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During toddlerhood, the rate of weight and height gain slows down from the rate of growth during infancy, body fat declines, muscle tone increases, and body proportions change as toddlers take on the physical appearance of children rather than infants. Excess weight gain during toddlerhood can increase the risk of overweight and obesity throughout childhood and adolescence [3, 4], which renders toddlerhood an ideal time to establish healthy dietary and physical activity habits. In 2014, 14.5% of US children aged 2–4 years who were participating in the Special Nutrition Supplemental Program for Women, Infants, and Children were obese (age-and sex-specific body mass index ≥ 95th percentile) [5], underscoring the increasing rates of excess weight gain in toddlers that have been observed globally.

Gross motor skills progress rapidly as toddlers become adept at walking and running without falling. Balance improves, and they are eager to jump and climb. Gradually toddlers build coordination, although skills such as riding a tricycle and catching a ball are often not accomplished before age 3 years.

Gross motor skills and physical activity are related and stimulate reciprocally. A recent review found that among children under 5 years of age, moderate-to-vigorous physical activity was consistently associated with motor development, fitness, and bone and skeletal health [6]. The World Health Organization has recently released guidelines for physical activity among children under 5 years of age [7], emphasizing the importance of toddlers developing appropriate physical activity habits.

By 12 months of age, oral motor skills, including tongue laterality, have progressed to enable toddlers to handle increasingly complex food by chewing, moving food to the back of the oral cavity, and swallowing. Fine motor skills also advance as toddlers practice picking up and manipulating small items, such as blocks and toys. They learn to stack blocks and to color with crayons. Applied to self-feeding, toddlers progress from using their hands to using utensils, and from drinking from a cup with a protective spout to an open cup. Although the advancing skills are often accompanied by spills and messes, they add to toddlers’ sense of mastery and autonomy.