Well Child Care at 2 1/2 Years

Nutrition

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 often a good idea. Ask your healthcare provider about 2% or skim milk.

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

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.

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.

Behavior Control

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. Many parents find this age difficult, so ask your healthcare provider for advice on managing behavior.

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, replace 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.

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.

Reading and Electronic Media

It is important to set rules about television watching. Limit total TV time to 1 hour 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.

Safety Tips

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.

Fires and Burns

• Practice a fire escape plan.
• 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).

Falls

• Teach your child not to climb on furniture or cabinets. Do not place furniture (on which children may climb) near windows or on balconies.
• Install window guards on windows above the first floor (unless this is against your local fire codes.)
• Lock doors to dangerous areas like the basement.

Car Safety

• Use an approved toddler car seat correctly.
• 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.

Pedestrian 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

• Continuously watch your child around any water.

Poisoning

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

Smoking

• 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.
• Teach your child that even though smoking is unhealthy, he should be civil and polite when he is around people who smoke.

Immunizations

Routine infant vaccinations are usually completed before this age. However some children may need to catch up on recommended shots at this visit. Children over 6 months of age should receive an annual flu shot. At age four, your child will need additional vaccinations. Ask your healthcare provider if you have any questions about whether your child needs any vaccines.

Next Visit

A three-year old check-up is recommended. Bring your child's shot card to all visits.