SDPA 1QR5 4/21/21

NEXT CHECK -UP – 3 YEARS OLD

Sleep: Your child will sleep 10-12 hours at night plus 1 nap for an average of 13-14 hours of sleep in 24 hours. Once your child attempts to crawl or climb out of the crib, it is time to transition to a “big” bed. Keep a consistent bedtime and praise your child for going to bed and following the routine. By this age, all bottles and pacifier use should be discontinued!

Growth & Nutrition: Your toddler’s rate of growth remains steady, with an average weight gain of 4-5 pounds per year and growth of 3-4 inches per year. Continue 3 well-balanced meals per day with 1-2 nutritious snacks. Children tend to eat more for breakfast and lunch and less at dinner. Your child’s appetite may fluctuate and your child will start voicing his/her opinions about foods. Keep offering healthy foods as picky eating is normal for many children at this age. Share mealtimes as a family whenever possible.

Continue to use skim or 1% milk. Avoid sweetened beverages. All liquids should be from a cup (no more bottles). If your child is not drinking fluoridated water, ask your provider about the need for fluoride supplements.

Talk to your provider about any concerns regarding food allergies or intolerances. There are no food restrictions at this age.

If you qualify for WIC (1-800-WIC-4030), be sure to take advantage to ensure good nutrition.

At this age: Continue to praise good behavior. Temper tantrums are normal at this age. Try to be consistent with rules as toddlers this age thrive on routine. Try not to make a big deal over small issues but always be strict about safety. Brief “time-outs” for 2-3 minutes are an effective means of discipline. Always avoid spanking as it leads to feelings of fear and anger in children. Limit screen time and TV to less than one or two hours per day of nonviolent, educational programs. Encourage and model routine physical activity. Remember: it’s not just what you say, but what you do that impacts your child.

2 1/2 Year or 30 Months Parent Information

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Name _________________________

Date __________________________

Weight: ___________

___________%

Height: ___________

__________%

BMI: ___________

___________%

Southdale Pediatrics

Questions: Please call during office hours. Our experienced pediatric nurses can advise you on issues regarding your child’s health and development. We have an after hours number (952-653-0261) to be used for urgent situations only. It is your responsibility to familiarize yourself with your insurance’s policy on after hours (urgent care or ER) availability, location, cost, and prior approval.

The American Academy of Pediatrics has additional useful information at www.aap.org. Additional links to common parenting questions can be found on our website.

Elimination: Most children show interest in toilet training between 24-30 months of age. However, some become interested later. Have a potty chair in the bathroom and allow the child to initiate training. Avoid power struggles. Use positive reinforcement and praise your child for sitting on the potty chair. There are many informative books and videos available for children who are beginning to toilet train. Nighttime dryness usually does not occur for at least another year or more. Most toddlers have bowel movements (BMs) every day or every other day. Intervals of two days or longer between BMs (or firm BMs) warrant discussion with your health care provider.

Patient Portal: Patients and families can securely access their medical records online utilizing our Patient Portal. With the portal, you will have the ability to schedule appointments, send messages to our clinical staff, request prescription refills, access immunization records, review test results and more. Ask to sign up for the portal at the front desk or sign up through our website.

SDPA 1QR5 4/21/21

Preventative Health

▪ Continue using a rear facing car seat. Your child should remain in a car seat until child reaches weight limits of the car seat.

▪ Supervise your toddler closely around water (including the bathtub and toilet). Keep your hot water thermostat set no higher than 120 degrees to prevent scald burns.

▪ Apply broad spectrum sunscreen (with SPF of at least 30) twenty minutes before outside summertime play. Products with sunblock (like titanium dioxide) are effective immediately.

▪ Bug repellants with up to 30% DEET are considered safe by the AAP. Avoid spraying on face and hands. Floppy hats keep bugs away from the face & neck.

▪ Keep your child’s environment smoke-free, including the car.

▪ Keep cigarettes, lighters, matches and alcohol out of your child’s sight and reach.

▪ Keep all firearms unloaded, locked and stored separate from ammunition, or remove them from the home altogether.

▪ Watch out for tablecloths, cords or cups of hot beverages that he/she may pull down.

▪ Keep him/her away from hot stoves, ovens, fireplaces, irons, curling irons and space heaters.

▪ Keep poisons, medications and toxic household products locked up. Have safety caps on all medications.

▪ The number for Minnesota Poison Control is 1-800-222-1222.

▪ Avoid giving him/her plastic bags, latex balloons, and small or sharp objects.

▪ Continue to use safety devices on windows.

▪ Be aware of the dangers of heavy furniture falling on to children as they climb and explore. Follow all recommended guidelines to secure and/or anchor furniture to prevent injury or death.

▪ Keep him/her away from moving machinery, lawn mowers, snow blowers, driveways, and streets.

▪ Always check behind your car before you back up!

▪ Work on crossing the street and parking lot safely.

▪ Teach your child to use caution around dogs, especially if they are unknown or eating.

▪ Brush your child’s teeth carefully using a pea-sized amount of fluorinated toothpaste if they can spit it out (a rice-sized amount if they cannot spit yet). We recommend brushing twice daily.

▪ Discontinue pacifier and bottle use completely for healthy teeth development! Your child should start seeing a dentist if they haven't already.

▪ Have your child wear a bike helmet when riding in a seat or trailer on an adult’s bike. Remember, adults need helmets too!

▪ Continue to avoid foods that may cause choking, such as peanuts, popcorn, whole grapes or hard candy. Cut up foods when possible.

▪ Make sure the batteries in your smoke and carbon monoxide detectors are working. Replace every six months.

Normal Development 2 1/2 YEARS (30 MONTHS)

* Runs well.

* Walks up stairs with rail, alternating feet.

Jumps in place.

Able to stand with both feet on balance beam.

Makes an 8 cube tower.

Washes hands.

Puts things away.

Brushes teeth with assistance.

Points to small details in pictures.

Imitates adult activities such as sweeping, talking on phone, brushing hair.

Follow 2 step commands: “Put block on box.”

Understands action words, such as “washing, playing, blowing, singing, eating, etc.”

Refers to self with correct pronoun.

Recites parts of well-known story.

Each child is unique. It is therefore difficult to describe

exactly what should be expected at each stage of a child’s

development. While certain attitudes, behaviors, and

physical milestones tend to occur at certain ages, a wide

spectrum of growth and behavior for each age is normal.

Consequently, these guidelines are offered as a way of

showing a general progression through the developmental

stages rather than as fixed requirements for normal

development at specific ages. It is perfectly natural for a

child to attain some milestones earlier and other mile-

stones later than the general trend.

We have begun using M-CHAT, a screening tool to help

diagnose autism, at the 15 month, 18 month and 2 year old

visits. Please discuss any concerns related to your child’s

own pattern of development with your pediatrician.

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Please download the free Milestone Tracker app to see photos and videos demonstrating children’s develop-ment at: www.cdc.gov/ncbddd/actearly/milestones-app.html