Well-Child Checkup: 2 Years

At the 2-year checkup, the doctor will examine your child and ask how things are going at home. At this age, checkups happen less often. So this may be your child's last checkup for a while. This checkup is a great time to have questions answered about your child's emotional and physical development. Bring a list of your questions to the appointment so you can address all of your concerns.

This sheet describes some of what you can expect.

The doctor will ask questions about your child. They will observe your toddler to get an idea of your child's development. By this visit, most children can:

• Say at least two words together, like "more milk."
• Point to at least two body parts and point to pictures in books.
• Use gestures, such as blow a kiss or nod yes.
• Run and kick a ball.
• Notice when others are hurt or upset. They may pause or look sad when someone is crying.
• Play with more than one toy at a time.
• Try to use switches, knobs, or buttons on a toy.

Don't worry if your child is picky about food. This is normal. How much your child eats at a single meal or in 1 day is less important than the pattern over a few days or weeks. To help your 2-year-old eat well and develop healthy habits:

• Keep serving different finger foods at meals. Don't give up on offering new foods. It often takes a few tries before a child starts to like a new taste.
• If your child is hungry between meals, offer healthy foods. Cut-up vegetables and fruit, cheese, peanut butter, and crackers are good choices. Save snack foods, such as chips or cookies, for a special treat.
• Don't force your child to eat. A child of this age will eat when hungry. They will likely eat more some days than others.
• Switch from whole milk to low-fat or nonfat milk. Ask the doctor which is best for your child.
• Most of your child's calories should come from solid foods, not milk.
• Besides drinking milk, water is best. Limit fruit juice. It should be100% juice, and you may add water to it. Don't give your toddler soda.
• Don't let your child walk around with food. This is a choking risk. It can also lead to overeating as the child gets older.

Advice includes:

• Brush your child's teeth twice a day. Use a small amount of fluoride toothpaste no larger than a grain of rice. Use a toothbrush designed for children.
• If you haven't already done so, take your child to the dentist.

Many 2-year-olds aren't yet ready for potty training. But your child may start to show an interest in the next year. If your child is telling you about dirty diapers and asking to be changed, this is a sign that they are getting ready. Here are some tips:

• Don't force your child to use the toilet. This can make training harder.
• Explain the process of using the toilet to your child. Let your child watch other family members use the bathroom, so the child learns how it's done.
• Keep a potty chair in the bathroom, next to the toilet. Encourage your child to get used to it by sitting on it fully clothed or wearing only a diaper. As the child gets more comfortable, have them try sitting on the potty without a diaper.
• Praise your child for using the potty. Use a reward system, such as a chart with stickers, to help get your child excited about using the potty.
• Understand that accidents will happen. When your child has an accident, don't make a big deal out of it. Never punish the child for having an accident.
• If you have concerns or need more tips, talk with the doctor.

By 2 years of age, your child may be down to one nap a day and should be sleeping about 8 to 12 hours at night. If they sleep more or less than this but seem healthy, it's not a concern. To help your child sleep:

• Encourage your child to get enough physical activity during the day. This will help them sleep at night. Talk with the doctor if you need ideas for active types of play.
• Follow a bedtime routine each night, such as brushing teeth followed by reading a book. Try to stick to the same bedtime and routine each night.
• Don't put your child to bed with anything to drink.
• If getting your child to sleep through the night is a problem, ask the doctor for tips.

To help keep your child safe:

• Don't let your child play outdoors without supervision. Teach caution around cars. Your child should always hold an adult's hand when crossing the street or in a parking lot.
• Protect your toddler from falls. Use sturdy screens on windows. Put gates at the tops and bottoms of staircases. Supervise the child on the stairs.
• If you have a swimming pool, put a fence around it. Close and lock gates or doors leading to the pool. Teach your child how to swim. Children at this age are able to learn basic water safety. Never leave your child unattended near a body of water.
• Have your child wear a good-fitting helmet when riding a scooter, bike, or tricycle or when riding on the back of an adult's bike.
• Plan ahead. At this age, children are very curious. They are likely to get into items that can be dangerous. Keep latches on cabinets. Keep products like cleansers and medicines out of reach.
• Watch out for items that are small enough to choke on. As a rule, an item small enough to fit inside a toilet paper tube can cause a child to choke.
• Teach your child to be gentle and cautious with dogs, cats, and other animals. Always supervise the child around animals, even familiar family pets. Never let your child approach an unfamiliar dog or cat.
• In the car, always put your child in a car seat in the back seat. Babies and toddlers should ride in a rear-facing car safety seat for as long as possible. That means until they reach the top weight or height allowed by their seat. Check your safety seat instructions. Most convertible safety seats have height and weight limits that will allow children to ride rear-facing for 2 years or more. All children younger than 13 should ride in the back seat. If you have questions, ask your child's doctor.
• Keep this Poison Control phone number in an easy-to-see place, such as on the refrigerator: 800-222-1222.
• If you own a gun, keep it unloaded and locked up. Never allow your child to play with your gun.
• Limit screen time to 1 hour a day. This includes time watching TV, playing on a tablet, computer, or smart phone.

At this visit your child may get the following vaccines:

• Influenza (flu)
• COVID-19

Over the next year, your child's speech development will likely increase a lot. Each month, your child should learn new words and use longer sentences. You'll notice the child starting to communicate more complex ideas and to carry on conversations. To help build your child's verbal skills:

• Read together often. Choose books that encourage participation, such as pointing at pictures or touching the page.
• Help your child learn new words. Say the names of objects, and describe your surroundings. Your child will pick up new words that they hear you say. And don't say words around your child that you don't want repeated!
• Make an effort to understand what your child says. At this age, children start to communicate their needs and wants. Reinforce this communication by answering a question your child asks. Or ask your own questions for the child to answer. Don't be concerned if you can't understand many of the words your child says. This is normal.
• Talk with the doctor if you're concerned about your child's speech development.