Your 2 Year Old

Developmental Milestones*

• Copies things that you do.
• Speaks in 2-3 word sentences
• Stacks towers of 5-6 small blocks
• Kicks a ball
• Plays alongside other children
• Walks up and down stairs holding wall or railing
• Names 1 picture
• Follows 2-step commands
• Throws a ball overhand
• Jumps up

 *All children develop differently.  If your 24-month-old hasn't yet reached these milestones, rest assured that she will soon. If you have concerns about your child's development, please schedule an appointment.

Feeding

No more than 24 ounces of milk per day is necessary.  In fact, 16-18 ounces per day is preferable.  You should now switch to either 2% or 1% milk, as babies do not need the high fat content of whole milk after age two.

Remember that nutrition is a very important component of your child’s health.  By now your toddler should be eating according to your schedule.  Snacks are important.  It is normal if your toddler is becoming more and more of a picky eater.  Continue to offer new and exciting choices.  Encourage your child to try something new.  He or she may surprise you.  Keep the definite foods on the backburner; however, you still need them to eat enough calories—even if it is the same thing for breakfast, lunch, and dinner!  Please inform us if you believe your child is not gaining weight or eating enough. 

We still only recommend pear or prune juice for the treatment of constipation.  No other juices are necessary and can lead to tooth decay. 

Calcium fortified orange juice can be beneficial if your baby does not like milk.  Cheese, yogurt, and ice cream are also helpful substitutes. 

Even though your child is becoming a more competent eater, there's still a chance he may choke on his food.  Continue to avoid common choking hazards like popcorn, grapes, hard candy, whole nuts, chewing gum and hot dogs.  Cut foods into small pieces and discourage your child from doing anything that might distract him from his meal. 

Please continue to administer a multi-vitamin with fluoride daily.  If you are interested in switching to a chewable vitamin, please ask during your child’s physical. 

Toilet Training

It seems like just yesterday that you changed your baby's first diaper, and now you're wondering if it's time to start toilet training.  There's no magic age at which children are ready to give up their diapers.  Most children will be developmentally ready between 2 and a half to 3 years old.  Some may be ready as early as 18 months while others are not interested in potty training until they're closer to 3, or even 4.

Keep in mind that starting before your child is truly ready does not mean you'll finish sooner — it's more likely that the process will just end up taking longer.   We cannot stress this enough.  This is one of those things that just cannot be rushed.  Children who struggle with constipation fare much better if they train a little on the later end.  If toilet training is not going well, do not hesitate to stop and try again in a few weeks.  
 
Use the checklist below to measure your toddler's progress toward readiness:

• Urinates a fair amount at one time.
• Has "dry" periods of at least three or four hours
• Dislikes the feeling of wearing a wet or dirty diaper.
• Shows interest in others' bathroom habits
• Wants to wear “big boy/girl” underwear.
• Asks to use toilet or learn how.
• Gives a physical or verbal sign when he's having or is about to have a bowel    movement.

Sleep

Most children require around 10-12 hours of sleep per night, although this is variable.   Some 2 year olds still nap during the day.

Your child may remain in his or her crib for as long as it is safe.  Once they start to climb out, they are safer in a toddler bed.  Be sure to utilize safety gates at night to prevent them from falling down stairs. 

Bedwetting may persist even if successful training occurs during the daytime.  This is normal.  Reward dry nights but do not punish accidents.  Restrict fluids after dinnertime.  Wake them to use the bathroom before your retire.  Be sure to discontinue use of Pull-ups as soon as dry nights are mostly achieved.  Protect their mattress and allow children to have accidents; this helps them learn.  Once children become dependent upon Pull Ups at night, it is very difficult to take them away.

Activity                     

• Don’t forget to brush your child’s teeth at least twice a day. A pea-sized amount of toothpaste may be used. If you notice any stains or discolorations on your baby’s teeth, please let us know. It is now time for your child to have their first dental visit. Please ask us if you need a pediatric dentist.
• A car seat is very important.  The car seat must be in the back of the car.  Most 2 year olds will be forward facing in convertible car seats or high back boosters with 5-point harnesses.  Please check your seat’s user manual to ensure your child is in the right seat according to his or her weight, age, and height.
• Avoid sun exposure since your child’s skin is delicate and more likely to burn. Sunscreen can safely be used and should be reapplied often.  
• Monitor your child at the pool or beach at all times.  Educate your children never to swim unsupervised.  It is never too early to start teaching them this.  Strongly consider purchasing a pool safety fence or cover for your home pool.  Lock all hot tub covers. 
• Insect repellent may be used.  Deet-free brands are preferable.  To be safe, only apply insect repellents to exposed skin. Do not apply it under clothing, on a child's hands, near the mouth or eyes, or over cuts and irritated skin.  Wash off insect repellents once it is no longer needed. Combination sunscreen/insect repellent products should be avoided, as sunscreen needs to be reapplied often.  Insect repellent should only be applied once per day.  
• Have this number handy (although we hope you never need it): POISON CONTROL 1-800-222-1222.

Vaccines

Your child may receive immunizations during his/her 2-year visit.  Please visit the vaccine section of this website for more information on specific vaccines and their administration schedule. 

Please note that we will not administer vaccines to any child whose parent or guardian is not present for the visit.  This is our office policy.  We understand that parents have busy schedules but no exceptions to this rule will be made.

Complete Blood Counts and Lead Testing

We routinely send all one and two year olds for blood testing.  You will receive a prescription at your child’s physical to take with you to a lab.  We report all normal and abnormal results.  If you have not received a phone call regarding your results within 5 days of going, please notify our office.  When you call, please let the receptionist know where and when you took your child so that we may track down their results. 

Why lead?  Abnormally high exposure to lead can harm a child’s growth, behavior, and ability to learn.  For years, lead was used in paint, gasoline, plumbing, and many other items.  Lead is still in some kinds of pottery.  As things are used or get worn out, the lead they contain can spread. Lead paint was banned from home use in 1978. If you live in a home built before 1978, or near a busy road, there could be lead in your house dust and soil.  A child can get lead poisoning by swallowing or breathing in lead. Young children spend a lot of time on the floor. They like to put hands, toys, and other things in their mouths. This raises their chances of swallowing lead dust and paint chips. Only a tiny amount of lead is needed to harm a young, growing child.

What is a complete blood count (CBC)?  A complete blood count is a measure of the different kinds of cells in the blood.  It is used to determine general health status and to screen for and monitor a variety of disorders.  It can detect many issues-- from anemia to leukemia.   

If you have any other concerns regarding your child’s health, would like any other testing done, or have a family history of any disorder, please let us know.  We may want to add some tests to your child’s blood work prescription.  

Medicines