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 growth charts.

2. Administer 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 three meals and two or three nutritious snacks a day. You’re in charge of the menu, but let your child be in charge of how much of it he or she eats.

Peeing and pooping. Most children are ready to begin potty training between 2 and 3 years. You may have noticed signs your child is ready to start potty training, including:

• 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 13 hours of sleep. This might still include one afternoon nap.

Developing. By 30 months, it’s common for many children 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. Perform a physical 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 receive them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

Looking Ahead

Here are some things to keep in mind until your next routine visit at 3 years:

Feeding

1. Try to eat meals together, as a family, whenever possible.
2. Serve low-fat or nonfat milk and other low-fat and nonfat dairy products.
3. Limit juice to no more than 4–6 ounces (120–180 ml) a day.
4. Limit foods and drinks that are high in sugar and fat.
5. Allow your child to make choices about healthy meal options. For example, “Do you want to have an apple or cheese as a snack?” This helps eliminate power struggles. Offer no more than two choices, as more can be overwhelming.

Learning

1. Have a safe play area and allow plenty of time for exploring, make-believe, and active play.
2. Read to your child daily to encourage language development and help prepare him or her for preschool.
3. Repeat back to your child what he or she says. This shows that you understood what was said and gives you a chance to correct grammatical mistakes.
4. Consider enrolling your child in a preschool program or arranging play dates to help build social skills.
5. Limit time in front of a TV or other screens, including computers and smartphones, to no more than one to two hours a day of quality children’s programming.

Routine Care & Safety

1. Children may start brushing their teeth with a small amount of fluoride 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.
2. Toddlers will test limits. Be sure to establish reasonable and consistent rules.
3. Tantrums are becoming less frequent and tend to be worse when children are tired or hungry. Try to head off tantrums before they happen — distract your child or remove him or her from frustrating situations.
4. Don’t spank. Children don’t make the connection between spanking and the behavior you are trying to correct. If necessary, use a brief time-out to discipline your toddler.
5. Most kids are ready to move from a crib to a regular bed with safety rails between 2 and 3 years.
6. Make sure your child wears a helmet when riding a bike or trike.
7. Apply sunscreen of SPF 30 or higher on your child’s skin at least 15 minutes before going outside to play and reapply about every 2 hours.
8. Limit your child’s exposure to secondhand smoke, which increases the risk of heart and lung disease.
9. Use a forward-facing car seat with a harness in the back seat until your child reaches the highest weight or height allowed by their car-seat manufacturer.
10. To prevent the risk of drowning, do not leave your child alone in the bathtub or in a pool, no matter how shallow the water.
11. 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 cannot access the keys.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.