Age: 2 Years

July 06, 2020

It is not true that two is terrible. In fact, most parents report that by the time their child is turning two, things are getting easier. Two year olds are finally able to articulate their wants and desires. They can tell you what is going on in their little minds, and that is a beautiful thing. Sure they still have their moments demonstrating independence in the grocery store, but what child doesn’t right?

SAFETY

  1. Car: Use a Convertible Car Seat in the back seat of the vehicle, rear-facing.

    1. Important Note: As of 11/2018, the American Academy of Pediatrics (AAP) recommends car seats remain rear facing as long as possible, until the child reaches the highest weight or height allowed by the seat. This replaces the previous age specific milestone of 2 years and 30 lbs. The recommendations are based on scientific studies showing that rear facing is safest in a crash

    2. For help securing the seat make an appointment with a Nationally Certified Child Passenger Safety Technician (to find a location nearest you visit https://highwaysafety.utah.gov/seat-belts-and-car-seats/car-seat-safety/)

  2. Sleep:

    1. The crib is the safest place; slats less than 2 3/8 inches apart; place the mattress at the lowest setting of the crib

    2. You may put mesh/breathable bumpers back into the crib if your baby is a wild sleeper and arms and legs are getting stuck outside of the slats

  3. Childproofing: Injuries are a big concern at this age. Toddlers this age will manage to get into everything and usually don’t have innate fear of getting hurt to stop them. Toddlers can climb onto and fall off of anything.

    1. Use outlet covers

    2. Store matches/lighters/chemicals/medications/cleaners/toxic household products out of reach or locked. (TIP: Add poison control’s number to your cell phone now 1-800-222-1222).

    3. Burns are common at this age, both by pulling hot things down onto themselves (e.g., cords from curling irons, handles from pots) and touching hot surfaces (e.g., fireplaces, grills, stovetops, etc.)

    4. Lock guns with ammunition separate and in a gun safe

  4. Water: Don’t leave unattended in the bathtub (even for a second to grab something). Empty all buckets and play pools of water. Keep water heater at less than 120 degree F (to prevent scalding).

  5. Smoking: Do not smoke in the home or in your car. Check smoke alarms to ensure they work properly and change batteries annually.

  6. Helmet: Wear a helmet on all things a kid can ride (e.g., bicycles, tricycles, scooters, ATVs, as passengers on adult bicycles, etc.).

  7. Sun: Limit sun exposure, use sunscreen when outside

NUTRITION

  1. Transition to low fat dairy products (e.g., milk, yogurt, and cheese). Should not drink more than 24 oz/day. If your child isn’t a big milk drinker, just ensure your child is getting enough calcium and vitamin D from other sources (e.g., almond milk, dark leafy greens, milk products, supplements, etc.)

  2. Provide 3 meals and 2-3 nutritious snacks a day.

  3. You have no limitations on what food to offer your child at this age. The key is offering your child a variety of nutritious foods.

  4. Limit the number of fats and sweets your child gets in a day. In addition, your child does not need juice, it is essentially fruit sugar. If you choose to give juice to your child, do so in limited quantities (e.g., 4 oz a day).

  5. You choose the menu. Offering good nutrition at an early age builds good lifetime eating habits. In addition, consider the fact that you are fueling your child’s growing brain. As a society, we are propagating this notion of ‘kid food’, e.g., mac n’ cheese, hot dogs, French fries, chicken nuggets. These have very little nutritional value. Instead, offer lots of fruits, vegetables, whole grains, and protein rich foods.

  6. Eat meals as a family. Expect and enforce reasonable behavior, but do not force feeding. Provide a booster seat or high-chair so your child can be at table height.

  7. Give a multivitamin daily only if your child is not eating a balanced diet (I prefer a hard chewable variety over a gummy).

SLEEP

  1. Should be sleeping through the night

  2. Crib. Most 2 year-olds should be in a crib still. Many parents are tempted to transition kids this age to a “big kid bed.” Be warned that most children this age are developmentally not ready for that change and doing so prematurely is often a set up for disaster (e.g., multiple night-time wakings, getting out of the bed, climbing into bed with mom and dad, etc.). If your child can get out of the crib, despite all your efforts to contain him/her, you may have to change to a bed as a fall from a crib is a safety hazard.

  3. Taking one nap a day (typically continues until between 3-4 years of age)

  4. Total sleep should be 11-14 hours in a 24-hour time period (including naps)

MILESTONES

  1. Can kick a ball

  2. Jumps

  3. Stands on tip toe

  4. Climbing on everything (can navigate pushing a chair up to a counter/table to climb on top)

  5. 50 words minimum (average is 200) and in 2-word phrases

  6. Speech is 50% intelligible by a stranger

  7. Follows a 2-step command

  8. Knows 5+ body parts

  9. Can stack objects and turn pages of a book

  10. Parallel play (playing next to, not interactively with other children)

  11. Adept at feeding self: can scoop with a spoon and drinking from a cup

ORAL HEALTH

  1. Start brushing with fluoride toothpaste.

  2. Brush teeth twice a day, morning and night. Your independent child will probably want to do this himself/herself. A simple solution to this problem is investing in two toothbrushes, one for your child, one for mommy. Once your child is “done,” then mommy gets to finish to her satisfaction.

  3. Schedule an appointment to see a dentist every 6 months.

  4. May need fluoride supplementation (depending on the content of your local water source)

OTHER

  1. Media Exposure: Limit total media time (TV, movies, ipad, games) to no more than 1 hour a day of high quality programming. Watch programs together.

  2. Sexual Education: Expect curiosity about genitals at this age. Use correct terms when making reference to anatomy (e.g., penis, vulva, vagina, etc.)

  3. Social Interactions: Reinforce limits, encourage self-expression, praise good behaviors, be consistent, read, and play together.

  4. Toilet Training: Begin when your child shows readiness (most kids are ready to potty train between 2-3 years old).

ILLNESS

At this age you may treat fever and minor illnesses at home as long as your child looks and acts ok. Bring your child to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your child has signs of dehydration, your child reports specific symptoms (e.g., sore throat, hurt arm, etc.), your child has difficult or labored breathing, your child is lethargic, or you are concerned.

YOUR NEXT VISIT

Your child’s next visit is at 2 ½ years old. If your child’s vaccines are up to date, your child should not need vaccines at that visit (aside from an annual flu shot, if the time of year is appropriate).

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