Well-Child Visit: 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 your help
• 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, most toddlers:

• say about 50 words
• say 2 or more words together with an action word, like “Doggie run!”
• name things in a book when you point and ask, “What's this?”
• says words like “I,” “me,” or “we”
• follow 2-step directions
• play next to other children, and sometimes play with them
• use things to pretend, like using a block as a phone
• know at least 1 color when asked
• take some clothes off by themselves
• jump off the ground with both feet

Talk to your doctor if your toddler is not meeting one or more milestones, or you notice that your toddler had skills but has lost them.

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.

Looking Ahead

Here are some things to keep in mind until your child's next checkup at 3 years:

Feeding

1. Eat meals together as a family whenever possible.
2. Serve low-fat or nonfat milk or a fortified soy beverage. Offer other low-fat and nonfat dairy products, like yogurt.
3. Limit 100% juice to no more than 4 ounces (120 ml) a day.
4.  Avoid food and drinks that are high in sugar, salt, and fat.

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 and help prepare them for preschool.
3. Repeat back to your child what they say. This shows that you understood what was said and helps your child learn the right words.
4. Consider enrolling your child in a preschool program or arranging play dates to help build social skills.
5. 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

1. 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.
2. Be positive about potty training. Praise your child's efforts and don't force them to use the potty or punish them for accidents.
3. Set reasonable and consistent rules. Use praise to encourage good behavior and calmly redirect unwanted behavior.
4. Give your child a sense of independence by giving two choices between two acceptable options. More than two can be overwhelming.
5. 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.
6. 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.
7. 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.
8. 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.
9. Apply sunscreen of SPF 30 or higher at least 15 minutes before your child goes outside to play and reapply about every 2 hours.
10. Protect your child from secondhand smoke, which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.
11. 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.
12. To prevent drowning, don't leave your child alone in the bathtub or in a pool, no matter how shallow the water.
13. 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.

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