2 Year Well-Child Visit

• Feeding: Your child should be completely off the bottle and able to drink from a small glass without spilling. Milk intake should be between 12 and 24 ounces per day, you can transition to low fat milk at this time. Offer your toddler small servings of nutritious food for three meals and two snacks per day. Attention spans are short. If your child is playing with her food or wants to get down from the table, allow her to but clear away the dishes and don’t offer cookies or crackers to make up for what she didn’t eat. If she’s hungry, she’ll enjoy her next scheduled meal or snack that much more. Rule of thumb on portion size: a “serving” is equal to 1 tablespoon for every year of age.
• Elimination: Toddlers are rarely ready to begin the potty training process until they are 24-30 months old. Children are ready to begin when they awake from naps with dry diapers, use words to signal that they have wet or dirty diapers, or when they begin to develop a routine of grunting or straining after a meal. Take advantage of their natural curiosity by explaining the process to her when she follows you into the bathroom. When you see these signs encourage your child to sit on the potty chair and praise her for any success.
• Sleep: Most 2 year olds sleep 10-12 hours at night. Some begin to resist their afternoon naps, but they need at least 1 hours of rest time in their beds each afternoon. Comfort items such as a special blanket or toy can be very helpful as can keeping a consistent bedtime routine. If your child has not already given up the pacifier, begin to encourage its use only at nap or bedtime.

Development:

• Motor Skills: Most 2 year olds are able to run safely, climb on furniture to look out the window, walk upstairs and often down while holding onto the railing or wall. They are beginning to undress themselves without help and pull on simple clothes. They usually hold crayons with their preferred hand and can make circular scribbles as well as imitating a vertical line. They turn pages singly and recognize familiar people or characters in pictures.
• Communication/Socialization: Your child now uses 50 words but recognizes many more. They put two to four words together to form simple sentences and refer to themselves by name. Stammering and stuttering is common and is best ignored.

Safety: Children this age explore the environment without fear. They are unable to differentiate actions that may be dangerous. Close observation at all times is essential to keep your child safe.

• Continue to use a car safety seat. If you have a passenger side airbag, your child needs to remain in the back seat until age 12 years. If your child attempts to get out of the seat, stop the car.
• Never leave your child alone in the car, tub, home or yard. Hold tightly to her hand as you walk through parking lots. Stay with her around any water, animals, or fire.
• Make certain that the crib mattress is at the lowest position. Change to a toddler bed if she climbs out of the crib or consider purchasing a crib tent.
• Any guns in the home should be locked up with ammunition kept separately.
• Keep matches lighters and cigarettes in a high, latched cabinet. Never allow smoking in your home or car.
• Keep the Poison Control phone number by your phone (1-800-222-1222).
• Protect any open windows with secure screens or barriers.
• Use smoke and carbon monoxide detectors and check them twice a year.

Parenting: Discipline with love by using firm, consistent rules. Tantrums are common at this stage. Use time-out and distraction for unacceptable behavior and always generously praise your child for good behavior. Give your child a choice whenever possible: “would you like to brush your teeth now or after a story?” Limit TV watching to less than 2 hours per day of good quality children’s entertainment. This is an excellent time to start giving your child some duties such as picking up her clothes and putting them in a hamper.

Play: Reading remains one of the most important activities that you can share with your child. 2 year olds can enjoy singing, dancing and rhymes. They now will play alone for longer periods of time and also play alongside other children but continue to have difficulty sharing toys. They enjoy being outside. Many two year olds enjoy riding toys like a tricycle but most still have difficulty with the pedals choosing instead to propel themselves forward with their feet. Be sure to establish the healthy habit of wearing a helmet for riding toys early.

Next visit is at 3 years of age.