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Developmental milestones and nutrition for babies aged 12-18 months


Brain development

From 12 months of age baby’s memory improves due to the development of the cerebral cortex, and they may seek out a favourite toy specifically rather than simply recognizing it when it is in front of them. For example, baby may ask “where’s teddy?”. The improvement in memory may also see an increase in separation anxiety when left with caregivers that are not the parents. While it can be distressing to see your little one upset, it is a normal part of development.

Once baby reaches about 18 months of age, the myelination of nerves and neurons involved in electrical signals is complete, as well as the development of the hippocampus (involved in recognition, spatial awareness and moving in different directions). The brain development during this time sees an increase in cognitive abilities, language and self-awareness. The brain continues developing until about the age of 3 [1,10].


Key nutrients for brain development

Nutrient Function Dietary Sources  RDI
DHA Critical for making new connections and neural activity in the brain. Contribute to immune function. Breastmilk or Infant Formula.

Fish: Salmon, tuna, sardines, marine algae/algal oil

AI: 10-12mg / kg of body weight [8]
Choline Supports cell division & growth. Supports neurotransmitter production in the brain. Breastmilk or Infant Formula.

Eggs, salmon, meat, broccoli.

200mg
Iron Brain development, red blood cells and energy. Breastmilk or Infant Formula

Red meat, spinach, lentils, fortified cereals.

9mg
Folate Brain development, neurotransmitter function & cell division. Breastmilk or Infant Formula.

Spinach, kale, broccoli, chickpeas

150mcg
Zinc Immune system support, hair, skin and nail growth and maintenance. Breastmilk or Infant Formula.

Meat, seafood, pumpkin seeds, nuts.

3mg
Vitamin D Deficiency may cause behavioural, memory, and learning disorders later in life [13]. Vitamin D promotes uptake of calcium, which is essential in neuron signaling. Breastmilk or Infant Formula. (Breastmilk contains low levels of vitamin D. Sunlight exposure is needed)

Sunlight exposure.

Eggs, fish, mushrooms.

5mcg
Vitamin B12 Support brain development, nervous system function and energy. Meat, fish, eggs, dairy. 0.9mcg [9]

RDI = Recommended Daily Intake 

AI = Average Intake 


Eye development

By 12-14 months, baby can recognize their own face in the mirror and point or gesture towards objects. They may also be able to recognize familiar objects in picture books and point when asked “where is..?” [5]. Baby now has clear distance vision and good depth perception, and the movements of the eyes have become more refined [2].

By now, baby should be eating a full diet, and although it can difficult getting toddlers to eat vegetables, offering lots of brightly coloured fruits and vegetables will provide vitamins, minerals and carotenoids supportive of healthy eyes and vision.


Key nutrients for eye development

Nutrient Function Dietary Sources RDI
Vitamin A Required for vision and retina development. Breastmilk or Infant Formula

Retinol (active vitamin A): meat, dairy, eggs.

Beta-carotene (precursor to retinol): pumpkin, sweet potato, mango, kale, broccoli.

300mcg [9]
Lutein A carotenoid that accumulates in the retina where it prevents damage from reactive oxygen species caused by light. Breastmilk or Infant Formula

Kale, spinach, broccoli, egg yolks.

No RDI set
DHA Needed for the growth and development of the brain and retina, where it accumulates [14]. Also supports eye fluids and soft tissues. Breastmilk or Infant Formula

Fish: Salmon, tuna, sardines, marine algae/algal oil

AI: 10-12mg / kg of body weight [8]

Intestinal and gut microbiota development

As baby is enjoying a wide variety of foods, including lots of different types of fruits, vegetables, wholegrains and cultured or fermented foods that can help the development of baby’s microbiome. During the first 2 years of life, the gut is forming bacterial colonies that can influence long-term health [3]. If baby has taken a course of antibiotics, it is important to replenish the gut microflora by taking an infant probiotic and increasing pre and probiotic foods in the diet, because antibiotics can inactivate “good” and “bad” bacteria.


Immune system development

As the immune system continues to develop you can expect baby to get sick a lot. Every new pathogen encountered will mount an immune response, whereby baby will create antibodies, building the immune system’s defence mechanism. As the immune system matures, the number of illnesses drops, because the immune system has learned how to respond.

By providing baby with a balanced, nutritious diet, you can help to support the normal function of the cells and tissues that make up the immune system. While you can’t necessarily prevent baby from getting sick, a healthy diet can improve the body’s immune response and decrease recovery time.

Vitamin C and zinc have been shown to reduce the frequency and duration of the common cold virus in children [4], while beta-glucan has been shown to reduce the number of sick days and respiratory symptoms observed in children in a day care setting and improve overall health [5].

Omega-3 is another essential nutrient for immune system health.  While some degree of inflammation is necessary for a healthy immune response, too much can be detrimental. The fatty acids EPA and DHA found in fish and marine algae improve the immune system by reducing excess inflammation and influencing the function of immune cells [15].


Key nutrients for digestive and immune development

Nutrient Function Source RDI
Vitamin A Formation and maintenance of mucous membranes (intestines), immune system development and function. Plays a role in measles prevention. Breastmilk or Infant Formula

Retinol (active vitamin A): meat, dairy, eggs.

Beta-carotene (precursor to retinol): pumpkin, sweet potato, mango, kale, broccoli.

300mcg
Zinc Formation and maintenance of mucous membranes (intestines), immune system development and function. Helps in healing and tissue repair. Contributes to preventing childhood diarrhea. Breastmilk or Infant Formula

Meat, seafood, pumpkin seeds, nuts.

3mg
Vitamin C Formation of collagen and connective tissue, immune system development and function. Breastmilk or Infant Formula

Cirtus fruits, kiwi fruit, mango, apple, pear

35mg [9]
DHA Immune system development and communication between immune cells. Breastmilk or Infant Formula

Fish: Salmon, tuna, sardines, marine algae/algal oil

AI: 10-12mg / kg of body weight [8]
Prebiotics Prebiotics – help to feed beneficial bacteria that colonize and reside in the gut. They also help with softening the feces. Breastmilk or Infant Formula

Chickpeas, lentils, beans, banana, onion, asparagus, chicory, leek, berries.

No RDI set
Probiotics Digestive health and immune system development and support. Yoghurt, kefir, kim chi, sauerkraut, miso, tempeh. No RDI set
Lactoferrin Stimulates the immune system, promotes growth of gut microbes; antibiotic properties. Breastmilk or Infant Formula

Dairy

No RDI set

Developmental milestones 12-18 months

Gross motor skills: walks independently, crawl up stairs (a good time to invest in a safety gate), play with pull and push toys (eg. push around a toy pram).

Fine motor skills:  Play with blocks and attempt to put them together, turn pages of a book, place small objects into a container, scribble using pencil or crayon.

Self-help skills: begin to use cutlery (spoon and fork), drink from cup unassisted, take off shoes and socks, attempt to put on clothing (eg. put arms through sleeves), help put toys away.

Cognitive skills: Enjoy looking at picture books, able to point to some body parts when asked, follow simple directions, start to match animals sounds to pictures [7].

References
  1. Fox SE, et al. Child Development. 2010; 81:28–40.
  2. http://www.optometrists.org/childrens-vision/guide-to-vision-development/
  3. Mohammadkhah AI, et al. Children (Basel). 2018;5(12):160.
  4. S Maggin Swadh. J Inter Med Res. 2010;38:386-414.
  5. Meng, J Nutr Food Sci. 2016, 6:4
  6. Gutiérrez S, et a. Int J Mol Sci. 2019;20(20):5028.
  7. http://www.childrensmn.org/educationmaterials/childrensmn/article/15317/developmental-milestones-12-to-18-months-/
  8. https://www.who.int/nutrition/topics/FFA_summary_rec_conclusion.pdf
  9. https://www.nrv.gov.au/nutrients
  10. Cusick et al. J Pediatr . 2016 August; 175: 16–21.
  11. Derbyshire E, Obeid R. Nutrients. 2020 Jun 10;12(6):1731.
  12. Cusick SE, Georgieff MK. The Journal of Pediatrics. 2016 Aug;175:16-21.
  13. Cerdó T, at al.Curr Opin Clin Nutr Metab Care. 2019 Nov;22(6):434-441.
  14. Huang HL, et al. Lipids Health Dis. 2013 Mar;12:27.
  15. Gutiérrez S, et al. Int J Mol Sci. 2019;20(20):5028.