Pediatric Group

24 Month Well Child Visit

Vaccines: No vaccines are needed unless previous vaccines were missed 

                    FEEDING  

·         Absolutely no more bottles!

·         You may begin to offer low-fat milk (16-24 ounces/day)

·         Offer 3 meals & 3 snacks daily

·         Let child decide how much to eat, you pick the foods

·         Do not force eating

·         Set a good example - eat healthy!

·         Eat as a family

·         Child should feed self, provide child sized utensils

·         Always supervise eating

·         Avoid choking foods (nuts, popcorn, carrots, raisins, hard candy) 

                GENERAL CARE / SAFETY  

·         You may begin potty training if your child:

o        Tells you after urinating or stooling

o        Has increased daytime dryness

o        Shows an interest in the toilet

·         Use a safety seat in the back seat

·         Childproof your home

·         Supervise child at all times

·         Begin using a small amount of fluoridated toothpaste

·         Keep poison center number handy – (800) 222-1222

·         Use sunscreen and insect repellant if needed

·         Praise good behavior

·         Reinforce limits, be consistent and reasonable

·         Discourage aggressive behavior

·         Use brief discipline such as “time out” to teach a lesson – not to punish

·         Set a good example with your behavior

·         Children may have fears & nightmares

·         Never smoke around children

·         Expect temper tantrums

                    PLAY

You can encourage development through play

• Talk, sing, & read together - explain stories & pictures
• Play interactive games
• Include toddler by offering simple & fun tasks
• Encourage imaginative play
• Avoid using the word “NO”
• Allow self-expression and choices
• Don’t expect child to share all toys

DEVELOPMENTAL MILESTONES

                    PHYSICAL & MOTOR SKILLS

• Runs well
• Walks up and down stairs
• Kicks ball
• Stacks 5-6 blocks
• Uses a spoon and a cup
• Takes off clothes & helps get dressed
• Washes hands
• Can draw horizontal lines & circular shapes

                        SENSORY & COGNITIVE SKILLS

• Says about 20-50 words
• Understood by strangers ½ of the time
• Uses 2-word phrases
• Names objects & body parts
• Understands 2-step commands
• Points to pictures in a book
• Enjoys imaginary play

Developmental Health Watch

Although children develop at different rates, failure to reach certain milestones may signal a problem.  If you notice any of the following warning signs in your infant, discuss them with your pediatrician.

·         Not running well

·         Uneven walk, limping, or frequent falling forward when walking

·         Does not make eye contact or gestures (pointing, etc)

·         Uses less than 20 words

·         Loss of previously known skills

Talk with your doctor if you have any concerns about your child’s development

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