DISCLAIMER: This material is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it. It is not intended to provide medical advice, diagnosis, or treatment, nor does it replace the advice or counsel of a doctor or health care professional. Reference to a specific commercial product, service, or external web site does not imply endorsement or recommendation of that product, service, or external web site content by CPCMG. We attempt to keep lists of resources and referrals as up to date as possible; however, this information is constantly changing. Please check with the service provider and your insurance company to verify coverage.
Visit our Health Hub at https://healthhub.cpcmg.net to learn more about your child’s health, wellness, and development. Available 24/7!
Your Child’s Behavior
Your child may act more clingy or nervous when around strangers or in new places.
This is a normal part of development at this age.
Continue to talk to your child about the events of each day.
Changes in routines can be hard and supporting your child is perfectly healthy.
Try to pick times when you know your child is fed and well rested.
Continue to read and play with your child often.
Books about potty training can help introduce the idea.
Books about being an older brother or sister are helpful if you are expecting a baby.
Stay consistent with rules, discipline, and limit setting.
Your child may be ready for potty training if they are:
Dry for over two hours.
Telling you when they are wet or have pooped.
Pulling their pants up and down.
Ready to learn and not afraid.
Praise your child often for all of the great things they can do.
If they sit on the potty clap for them.
Avoid asking them to do things you know they cannot.
If they are still afraid of the potty that is okay and normal.
Your Child and Screens
Keep screen time to no more than one hour a day but less is better.
Avoid screens to keep your child busy.
Look for apps that are made for your child’s age and learning based.
Be mindful of your screen time use, as your child is looking to you as their role model.
When using screens, do it together, as you want to know what your child is exposed to.
Make exercise and fun moving activities a part of your family’s daily routine.
Caretakers should keep your child active as well.
Reading, singing, and playing games are fun and great alternatives to screen time.
Talking and Hearing
When you talk to your child and ask them to do something, use simple phrases.
Give words to help them understand their feelings.
Read lots of books.
Talk to them about the book and point to pictures and words .
Offer praise when they answer a question.
Sing to your child for fun and for learning.
This is another way to help your child understand words.
Healthy Eating
Encourage healthy eating with lots of fruit, vegetables, whole grains, dairy, and lean meats (like chicken, fish, beans) for meals and snacks.
You can offer one big meal and then smaller meals or snacks throughout the day.
Include them in family meals.
Try to avoid processed, highly spiced, and sweetened foods.
To prevent choking, cut food into small pieces and avoid hot dogs, raw vegetables, chips, candy, pretzels, popcorn, and peanuts.
Never force your child to eat.
Allow them to stop when they are done.
Allow them to feed themselves, although messy; this is good for independence and development.
Your child can try using soft plastic utensils like a fork and spoon.
Your child is learning about eating habits now.
The healthier you make it, the healthier they will be.
Avoid giving snacks for entertainment, boredom, or comfort when they are upset.
Offer them lots of different foods for them to continue to try.
Water is needed; juice is not.
If you choose to give juice, give no more than 4 ounces of 100% pure fruit juice daily.
Although you may have some spills, you can help them learn how to drink out of an open cup now.
If your child drinks plant-based or cow’s milk, give no more than 18 ounces per day.
Make sure to give unsweetened milk.
If your child’s appetite drops, decrease the amount of milk they drink.
If your child doesn’t drink milk or eat much dairy, a vitamin D supplement is recommended.
You can buy liquid vitamin D for your child’s age.
Follow packaging directions or ask your child’s primary healthcare provider for advice.
Healthy Teeth
Be sure to brush your child's teeth twice a day.
Use a rice grain amount of fluoride toothpaste, as this is safe for them to swallow.
Use a soft bristle toothbrush.
Some toddlers really enjoy this, and some don’t.
This is normal, so try to make it fun and sing songs about it.
The more you do it, the more it becomes a routine, and they will get used to it.
After brushing their teeth at night, avoid anything more than water.
Offer lots of water and try to avoid juices and sweets.
Once your child has teeth, they can get cavities.
If you have not taken them to the dentist, now is a good time.
To find Medi-Cal dental clinics near you:
Call: 1-800-322-6384
Visit: Denti-Cal Website here.
Fluoride varnish can be applied by a dentist or at your child’s well visit to protect their teeth.
This can be applied every 3 to 6 months.
If your child seems uncomfortable from teething, giving acetaminophen, ibuprofen, or teething rings can be helpful.
If your child uses a bottle, you need to work on weaning now to reduce the risk of cavities.
Your child’s primary healthcare provider can help with tips for this.
Safety
Make sure your home has working smoke and carbon monoxide detectors.
Avoid any tobacco product, drug or alcohol use around your child.
Make sure that someone is always watching your child.
They are curious and can get into things fast.
Make sure you have a gait for any stairs and around any pools.
Make sure all chemicals, medications, poisons and sharp objects are locked up or high enough that your child can’t reach them.
If you think your child may have consumed anything dangerous call poison help at: 1-800-222-1222.
Keep all small objects, balloons, and plastic bags away from your child, as these are choking dangers.
Do not let them play with magnets or any toys with button batteries.
Make sure drawers, toilets, and windows have locks on them.
Keep all furniture away from windows.
Keep all cords, including those for blinds are out of reach.
Make sure everything like TVs and lamps are secured so they cannot fall over on your child.
Empty anything with water in it after you are done, like buckets, pools, and tubs.
Children can drown in small amounts of water.
When you are around any water, make sure your child is close enough for you to reach them with a hand.
When cooking, make sure you know where your child is at all times.
Keep anything sharp, hot, or dangerous out of your child’s reach.
Never open an oven with your child in the room.
Use back burners for any cooking so your child cannot grab pot or pan handles.
Keep your child covered when out in the sun to avoid any burns.
Use sunscreens of 15 or higher SPF, apply every 2 hours while in the sun and one hour prior to swimming.
If swimming or boating have a Coast Guard approved personal flotation device for your child.
If you think your child has been burned, call your child’s primary healthcare provider.
Your child is safest in the car when rear-facing in the back seat in their car seat .
Avoid turning them to forward facing until they have reached the maximum weight and height noted on their carseat.
Never place your child in the front seat.
Keeping guns out of the home is best.
If you have guns, keep the guns and ammunition locked separately.
Immunizations
Routine vaccines recommended for 18 months are:
Hepatitis A
Flu Vaccine is recommended during flu season, which is typically September-March/April.
It is safe to give the flu vaccine with other vaccines.
Vaccines are safe and effective, and proven to save lives.
Learn more about recommended immunizations from the American Academy of Pediatrics.
To learn about COVID vaccines, please see the recommendations from the American Academy of Pediatrics.
If you have concerns about vaccines, please talk to your child’s primary healthcare provider for accurate information.
Fever - can be treated with acetaminophen or ibuprofen.
Soreness - can be treated with ibuprofen or cool compress.
Swelling at injection site - can be treated with cool compress.
Your child may have a rash one to two weeks after the MMR vaccine, and that is a normal reaction to the vaccine. It is usually a red blotchy rash.
For more details, visit the immunizations section on our Health Hub.
What To Expect at Your Child’s 2 Year Well Visit
We will talk about caring for your child, family, and yourself.
We will talk about potty training tips and how to handle changes in your child’s behavior.
We will talk about how to continue to support your talking child.
We will talk about safety in your home and recommended vaccines.
We will continue to work as a team.
📚 References
This content was adapted from Bright Futures.
Reviewed by TT DO, JW MD, Patient Education Committee.