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Well Child Visits

2 Year Visit

At this visit, your doctor will …

  • Check your toddler’s weight, height and head circumference; Assess Body Mass Index (BMI).
  • Do a screening test that helps identify developmental delays or autism.
  • Do a physical exam with your toddler undressed while you are present to include: eye exam, tooth exam, listening to the heart and lungs, and paying attention to your toddler’s motor skills and behavior.
  • Discuss your toddler’s development.
  • Address any concerns/questions you may have.
  • Immunizations: No vaccines at this check up unless there is a need to catch up.

Eating

  • Offer your toddler 3 meals and 2-3 nutritious snacks a day, but don’t be surprised if he/she skips a meal occasionally, or loves something one day and not the next.
  • Growth slows down in the second year of life so don’t be surprised if your child’s appetite has decreased.
  • Limit juice to no more than 4 ounces (120 ml) a day.
  • Avoid foods that are high in sugar and fat and low in nutrients including sugary drinks like soda.
  • Begin the switch to low-fat or nonfat milk, or a fortified-milk alternative like almond or soy milk. Offer dairy products that are low-fat or nonfat.
  • As you introduce more foods, the appearance and frequency of your child’s poopy diapers may change. Let your doctor know if your child has diarrhea, is constipated, or has poop that’s hard to pass.

Sleeping

  • There’s a wide range of normal, but generally toddlers need about 11 to 14 hours of sleep a day, including one daytime nap.
  • Stick to a regular bedtime, continue bedtime routines, and keep them calm and comforting.
  • If your child wakes up at night, reassure, and give blanket or toy to hold. Keep interaction brief.

Tips

  • Consider joining or starting a toddler playgroup.
  • Visit the library or bookstore with your child.
  • Make sure you are taking care of yourself.
  • Always ask us if you need help finding resources for your family.

Routine Baby Care

General Care

  • Keep daily routines for your toddler; Continue feeding, sleeping, bathing and playing routines.
  • Watch over your toddler as he/she explores inside and outside of the home.
  • Keep outings with your toddler brief – 1-2 hours or less

Healthy Teeth

  • Let your child brush his or her teeth with your guidance. Twice a day, use a small amount of toothpaste (about the size of a pea) with a soft toothbrush. Go over any areas that may have been missed.
  • Any concerns or problems with teeth should be examined by a dentist, but regular teeth cleanings are typically recommended at 3 years of age. Some dentists will schedule an exam (without cleaning) between 18 months – 2 years.

Development

  • Play often with your toddler and read to him/her everyday.
  • Talk about and describe pictures in books and the things you see and hear together.
  • Parent-child play, where the child leads, is the best way to help toddlers learn to talk.
  • Your child may love hearing the same story over and over.
  • Ask your child to point to things as you read.
  • Stop a story to let your child make an animal sound or finish a part of the story.
  • Use correct language; be a good model for your child.
  • Talk slowly and remember that it may take a while for your child to respond.

By 2 years, it’s common for many children to:

  • Say more than 50 words
  • Form small 2 word sentences
  • Follow a 2 step command
  • Run
  • Kick a ball
  • Walk down stairs
  • Make lines and other scribbles
  • Play with other children

     * All children develop at different rates, and meet developmental milestones differently.

Your Child and TV

  • Limit screen time for your toddler (TV, videos, computers, phones) to no more than 1-2 hours per day.
  • Watch TV with your child and discuss what you see.
  • Be careful about the programming and advertising your young child sees.
  • It is better for toddlers to engage interactive, non-screen, play.

Toilet Training

  • Most children do well with “potty” training between 2 and 3 years of age.
  • Look for the signs that your child is ready to start toilet training. If he or she doesn’t show interest, it’s OK to wait before trying again. A child who uses the potty and is accident-free during the day may still need a diaper at night.
  • Signs that your toddler is ready to begin toilet training are:
    • Dry diapers for longer periods.
    • Knows if he/she is wet or dry.
    • Can pull pants down and up.
    • Wants to learn – shows interest in a parent/sibling using the bathroom.
    • Can tell you if he/she is going to have a bowel movement.
    • Plan for toilet breaks often – children use the toilet as many as 10 times each day.
    • Help your child wash his/her hands after using the toilet and diaper changes.
    • Clean potty chairs after every use.
    • Take the child to choose underwear when he/she feels ready to do so.

Behavior and Discipline

  • Set reasonable and consistent rules.
  • Praise your child for behaving well and redirect unwanted behavior.
  • It is normal for your child to protest being away from you or meeting new people.
  • Listen to your child and treat him with respect. Expect others to as well.
  • Play with your child each day, joining in things the child likes to do.
  • Hug and hold your child often.
  • Give your child choices between 2 good things in snacks, books, or toys.
  • Help your child express his feelings and name them.
  • Help your child play with other children, but do not expect sharing.
  • Never make fun of the child’s fears or allow others to scare your child.
  • Watch how your child responds to new people or situations.
  • Your child may be independent or clingy as they learn to navigate new situations. This is normal. Be patient.

Safety

Car Safety

  • Be sure your child’s car safety seat is correctly installed in the back seat of all vehicles.
  • All children 2 years or older (or those younger than 2 years who have outgrown the rear-facing weight or height limit for their car safety seat) should use a forward- facing car safety seat with a harness for as long as possible, up to the highest weight or height allowed by their car safety seat’s manufacturer.
  • Everyone should wear a seat belt in the car. Do not start the vehicle until everyone is buckled up.

Child Safety Seat Inspection:
1-866-SEATCHECK (732-2432) or www.seatcheck.org

General Safety

  • Make sure places your child stays and plays are safe.
  • Never leave your child alone in your home or yard, especially near cars, without a mature adult in charge.
  • When backing out of the garage or driving in the driveway, have another adult hold your child a safe distance away so he is not run over.
  • Keep your child away from moving machines, lawn mowers, streets, moving garage doors, and driveways.
  • Have your child wear a good- fitting helmet on bikes and trikes.
  • Never have a gun in the home. If you must have a gun, store it unloaded and locked with the ammunition locked separately from the gun.

Medication

  • Always follow the advice of your doctor when giving any medication.
  • Use our Medication Dosing Chart as a guideline for the appropriate dose of Tylenol (acetaminophen) or
    Advil/Motrin (ibuprofen) to give baby.