Well Child Care at 2 1/2 Years

Nutrition

Eating meals together as a family has many benefits. Mealtime is a great time to let your child tell you about her interests, concerns, and worries. Encourage your child to talk and to listen to others as they share stories and experiences. This helps your child to learn new words and keeps your family feeling close and connected. Don’t have the TV on during family meals.

You can model healthy eating by what you eat and how much you eat. Give your child chances to choose what foods to eat. Be sure to give him only healthy foods to choose from. Lower fat content in milk and other dairy products is often a good idea. Ask your healthcare provider if 2% or skim milk is a good choice for your child.

Let your child feed himself. Your child will get better at using the spoon, with fewer and fewer spills. Make sure that your child’s food is not too hot.

It is very important for your child to be completely off a bottle. Ask your healthcare provider for help if your child is still using one.

Development

Two-and-a-half year olds have lots of energy and curiosity but often do not know the right way to behave. You need lots of energy, patience, and a sense of humor while you teach your child. It also helps to get support from other parents.

Spend time teaching your child how to play. Encourage imaginative play and sharing of toys, but don't be surprised that children this age 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 have concerns.

Set rules about media use. Know what kinds of apps and games your child uses, and what they are doing online. Limit how much time your child spends using computers, tablets, TV, videos, and other electronics. Don’t let your child watch shows with violence or sex. Play video games, read, or watch TV with your child and communicate with your child while you do. Children need physical play and face-to-face conversation to stay healthy and learn language and social skills. Having a TV, computer, or video game in your child's bedroom increases your child's risk for obesity, sleep disorders, and attention problems. Your child needs time to unplug and recharge. Participate in active play with your child, and be a role model by limiting your own use of technology.

Toilet Training

Some children at this age show signs that they are ready for toilet training. When your child tells you that he has wet or soiled diapers, it’s a sign that your child prefers to be dry. Praise your child for telling you. Young children 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 your child or shame your child about toilet training. When your child does use the toilet, let him know how proud you are.

Behavior Control

Testing the rules and limits is common. Be consistent with rules that are not too strict and not too lenient. Be gentle but firm with your child. Many parents find this age difficult, so ask your healthcare provider for advice on managing behavior.

Here are some good ways to help your child learn about rules:

• If your child is playing with something you don't want him to have, replace it with another object or toy that he enjoys. This approach avoids a fight and does not give your child a chance to say no.
• Make rules and let your child know what will happen if he breaks a rule. Make consequences logical. For example, you might say, “If you don't stay in your car seat, the car doesn't go,” or “If you throw your toys, I will put them away.” When your child breaks a rule, follow through each time and do what you have said you would do. Your child will learn that you mean what you say.
• If your child breaks a rule, after a short, clear, and gentle explanation, immediately find a place for your child to sit alone. It’s very important for the "time-out" to happen right after the rule is broken. Time-outs should last 1 minute for each year of age.

  Don’t send your child to their room for time-outs. A bedroom should not feel like a place of punishment.

• Be warm and positive. Children like to please their parents. Encouragement and praise are more likely to motivate a young child than threats and fear.

Talk to your child’s healthcare provider if you have questions about discipline or need help with behavior problems.

Dental Care

It’s important to take care of your child’s baby teeth because they help your child chew food and speak clearly. They also help save space for the permanent teeth that will come in later. You can help care for your child’s teeth by following these tips:

• Avoid sugary foods and limit juice to help prevent cavities. One cup of juice a day is enough.
• Make sure that your child brushes his teeth after meals. Think up a game to make brushing fun. Once your child learns how to spit out toothpaste, you can start using fluoride toothpaste.
• Talk with your healthcare provider or dentist if your child still sucks a finger or pacifier, or still uses a sippy cup. These habits can cause dental problems.
• Your child should see a dentist every 6 months or as often as the dentist recommends.

Safety Tips

Child-Proofing Your Home

• Go through every room in your house and remove valuables or anything that is dangerous for a child. Preventive child-proofing will stop many possible accidents, injuries, and discipline problems. Don't expect your child not to get into things just because you say no.
• Use stair gates or lock doors that lead to dangerous areas like the basement.
• Keep all electrical devices in the bathroom unplugged and put away.
• Keep cords out of reach, especially for coffee makers, irons, or other hot devices.

Falls

• Don’t put furniture near windows or on balconies and teach your child not to climb on furniture or cabinets.
• Install window guards on windows above the first floor (unless this is against your local fire codes.)
• Always buckle the safety belts or straps when your child is in a shopping cart.

Car Safety

• Use an approved toddler car seat in the back seat. Sometimes children 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 your child a toy to play with once in the seat.
• Never leave children alone in a parked car, even for a few minutes. Children are at risk for heat illness and injury when left alone. Always check to make sure your child is not still in the car when you leave your car.

Traffic Safety

• Hold onto your child when you are near traffic.
• Provide a play area where balls and riding toys cannot roll into the street.

Water Safety

• NEVER leave your child in a bathtub alone.
• Watch children and never leave them alone around water, including wading pools, swimming pools, spas or hot tubs, ponds, lakes, streams, or any other open water. If a child is in the water, an adult should also be in the water close enough to reach and grab the child if needed. Toddlers who have completed swimming programs are still not safe from drowning.

Poisoning

• Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away.
• Buy medicines in containers with safety caps.
• Do not store poisons in drink bottles, glasses, or jars or anywhere children can reach them.
• Put the poison center number on all phones.

Fires and Burns

• Keep matches and lighters out of reach.
• Keep hot curlers, iron, or things on the stove or in the microwave out of reach.
• Turn your water heater down to 120°F (49°C) or lower.
• Install smoke detectors. Check your smoke detectors as often as recommended by the manufacturer or at least once a month to make sure they work. For all detectors that use batteries, replace batteries at least once a year or when they are low.
• Practice a fire escape plan.
• Keep a fire extinguisher in or near the kitchen.

Smoking

• Children who live in a house where someone smokes have more respiratory infections, like colds, flu, and throat 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. Ask your healthcare provider for help in quitting. If you cannot quit, do NOT smoke in the house, car, or near children. It helps keep your child healthy and sets a good example.

Immunizations

Immunizations protect your child against several serious, life-threatening diseases. Your child should get a flu shot every year. Your child’s healthcare provider will let you know if your child is up to date on all recommended vaccinations. Be sure to bring your child's shot record to all visits with your provider.

Next Visit

A checkup at 3 years is recommended.