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Two Year Well Visit

Your child should now be running around and talking some.  Remember girls develop as a group a little faster so there is a difference and a range of normal.  Males are more active and into everything, throw things and hit more than girls and talk later and potty train later than girls.  Try not to compare them.  Children at this age are now potty trained but may not be going on the potty yet. They know what to do but can not control the muscles to release it on the potty. They develop the control with time and when they can, they will ask to go on their own. They will come and pat the dry diaper and say  pee pee, hold it till they get there, and release it when they get up on  the toilet. This happens earlier in females at 2 to 2 and boys at 3 to 3 1/2.  But the range of normal is wide with children going on the potty between 18 months and 4 years old.   Also they have total control and if they don’t want to go on the toilet, you can not make them. Wait  till they ask. Also wait till they are dry at night for two weeks and  then put cloth pants on them to sleep in.  Amazingly 10% still wet the bed in school age so it  can be years before they are dry at night. Wait on that too.

Keep working with the speech. Again girls talk more and earlier.  Boys may be saying some words and the published norm is 50+ words and putting 2 words together in a semi sentence by age 2.  However, if the child understands everything you  tell them and they hear quiet noises, they probably are normal and the  speech will come out soon.  See the doctor and discuss this development.  If they get what they want by grunting, then they do not have to talk.  You might try frustrating them by playing like you do not know what they want.   It will upset them and they will learn that they have to talk to get what they want. You also can put them into a mother’s day out to get around other children talking.  You need to use large adult words in speaking to them. They will not know what they mean at first, but with use they will learn them out of context. For example, there are now "perforations" instead of holes in the paper. The tree is "exfoliating".  The more you talk big words the more they learn and increase their vocabulary. You can increase their IQ and performance in grade school by talking adult language to them. When they are school age they have to sit and memorize a vocabulary list. At this age they just absorb the words into their brain. Read some 10 year-old's books as well as "The Cat in the Hat." Let them watch the Discovery channel and the Learning channel on TV as well as Sesame Street. Practice the alphabet letters. Have them learn the letters on sight, not just the alphabet song.  Repeat the letters over and over. They can learn them just as they learn what a  cat, dog and elephant look like.  Also they typically stutter close to three years old.  So if you notice stuttering later this year, do not be alarmed. That will go away by 4 years old. Correct mispronunciations and practice letters they miss. They typically say "yeyo" instead of yellow. We expect clear pronunciations by 4 years old  also.

Eating is now even slower. This next year they gain only 4 lbs. and that is only 1 lb. every 3 months. We can gain 1 lb. in 1 day!!! They only require 1 good meal a day and nibble at the other meals. Do not fight the dinner table. Remember what we said at 18  month’s check up: the parent’s job is to put a balanced diet in front of  them, the child’s job to eat enough, and the doctor’s job to test them  if they do not eat enough to grow. All adults and children eat a  different amount. Make the dinner a pleasant family time. Keep the  dessert in proportion to the amount of proper foods eaten. You can work  the finicky eater in three ways; just be consistent with your approach.  1. Out wait them. Put the meats and vegetables in front of them and wait till they get hungry.  They will not starve.  Keep putting the food back into the refrigerator and warming it back up.  After a day or so they will eat the dog food if they get hungry  enough.(they probably have already tried it.) If you wait long enough  they will eat anything. 2. Let them do their thing. Let them eat what they want, give them 16 oz. of milk a day, and a Flintstone chewable  vitamin, and they will grow up big and strong. To be blunt it probably does not matter as long as they get a vitamin and calcium.  3. Disguise the foods they don’t like.(I prefer this) Grind up the proper foods and put it in the foods they eat, like macaroni and cheese. Grind them up and put them into the Ragu Spaghetti  sauce, or into the pancake batter before you cook the pancakes. There is a way to get a proper diet down the throat in a better tasting way. Get wild and creative. You may now go to low fat milk (16 oz. / day) instead  of whole and give them a Flintstone Vitamin every day no matter if they eat well or not. Keep cutting the food up so they do not choke.

They are in terrible twos so read up on parenting from text books and be consistent!! If you buy them candy one time you go to the store every 6 months, then they will cry for candy every trip to the store for a year because you are not consistent.  You are causing them to throw more temper tantrums.  Do not punish the tantrums but do not give in to them. Have as many good times as you do have times when you have to discipline them.

They have night mares during the next 2 years so be prepared to be awakened in the night. It is our job to feed them, clothe them and make them feel safe. If they wake in the night, you have several choices in how to handle this. 1. Call out to them. Tell them that you are here and they are OK. Some kids will go on back to sleep. 2. You go into their room and stay till they go back to sleep. 3. You take them into bed with you or let them stay if they climb in bed with you. 4. If they come into bed with you, take them back to their bed till they go back to sleep.  5. Make a pallet by your bed and let them come sleep there if you cannot sleep with them in bed with you. It does not matter which, just be consistent.  Most parents end up sleeping with their child so do not feel guilty for doing that. There is nothing wrong with sleeping with them. Do what you  two parents can continue. However, do not do one thing one night and then make them do another the next night. Be consistent!! And keep the door locked during bed activities so they do not accidentally come in on you. 

This is a fun age. Challenging, but fun.   It is all worth it when they snuggle and tell you they love you.

Dr. Knapp