of pin worms.
  • If the development of the child’s nervous system is slower than normal, bedwetting could occur.
  • If the child is tense and upset, bed-wetting could occur (changes such as a move or a new child entering the family might cause the child to feel less secure and may unconsciously result in the child wanting to get more attention through bed-wetting).
  • Sleep disorders can be associated with bed-wetting.
  • Too severe original toilet training might result in bedwetting later on in life.
  • Problems in school may be reflected in the occurrence of bed-wetting at home.
  • Support the child by a positive statement (i.e. Accidents do happen. I will try to help you to keep from having further accidents.) When an accident does occur.

Things not to do

  • Do not shame the child.
  • Do not punish the child.
  • Do not scold the child.
  • Managing and overcoming bedwetting is a team effort.

Further reading

  1. Leung AK, Marchand V, Sauve RS; Canadian Paediatric Society, Nutrition and Gastroenterology Committee. The ‘picky eater’: The toddler or preschooler who does not eat. Paediatr Child Health 2012;17:455-60. 3.
  • Zangen T, Ciarla C, Zangen S, Di Lorenzo C, Flores AF, Cocjin J, et al. Gastrointestinal motility and sensory abnormalities may contribute to food refusal in medically fragile toddlers. J Pediatr Gastroenterol Nutr 2003;37: 287-93.
  • Madeleine Sigman-Grant, PhD, RD Associate Editor, Journal of Nutrition Education and Behavior Professor Emeritus with University of Nevada-Reno Maternal & Child Health Extension Specialist University of Nevada-Reno, Reno, NV
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