Read What to Expect the Toddler Years Online
Authors: Heidi Murkoff
What to Expect the Toddler Years (34 page)
Although you should make every attempt to comprehend, respond to, and encourage your toddler’s primitive language, you should also use it to help her develop modern-day linguistic skills. If she pulls you in the direction of the refrigerator, for example, do a simultaneous translation: “Oh, you want to go to the refrigerator. What do you want? Do you want juice?” If she grunts and points to the stuffed clown on the shelf, ask, “Do you want the clown? Should I get the clown for you?” and then, “Here’s the clown.” For more tips on stimulating language development, see page 37.
IRTHMARKS
“I thought that by now my son’s strawberry birthmark would be less noticeable, but it doesn’t seem to be.”
BIRTHMARKS, A YEAR LATER
Newborns can come with a variety of birthmarks—some small, some large, some flat, some raised, some brightly hued, some subdued. Certain birthmarks will fade, others will shrink, others will stick around for a lifetime. Few can, or should, be removed. Chances are that if your toddler has a birthmark it is less noticeable now than it used to be, either because it’s grown smaller or because your toddler’s grown larger—or just because you’ve grown accustomed to it. Here’s what you can expect from the most common birthmarks a year or so after birth:
Salmon patch (nevus simplex).
These pale-pink or coral blotches with diffuse borders (sometimes called “stork bites”) appear on 40% to 45% of newborns. They are usually located on the eyelids, on the center of the lower forehead (glabellar), and, most often, at the nape of the neck (nuchal). Generally, eyelid lesions fade by a year, those on the forehead take longer, and those on the nape of the neck may not fade at all, but will eventually be covered by hair. Sometimes, even after they seem to have disappeared, stork bites become temporarily visible when a child cries or exercises.
Port-wine stains (nevus flammeus).
These less-common birthmarks are found on 1 in 200 children, and vary in color from pink to deep purple, though in children with dark skin they may look black. They can appear anywhere on the body and are usually flat (though occasionally they become bumpy) with clearly defined edges. Rarely, they are associated with other anomalies (check with your toddler’s doctor if you have any concerns). Port-wine stains may change color somewhat but don’t generally fade. Cosmetics, such as Covermark, can be used, if desired, to camouflage port-wine stains early in childhood. Research shows that pulse-dyed laser therapy provides good cosmetic improvement in these birthmarks, with a low incidence of scarring. Unlike argon laser therapy, which often causes scarring in children under sixteen, pulse-dyed laser therapy may be used on infants and young children. Check with a pediatric dermatologist for information.
Strawberry marks (hemangiomas).
By the end of the first year, about 8% to 10% of children will have developed one of these bright red, rather clearly defined, bumpy birthmarks that resemble strawberries and range from freckle-size to 2 or 3 inches across. During the toddler years these clumps of dilated capillaries in the top layers of the skin begin to fade very gradually, turning grayish in color. Eventually, they disappear entirely—in about half of affected children by age five; in 70% by age seven; and in 90%
by age nine. A strawberry mark is best left untreated, unless it appears on a problem area (such as an eyelid, where, because of lumpiness, it could hamper eyelid movement and interfere with vision) or if it becomes infected, hemorrhages, ulcerates, or continues to grow. A child with numerous hemangiomas also needs medical attention. In the rare instances that treatment is needed, options include surgery, steroids, pressure, argon laser, cryotherapy, and radiation.
Cavernous hemangiomas.
These birthmarks are composed of larger blood vessels than those that make up strawberry hemangiomas. They are bluish in color, with less clearly defined borders than their cousins. They are less common (only 1 or 2 in 100 children have one) and slower to fade—though most do disappear before the teen years. Occasionally, a scar remains. Treatment, when needed, is similar to that for strawberry marks.
Mongolian spots.
These bluish black spots, which look like bruises and are most often found on the back or buttocks (and less often on the legs and shoulders) are extremely common among Black (98.8%), Asian (81%), and Hispanic (70%) infants. Most mongolian spots fade by the end of the first year; rarely, they develop later in childhood and persist into adulthood.
Café-au-lait spots.
These flat patches of darkened skin can range in color from creamy beige (coffee with lots of milk) to dark brown (coffee with just a touch of milk) and usually remain visible for a lifetime. If necessary, makeup can be used to cover them. If your toddler has a number of these spots, mention this to the doctor; they could be related to an hereditary disorder.
Congenital pigmented nevi, or moles.
Small moles, which can vary in color from light brown to blackish and tend to grow with a child, are fairly common, affecting 1 in 100 children. Although they don’t disappear, they are not cause for concern unless they grow rapidly or change in shape or color. Large moles, which can be flat or raised, range from half-dollar to melon-size, and are sometimes hairy, are seen less often than small ones, but do have a greater potential for malignancy. It’s usually recommended that large moles and suspicious smaller ones be surgically removed when possible and monitored carefully by a doctor when they can’t be removed. Check with your child’s doctor.
Acquired nevi, or moles.
Most light-skinned people develop a number of small moles during their lifetimes, but these don’t usually appear before age five. A new mole, however, that appears suddenly on your toddler’s skin and is larger than a pencil eraser, has an irregular perimeter, or contains a mixture of shades or colors, should be shown to your child’s doctor.
Strawberries are still in season—these colorful birthmarks generally stick around for several years at least. Chances are, however, that your toddler’s strawberry mark (clinically known as a hemangioma) is actually looking less and less like its namesake fruit, that it’s becoming lighter and grayer, smaller and flatter, but that you are unable to perceive the difference because you see the mark each day. Your toddler’s doctor probably checks the birthmark at each visit, though perhaps without commenting on it to you. If you took a photo of it when it first appeared, compare the birth-mark in the early photo with the way the mark looks now. You’re sure to notice a pronounced change.
To monitor a strawberry mark’s changes, take a color photo of it now and measure it at least once a year. The box that begins on the facing page will explain just what you can expect over the next few years.
Adults take their senses largely for granted. Though we use them every waking hour, we hardly ever use them to their full potential. How many of us, after all, actually stop to smell those roses? Or to listen to the chatter of the birds? Or to savor the taste of the cinnamon in our breakfast muffins? Or let our fingertips revel in the textures of everything we touch, our eyes appreciate every beautiful sight?
Toddlers, on the other hand, not only stop to smell the roses, they stop to look at them, touch them, and more than likely, taste them. They use their senses the way the scientist uses the laboratory. It’s through these five miraculous resources that toddlers make their discoveries about the complex world they live in, discoveries that come fast and furious during this intensely curious stage of development.
Even without encouragement, a toddler will instinctively tap into these natural resources. With your encouragement, your child will utilize them even more fully. Use the following as a guide to stimulating your toddler’s sensory perceptions and to inspire your own toddler-stimulating strategies.
Sight.
Because toddlers have not yet developed the ability to pick and choose visually, everything within their range of vision vies for their attention. The park is a kinetic kaleidoscope: tall trees, brightly colored flowers, a little girl circling on a tricycle, a boy zipping past on roller skates, a man pushing a baby carriage, a woman jogging, a squirrel nosing around for acorns, a dog chasing a butterfly. With so much to see, it’s not easy for a toddler’s untrained eyes to focus on just one part of the picture for more than a fleeting moment.
You can help your toddler practice focusing by calling attention to one object in the scene at a time. At first, keep it simple: “Look at the girl on the pink tricycle. She’s riding the tricycle.” When your toddler is a bit older, you can begin adding other details: “She’s a good rider. Look at the girl’s hair—there’s a pretty red ribbon in her hair. And her pants have red flowers on them.”
Play the “looking” game everywhere you go. Try it in settings that are virtual visual feasts—the beach, the zoo, a crowded city sidewalk—and in settings that seem visually less exciting—the doctor’s office, the supermarket parking lot, the post office. Visually explore objects that you and your toddler have seen dozens of times, challenging her to spot something new in the familiar, as well as objects that you’ve never seen before. The “looking” game will not only be visually invigorating for a toddler but will (as you associate sights with words) help speed her speech development and turn potentially tedious and fussy times (when you’re waiting your turn at the deli counter, for instance) into time well-spent.
Your toddler will also enjoy seeing the world from other perspectives:
Through the looking glass,
for example. Toddler’s love to look at themselves (most can recognize themselves in a mirror by the end of the fifteenth month) and others in a mirror. You can also show them what their toys and other objects look like in that magic medium.
Through rose-colored glasses.
The distortion of color seen through tinted glasses often captivates young children. So does the distortion of images and shapes viewed through a sheer curtain, a glass block, or a stained-glass ornament.
Through a magnifying glass
. Older toddlers find investigating their surroundings with a magnifying glass fascinating (make sure the lens is unbreakable). Show your junior scientist how the magnifying glass works, then provide plenty of opportunities to use it in the house and outdoors.
Sound.
Like your toddler’s eyes, your toddler’s ears are bombarded daily. Even at home, the auditory competition is fierce: There’s music from the radio, a clock ticking, a dog barking in the neigh-bor’s yard, a siren wailing blocks away, an airplane flying overhead, Mommy talking on the telephone, a fan whirling in the kitchen. Encouraging a toddler to focus on a single sound—to shut out the others so that one sound can be fully appreciated—provides a good exercise for young ears.
Flex your toddler’s auditory muscles by playing the “listening” game. Call his or her attention to sounds as you sit in the living room, ride in the car, or walk through the park. “Do you hear that siren (whooo, whooo, whooo)? That sounds like a fire engine.” “Do you hear the birdie singing (tweet, tweet, tweet)? It sounds pretty.” “Do you hear the airplane (vrooom) up in the sky? Isn’t it loud?” (Cover your ears with your hands to emphasize the loud noise.) As your child gets older and comprehends more, you can add more details: “We can’t see the bird because it’s too high up in the tree, but we can hear the singing.” “The fire engine is going to a fire.” “I wonder where the airplane is going. Maybe to California, where Grandma lives.”
When your toddler is older you can intensify the auditory experience and double the fun by turning the listening game into a guessing game. Have your toddler close his or her eyes. Then, one at a time, present a variety of sounds (the ticking of a watch, clanging of a bell, music from a music box) for identification. Some older toddlers enjoy playing this game blindfolded, but others may be frightened by having their eyes covered.
The sound of music can be not only entertaining and tranquilizing for toddlers but it can also teach them to be careful listeners. Expose your child to a variety of musical styles (classical, country, folk, jazz, soft rock) on a CD or an mp3 player with external speakers or on the radio (though avoid turning the volume up too high because that could damage hearing). Take in a children’s concert together when one comes to your neighborhood. Play music in the background while your toddler plays, or center play around it, through musical games such as “Ring-Around-a-Rosie” and “Farmer in the Dell.” Dancing to music (alone, in your arms, or holding your hands) will also help your toddler tune in to the sound of music.
And don’t forget to give your toddler a chance to make his or her own “music”—by banging on a pot with a wooden spoon, clanging two spoons together, playing a toy instrument, fingering the keys on the family piano, scratching fingernails across various surfaces (the living room carpet, venetian blinds, the brick on the outside of a building, a piece of paper).
The sound of voices is another fascinating subject for auditory study. Using a tape recorder (there are some especially designed for young children), tape a variety of voices: your toddler’s, yours, your spouse’s, a sibling’s, Grandma’s, Grandpa’s, a friend’s, the baby-sitter’s. Then play them back for your toddler and try to identify them together. You can also include other sounds on the tape for identification: a dog barking, a horn honking, the washing machine agitating, the faucet running, the doorbell ringing.
Smell.
Toddlers’ noses are fairly undiscerning—which probably explains why the odor of their own soiled diapers doesn’t offend them as much as it does those around them. And why they’ll
cuddle up without reservation to a parent who’s just downed a garlicky Caesar salad when everyone else in the house is staying safely upwind. And why, unfortunately, their noses don’t stop them from sampling dangerous substances (such as cleaning fluids or spoiled food) that would smell noxious to an older child or to an adult.
