Gross Motor Development Issues in Toddlers

Gross motor development issues

Hello, Dr.
Lin.
My younger brother is currently one year and seven months old, and he is 85 cm tall and weighs 11.6 kg.
I have a few questions to ask:
(1) He walks with a slight outward toeing and sometimes shuffles his feet.
When he runs, his head bobs back and forth.
Is this normal?
(2) He can walk up and down the stairs while holding onto the handrail with both hands, but when he tries to go up using one hand, he seems to exert a lot of effort and doesn't appear very relaxed.
Is this normal?
(3) For the past three weeks, he has completely refused to drink any formula milk.
I tried giving him fresh milk, but he also refuses that and only wants yogurt.
I'm at a loss.
Is it appropriate to wean him at his current age?
(4) Additionally, I've noticed that he now completely refuses to drink from a bottle or with a nipple and only wants to use a straw or drink from a cup like an adult.
This seems a bit strange...

Xue Er, 30~39 year old female. Ask Date: 2004/11/04

Dr. Lin Wenxian reply Pediatrics

Dr.
Lin Wen-Hsien, the head of the pediatrics department at Tainan Hospital under the Ministry of Health and Welfare, responded to DEAR Xueer: The situation you described in your letter can be considered normal.
A child who is over one year and seven months old typically exhibits developmental milestones such as running, climbing stairs, and descending stairs at this age.
Of course, when assessing motor and neurological development, it is essential to look at the overall condition rather than focusing on a single aspect.
If your child can independently hold a cup, call out for mom or dad, recognize more family members, respond when their name is called, understand simple instructions from adults, and stack a few blocks, they can be considered within the normal range.
Minor differences in individual skills can be monitored further.
You can also take advantage of the infant and toddler health check-ups provided by the government for a more thorough evaluation by a pediatrician.

Regarding foot posture, it typically stabilizes around the age of eight.
Conditions such as in-toeing, out-toeing, bow legs, and knock knees may appear and disappear or persist.
These may be related to congenital factors, and unless they affect walking function, no special treatment is necessary.

In terms of diet, children over one year old should eat foods similar to adults, focusing on solid foods.
Milk intake should be reduced to twice a day.
At this stage, it is more important to encourage children to practice eating a variety of foods to avoid developing picky eating habits.
A new food may require 7 to 8 attempts before a child accepts and becomes accustomed to it.
Therefore, parents need to be patient and foster a pleasant mealtime atmosphere.

After one and a half years of age, children should transition to using a cup for drinking milk or water, and it is not advisable to continue using pacifiers or bottles, as this can lead to oral structural changes.
Additionally, oral hygiene should be emphasized; adults should help children brush their teeth, and children should also start practicing brushing their own teeth.
Tainan Hospital wishes you good health and all the best!

Reply Date: 2004/11/04

More Info

Understanding gross motor development in toddlers is crucial for parents and caregivers, as it helps to identify any potential developmental delays or issues. In your case, your brother is 19 months old, and you have raised several concerns regarding his walking patterns, stair navigation, milk consumption, and drinking habits. Let’s address each of your questions in detail.

1. Walking Patterns: It is common for toddlers to exhibit a wide variety of walking styles as they develop their gross motor skills. Walking with feet turned outward (often referred to as "toeing out") is quite typical at this age. Many toddlers will also walk with a slight waddle or bounce, and their heads may bob as they run due to their developing balance and coordination. As long as your brother is not experiencing pain or discomfort while walking, these behaviors are generally considered normal. However, if you notice that he is consistently struggling to maintain balance or if his gait appears significantly abnormal, it may be worth consulting a pediatrician or a pediatric physical therapist for further evaluation.

2. Stair Navigation: Climbing stairs is a significant milestone in gross motor development. It is normal for toddlers to require support when navigating stairs, and using both hands for balance is a common practice. If he is using both hands to climb up the stairs, that indicates he is using a safe method to ensure stability. When using one hand, it is also typical for toddlers to exert more effort, as they are still developing their strength and coordination. Encouraging him to practice climbing stairs with supervision can help build his confidence and skills over time.

3. Milk Consumption: At 19 months, many toddlers begin to transition away from formula or breast milk to whole milk and other dairy products. It is not unusual for toddlers to show preferences or aversions to certain types of milk. If your brother is refusing formula and whole milk but enjoys yogurt, it may be a sign that he is ready to transition away from formula. You can try offering whole milk in different forms, such as smoothies or mixed with other foods, to see if he is more receptive. It is generally recommended to consult with a pediatrician regarding the best approach to weaning and ensuring he receives adequate nutrition.

4. Drinking Habits: The shift from bottles to cups is a typical part of toddler development. Many children prefer using straws or regular cups as they grow older, as it gives them a sense of independence and mimics adult behavior. If your brother is refusing to use a bottle or nipple but is willing to drink from a straw or cup, this is a positive sign of his development. It is advisable to encourage this behavior, as it can help with fine motor skills and oral development.
In summary, your brother's behaviors appear to be within the normal range for his age. However, if you have ongoing concerns about his walking, stair climbing, or nutritional intake, it is always best to consult with a pediatric healthcare provider. They can provide personalized guidance and support based on his specific developmental needs. Remember, every child develops at their own pace, and variations in milestones are common.

Similar Q&A

Can Hand Coordination Issues in Toddlers Be Corrected?

Dear Director: I have a 3-year-old daughter, and I pay close attention to her growth process, which has been normal. However, she often drops things from her hands, regardless of whether they are light or heavy, big or small. Is this something that can be corrected? Thank you!

Dr. Chen Xianchang reply Rehabilitation
Hello, thank you for your inquiry. Here are my responses and suggestions: 1. There may be a mild brain injury or issues with sensory integration. 2. You can visit a nearby pediatric rehabilitation clinic for evaluation. 3. Early intervention is crucial, as the period before age t...

Understanding Developmental Delays in Infants: Key Concerns and Insights

The child was born weighing 2300g and is currently 8.5 months old. He appears to have some hypotonia, with a weight of 6 kg and a height of 62 cm, both below the 3rd percentile, while his head circumference is at the 85th percentile. We have consulted with specialists in neurolog...

Dr. Xiao Kaiwen reply Pediatrics
When can a child catch up to their same-age peers, and can hypotonia improve or recover? This depends on the underlying cause of their developmental delay. Conditions such as brain injury (e.g., birth asphyxia, meningitis, encephalitis, intracranial hemorrhage), chromosomal abnor...

Understanding Frequent Falls in Toddlers: Coordination and Rehabilitation Insights

Hello Doctor: My daughter is four years old and has been diagnosed with tightness in her calf muscles, which sometimes causes her to walk on her toes. The doctor advised occasional stretching. Now, she frequently falls while running and sometimes trips over her own feet while wal...

Dr. Su Hongci reply Rehabilitation
Motor development is the foundation for a child's future physical fitness, exploration of the environment, and the beginning of cognitive development and confidence building. If a child consistently falls behind, it may impact subsequent learning. There are many factors that...

Understanding Infant Development: When to Seek Early Intervention

Hello Doctor: For over seven months, my baby's left hand has been contracted, and we went to a neurologist who performed a brain ultrasound and EEG, both of which showed no issues (the left hand is now more flexible). Currently, at nine months, my baby still cannot crawl (sh...

Dr. Yin Xinbei reply Rehabilitation
Both physicians are correct. The first physician found no abnormalities in the neuromuscular system, while the second noted that the child's motor function development is slower. Providing more stimulation to the toddler can promote development. The hospital's early int...