Well-Child Checkup: 2 Years

At the 2-year checkup, the healthcare provider will examine the child and ask how things are going at home. At this age, checkups become less frequent. So this may be your child’s last checkup for a while. This sheet describes some of what you can expect.

Use bedtime to bond with your child. Read a book together, talk about the day, or sing bedtime songs.

Development and milestones

The healthcare provider will ask questions about your child. He or she will observe your toddler to get an idea of your child’s development. By this visit, your child is likely doing some of the following:

• Using 2 to 4 word sentences
• Recognizing the names of body parts and the pointing to pictures in books
• Drawing or copying lines or circles
• Running and climbing
• Using one hand for more than the other eating and coloring
• Becoming more stubborn and testing limits
• Playing next to other children, but likely not interacting (this is called “parallel play”)

Feeding tips

Don’t worry if your child is picky about food. This is normal. How much your child eats at one meal or in one day is less important than the pattern over a few days or weeks. To help your 2-year-old eat well and develop healthy habits:

• Keep serving a variety of finger foods at meals. Be persistent with offering new foods. It often takes several tries before a child starts to like a new taste.
• If your child is hungry between meals, offer healthy foods. Cut-up vegetables and fruit, cheese, peanut butter, and crackers are good choices. Save snack foods such as chips or cookies for a special treat.
• Don’t force your child to eat. A child of this age will eat when hungry. He or she will likely eat more some days than others.
• Switch from whole milk to low-fat or nonfat milk. Ask the healthcare provider which is best for your child.
• Most of your child's calories should come from solid foods, not milk.
• Besides drinking milk, water is best. Limit fruit juice. It should be100% juice and you may add water to it. Don’t give your toddler soda.
• Do not let your child walk around with food. This is a choking risk and can lead to overeating as the child gets older.

Hygiene tips

Recommendations include the following:

• Many 2-year-olds are not yet ready for potty training, but your child may start to show an interest within the next year. A child often signals that he or she is ready by regularly complaining about dirty diapers. If you have questions, ask the healthcare provider.
• Brush your child’s teeth twice a day. Use a small amount of fluoride toothpaste (no larger than a grain of rice) and a toothbrush designed for children.
• If you haven’t already done so, take your child to the dentist.

Sleeping tips

By 2 years of age, your child may be down to 1 nap a day and should be sleeping about 8 to 12 hours at night. If he or she sleeps more or less than this but seems healthy, it’s not a concern. To help your child sleep:

• Make sure your child gets enough physical activity during the day. This will help him or her sleep at night. Talk to the healthcare provider if you need ideas for active types of play.
• Follow a bedtime routine each night, such as brushing teeth followed by reading a book. Try to stick to the same bedtime each night.
• Do not put your child to bed with anything to drink.
• If getting your child to sleep through the night is a problem, ask the healthcare provider for tips.

Safety tips

Recommendations include the following:

• Don’t let your child play outdoors without supervision. Teach caution around cars. Your child should always hold an adult’s hand when crossing the street or in a parking lot.
• Protect your toddler from falls with sturdy screens on windows and gates at the tops and bottoms of staircases. Supervise the child on the stairs.
• If you have a swimming pool, it should be fenced. Gates or doors leading to the pool should be closed and locked.
• At this age, children are very curious. They are likely to get into items that can be dangerous. Keep latches on cabinets and make sure products like cleansers and medicines are out of reach.
• Watch out for items that are small enough to choke on. As a rule, an item small enough to fit inside a toilet paper tube can cause a child to choke.
• Teach your child to be gentle and cautious with dogs, cats, and other animals. Always supervise the child around animals, even familiar family pets.
• In the car, always use a child safety seat. After your child turns 2 years old, it is appropriate to allow your child's seat to face forward while remaining in the back seat of the car. Always check the weight and height limits for your child's seat to make sure of proper use. All children younger than 13 should ride in the back seat. If you have questions, ask your child's healthcare provider.
• Keep this Poison Control phone number in an easy-to-see place, such as on the refrigerator: 800-222-1222.

Vaccines

Based on recommendations from the CDC, at this visit your child may receive the following vaccine:

• Hepatitis A
• Influenza (flu)

More talking

Over the next year, your child’s speech development will likely increase a lot. Each month, your child should learn new words and use longer sentences. You’ll notice the child starting to communicate more complex ideas and to carry on conversations. To help develop your child’s verbal skills:

• Read together often. Choose books that encourage participation, such as pointing at pictures or touching the page.
• Help your child learn new words. Say the names of objects and describe your surroundings. Your child will pick up new words that he or she hears you say. (And don’t say words around your child that you don’t want repeated!)
• Make an effort to understand what your child is saying. At this age, children begin to communicate their needs and wants. Reinforce this communication by answering a question your child asks, or asking your own questions for the child to answer. Don't be concerned if you can't understand many of the words your child says. This is perfectly normal.
• Talk to the healthcare provider if you’re concerned about your child’s speech development.

Next checkup at: _______________________________

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