Well Child Care 2 Years

Family meals are important for your child. They teach your child that eating is a time to be together and talk with others. Letting your child eat with you makes her feel like part of the family. Let your child feed herself. Your toddler will get better at using the spoon, with fewer and fewer spills. It is good to let your child help choose what foods to eat. Be sure to give her only healthy foods to choose from. For many children, this is the time to switch from 2% milk to nonfat or 1% milk. 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.   Televisions should never be on during mealtime.

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 the bottle. Ask your doctor for help if she is still using one.

Spend time teaching your child how to play. Encourage imaginative play and sharing of toys, but don’t be surprised that 2-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. Preschoolers require 11-13 hours of sleep per night.

Some children at this age are showing 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.

At this age, children often say “no” or refuse to do what you want them to do. This normal phase of development involves testing the rules that parents make. Parents need to be consistent in following through with reasonable rules. Your 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. Many parents find this age difficult, so ask your doctor for advice on managing behavior.

Here are some good methods for helping children learn about rules:

·         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.”

·         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 (for example in the dining room). It is very important that a “time-out” comes immediately after a rule is broken.

·         Make consequences as logical as possible. Remember that encouragement and praise are more likely to motivate a young child than threats and fear. Do not threaten a consequence that you do not carry out. If you say there is a consequence for misbehavior and the child misbehaves, carry through with the consequence.

·         RULE OF THUMB:  Be consistent with discipline. Don’t make threats that you cannot or will not carry out.  If you say you’re going to do it, do it.  If it is a rule for mom then it must also be a rule for dad.   Unfortunately, children will always follow the easiest set of rules.  Don’t confuse your kids – have ONE set of rules.

·         Be warm and positive. Children like to please their parents. Give lots of praise and be enthusiastic. When children misbehave, stay calm and say “We can’t do that. The rule is ________.” Then repeat the rule.

Children learn reading skills while watching you read. They start to figure out that printed symbols have certain meanings. Young children love to participate directly with you and the book. They like to open flaps, ask questions, and make comments. It is important to set rules about television watching. Limit TV and video to no more than 1 to 2 hours of quality programming per day. If you allow TV, watch with your child and discuss. Choose other activities instead of TV, such as reading, games, singing, and physical activity.

·         Brushing teeth regularly after meals is important. Think up a game and make brushing fun.

·         Fluoride supplementation is important to make teeth stronger and prevent decay.  If the water in your community is fluoridated you will not require an additional supplement.  If there is no fluoride in the water your doctor will recommend a fluoride supplement for your child.  Since your child is receiving fluoride in either the water or by supplement avoid toothpaste that contains fluoride.

Child-proof the home. Go through every room in your house and remove anything that is either valuable, dangerous, or messy. Preventive child-proofing will stop many possible discipline problems. Don’t expect a child not to get into things just because you say no.

·         Practice a fire escape plan every 3 months.  First, set off your smoke detectors.  Everyone in the house should walk outside and go to the same meeting place every time.  Make sure the meeting place is at least 20 adult paces from your home so that your children not be standing in smoke.

·         Check smoke detectors and carbon monoxide 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.

·         Use stair gates or lock doors to dangerous areas like the basement.

·         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, NEVER 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).