Well Child Care 2 1/2 Years

Family meals are important for your child. Letting your child eat with you makes her feel like part of the family. Let your child feed herself. It is good to let your child help choose what foods to eat. Be sure to give her only nutritious foods to choose from. Lower fat content in milk and other dairy products is almost always a good idea. Lowering the fat content of milk DOES NOT change any of the nutritional value of the milk.  Most families should be using nonfat or 1% milk. Your doctor will advise you if you should be using milk with a higher fat content.

If your doctor recommends Vitamin D please continue it every day.  Many children will be ready for chewable vitamins that contain 400 I.U. of Vitamin D.  Make sure your child consumes 4 or more calcium servings per day (milk, cheese, yogurt, cottage cheese or calcium fortified fruit juices such as orange or apple).It is very important for your child to be completely off a bottle.

Development

Two-and-a-half year olds often have lots of energy and curiosity; yet they often lack social and language skills to know the limits of appropriate behavior. As such, this is a time when parents and child alike need lots of support. A parent needs lots of energy, patience and interest in teaching her child. Preschoolers require 11-13 hours of sleep per night.

Toilet Training

Some children show signs that they are ready for toilet training. When your child starts reporting wet or soiled diapers to you, this is a sign that your child prefers to be dry. Praise your child for telling you. Toddlers are naturally curious about other people using the bathroom. If your child seems curious, let him go to the bathroom with you. Buy a potty chair and leave it in a room in which your child usually plays. It is important not to put too many demands on the child or shame the child about toilet training. When your child does use the toilet, let him know how proud you are.

Testing the rules and limits is common. Parents need to be consistent in following through with reasonable rules. Rules should not be too strict or too lenient. Enforce the rules fairly every time. Be gentle but firm with your child even when the child wants to break a rule. Here are some good methods to help children learn rules and keep them safe:

1.  Divert and substitute. If a child is playing with something you don’t want him to have, re-place it with another object or toy that he enjoys. This approach avoids a fight and does not place children in a situation where they’ll say “no.”

2.  Teach and lead. Have as few rules as necessary and enforce them. These rules should be rules important for the child’s safety. If a rule is broken, after a short, clear, and gentle explanation, immediately find a place for your child to sit alone for 2 minutes. It is very important that a “time-out” comes immediately after a rule is broken.

3.  Make consequences as logical as possible. For example, if you don’t stay in your car seat, the car doesn’t go. If you throw your food, you don’t get any more and may be hungry.

4.  Be consistent with discipline. Don’t make threats that you cannot carry out. If you say you’re going to do it, do it.  Children do best with a single set of rules that mom and dad enforce equally.

Spend time teaching your child how to play. Encourage imaginative play and sharing of toys, but don’t be surprised that 2-and-one-half year-olds usually do not want to share toys with anyone else.

Mild stuttering is common at this age. It usually goes away on its own by the age of 4 years. Do not hurry your child’s speech. Ask your healthcare provider about your child’s speech if you are worried.

It is important to set rules about television watching. Limit total TV time to 1-2 hours per day. Watch television shows with your child. Ask your child questions about what the characters were doing and how they were feeling. Children should not be allowed to watch shows with violence or sexual behaviors. Find other activities you can do with your child. Reading, hobbies, and physical activities are good alternatives to TV.  Children should never have televisions in their rooms.

Safety Tips

·         Practice your fire escape plan. Children under the age of 5 should be led from the house in a calm, efficient way.  Check smoke detectors. Replace the batteries if necessary.

·         Check food temperatures carefully. They should not be too hot.

·         Keep hot appliances and cords out of reach.

·         Keep electrical appliances out of the bathroom.

·         Keep matches and lighters out of reach.

·         Don’t allow your child to use the stove, microwave, hot curlers, or iron.

·         Turn your water heater down to 120°F (50°C).

·         Teach your child not to climb on furniture or cabinets. Do not place furniture (on which children may climb) near windows or on balconies.

·         Lock doors to dangerous areas like the basement.

·         Your child should use a forward facing car seat as long as possible, up to the highest weight and height allowed by the manufacturer.   Your child must ride in the back seat. 

·         Sometimes toddlers may not want to be placed in car seats. Gently but consistently put your child into the car seat every time you ride in the car.

·         Give the child a toy to play with once in the seat.

·         Parents wear seat belts.

·         Never leave your child alone in a car.

·         Children must ride in the back seat.

·         Hold onto your child when you are near traffic.

·         Provide a play area where balls and riding toys cannot roll into the street.

·         Continuously watch your child around any water.

·         Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away.

·         Keep the POISON CONTROL number (1-800-222-1222) on all phones.

·         Buy medicines in containers with safety caps.

·         Do not store poisons in drink bottles, glasses, or jars.

·         Children who live in a house where someone smokes have more respiratory infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.

·         If you smoke, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.

·         Routine infant vaccinations are usually completed before this age. However some children may need to catch up on recommended shots at this visit.

The virus that cause influenza (also called the flu) changes each year.  Children over 6 months of age should receive an annual flu vaccine starting in late September.  Many offices offer both tradition flu shots as well as Flumist (which is a painless squirt in the nose without any needles).