IMMUNIZATIONS: None

This is an important age to reassure parents that other parents also spend most of their day correcting their children. The children are just growing and continuing to test their limits and learn. Realize this, and continue to maintain limits as we have discussed in the past.

Developmentally at 2 years of age, a child's language should be continuing to increase. Most children are putting at least 2 words together and amaze their parents with each new phrase. They should feed themselves relatively well. Two year olds are starting to undress themselves, climb steps standing, draw horizontal lines, and wash and dry their hands.

Children should still be riding in car seats and seat belts. Car seats are still safer than a seat belt alone. Also, it is an age to begin to warn children about going with strangers. This is difficult to balance between getting children used to being left alone with sitters and acting nice to new acquaintances, but at the same time not going with strangers. This can only be done with patience and repeated explanations each time they ask, or the proper opportunity presents itself Another help may be one of the many children's books that discuss this in a story form.

Speaking of separation anxiety with baby-sitters, this again may be common-at this age. It becomes funny that your child can walk away from you without hesitation, but if you leave your child, that is good for a temper tantrum. The best way to deal with this is most importantly, not to get upset. If you want to go out for the evening, go! Have the sitter come about 20 minutes early so that she has time to know your child, get your instructions (and a list of numbers with whom to call in an emergency), and a chance to start to play with your child before you leave. Also, tell your child when you do leave, rather than sneaking out, and tell him/her that you will return. In this way, the child will learn to trust you.

Many parents ask about when to switch their child from a crib to a bed. One rule of thumb is that if your child is able to climb out of the crib, it is time for a bed. Also, if mom is pregnant again, most parents will switch their child to a bed. Make the switch seem as a reward for growing up so that the child sees this as a gain rather than thinking he/she is losing something.

For some parents, toilet training of their child has been accomplished, but for most, this is just a dream. Refer to the 18 month sheet for some suggestions. As an addendum, try to keep the child's bowel movements soft. If the child is confused or afraid to have bowel movements on the toilet, he/she will hold the bowel movement. When he/she finally does go, the bowel movement will be hard, and this will reinforce his/her holding the bowel movement longer the next time. This becomes a vicious cycle. The best way to prevent this is to push apple juice and prune juice, as well as decreasing the amount of milk that he/she drinks. If this becomes a problem, call during office hours and we will try to help you out.

Normal activity during this year of the "terrible two's" includes your child being in constant motion. Your child should gain confidence through this year, but also will become more aggressive and fight for what he/she wants. She will play side by side with other children. not despair if this describes your child as it is normal activity. Try to avoid unpleasant situations so that you do not have to reprimand your child. If the child does do something you disagree with, try to distract him/her. If that does not work, sit him/her on a chair for two minutes. Also, do not forget to praise your child when he/she does well. Sometimes we are quick to punish, but forget to praise, and this can cause a poor self image.

PREVENTION STRATEGIES FOR INJURIES - 2 YEARS

GHOKING/ASPIRATION/SUFFOCATION

Learn what to do when a child chokes.
Allow no cords near crib or around neck.
Keep plastic bags, balloons, and baby powders out of reach.
Keep all small, hard objects out of reach.
Use only unbreakable toys without sharp edges or small parts that can come loose.
Avoid foods on which child chokes easily (hot dogs, peanuts, popcorn, chewing gum, and hard fruits and vegetables).
Cut food into small pieces.
Store toys in a chest without a dropping lid.

FIRES AND BURNS

• Never eat, drink, or carry anything hot near or while holding a baby or child.
• Turn down water heater so water from the hot water tap is no more than 120 degrees Fahrenheit.
• Develop and practice a fire escape plan.
• Install and maintain smoke detectors.
• Keep a fire extinguisher in or near the kitchen.
• Treat a burn immediately with cold water, and then call your doctor.
  Check formula, food, and drink temperatures carefully.
• Don't smoke near the baby.
• Keep hot foods and liquids out of reach.
• Put shock stops in unused electrical outlets; put cords out of reach.
• Keep hot appliances and cords out of reach.
• Keep all electrical appliances out of the bathroom.
• Don't cook with child at feet, use playpen, high chair or crib as a safety area for small child.
• Provide non flammable barriers around hot home heating surfaces and fireplaces.
• Insulate junctions of extension cords with electrical tape.
• Use back burners on stove with pan handles out of reach.
• Keep matches and lighters out of reach.
• Do not store items that attract a child above the stove.
• Do not allow child to use stove, microwave, hot curlers or iron.

MOTOR VEHICLE ACCIDENTS

• Never leave a child unattended in car.
• Parents should wear their seat belts.
• Use approved toddler car seat correctly.
• Don't carry child on tractor or riding mower.
• The ONLY way you can PREVENT car injuries and deaths is to use car safety seats or seat belts EVERY TIME you child is in the car.

PEDESTRIAN/PEDAL CYCLE INJURIES

• Avoid carrying child as a passenger on adult's bike except in special seat, helmeted and off street.
• Hold on to walking child around traffic.
• Fence and/or supervise outside play area.
• Provide play area that prevents balls and riding toys from rolling into street.
• Prohibit riding of trikes, bikes and big wheels in or near traffic or on driveways.

DROWNING

• Remain in the room during every second of a bath.
• Provide unbreachable barrier around pool or spa.
• Continuously supervise child around any water.

POISONING

• Keep all medicines, vitamins, cleaning, plumbing, gardening, painting, refinishing, and agricultural chemicals and supplies out of reach, preferably locked away, or dispose of after use.
• Remove all poisonous plants from the home.
• Install safety latches to delay access to cabinets.
• Put poison center number on all phones; call if child puts something in his mouth that may be poisonous.
• Buy syrup of ipecac; use only if directed to do so.
• Purchase all medicines in containers with safety caps.
• Do not transfer toxic substances to drink bottles, glasses, or jars.

ANIMAL BITES

• Teach child not to approach pets he doesn't know well.
• Teach child not to handle wild animals.

CUTS

• Remove (or pad) low furniture with sharp corners from child's living area.
• Keep sharp objects out of reach (safety latches or locks help to delay access).
• Prohibit use of any proximity to knives, power tools and mowers.