Developmental Goals:

• A two year old should start to be able to do circular scribbling, as well as vertical lines.  Offer crayons or pencils under supervision.
• At this age a child should be able to build a tower of 6 blocks.  Keep stacking toys around for play.
• Two year olds usually love balls and should be able to kick a ball well as well as throw it.  Many enjoy hitting a t-ball.  This helps with hand-eye coordination.
• Encourage running, kicking and climbing - with supervision!
• Speech in a two year old is changing rapidly.  They are able to use two word sentences, have about a 50 word vocabulary and are able to use plurals.  A general rule of speech:  2 of 4 words should be understood by a stranger at 2 years, 3 of 4 words understandable at 3 years and 4 of 4 words by 4 years.
• Toddler rules:  I see it, I want it, it’s mine.  Toddlers don’t share well.  Anticipate problems and intervene as appropriate.  Talk about sharing, using gentle touches, hugs not hits, etc. 
• Expect curiosity about genitals - teach correct terms.
• Potty training:  Kids develop at various stages.  Let them take the lead when to start potty training.  They are ready when they show interest (wanting to sit on a potty chair, wanting a wet diaper off, telling you when they are wet).  If you push, they will resist.  Show excitement and give praise for interest and any steps in the right direction (sitting on potty, peeing in potty, washing hands, etc.).  You can put the idea in their head… “I’m going to the potty.  Boy, do I feel good!  I went on the potty, didn’t get my pants dirty, got to flush the toilet, got to use the foamy soap, etc.” but don’t tell them directly to go.  They resist being told anything!
• Limit television time to less than 1/2-1 hour daily.  Excess television is linked to many behavior problems!
• Reading daily is critical at this age!!  What a fun way to bond, to teach language and to continue a love of books!

Discipline:

• Use time-outs (1 - 2 minutes).  See our time out rules on our parenting page. 
• Children learn by example.  Never hit them to teach that hitting is wrong.
• Praise good behavior, be consistent, reinforce limits.

Diet:

• Unrestricted types of foods at this age, but well balanced.
• Toddlers graze - offer healthy snacks.  Be sure to balance all the food groups over the course of the week.
• Limit juice to 4-6 oz. daily (or none at all!).
• Don’t force feed.  Toddlers don’t need many calories; just be sure what they eat is good for them.
• Begin 2% milk, up to 24 oz. daily.  Too much milk is actually dangerous.
• All children should receive a supplement of vitamin D and iron because they do not get enough in their diet.  For more information, click here.
• Sippy cups, straw cups or regular cups may be used.  No bottles at this age unless the child has developmental issues!
• Click here for more age specific feeding recommendations.

 Health:

• Kids get 8-12 viral infections per year.  Visit our cold and cough page as needed.
• Smoke exposure and day care increase risk of viral infections.
• Fever (temperature more than 100.5° F. under the arm) is the body’s response to illness.  It can be a good thing by helping to eliminate infection.  Treat only if uncomfortable.
• Continue to wipe or brush child's teeth daily.
• Do not use fluorinated toothpaste until your child can spit it out.  Dentists recommend the first dental visit at 1 year or 6 months after the first tooth, whichever is first.
• For more on dental care, see our dental pages.
• Smoking in enclosed spaces allows smoke dust to settle on cloths and hair.  When held, the child inhales the smoke dust and can develop allergies, asthma, and ear infections.  Never smoke around your child or in the home or car - even if the child is not present at the time.
•  If you choose to stop the pacifier, there are many methods.  Some parents choose the cold turkey method.  Others keep it in the crib only for a few weeks, then stop it.  Some will cut off the tip, so the child loses interest.  See our dental pages for more information.
• For fever, use Acetaminophen (Tylenol) or Ibuprofen as directed.  Dosing chart is on our medication page.
• Immunizations:
• Fever is common after shots for 1-2 days.  Give Acetaminophen every 4-6 hours only as needed for symptoms.  It is no longer recommended to prevent symptoms after shots because that might make the vaccines less effective.
• Bring your shot record each visit.
• Review the VIS (Vaccine Information Sheet) before visits.
• Flu (Influenza) shots are recommended each Fall.

Safety:

• Continue a car seat with harness until at least 4 years of age, regardless of weight.  Never use thick clothing in the car seat.
• Street safety:  Teach toddlers to stay out of the street and hold hands if possible in parking lots and when crossing the street.
• Lock up poisons, knives and guns.  Keep ammunition locked separately.  No plastic bags or balloons - did you know balloons are one of the top choking hazards?
• To learn how to properly dispose of outdated or recalled medications, click here.  For most medicines, do not flush down the toilet or pour down the drain.
• Sunscreen - use whenever outdoors.  Apply 30 minutes before going out and re-apply every 2 hours.  Remember to use sunscreen on cloudy days too.
• Use a helmet whenever on wheels:  Trikes, Big Wheels, scooters, etc.
• Do not expose any children to smoke!  Remember that smoke dust stays on clothes, hair, carpet, and upholstery long after the cigarette is extinguished. 
• Change smoke alarm batteries yearly.   Write the date of change on the alarm so you remember.  Consider putting an alert in your calendar to remind you when to change it again.
• Install new smoke alarms and carbon monoxide detector every 5 years.
• We recommend reducing the temperature of your hot tap water to less than 120° F. to prevent burns.
• All parents should learn CPR and refresh skills every 2 years.  For a list of CPR classes for both non-medical and medical professionals, click here.

Be sure to obtain any required health forms at your well visit!

See our Website page for much more information on recommended links.