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A prospective longitudinal design was employed to ascertain whether different types of behavioral inhibition (i.e., traditional, peer-social) were stable from toddler to preschool age, and whether inhibited temperament and/or parenting style would predict children's subsequent social and behavioral problems. At Time 1, 108 toddlers (54 males, 54 females) and their mothers were observed in the Traditional Inhibition Paradigm and in a toddler-peer session; then at age 4 years, 88 children were observed with unfamiliar peers, and maternal ratings of psychological functioning were obtained. How mothers and their toddlers interacted was also observed. Results revealed meaningful connections between toddler inhibition, maternal intrusive control and derision, and nonsocial behaviors at age 4. Both forms of toddler inhibition predicted socially reticent behavior during free play at 4 years. If mothers demonstrated relatively high frequencies of intrusive control and/or derisive comments, then the association between their toddlers' peer inhibition and 4-year social reticence was significant and positive; whereas if mothers were neither intrusive nor derisive, then toddlers' peer inhibition and 4-year reticence were not significantly associated. Thus, maternal behaviors moderated the relation between toddlers' peer inhibition and preschoolers' social reticence.

OBJECTIVES: To determine the prevalence of vitamin D deficiency and to examine whether 25-hydroxyvitamin D (25OHD) concentration varies as a function of skin pigmentation, season, sun exposure, breastfeeding, and vitamin D supplementation. DESIGN: Cross-sectional sample. SETTING: Urban primary care clinic. PARTICIPANTS: Healthy infants and toddlers (N = 380) who were seen for a routine health visit. OUTCOME MEASURES: Primary outcomes were serum 25OHD and parathyroid hormone levels; secondary measures included data on sun exposure, nutrition, skin pigmentation, and parental health habits. Wrist and knee radiographs were obtained for vitamin D-deficient participants. RESULTS: The prevalence of vitamin D deficiency (< or =20 ng/mL) was 12.1% (44 of 365 participants), and 146 participants (40.0%) had levels below an accepted optimal threshold (< or =30 ng/mL). The prevalence did not vary between infants and toddlers or by skin pigmentation. There was an inverse correlation between serum 25OHD and parathyroid hormone levels (infants: r = -0.27, P < .001; toddlers: r = -0.20, P = .02). In multivariable models, breastfeeding without supplementation among infants and lower milk intake among toddlers were significant predictors of vitamin D deficiency. In vitamin D-deficient participants, 3 participants (7.5%) exhibited rachitic changes on radiographs, whereas 13 (32.5%) had evidence of demineralization. CONCLUSIONS: Suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D status vary in infants vs toddlers, information that is important to consider in the care of these young patients. One-third of vitamin D-deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.

Abstract This study was designed to examine parenting self‐efficacy beliefs as correlates of mothers' competence in parenting toddlers and as predictors of toddlers' behavior and development. Sixty‐eight predominantly middle‐class mother–toddler pairs participated in this study. Mothers completed questionnaires, toddlers were administered the Bayley Scales of Infant Development (BSID‐II), and each dyad participated in the Crowell Procedure, which is designed to observe parent and toddler behaviors in a semistructured laboratory context. Although domain‐general and domain‐specific parenting self‐efficacy beliefs were not associated with parenting competence, domain‐specific beliefs were significantly related to toddlers' scores on the Mental Scale of the BSID‐II and several behaviors observed during the Crowell Procedure (Affection Towards Mother, Avoidance of Mother, Compliance, Enthusiasm, and Negativity). Implications of the findings are discussed. ©2003 Michigan Association for Infant Mental Health.

Iron deficiency (ID) is the most common micronutrient deficiency worldwide and young children are a special risk group because their rapid growth leads to high iron requirements. Risk factors associated with a higher prevalence of ID anemia (IDA) include low birth weight, high cow's-milk intake, low intake of iron-rich complementary foods, low socioeconomic status, and immigrant status. The aim of this position paper was to review the field and provide recommendations regarding iron requirements in infants and toddlers, including those of moderately or marginally low birth weight. There is no evidence that iron supplementation of pregnant women improves iron status in their offspring in a European setting. Delayed cord clamping reduces the risk of ID. There is insufficient evidence to support general iron supplementation of healthy European infants and toddlers of normal birth weight. Formula-fed infants up to 6 months of age should receive iron-fortified infant formula, with an iron content of 4 to 8 mg/L (0.6-1.2 mg(-1) · kg(-1) · day(-1)). Marginally low-birth-weight infants (2000-2500 g) should receive iron supplements of 1-2 mg(-1) · kg(-1) · day(-1). Follow-on formulas should be iron-fortified; however, there is not enough evidence to determine the optimal iron concentration in follow-on formula. From the age of 6 months, all infants and toddlers should receive iron-rich (complementary) foods, including meat products and/or iron-fortified foods. Unmodified cow's milk should not be fed as the main milk drink to infants before the age of 12 months and intake should be limited to <500 mL/day in toddlers. It is important to ensure that this dietary advice reaches high-risk groups such as socioeconomically disadvantaged families and immigrant families.

The authors examined the relations of maternal supportive parenting to effortful control and internalizing problems (i.e., separation distress, inhibition to novelty), externalizing problems, and social competence when toddlers were 18 months old (n = 256) and a year later (n = 230). Mothers completed the Coping With Toddlers' Negative Emotions Scale, and their sensitivity and warmth were observed. Toddlers' effortful control was measured with a delay task and adults' reports (Early Childhood Behavior Questionnaire). Toddlers' social functioning was assessed with the Infant/Toddler Social and Emotional Assessment. Within each age, children's regulation significantly mediated the relation between supportive parenting and low levels of externalizing problems and separation distress, and high social competence. When using stronger tests of mediation, controlling for stability over time, the authors found only partial evidence for mediation. The findings suggest these relations may be set at an early age.

Functional gastrointestinal disorders (FGIDs) are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on the symptom-based Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents. In this review, we discuss the novel Rome IV criteria for infants and toddlers. The criteria for infant colic were drastically changed, whereas only minor changes were made for regurgitation, cyclic vomiting syndrome, functional diarrhea, infant dyschezia and functional constipation. In addition to this, the new Rome IV discusses underlying mechanisms of pain in infants and toddlers, including the neuro-development of nociceptive and pain pathways, the various factors that are involved in pain experience, and methods of pain assessment in infants and toddlers is essential for the clinician who encounters functional pain in this age group. Overall, the Rome IV criteria have become more distinctive for all disorders in order to improve the process of diagnosing pediatric FGIDs.

PURPOSE: This exploratory study investigated the responsive language input of 26 child care providers to young children enrolled in community child care centers. METHOD: Three subtypes of responsive interaction strategies were rated and compared across two age groups (toddlers, preschoolers) and two naturalistic contexts (book reading, play dough activity). The toddlers were between 17 and 33 months of age and the preschoolers were between 30 and 53 months of age. Caregiver-child interactions were rated using the Teacher Interaction and Language Rating Scale (Girolametto, Weitzman, & Greenberg, 2000) to provide information about the frequency of responsive language strategies. RESULTS: Caregivers used similar levels of child-centered and interaction-promoting strategies with both age groups, but used more labelling with toddlers and more topic extensions with preschoolers. The context of the interaction exerted a systematic influence on the caregivers' use of responsive strategies, with the play dough activity providing the most responsive input overall. There was a strong positive relationship between all three subtypes of caregivers' responsiveness and variation in the preschoolers' language productivity. In contrast, only interaction-promoting strategies were positively related to measures of the toddlers' language productivity. CLINICAL IMPLICATIONS: The results of this study suggest that caregivers' responsiveness in group interactions is highly dependent on the context of the interaction and, to a lesser extent, on the language abilities of the children. Future research is required to determine if inservice training can enhance levels of responsiveness and accelerate language learning in young children in group care.

In this Monograph, we examine how toddlers and their caregivers from four cultural communities collaborate in shared activities. We focus both on similarities across communities in processes of guided participation--structuring children's participation and bridging between their understanding and that of their caregivers--and on differences in how guided participation occurs. We examine the idea that a key cultural difference entails who is responsible for learning--whether adults take this responsibility by structuring teaching situations or whether children take responsibility for learning through observation and through participating in adult activities with caregivers' support. We speculate that these two patterns relate to cultural variation in the segregation of children from adult activities of their community and in emphasis on formal schooling. The four communities of our study vary along these lines as well as in other ways: a Mayan Indian town in Guatemala, a middle-class urban group in the United States, a tribal village in India, and a middle-class urban neighborhood in Turkey. In each community, we visited the families of 14 toddlers (aged 12-24 months) for an interview that was focused on child-rearing practices, which included observations of caregivers helping the toddlers operate novel objects spontaneously during adult activities. Results are based on systematic analysis of patterns of communication and attention in each family in each community, combining the tools of ethnographic description, graphic analysis, and statistics.(ABSTRACT TRUNCATED AT 250 WORDS)