| Development: |
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Walks quickly, walks up stairs with one hand held, walks backwards, climbs up onto an adult chair, may run. Eats with a spoon and a fork, stacks blocks, scribbles with crayons. Knows the location of objects that have been hidden, plays at pretend games such as drinking from an empty cup, hugging a toy doll, talking into a toy telephone.
Understands commands, points to body parts on command, may put two words together. Likes to play with other children. |
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| Nutrition: |
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Parents are encouraged to have regular family meals with casual conversation. A decline in appetite may occur but should not limit the intake of the essential components of growth.
Avoid arguments with a child about food intake. Many children this age have particular and often fickle preferences. Do not allow the child to be mobile with food in his mouth.
Vitamins are unnecessary if the diet includes fruits and /or vegetables. Children should be feeding themselves and drinking from a cup. Children should not have excessive amounts of fat, sodium, or sugar in their diet.
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| Oral Health: |
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Continue to brush your toddler’s teeth twice a day with a fluoridated toothpaste. The manual dexterity to clean their own teeth is not present until the age of 4 or 5 years. |
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| Sleep: |
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Some children continue to take two naps a day, others may only have one nap in the middle of the day. Even if children resist sleeping during the day, a regular rest or quiet time should be expected. Encourage a regular bedtime and routine. Regularly reading to children at bedtime fosters language development and decreases bedtime problems. Frequently encountered sleep problems include resistance to falling asleep, nighttime awakening, and night fears. |
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| Toilet Training: |
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Toilet training is possible only when the child is developmentally ready. Training should be delayed until the toddler is dry for periods of about two hours, knows the difference between wet and dry, can pull their own pants up and down, wants to learn, and can let you know when they are about to have a bowel movement. You may want to set up a potty chair so that the child can imitate other family members as they use the bathroom. Parents should encourage or offer rewards for success but should not use shame or punishment if the child is not successful. Most children demonstrate readiness for toilet training between 24 to 30 months of age. |
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| Behavior: |
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Children at this age rarely share. They enjoy active play such as chase and tag. Children this age are frequently interested in the contents of drawers, cabinets, and wastebaskets! Limit disciplining at this age by using structure, routine, distraction, gently restraint of the toddler, removing the object or toddler from the situation, and ‘time out’. ‘Time out’ to a child under the age of 2 mainly establishes who is in charge and later provides a chance for the child to think about the misbehavior. Playpens or cribs usually work well for younger children who do not understand staying in a chair or some other specified location. The parent may need to stay with the child because isolation at this age can be disturbing. A good rule of thumb for length of a time out session is 1 minute for every year of age. |
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| Injury Prevention: |
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Stair and window safety guards should be in place.
Always use seat belts or car seats.
Supervise children when playing near a street or driveway. Never leave children unattended in a car or alone in the home. Remember that the toddler is very active and needs protection from their new environment. Confine outside play to areas within fences and gates.
Reexamine the hot water temperature to ensure that it is below 120 degrees. Provide constant supervision whenever the toddler is around water, buckets, toilets, bathtubs or pools. Young siblings should not be left alone to supervise a toddler. Continue to empty buckets, pools and tubs immediately after use. Keep bathroom doors closed.
Obtain a bottle of Ipecac to have on hand should your child ingest a harmful substance. Obtain instructions from the poison control center or other health professional before giving Ipecac.
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| Safety Tips: |
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- Get down on the floor and check for hazards at their level.
- Use plastic plugs for outlets and safety latches on cabinets and drawers.
- Keep poisonous substances out of baby’s reach or behind locked doors.
- Use gates on top and bottom of unprotected stairways.
- Keep small and sharp objects out of reach to keep them out of their mouths.
- Do not give infants latex balloons or plastic bags to play with.
- Empty tubs and pools immediately after use. Remember that toilets and buckets of liquid are also potential hazards.
- Turn handles of pans on the stove inward. Avoid placing hot liquids where they can be tipped over or on surfaces with tablecloths that can be pulled off.
- Use smoke alarms and never leave the child alone in the house.
- Lower crib mattress to lowest level and keep curtains and curtain cords out of reach.
- Never leave a child alone with a pet and instruct them to use caution when approaching an eating or unknown dog.
- Keep toddlers away from moving machinery, driveways and streets.
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| Illness: |
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What to call for:
- Fever (above 101)
- Unusual fussiness or tiredness
- Rashes
- Poor Eating
- Vomiting
- Diarrhea
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| Immunizations: |
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Vaccines for diphtheria, tetanus, and pertussis (DTaP), and haemophilus influenzae type B (HIB). Minor reactions, including mild fever and redness, swelling or tenderness at the site of the shot, are not uncommon. Giving the correct dose of Tylenol (Acetaminophen) or Motrin (Ibuprofen) and placing a warm cloth over the site may provide some comfort. Call the office if your child develops a high fever or has any other unusual reaction. |
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| Next visit at 2 years. Hepatitis A vaccine will be offered at the two year visit. No other vaccines will be needed unless the child is behind on other immunizations. |
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| Please call your insurance company before your next visit to find out if they cover vaccines. If they do not, it will be much less expensive for you to have the vaccines done at the Health Department. We can give you more information about this if you call us at 492-1999. |
