Educational Materials for 2 Year Well-Visit

The topics listed below are based on American Academy of Pediatrics national recommendations about the kinds of things that are important to discuss or get more information about for children your child's age.

Click on the info to get education and tips from pediatric health care experts about each topic.

Promoting language development:

Words and phrases your child uses and understands More Info
Words and phrases your child uses and understands
What is this and why is it important?

Your two-year-old understands most of what you say to him and may speak with a rapidly growing vocabulary of fifty or more words.   Being able to tell you what he wants will give your child great pleasure – and reduce frustration.

Your child should begin using 2-word sentences or phrases, such as, “want milk,” “have cookie,” and “go home.” He should, or will soon, point to and name several body parts. He should be able to follow simple 1-or 2-step commands, such as, “Pick up the ball and bring it to me.”  Your two year old will start using verbs to make short sentences and is beginning to use simple adjectives.  He is also beginning to use pronouns (I, you, me we, they) and understand the concept of “mine” (I want my cup, I see you mommy).

It’s common for parents  to compare their child’s speaking abilities to other children, but you should avoid this as there is more variation in language development than in any other area at this age. Some children are naturally more talkative than others and a more talkative child is not “smarter” or more advanced than a less talkative child. Encourage your child’s language development by reading books, singing songs to him and by talking about the things you see and do together.  If your child is having a hard time sitting still for too long with reading, try and choose activity orientated books that ask him to touch, point, and name objects or repeat certain pages.

Make sure to model the appropriate use of language and avoid “baby talk.”  If you want a two-year to say words, you can encourage your child by saying slowly, “I think I know what you want, but you must say it to me. Try this. Is it a truck, or a house or doll?”  Repeat what your child says often so that he experiences being heard.  Respond to the meaning and not the exact words that are spoken. Ask questions and wait for an answer. Don’t focus on correcting the words.

Many children struggle to respond quickly to questions or directions at this age, so talk and ask questions slowly so that your child has the opportunity to respond without pressure.  Parents are often concerned when a child stutters. Most two and three-year-olds stutter and stammer when speech is coming in so rapidly. They can’t keep up with it. It’s like falling over their feet when they are learning to walk. Correcting or saying words for the child only adds to the pressure. Usually it is best to give your child time or let him not push or let him feel pushed.

If your child has difficulty responding to you without looking at you, let your child’s health care provider know. Hearing problems are important to identify early and are more common in children with many ear infections.

Children exposed to a second language in the home often learn to speak both languages at the same pace as a child who hears and learns only one. Sometimes they may start speaking a little later, and less often, as much as a year later.  This is rarely a problem.

You can talk to your child’s health care provider about words and phrases your child uses and understands and if you have any concerns about your child’s language development or ability to hear or understand.

What are common questions I can ask my health care provider?
  • Do boys usually talk later than girls?
  • Our family is bi-lingual. Should we stick to just one language while our little girl is learning?
  • I sometimes talk to my child in “baby talk,” is this okay?
  • My child is not talking as much as other children his age. Should I be concerned?
Where can I find more information about this topic?

Language Development: 2 Years Old (AAP)

Language and Your 2-Year Old: Thoughts, Words and Action (AAP)

Your Child's Development: 30 to 36 Months (Zero to Three)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Importance of using simple words, asking simple questions, and repeating what you heard from your child More Info
Importance of using simple words, asking simple questions, and repeating what you heard from your child
What is this and why is it important?

Using brief, clear, specific words and gestures over and over will help your toddler better understand what you are saying and feel like he can try to use them too, such as “eat,” “shoe,” “more milk.” When he speaks and you understand him , repeat the words. He’ll feel pleased about having made his point. Communicating and being understood is a universal need.

When your child talks, repeat what he says often so that he child experiences being heard.  Respond to the meaning and not the exact words that are spoken. Ask questions and wait for an answer. Don’t focus on correcting the words. Giving kids questions to answer and time to respond enhances language development.

Using simple words and phrases is also important when asking your child to do something or giving directions. Tasks that seem simple, like getting dressed in the morning, actually have many steps.  If your child “can’t” or “won’t” do something, it may be that he still needs to learn the steps.  Explain steps one at a time and then offer praise.  For example:

  1. “Please go get your clothes.  They are on the bed.”
  2. “OK, now take off your pajamas.”
  3. “Now put on your shirt.”
  4. “You look very nice today.  You did a good job getting dressed.”

Take time to remind your child about each step rather than just doing it yourself or getting upset.  It will take longer at first but is well worth it for you and your child!

You can talk to your child’s health care provider about the importance of using simple words, asking simple questions and repeating what you heard from your child.

What are common questions I can ask my health care provider?
  • I often hear the importance of simple words and simple questions – what does “simple” mean? How can repeating what my child says to me help their language develop?
  • I often cannot understand what my child is saying. How clearly should my child be speaking?
Where can I find more information about this topic?

Language Development: 2 Year Olds (AAP)

Language and Your 2-Year Old: Thoughts, Words and Action (AAP)

Your Child's Development: 30 to 36 Months (Zero to Three)

How Babies Communicate (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways to read to your child that promote his language development More Info
Ways to read to your child that promote his language development
What is this and why is it important?

Sharing books and songs will help your child learn new words and new ideas. Two-year-olds have favorites and you may find that you are reading the same books over and over, but your child is learning something new each time! Reading aloud to your child will help develop an understanding of the way language works and sounds. 

Ask your child to point to pictures of objects, animals or people on the page. Books can also be “read” by just looking at the pictures and talking about them. You might find that your child notices if you skip a page or change a word. Try reading something your child knows well, and letting him “fill in” a key word.  If your child is having a hard time sitting still for too long with reading, try and choose activity orientated books that have her  touch, point, and name objects or repeat certain actions. These are all ways of reading with your child that will help promote his language development.

You can talk to your child’s health care provider about ways to read that promote language development.

What are common questions I can ask my health care provider?
  • My two-year-old loves his books, but only wants to talk about the picture. He doesn’t always want to listen to me read the story. Is that ok?
  • How can I manage to read with him when he won’t sit still?
  • My child insists on reading the same one or two books over and over. Should I insist that he choose others?
Where can I find more information about this topic?

Using Their Words: Helping Preschoolers Get a Good Start in Reading and Learning (AAP)

Tips for Sharing Books With Babies And Toddlers (Zero to Three)

Importance of Reading Aloud (Reach Out and Read)

Reading Tips for Parents and Educators (Reach Out and Read)

Developmental Milestones (Rearch Out and Read)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your child’s health and behavior:

Behaviors to expect in the next few months More Info
Behaviors to expect in the next few months
What is this and why is it important?

Your child is now advancing from infancy into the preschool years! During this time your child's physical and motor development will slow, but you can expect many changes intellectually, socially, and emotionally.

The language skills your child will develop over the next several months are the most significant changes you will see. Your child is becoming more of an individual and active participant in family life. Your two-year-old is or soon will be using verbs to make short sentences and using simple adjectives.  Using simple words and questions, repeating what you heard your child say, reading with your child and describing what you’re doing together are all ways to encourage your child's language development. You may hear your child begin “talking himself to sleep” at night, which in addition to being entertaining, is another way he learns to speak and to get himself to sleep.

Your child will also begin to play in a way called “symbolic play,” in which he will imitate other people's mannerisms and activities. For example, he might have a conversation between two dolls that imitates experiences he has seen. This is a great accomplishment!

You can also expect your child to grow increasingly independent and desire self-control. It is likely that most of the time he will be cheerful, helpful and easygoing, but of course you should expect some bumps in the road as your child is learning to share his ideas and feelings. Two-years-old often get the label “terrible twos,” because they cannot control their emotions. One minute your child is happy, the next he is sad and suddenly he will become angry and out of control and may bite, kick or bang his head. He might even hold his breath, which can be frightening for parents. Don't worry, he will relax and his oxygen will recover immediately. The most effective response to this behavior is to put him in his room where he is safe and walk away saying, “I don’t like this behavior. When you are through with that, I will come back.” Afterward, you can comfort him and say, “Someday, you will learn to control this yourself.” You can read about more strategies in the Ways to guide and discipline your child topic.

Night terrors most commonly appear now. They can be more frightening for parents than for the child who is not truly awake during them and will have no memory of them the next morning.  These occur during the transition from deep sleep to light sleep and are characterized by out-of-control screaming and thrashing.  Trying to rouse or comfort your child are likely to lead him to become more agitated. Your calm presence is usually enough to be sure he doesn’t hurt herself.  When they occur more than a few times in a short period, they might be a sign of your child being under stress and you should talk to your child’s health care provider about them.

You can talk to your child’s health care provider about behaviors to expect in the next few months.

What are common questions I can ask my health care provider?
  • How much should my child be speaking at this age?
  • My child is throwing temper tantrums. Is this normal and how can I deal with them?
  • My child is having night terrors and they are very frightening. Is he okay and what should I do when he has them?
  • I am often my child’s only playmate, but should I play directly with him or just watch him play with toys?
Where can I find more information about this topic?

Getting a Handle on Behavior: Your 2-Year-Old’s Temperament (AAP)

Cognitive Development: Two-Year-Old (AAP)

Emotional Development: 2 Year Olds (AAP)

Your Child's Development: 24 to 30 Months (Zero to Three)

The Magic of Everyday Moments: 24 to 36 Months (Zero to Three)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Your child’s moods and emotions More Info
Your child’s moods and emotions
What is this and why is it important?

It’s so difficult to follow the ups and downs of a two-year-old. One moment he’s beaming and friendly; the next he’s sullen and weepy—and often for no apparent reason. These mood swings, however, are just part of growing up. They are signs of the emotional changes taking place as your child struggles to take control of actions, impulses, feelings and his body.

At this age, your child wants to explore the world and seek adventure. As a result, he’ll spend most of his time testing limits—his own, yours, and his environment’s. Unfortunately, he still lacks many of the skills required for the safe accomplishment of everything he needs to do, and he often will need you to protect him . Therefore, children at this age often get the terrible two reputation because they cannot control their emotions.

When he oversteps a limit and is pulled back, he often reacts with anger and frustration, possibly with a temper tantrum or sullen rage. He may even strike back by hitting, biting, or kicking. At this age, he just doesn’t have much control over his emotional impulses, so his anger and frustration tend to erupt suddenly in the form of crying, hitting or screaming. It’s his only way of dealing with the difficult realities of life. He may even act out in ways that unintentionally harm himself or others. It’s all part of being two.

The more confident and secure your two-year-old feels, the more independent and well behaved he’s likely to be. You can help him develop these positive feelings by encouraging him to behave more maturely. To do this, consistently set reasonable limits that allow him to explore and exercise his curiosity, but that draw the line at dangerous or antisocial behavior. With these guidelines, he’ll begin to sense what’s acceptable and what’s not. Again, the key is consistency.

Praise him every time he plays well with another child, or whenever he feeds, dresses or undresses himself without your help, or when you help him to start with the activity and he completes it by himself . As you do, he’ll start to feel good about these accomplishments and himself . With his self-esteem on the rise, he’ll also develop an image of himself as someone who behaves a certain way—the way that you have encouraged—and negative behavior will fade. Reassuring him with hugs and love works better than sweets or new toys and helps him learn to adjust his moods as he gets older. You can find more strategies in the Ways to guide and discipline your child topic.

Since two-year-olds normally express a broad range of emotions, be prepared for everything from delight to rage. However, talk to your child’s health care provider  seems very passive or withdrawn, perpetually sad, or highly demanding and unsatisfied most of the time.

You can talk to your child’s health care provider about your child’s moods and emotions.

What are common questions I can ask my health care provider?
  • My two-year-old is always happy except he often wakes at night crying. It takes us time to calm him down and get him back to sleep. What could be upsetting him and what can we do?
  • My child says no to everything and especially is not willing to get dressed or wear his coat or shoes. How do I handle this new phase?
  • My child seems to be happy one minute and miserable the next. Is this normal?
Where can I find more information about this topic?

Emotional Development: 2 Year Olds (AAP)

Social Development: 2 Year Olds (AAP)

Your Toddler and Others: Socialization (AAP)

How to Help Your Toddler Begin Developing Empathy (Zero to Three)

Growth Milestones - 2 Years (KidsGrowth)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways to guide and discipline your child More Info
Ways to guide and discipline your child
What is this and why is it important?

Toddlers need to have limits set to help them learn what we expect, as well as to protect them from harmful situations. At this age, it is common for them to obey a command on one day and not the next. Remember, they are only 2-years-old. It is much more effective to remove breakables than to constantly scold your child with “NO”.

Remember that to discipline means to lead and to teach. Teaching is best done before something negative happens, rather than afterwards. Do all you can to set your child up for successful behavior. Two-year-olds want to please and they do better with praise than with scolding.  Help your child learn the kinds of behavior you expect and prefer when he is doing things the right way. This can take lots of repetition – “we pick up the toys we played with,” “let’s put everything back in the toy chest,” “no throwing toys.” Children learn more easily if it’s the same message used each time and not just once in a while.  Being consistent with discipline strategies stresses the importance and lessens the confusion for your child.

This age marks the reputation of the “terrible twos.”  Frustration, anger and an occasional tantrum are inevitable for all two-year-olds.  Allow your toddler to express his emotions but also try to help him channel his anger away from violent or overly aggressive behavior.  When you see your child starting to get worked up, try to divert his attention to a new activity and if you can’t do this, ignore his tantrum.  Every time you react to an outburst in any way, you are rewarding his negative behavior.  If you are in public, simply remove him without discussion or fuss – wait until he has calmed down before you return or continue with your activities.  When possible, address the behavior immediately. If you wait an hour to correct the behavior, he won’t connect the punishment with the behavior.

If tantrums involve biting, hitting or other harmful behavior, you cannot ignore it but overreacting won’t help either.  Instead, tell him immediately and clearly that he is not to behave this way and move him off by himself for a few minutes.  he cannot understand complicated explanations or how it would feel to have the same thing done to him , so don’t try to reason with him .

No matter what your child has done, spanking has not been shown to be an effective method of teaching your child acceptable behavior.  Spanking only teaches your child to deal with frustration by violence. Instead, try a “time out.” Set aside a safe spot in a room, free from distractions and toys. When your child breaks a rule, move him to the time out and walk away. Do not lose your temper, reprimand or lecture him . If your child leaves, do not get angry. Just put him back. To make this effective, it must be done every time the rule is broken. A general rule of thumb for time out is about 1 minute per year of age.

It is common for two-year-olds to be testing limits; his own, yours and his environment's.  It’s common for parents to worry at this age that their child is spoiled or out of control but it is quite normal behavior and he will pass through this phase.  You might also find that your child behaves better for others than he does for you. This is because he doesn’t trust other people enough to test their limits.  

You can talk to your health care provider about ways to guide and discipline your child and to identify strategies that match your child’s temperament and style of learning.

What are common questions I can ask my health care provider?
  • Sometimes my child says NO when I tell him to pick up his toys so I end up doing it all myself. What can I do?
  • My partner believes we should be using time outs. Isn’t two too young?
  • Is it ever appropriate to spank?
Where can I find more information about this topic?

Getting a Handle on Behavior: Your 2-Year-Old’s Temperament (AAP)

Family Life: Disciplining Your Child (AAP)

Disciplining Your Toddler (KidsHealth)

Discipline: Questions and Answers (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Giving your child choices between 2 options More Info
Giving your child choices between 2 options
What is this and why is it important?

Two-year old children have increased language development and are beginning to form mental images for things, actions, and concepts. He can solve a problem in his head and perform mental trial and error rather than having to manipulate objects. His memory and intellectuall skills are developing.  As this development is happening, it is important to foster his sense of competence and control. One way to promote these is to let your child make choices limited to two equally acceptable options when possible. For example, give him decisions about foods to eat, clothing to wear or toys to play with. Fortunately, “choice” and “preference” are not the same thing. As parents and caregivers, you can provide a choice of acceptable options and let your toddler decide which of those he prefers.

This approach is also helpful when you want him to do something, but he is resistant. For instance, instead of saying “put your toys away”, say “Do you want to put the cars away in the toy chest or in the drawer?” Instead of saying “Eat your fruit”, offer “Do you want banana or apple?”  This will give him a sense of control and he will be more likely to comply. When offering choices, limit to two so he is not overwhelmed with too many possibilities. Too many choices can make it hard to make a decision at all.

You can talk to your child's health care provider about how you start to give your child a choice between options and how this may reduce behavior issues.

What are common questions I can ask my health care provider?
  • I feel like I make good choices for my child so why should I always have to come up with more than one option for her? Who is in charge?
  • My two year old is just not ready for this kind of choosing. Is he falling behind other kids?
  • I can give choices but am not sure about others, like child care providers. Is it all right to ask them to use this method to reduce his tantrums?
Where can I find more information about this topic?

What You Can Do to Help Your Toddler Begin to Develop Self-Control from 24-36 Months (Zero to Three)

Toddlers at the Table: Avoiding Power Struggles (KidsHealth)

Growth Milestones: 2 Years (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How your child reacts in new situations More Info
How your child reacts in new situations
What is this and why is it important?

Separation anxiety can still be common in two-year olds.  Even if they seemed to be over it, it can reemerge due to changes in routine, a move, a new baby or illness.  Whatever protest pattern you child has developed to a new situation can persist. For instance, when you’re about to leave him with a sitter, he may become angry and throw a tantrum in anticipation of the separation. Or he may whimper, or whine and cling to you. Or he simply could become subdued and silent. Whatever his behavior, try not to overreact by scolding or punishing him . The best tactic is to reassure him before you leave that you will be back and, when you return, to praise him for being so patient while you were gone. Take solace in the fact that separations should be much easier by the time he is three-years-old.

Reassuring your child is important to making him feel safe in new situations and places. Forcing him to accept new situations will make him more anxious than if you gently help him explore the new place or situation until he feels used to it. 

Give him trial runs and ease him into new situations, such as play dates,  visiting new people’s houses or even going to his health care provider’s office.  When he is in new environment, let him have a favorite blankie, stuffed animal or toy for comfort.  Give him time and encourage new people to  be patient with him and let him warm up, he will feel a great sense of pride in mastering his own stress.

You can talk to your child’s health care provider about how he reacts in new situations and strategies you can use to make the transitions easier.

What are common questions I can ask my health care provider?
  • My two-year-old still screams when I leave for work or go out for a date – is that normal? Should I not go?
  • My two-year-old has been fearful since he saw people in costumes at a program we attended. How do I help him understand this?
  • I want to join a mom’s group, but my child is very shy and fearful of strangers. Should I force him to go?
Where can I find more information about this topic?

Getting a Handle on Behavior: Your 2-Year-Old’s Temperament (AAP)

Social Development: 2 Year Olds (AAP)

Soothing Your Child's Separation Anxiety (AAP)

Confidence (Zero to Three)

How I Grow in your Care: Eighteen Months to Three Years (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Playgroups and how your child gets along with others More Info
Playgroups and how your child gets along with others
What is this and why is it important?

At two-years old, you should be encouraging your child to play with other children, however, it is early to expect him to share toys or play interactively with other children.  Try to set up play dates with other children around his age and to look for playgroups he can be a part of. 

Your two-year old views the world almost exclusively through his own needs and desires.  He is just learning about “mine” and “yours” and he may refuse to share things that interest him .   Keep teaching him the concept of sharing, but don’t expect him to always comply. He may or may not interact easily with other children, even when playing side-by-side.  At this age, side-by-side play without interaction is typical.

There may be times when your child’s behavior may make you upset, but if you take a close look, you’ll notice that all the other toddlers in the playgroup probably are acting the same way.  However, don’t let his relatively “antisocial” behavior discourage you from joining playgroups.  The best way for your child to learn how to behave and play with others is to be given plenty of practice.  At first, limit the groups to two or three children and monitor their activities, but let them guide themselves as much as possible so they learn how to play with one another.  Your child’s social abilities will grow over time.

New people and places are great for children but they need to get comfortable  with them at their own speed. Your child may be shy around new adults even if he wasn’t before.  Allow your child time to get to know new places or new people. Your old friends may still be “new people” for your child.

Because your two-year-old’s behavior seems only self-directed, you also may find yourself worrying that he’s spoiled or out of control. In all likelihood, your fears are unfounded, and he’ll pass through this phase in time. Highly active, aggressive children who push and shove usually are just as “normal” as quiet, shy ones who never seem to act out their thoughts and feelings.

You can talk to your child’s health care provider about how he gets along with others.

What are common questions I can ask my health care provider?
  • My child won’t share with other kids and rarely plays with them, but rather, next to them – is that normal?
  • Is it ok if my child doesn’t want to be held by my aunt and uncle? He just doesn’t get comfortable with them on visits. I have trouble explaining it but I don’t think I should force him .
Where can I find more information about this topic?

Social Development: 2 Year Olds (AAP)

Your Toddler and Others: Socialization (AAP)

Understanding a Shy Child (AAP)

Ages & Stages: Aggressive Behavior (AAP)

What to Expect From Your Toddler's Development (Zero to Three)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Issues related to preschool More Info
Issues related to preschool
What is this and why is it important?

Your child may already be in child care or play groups and you may be thinking about getting ready for preschool in the next year. Childcare and preschool settings offer young children the opportunity to develop social skills with other children on a regular basis.  They also help children learn skills that will help them make the transition to kindergarten.

Preschool gives your child a chance to improve social skills by meeting and playing with other children and adults, as well as introducing him to more formal rules that you have may have established at home. A pre-school program may be especially beneficial if your child doesn’t have many opportunities to meet other youngsters or adults, or if he has unusual talents or developmental problems that might benefit from special attention. Preschool can also help a parent to meet some of your own needs. At this age, the separation can be good for  both of you.

There are several options for preschool settings.  The resources provided below give you specific information about what you should look for in a preschool and how you can evaluate whether it will meet your child’s needs and be an environment that will promote your child’s health development.

It is important to assess your child’s readiness for preschool.  Some children do well in a larger classroom setting; others do better in a smaller home setting with only a few other children. Look at how your child does in settings you are familiar with. How excited or fearful he in with other children? Does he seem ready for more organized activities? If you plan on putting him in a school that requires him to be toilet trained, plan on starting the training process several months in advance.  Most schools or programs will allow you and your child to observe the class prior to enrollment to see if it is a good fit.  If he isn’t ready yet, you can reevaluate in a few months. There will be lots of learning going on wherever he spends his time!

If you choose not to enroll your child in child care or preschool, visit a teacher’s store or bookstore to look at books for ideas about preparing your child for the transition to school.

You can talk to your child’s health care provider about issues related to preschool.

What are common questions I can ask my health care provider?
  • Is preschool really necessary for all children? I never went to one.
  • How can I tell if my child is ready for preschool?
  • Should I worry about all the germs circulating about preschools? I have heard they are breeding grounds for illness.
Where can I find more information about this topic?

Thinking About Preschool: Topics for the 2½ Year Visit (AAP)

School Readiness: Preparing for Success (AAP)

What to Expect From Your Child’s Development (Zero to Three)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Any alternative or natural care therapies or products you may use with your child More Info
Any alternative or natural care therapies or products you may use with your child
What is this and why is it important?

More patients and families are using complementary and alternative medicine (CAM) to care for their children, especially those with chronic illness.  A recent study conducted by the U.S. Centers for Disease Control and Prevention showed that more than 1 in 9 children use some form of CAM, including herbal medicine, acupuncture, and chiropractic care.

Be sure to let your doctor know about any products or treatments you use that might be considered “alternative” or “natural care.” This is important because your primary care provider will want to factor in any effects on your child's care provided by them. While many treatments, therapies and supplements have strong evidence that they are effective and safe, some therapies do not and some can interfere with each other— even dangerously.  It’s important that you talk openly with your health care provider about any therapies or products you are using with your children. Because something is “natural” doesn’t mean it is safe, and because it might be safe for an adult doesn’t mean it is safe—or effective—for a child.

Make sure to consult with licensed complementary health care providers.  Each state has different licensing rules so check with the licensing board for your state to find out if a health care professional has a license to practice.  If your state does not require a license to practice, be sure the professional is certified by a national professional organization. Included in the resources below are links to the websites in which you can verify licensure of medical doctors (MD), acupuncturists (LAc), chiropractic doctors (DC) and naturopathic doctors (ND).

Be sure that you and your CAM practitioner communicate with your child’s primary care provider about care provided.  Your child's CAM provider and primary care provider can call or email each other about your child's care but you might need to give them the other's contact information.

You should talk to your child’s health care provider about any alternative or natural care therapies or products you use with your child.

What are common questions I can ask my health care provider?
  • Should I give my child the vitamins the doctor suggests along with the other products I’m using or is it too much?
  • We use yoga together with our child. Is there any risk in that for a two-year-old? He loves doing it with us.
Where can I find more information about this topic?

Natural Therapies (AAP)

Complementary and Integrative Medicine: Parent Resources (AAP)

Herbal Medicines May Hurt Children (KidsGrowth)

Oregon Board of Medical Examiners (MD and LAc)

Oregon Board of Chiropractic Examiners (DC)

Oregon Board of Naturopathic Medicine (ND)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

U.S. Dept. of Health and Human Services. National Institutes of Health. National Centers for Complimentary and Alternative Medicine (NCCAM). CAM Use and Children. Retrieved 4/1/2010 from http://nccam.nih.gov/health/children/D383_BKG.pdf

Toilet training:

Signs your child is ready to potty train More Info
Signs your child is ready to potty train
What is this and why is it important?

Determining the best time to begin toilet training is not easy—not only because readiness occurs at different ages for different children, but because your child may be ready in one area of development but not in another. A one-year-old who happily sits on his potty to look at picture books still may not be able to comprehend the potty’s real purpose, while a two-year-old who knows what potties are for may refuse to use his out of a toddler’s natural desire to remain in almost constant motion.

In general, most children become physiologically ready for toilet training at around eighteen months of age—that is, their digestive system and bladder have matured to the point where they can delay a bowel movement or urination long enough to get to a potty. But they are usually not cognitively ready—able to associate the need to eliminate with potty use, to remember to use it, and to resist distraction long enough to complete the process—until sometime after their second birthday.

The motor skills needed to get to the bathroom, manage clothes and sit still on the potty are also clearly important.  So is the emotional urge toward independence and self-mastery—as well as sufficient emotional maturity to relax control sufficiently to avoid constipation. Social readiness—an awareness of others’ toilet use and a desire to imitate their behavior—is a powerful motivating force for toddlers and preschoolers. Another factor is the verbal ability to understand your explanations of how toilet use works and to communicate to you any confusion or uneasiness they feel.

As you can see, a range of physical and psychological developments help support the process of toilet training. While it isn’t necessary to wait until you’re sure that every one of these developments is in place, each step does increase the chances of toilet-training success. Pushing your child too early might actually prolong the process.

You can talk to your child's health care provider about signs that your child is ready to potty train.

What are common questions I can ask my health care provider?
  • How do I know when my child is ready to potty train?
  • Should my child be potty trained already?
Where can I find more information about this topic?

Toilet Training Resources (AAP)

2 Year Visit -- Toilet Training (AAP)

References

HealthyChildren.org by the American Academy of Pediatrics. Psychological Readiness and Motor Skills Needed for Toilet Training. Retrieved 1/1/10 from http://www.healthychildren.org/English/ages-stages/toddler/toilet-training/pages/Psychological-Readiness-and-Motor-Skills-Needed-for-Toilet-Training.aspx.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Helping your child potty train More Info
Helping your child potty train
What is this and why is it important?

The best way to introduce your toddler to the concept of using the toilet is to let him watch other family members of his sex and by talking to him frequently about the process or reading children’s  books about how to use the potty. Get a potty chair that sits on the floor, as some children may be fearful of falling into or off a regular toilet. With boys, encourage them to sit down for both toilet functions until they master pooping in the potty chair. Be sure to praise your child for his successes using the potty chair and staying clean and dry.

When starting, remember that children urinate more frequently than adults (up to 10 times a day).  So you will need to remind them to use the potty often.  Some children may try it for a while and then go back to wetting themselves. This is common and not a battle to engage in. Just keep trying by talking about it, making frequent trips to the potty and dressing him in clothes that he can take off easily.  Give rewards such as praise or stickers for every success, without anger or punishment for accidents.  Do not expect that he will both urinate and have bowel movements right away.  Many children do not master both at the same time. Typically children will begin to use the potty for urination first.

Review the resources below and visit the AAP’s website to get more tips about toilet training.  And remember that you can talk to your child’s health care provider about toilet training readiness and strategies.

What are common questions I can ask my health care provider?
  • My girls were trained by this age and my son isn’t sure what it is all about. How can we help him get trained?
  • Toilet training was going well but now he won’t go along with it and hides to poop in his diaper. How do we get him back to using the potty?
  • Is it better to train him on a kid’s potty or the same one we use?
Where can I find more information about this topic?

2 Year Visit -- Toilet Training (AAP)

Toilet Training (AAP)

References

HealthyChildren.org by the American Academy of Pediatrics. Toilet Training. Retrieved 1/1/10 from http://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/default.aspx.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of teaching your child to wash his own hands after using the toilet and before meals More Info
Importance of teaching your child to wash his own hands after using the toilet and before meals
What is this and why is it important?

Good health habits are learned from practice and consistency. If your child sees that you always wash your hands with soap and water in the bathroom then it can make it easier to teach your two-year-old the habit of hand washing. It is especially important to make it a routine to teach your child to wash his hands after using the toilet and before eating. Again, consistency and routine is the key.  Some children love to play in the sink and with a small stool can learn to wash by themselves. Others may prefer using a washcloth to clean their hands before eating.  Give your child a role in hand washing and he’ll likely enjoy it!

You can talk to your child’s health care provider about the importance of teaching your child to wash his own hands.

What are common questions I can ask my health care provider?
  • My child is always getting dirty and then grabs food before I can wash him . Isn’t a little dirt harmless to him?
  • I hate chasing my child around to wash his hands. He loves the bathtub for getting washed but we can’t do that several times a day! What else can I try?
Where can I find more information about this topic?

Hand Washing: A Powerful Antidote to Illness (AAP)

Hand washing: Do's and don'ts (Mayo Clinic)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

TV watching and physical activity:

Television – How much TV is okay? More Info
Television – How much TV is okay?
What is this and why is it important?

Moderation is key!  National recommendations say that children older than two-years-old should limit screen time, which includes television and video viewing and computer time, to no more than 1 to 2 hours of quality programming per day.

There is a lot about television that concerns national experts, a large part of is the inactivity and lack of interaction of TV viewing.  If your child watches TV, there are ways to avoid the concerns of experts.  For example, make sure the programs are appropriate for your two-year-old and that they are intellectually stimulating.  Watch together and talk about what you see.  While some TV shows seem geared for young children, you’ll have to evaluate what’s right for YOUR child. 

Another concern of experts is the effect of violence portrayed in even many children’s cartoons on your child.  Some programs can be too stimulating or frightening for a two-year-old.  Watch a new program with your child so you can see his reactions.  Be aware that the TV show may be appropriate for your child, but the commercials may not be. For example, too much of prime-time television is dominated by programs that depict violence and aggression or promote family-role stereotypes that may not reinforce the values you hold. This may result in fears showing up later that are hard to connect to anything. Some cartoons are designed to make it difficult for children to distinguish between fantasy and reality. Commercials and other advertising can expose children to products that parents often do not approve of and cannot afford.

Be sure to monitor how much your child is watching TV and try to keep it under 1 to 2 hours per day.  It is more important to provide your child with opportunities for active intellectual, emotional, artistic, and physical growth. Make sure your child is playing outdoors, reading books with you, conversing, or playing actively each day. Children learn best in the context of relationships and meaningful interaction with people they respect. In most cases, even in a group, television viewing is a passive, solitary activity.

You can talk to your child’s health care provider about why the experts say to limit ”screen time” and how can you evaluate what are some quality options for your child.

What are common questions I can ask my health care provider?
  • How do I know what TV or videos are “good” or “age-appropriate” and which ones are not?
  • My husband thinks professional football is great for our toddler to watch. Is it going to be a problem if he watches with his father?
Where can I find more information about this topic?

Play, Television and Physical Activity; Healthy Advice at the 2 Year Visit (AAP)

Where We Stand: TV Viewing Time (AAP)

How TV Affects Your Child (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of outside family activities that involve playing, walking, running or playing chase More Info
Importance of outside family activities that involve playing, walking, running or playing chase
What is this and why is it important?

Establishing family activities and routines are important, even at this age. Family activities that everyone can join in create a sense of family fun but also emphasize the importance of physical activity.  Not only will your toddler find active family games fun, but this is also a great way for the rest of the family to get exercise.

Your toddler may not need real “exercise” now but overweight and obesity at this age is correlated with obesity later in life. Being active now will begin to instill the habit of active play for a lifetime.  If you can, try to do activities that get your child outdoors The fresh air and being in nature has value in itself and it is often safer for your child to run around in the open than to bump into walls and furniture inside.   Examples of fun, active activities are going for a hike together, playing chase, listening to music and dancing or going to a park and playing hide and seek. Avoid watching TV during “family time.”

You can talk to your child’s health care provider about family activities and having fun together.

What are common questions I can ask my health care provider?
  • Playgrounds in our neighborhood seem geared for older kids – basket ball hoops and big kids. What kind of active games can we play with our 2-year-old?
  • Our neighborhood isn’t really too safe – what’s the best way to find places in our city for little kids?
  • We live in a rural area without sidewalks and with few neighbors so we have to drive to safe places to walk and play. Is it enough exercise for our child just to be out in our yard?
Where can I find more information about this topic?

Ages & Stages: The Active Toddler (AAP)

Physical Activity for Preschoolers (USDA)

How Can You Help with Physical Activity? (USDA)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

A healthy weight for your child More Info
A healthy weight for your child
What is this and why is it important?

Children come in many shapes and sizes. With their weights in mind, most kids fall within the normal range, although in recent years, more parents than ever are being told by their pediatricians that their youngsters are overweight. Although it will happen more slowly now, your child will continue to grow steadily. Preschoolers grow an average of 2 1/2 inches (6 cm) annually and gain about 4 pounds (2 kg) each year.

Your child’s health care provider has most likely been charting your child’s height and weight since he was an infant, typically during every office visit and telling you what percentile your child falls into for height and weight.  When your child turns two years old, recommendations call for your child’s health care provider to calculate his body mass index (BMI). This is the weight in pounds divided by the height in inches squared, and then multiplied by 703 (or, weight in kilograms divided by height in meters squared). A child with a BMI greater than the 85th percentile for age and sex is considered overweight; when the BMI is at or above the 95th percentile, he is considered obese. 

The BMI,  after age 2, is a more accurate indicator of whether your child is overweight than looking solely at height or weight. The BMI provides a clear picture of your two-year-old’s present status and areas that need attention. Keep in mind that although BMI is not a specific measure of body fat, it is closely linked with body fat calculations.

Early eating behaviors can influence the risk of obesity throughout life. Lifetime eating habits can be established at a very early age. It is important for parents to teach and exemplify healthy eating habits right from the start.  You can help your child maintain a healthy weight by introducing new, healthy foods, engaging your child in active play and limiting sugary foods. 

If you are concerned that your child does not eat enough or refuses to eat only a limited number of foods, know that it is typical for children at this age to become picky eaters.  For some children, it can take up to 15 tries before they like and accept a new food.   Ask your child’s doctor to discuss the growth charts with you to be sure your child is growing properly.

You can talk to your child’s health care provider about your child’s weight and whether it within a healthy range.

What are common questions I can ask my health care provider?
  • Does it really matter if a two-year is considered “obese”? It seems like it is too early to matter.
  • Is it all right to start using low fat products for my child since he is so big?
  • How do I get my child to eat more? He wasn’t always so picky but now he eats only about five foods and won’t try other things.
Where can I find more information about this topic?

Promoting Healthy Weight: A Lifetime Gift (AAP)

Feeding Guide for Children (AAP)

Growth During the Preschool Years (USDA)

Help Them Know When They've Had Enough (USDA)

Growth and Your 2 to 3 Year Old (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your child's safety:

Preventing injuries indoors and outdoors More Info
Preventing injuries indoors and outdoors
What is this and why is it important?

By this age most two-year-olds have learned many skills that can help them get into all sorts of exciting - and dangerous places! They climb, open cabinets, try to eat things that may or may not be food, and generally need to be watched full time. Look at  some of the childproofing you did when your child started crawling and consider the new abilities your child has. Try getting down on your child’s level to see if there are dangers you may have missed.

Check for the safety and security of cabinets and bookshelves that might be used for climbing. Be sure that all medicines and household cleaning products are out of your child’s reach.  Even though your child has probably mastered walking, gates can still be useful at the top of stairs. If your child spends time in someone else’s home, make sure that they also have appropriately childproofed their home.  This also includes grandparents’ homes or anywhere your child visits. 

Outside there are even more fun and more risks - from cars, machinery, animals, and bikes. A watchful adult is an important 2-year-old accessory!  Check your yard for dangerous plants. Among preschoolers, plants are a leading cause of poisoning. If you are unsure about any of the plants in your yard, call your local Poison Help Line (1–800–222–1222) and request a list of poisonous plants common to your area.  If a poisoning from any source occurs or if your child swallows something he should not have, always call the POISON CONTROL CENTER at (800) 222-1222 first! Currently, Syrup of Ipecac is not recommended.

When outside, hold on to your toddler’s hand whenever you are near streets, parking lots and driveways, even in quiet neighborhoods.
Cars are very appealing to small children but are not places to play. Don’t leave your child in the car alone or outside alone and be especially watchful when others may be driving into or out of your driveway or parking spot.  A 2-year-old is too small to be easily seen by a car backing up.  At playgrounds or play structures at home, make sure there is sand, woodchips, or other soft surfaces under the outdoor play equipment.

There are many tips for childproofing for a walking/running toddler in the resources below and you can also talk to your child’s health care provider about this.

What are common questions I can ask my health care provider?
  • As a parent, I worry all the time about the risks for a 2-year-old. How can I keep from making my child nervous about those risks?
  • We have gates, cabinet locks, and have childproofed all we can, but he is always on the move. What are some additional childproofing strategies for a 2-year-old?
Where can I find more information about this topic?

Safety Basics (Safe Kids USA)

Your Child’s Body Guard: Safety at the 2 Year Visit (AAP)

Home Safety: Here's How (AAP)

Making Your Home Safe for Your Child

Safety Outside

References

American Academy of Pediatrics (AAP). Backyard Safety. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/at-home/Pages/Backyard-Safety.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 (4th ed.). New York: Bantam Books, 2004.

Installing a car seat correctly/when to use a booster seat More Info
Installing a car seat correctly/when to use a booster seat
What is this and why is it important?

Studies show that up to 80% of car safety seats are not installed or used correctly. It is best for children to ride rear-facing as long as possible to the highest weight and height allowed by the manufacturer of their car seat.  When your child has outgrown the seat rear-facing, he should use a forward-facing seat with a full harness as long he will fit in it (usually called a “convertible seat” or “forward-facing car seat”). Do not put toddler car seats in the front seat. This is especially dangerous if the car has an airbag on the passenger side.  Booster seats are for older children who have outgrown their forward-facing car safety seats. A two-year-old is too young and small for a booster seat and shouldn’t be using one until about 4 years old and 40 pounds.

It’s important that you insist on using the car seat every time without exception. Don’t let your child think you will let him out of the seat when driving.  Do not start your vehicle until everyone is buckled up – children watch everything their parents do.

This is a good time to double check the manufacturer’s instructions (remember, most people have the car seat installed wrong).  Contact the Child Safety Seat Inspection Station locator to find the nearest certified inspector who can check the installation and make any corrections needed.   You can find this information at www.seatcheck.org or by calling 1-866-SEAT-CHECK.

You can talk to your child’s health care provider about installing the car seat correctly.

What are common questions I can ask my health care provider?
  • I have trouble making my child stay in his car seat when we go do errands. He hates being buckled in and I hate bribing him . What can I do?
  • My child is very big for his age and there are varying instructions to follow, how do we determine the best instructions to follow?
  • My child has a special need and doesn’t fit in a regular safety seat – as he grows, who can help us figure out the best one to use?
Where can I find more information about this topic?

Car Safety Seats: Information for Families for 2012 (AAP)

Your Child’s Body Guard: Safety at the 2 Year Visit (AAP)

SeatCheck.org

Car and Booster Seats for Your Toddler (Children's Hospital of Philadelphia)

Child Safety Seat Inspection Station Locator

References

American Academy of Pediatrics (AAP). Car Safety Seats: Information for Families for 2010. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families-2010.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Tombrello, S. When should my child switch from a car seat to a booster seat? Retrieved 4/1/2010 from http://www.babycenter.com/404_when-should-my-child-switch-from-a-car-seat-to-a-booster-sea_1384636.bc

Setting a positive example for your child by always using your seat belt More Info
Setting a positive example for your child by always using your seat belt
What is this and why is it important?

Do not start your vehicle until everyone is buckled up – children watch everything their parents do and love to copy them so it is important for you to model safe behaviors by always wearing your safety belt. The best way to get your child to accept car seats as a natural way to travel is to use your seatbelt yourself every time you are in a car. Your good habits keep everyone in the car safer.

You can talk to your child’s health care provider about setting a positive example for your child by always using your seat belt.

What are common questions I can ask my health care provider?
  • On short trips I might not use my seat belt but I do put my 2-year-old in his car seat. Isn’t that good enough?
  • What can I say that will convince my parents to wear their seat belts when they have my child with them?
Where can I find more information about this topic?

Encouraging Seat Belt Use (National Safety Council)

BUCKLING UP (Advocates for Highway & Auto Safety)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of your child wearing a helmet More Info
Importance of your child wearing a helmet
What is this and why is it important?

Be sure that your child wears a helmet approved by the Consumer Product Safety Commission (CPSC) when riding on a tricycle, on a scooter, or in a seat on an adult’s bicycle. 

It is important to establish the habit of wearing a helmet early and to be consistent with the rule that your child must wear one.  If your child learns to wear helmets whenever they ride tricycles and bikes, it becomes a habit for a lifetime. Allow your child to participate in choosing their helmet. They'll be able to let you know if it is comfortable. And if they like the design, they are more likely to wear it. Wear a helmet yourself, not only for safety reasons but also to model safe behaviors for your toddler. 

Make sure that everyone’s helmets properly fit according to the manufacturer’s instructions. A helmet should be worn squarely on top of the head, covering the top of the forehead. If it is tipped back, it will not protect the forehead. The helmet fits well if it doesn't move around on the head or slide down over the wearer's eyes when pushed or pulled. The chin strap should be adjusted to fit snugly.  Remember: Head injuries can occur on sidewalks, on driveways, on bike paths, and in parks as well as on streets. You cannot predict when a fall will occur. It's important to wear a helmet on every ride.

You can talk to your child’s health care provider about the importance of your child wearing a helmet.

What are common questions I can ask my health care provider?
  • I didn’t think helmets were so important, but should I be getting one for my child for activities?
  • Does my child need a helmet on a tricycle?
Where can I find more information about this topic?

How To Get Your Child To Wear a Bicycle Helmet (AAP)

Bicycle Helmets: What Every Parent Should Know (AAP)

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

Bike Safety for Babies and Toddlers (MN Safety Council)

Tips on Getting Kids to Wear Bike Helmets (Bicycle Helmet Safety Institute)

Pamphlet: A Bicycle Helmet for My Child (Bicycle Helmet Safety Institute)

Back Seat Bikers (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Bathtub, water, and pool safety More Info
Bathtub, water, and pool safety
What is this and why is it important?

Drowning is a leading cause of injury-related death in children.  Toddlers are so quick and curious – and so often attracted to water.  Bathtubs, pools and lakes are obvious places to keep a close eye on your child. But you also need to be cautious when your child is near even small amounts of water - in a bucket, toilet or even a few inches in a tub.  Always keep a close eye on your toddler around water – be sure you’re within arm’s reach. 

There are many strategies to maintain bathtub, water and pool safety. Parents and caregivers should never—even for a moment—leave your child alone or in the care of another young child while in bathtubs, pools, spas or wading pools or near irrigation ditches or other open standing water.  You should remove all water from containers, such as pails and 5-gallon buckets, immediately after use. To prevent drowning in toilets, young children should not be left alone in the bathroom even for a few seconds and unsupervised access to the bathroom should be prevented.   Children like to turn the faucets but it could cause burns if an adult is not there. You can set the upper temperature for your hot water on your water heater to lessen the risk of these burns.

You can talk to your child’s health care provider about bathtub, water and pool safety at your child’s next well-visit. 

What are common questions I can ask my health care provider?
  • I have to watch my child closely around any pool as he has no fear of the water. Is he too young for swimming lessons to make it safer?
  • Is it okay to let my older child watch my toddler in the bathtub while I run to answer the door or the phone?
Where can I find more information about this topic?

Home Water Hazards for Young Children (AAP)

Avoiding Danger: Safety Tips at the 2½ Year Visit (AAP)

Making Your Home Safe for Your Child

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Gun safety in your home and places where your child visits More Info
Gun safety in your home and places where your child visits
What is this and why is it important?

More than 44 million Americans own firearms and research shows guns in homes are a serious risk to families.  Guns and children don’t mix.  In 2006 alone, 31 American kids under the age of 10 were killed in unintentional shootings and 187 were injured. 2-year-olds are curious creatures! If you or someone in your house does have a gun, be sure to store it unloaded under lock and key, with the ammunition stored (and locked) in a separate place.  Make sure to hide the keys to the locked boxes. 

Also make sure the places where your child visits or receives childcare do not have guns or at a minimum, that they are safely stored.  Given that over 40% of homes with children have a gun, and many of those guns are left unlocked or loaded this a common risk to your child’s safety. A tip sheet for asking about guns in the home is provided in the resources below. 

You can talk to your child’s health care provider about gun safety in your home and in places where your child visits.

What are common questions I can ask my health care provider?
  • I hunt every fall and can’t wait to teach my child how to hunt with me. When can I show him my gun collection?
  • Our childcare provider’s husband is a police officer with a gun. It’s probably stored correctly, but should I ask?
Where can I find more information about this topic?

Protecting Your 3-Year Old: Paying Attention to Safety (AAP)

Where We Stand: Gun Safety (AAP)

Gun Safety: Keeping Children Safe (AAP)

Home Safety: Here's How (AAP)

References

American Academy of Pediatrics (AAP). Gun Safety: Keeping Children Safe. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/all-around/Pages/Gun-Safety-Keeping-Children-Safe.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Centers for Disease Control and Prevention (CDC). Injury Prevention & Control: Data & Statistics (Web-based Injury Statistics Query and Reporting System [WISQARSTM]). Retrieved 4/1/2010 from http://www.cdc.gov/injury/wisqars/index.html

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

PAX / Real Solutions to Gun Violence ASK (Asking Saves Kids) Campaign. Is there a gun where your child plays? Retrieved 4/1/2010 from http://www.paxusa.org/ask/index.html