Nutrition

Family meals are important for your child. Letting your child eat with you makes her feel like part of the family. Don't make mealtime a battle. Let your child. feed herself. Your toddler will continue to improve 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 him/her only nutritious foods to choose from. For many children, now is the time to switch from whole milk to 2% milk.

Limit sweets, salty or fatty foods, pop and sugared drinks. Healthy eating habits are learned early and by example. A useful rule of thumb for serving sizes is 1 spoonful for each year of age for each food that is served.

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

Dental Care

• Clean teeth with a toothbrush after meals or at least twice daily. Make sure bits of food are not caught between teeth.
• Put just a tiny-pea sized amount of toothpaste on the toothbrush.
• Place the head of the toothbrush along the side of the teeth.
• Angle the tips of the bristles against the gum line and move the brush back and forth several times.
• Let your child "help" with tooth brushing or brush his teeth together, then you finish.

Behavior and Discipline

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 care provider for advice on managing behavior.

Here are some good methods for helping children learn about rules and to keep them safe:

1. 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.
2. 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/she enjoys. This approach avoids a fight and does not place children in a situation where they'll say "no."
3. 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 punishment come immediately after a rule is broken.
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.
5. Praise desired behavior.

Toilet Training

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.

Physical Development

• is constantly in motion
• tires easily
• runs and climbs
• walks up and down stairs alone
• begins to tiptoe
• builds a tower of 3 to 5 blocks
• progresses from random scribbling to somewhat more controlled. movements
• begins to button and unbutton large buttons
• develops greater independence in toileting needs (still needs some assistance)
• has difficulty settling down for bedtime

Emotional Development

• is in the "terrible twos"--easily gets upset and impatient
• shows anger by crying
• becomes frustrated when not understood
• wants own way
• asserts self by saying "no" to everything
• reverts to baby behavior at times
• gets upset when daily routine changes
• shows sharp mood changes

Social Development

• imitates with considerable realism
• becomes more interested in brothers and sisters
• may have an imaginary playmate
• enjoys playing among, not with, other children
• does not share
• claims everything is "mine"
• may scratch, hit, bite, and push other children

Mental Development

• dramatically increases interest in language
• shows frustration if not understood
• uses child grammar
• uses three- to five-word phrases by end of second year
• understands more words than can speak
• is in the "do-it-myself" stage
• cannot be reasoned with much of the time
• cannot choose between alternatives

Each child is unique. It is therefore difficult to describe exactly what should be expected at each stage of a child's development. While certain attitudes, behaviors, and physical milestones tend to occur at certain ages, a wide spectrum of growth and behavior for each age is normal. These guidelines are offered as a way of showing a general progression through the developmental stages rather than as fixed requirements for normal development at specific ages. It is perfectly natural for a child to attain some milestones earlier and other milestones later than the general trend. Keep this in mind as you review these milestones.

If you have any concerns related to your child's own pattern of development, check with your pediatrician or family physician.

What You Can Do

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. Limit television viewing, and watch children's shows with your child. Read baby books, sing songs and talk with your child.

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 care provider about speech problems if you are worried about them.

Safety Tips

Prevent 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.
• Don't smoke near children.
• Keep hot appliances and cords out of reach.
• Keep all 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 degrees F (50 degrees C).

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.

Prevent Drowning

• Continuously watch your child around any water.

Avoid Falls

• Teach your child not to climb on furniture or cabinets.
• Lock doors to dangerous areas like the basement.

Poisons

• Keep all medicines, vitamins, cleaning fluids, etc., locked away.
• Put poison center number on all phones. The Poison Control number is 1-800-222-1222.
• Ask your doctor about syrup of Ipecac. Use only if directed to do so.
• Purchase all medicines in containers with safety caps.
• Do not store toxic substances in drink bottles, glasses, or jars.

Next Visit

A once-a-year check-up is recommended. Before starting school, your child will need more vaccinations.

Additional Health Resources

• Health Informatics - http://www.uiowa.healthinformatics.net
• http://www.kidshealth.org
• http://www.generalpediatrics.com

Credits:

American Academy of Pediatrics
Pediatric Behavioral Health Advisor