Your Child’s Checkup: 2.5 Years (30 Months)
What to Expect During This Visit Your doctor and/or nurse will probably:
1. Check your child’s weight and height, calculate body mass index (BMI), and plot the measurements on a growth chart.
2. Give a screening (test) that helps with the early identification of developmental delays.
3. Ask questions, address concerns, and offer guidance about how your child is:
- Eating. Don’t be surprised if your toddler skips meals occasionally or loves something one day and won’t touch it the next. Schedule 3 meals and 2–3 healthy snacks a day. You’re in charge of the menu, but let your child be in charge of how much they eat.
- Peeing and pooping. Most toddlers are ready to begin potty training when they’re 2–3 years old. Signs that your child is ready to start potty training include: showing interest in toilet (watching parent or sibling in the bathroom, sitting on potty chair) staying dry for longer periods pulling pants down and up with assistance connecting feeling of having to go with peeing and pooping communicating that diaper is wet or dirty
- Sleeping. Your child needs about 11–14 hours of sleep. This might still include an afternoon nap.
- Developing. By 30 months, it’s common for many toddlers to:
- speak using pronouns (I, me, you)
- identify body parts
- wash and dry hands
- pull pants up with assistance
- jump in place throw a ball, overhand
- match shapes and colors
- begin to play with other children
4. Do an exam with your child undressed while you are present. This will include an eye exam, listening to the heart and lungs, and paying attention to your toddler’s coordination, use of language, and social skills.
5. Update immunizations. Immunizations can protect kids from serious childhood illnesses, so it’s important that your child get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.
Here are some things to keep in mind until your child’s next checkup at 3 years:
- Eat meals together as a family whenever possible.
- Serve low-fat or nonfat milk or a fortified soy beverage.
- Offer other low-fat and nonfat dairy products, like yogurt.
- Limit 100% juice to no more than 4 ounces (120 ml) a day.
- Avoid food and drinks that are high in sugar, salt, and fat.
- Have a safe play area and allow plenty of time for exploring, make-believe, and active play.
- Read to your child daily to encourage language and help prepare them for preschool.
- Repeat back to your child what they say. This shows that you understood what was said and helps your child learn the right words.
- Consider enrolling your child in a preschool program or arranging play dates to help build social skills.
- Limit screen time (time spent with TV, computers, tablets, and smartphones) to no more than 1 hour a day of high-quality children’s programming.
- Watch with your child to boost learning. Keep TVs and other screens out of your child’s bedroom.
- Routine Care & Safety
- Children may brush their teeth with a soft toothbrush and a small amount of toothpaste (no more than the size of a pea). Let your child brush his or her teeth with your guidance. Go over any areas that may have been missed. If you haven’t already, schedule a dentist visit. To help prevent cavities, the doctor or dentist may brush fluoride varnish on your child’s teeth 2–4 times a year.
- Be positive about potty training. Praise your child’s efforts and don’t force them to use the potty or punish them for accidents.
- Set reasonable and consistent rules. Use praise to encourage good behavior and calmly redirect unwanted behavior.
- Give your child a sense of independence by giving two choices between two acceptable options. More than two can be overwhelming.
- Tantrums tend to be worse when kids are tired or hungry. Try to head off tantrums before they happen — find a distraction or remove your child from frustrating situations.
- Don’t spank. Children don’t make the connection between spanking and the behavior you’re trying to correct. You can use a brief time-out instead.
- Most toddlers are ready to move from a crib to a regular bed with safety rails when they’re 2–3 years old. Follow a calm bedtime routine that will help your child settle into a good night’s sleep.
- Watch closely when your toddler is playing outside and on playground equipment. Make sure your child wears a helmet when riding a bike or trike.
- Apply sunscreen of SPF 30 or higher at least 15 minutes before your child goes outside to play and reapply about every 2 hours.
- Protect your child from secondhand smoke, which increases the risk of heart and lung disease.
- Secondhand vapor from e-cigarettes is also harmful.
- Keep your child in a rear-facing car seat until they reach the highest weight or height limit allowed by the seat’s manufacturer. If your child has outgrown the rear-facing height or weight limit, turn the car seat forward-facing. Keep the car seat in the back seat and continue to use the car seat harness.
- To prevent drowning, don’t leave your child alone in the bathtub or in a pool, no matter how shallow the water.
- Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids can’t get to the keys.
Doctor visit: The three-year checkup
You can expect your child’s doctor to:
- Weigh and measure your child to make sure she’s growing at a healthy, steady rate.
- Check her blood pressure.
- Check her heart and breathing.
- Check your child’s eyes and ears.
- Give your child any immunizations she has missed.
- Do a tuberculosis test if your child has any risk factors.
- Screen for anemia and lead poisoning with a blood test if your child has any new risk factors.
- Address any health and safety concerns. (Colds are common at this age, especially if your child attends daycare or preschool where they’re exposed to many children. Scrapes and bruises are common, too, since 3-year-olds are so active.)
- Answer any questions you may have about toilet training, discipline, or, if your child has brothers or sisters, sibling rivalry.
- Ask about any changes in your child’s routine (for example, if she now attends preschool).
- Talk to your child about which activities she enjoys, what books she reads, and who her friends are, to assess her hearing and language skills. (If your child talks too loudly or too softly, for example, she may have a problem with her hearing).
- Give your child some simple directions to follow. (If your child doesn’t follow your commands, or appears not to hear you, tell the doctor.)
- Offer insight into your child’s development, temperament, and behavior.
Questions the doctor may ask:
Is he having trouble sleeping? Three-year-olds sleep an average of 12 hours a day, and some still need one afternoon nap. Older toddlers have an active imagination, which can fuel their fears about the dark, strange noises, or being alone. This can make falling asleep difficult. Once they’re sleeping, they can be awakened by nightmares or night terrors, which may still crop up around this age.
What does he like to eat? Your child needs to have a varied, healthy diet so he has the energy to keep going during his busy days. Is he left- or right-handed? By age 3, most children have a dominant hand. Children who are confused about which hand to use could have some coordination problems.
The doctor may ask your child to draw on a piece of paper so she can observe him. How’s toilet training going? By now many toddlers have gotten the hang of using the potty, although they’ll still have accidents and may need to wear a diaper overnight. But some aren’t ready to start toilet training until they’re as old as 4.
Does your child play well with others? Three-year-olds normally have a hard time sharing their toys. The doctor will ask whether your child has become aggressive with other kids, hitting or biting to express frustration. She may have some tips on curbing aggressive behavior and suggestions on how to encourage generosity.
How does your child react when you leave him at daycare or with someone else? Although your child still prefers you to others, it should be easier for him to separate from you than when he was 1 or 2 years old. Adjusting to being away from you is a sign that he’s maturing emotionally and is fairly secure.
What games does he like? A list of activities your child enjoys gives the doctor insight into how he’s developing. Children this age enjoy fantasy play – for example, pretending to host a tea party for stuffed animals. They also tend to like reading books, coloring, and drawing.
Has he seen a dentist? The American Academy of Pediatrics recommends that children see a dentist after their first birthday. If your child hasn’t been to the dentist yet, now is the time. (At this age, he should be brushing, with your help, twice a day.)
My toddler’s three-year checkup is coming up. What should I expect at the appointment?
No need to stress about shots. The three-year-old physical exam is generally a needle-free affair, meaning there are typically no annual vaccines scheduled for this age.
Instead, your pediatrician will probably be looking closely at how your child is developing, both from a physical and from an emotional/ social standpoint. On the physical side, she’ll probably ask how things are going with hand-eye coordination, dexterity and fine motor skills, such as maintaining balance, riding a tricycle or drawing a circle. She may also ask about speech, language skills and other signs of cognitive development, and check up on your child’s sleep habits and nutrition.
Remember, this is a good opportunity for you to ask any burning questions you may have about your child’s development or behavior — so write them down in advance and bring them your appointment so you don’t forget.
Your Child’s Checkup: 2.5 Years (30 Months)
Doctor visit: The three-year checkup