| Development: |
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Says about 25 words, uses 2 word phrases. Half of speech understood by others outside family. Can follow 2 step commands Walks with confidence and can carry objects. Can go up and down stairs one at a time. Can kick a ball. Likes to imitate adults and older children.
Children learn appropriate social behaviors through play. The child should experience playing with siblings and peers, as well as by themselves. Do not expect shared play.
Model appropriate language. Encourage language development through reading books, singing songs, and interacting with others. |
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| Nutrition: |
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Encourage the child to feed himself at family mealtimes. Offer 2-3 nutritious snack a day and always let them decide how much to eat. Enforce desired mealtime behavior, not eating. Two year olds will eat a lot at one meal and very little at the next. Make servings small. One tablespoon of each food for each year of age or one quarter of an adult serving is generally an appropriate serving.
2 year olds may develop ‘food jags’ where they will only eat certain foods. Offer a variety of foods, including new ones, and after several tries the child may begin to accept them more readily. Continue to avoid foods which can result in choking such as peanuts, popcorn, hard candy, tough meats, hot dogs and large pieces of fruits or vegetables.
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| Oral Health: |
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By 2 ½ years of age all 20 teeth should be in place. Continue to brush your child’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. It is recommended that your child see a pediatric dentist sometime between ages two and three. |
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| Sleep: |
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By 2 years of age they should sleep through the night and have one nap per day. They are able to talk to and amuse themselves while falling asleep and waking up. Have a regular routine at bed and nap time. Your child may begin to crawl out of his crib so you can change to bed or leave side rails down.
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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 child 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 let them begin to practice with a potty chair, with or without diapers on, letting the child indicate when ready. Avoid a power struggle.
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| Behavior: |
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Negativism, or the use of ‘no’ will teach the child acceptable behavior. Avoid situations where the child can use negative responses. Demonstrate acceptable behavior by giving more attention to desirable behaviors instead of concentrating on the undesirable behaviors. Children at this age are beginning to assert their independence. Praise them for good behavior. Anticipate and avoid unnecessary conflicts. Although you should have fixed limits on acceptable behaviors, sometimes it is wise to give in on some of the small things that don’t really matter. Too many rules are confusing. Limit the number of rules and enforce them consistently and promptly. Spend most of your time rewarding good behavior. Limit disciplining by using structure, routine, distraction, gentle restraint, removing the object or child 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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Continue to use car seats at all time because they protect your child from the major threat to their health. Remember that the 2 year old is very active and needs protection from their new environment. Confine outside play to areas within fences and gates. Young children should be supervised at all times. Reexamine the hot water temperature to ensure that it is below 120 degrees. Provide constant supervision when ever the child is around water, buckets, toilets, bathtubs or pools. Young siblings should not be left alone to supervise a 2 year old. Continue to empty buckets, pools and tubs immediately after use. Close bathroom doors. Obtain a bottle of Ipecac to have on hand should your child ingest a harmful substance. Obtain instructions from the poison control center or another health professional before using it.
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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.
- Keep sharp objects out of reach.
- Do not let your child play with latex balloons or plastic bags because they can cause choking.
- 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 change the batteries yearly. Never leave the child alone in the house.
- Never leave a child alone with a pet and instruct them to use caution when approaching an eating or unknown dog.
- Keep your child away from moving machinery, driveways and streets.
- Supervise on stairs or use locked gates or doors. Use safety locks on windows.
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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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At this visit your child has the option to receive the Hepatitis A vaccine. This is a two dose series. If you choose to give your child this vaccine, he will need the second dose in six months. You should also make sure your child has received all other recommended vaccines for his age. |
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| Next visit at 3 years. No vaccines will be needed if the child is current on his 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. |
