Well Child Care, 30 Months

PHYSICAL DEVELOPMENT

The child at 30 months is always on the move, running, jumping, kicking, and climbing. The child scribbles, can imitate a vertical line, and builds a tower of at least six.

EMOTIONAL DEVELOPMENT

The child demonstrates increasing independence, expresses a wide range of emotions, and may resist changes in routines. Many parents feel that their child seems somewhat hyperactive at this age.

SOCIAL DEVELOPMENT

The child learns to play with other children and may enjoy going to preschool. The child begins to understand gender differences. At 30 months, children like to participate in common household activities.

MENTAL DEVELOPMENT

By 30 months, the child can name common animals or objects and identify body parts. The child can make short sentences of at least 2-4 words. At least half of the child's speech should be easily understandable.

IMMUNIZATIONS

Although not always routine, the caregiver may give some immunizations at this visit if some "catch-up" is needed. Annual influenza or "flu" vaccination is suggested during flu season.

TESTING

The health care provider may screen the 30 month old for developmental skills.

NUTRITION AND ORAL HEALTH

  • Continue reduced fat milk, either 2%, 1%, or skim (non-fat), at about 16-24 ounces per day.

  • Provide a balanced diet, with healthy meals and snacks. Encourage vegetables and fruits.

  • Limit juice to 4-6 ounces per day of a vitamin C containing juice and encourage the child to drink water.

  • Do not force the child to eat or to finish everything on the plate.

  • Avoid nuts, hard candies, popcorn, and chewing gum.

  • Allow the child to feed themselves with utensils.

  • Brushing teeth after meals and before bedtime should be encouraged.

  • Use a pea-sized amount of toothpaste on the toothbrush.

  • Continue fluoride supplement if recommended by your health care provider.

  • The child should have the first dental visit by the third birthday, if not recommended earlier.

DEVELOPMENT

  • Read books daily and encourage the child to point to objects when named.

  • Recite nursery rhymes and sing songs with your child.

  • Name objects consistently and describe what you are dong while bathing, eating, dressing, and playing.

  • Use imaginative play with dolls, blocks, or common household objects.

  • Some of the child's speech may still be difficult to understand.

TOILET TRAINING

Many girls will be toilet trained by this age, while boys may not be toilet trained until age 3. Continue to use praise for success. Night-time accidents are still common. Avoid using diapers or super absorbent panties while toilet training. Children are easier to train if they appreciate the sensation of wetness.

SLEEP

  • Use consistent nap-time and bed-time routines.

  • Encourage children to sleep in their own beds.

PARENTING TIPS

  • Spend some one-on-one time with each child.

  • Be consistent about setting limits. Try to use a lot of praise.

  • Allow the child to make choices when possible.

  • Discipline should be consistent and fair. Recognize that the child has limited ability to understand consequences at this age. All adults should be consistent about setting limits. Consider time out as a method of discipline.

  • Limit television time to no more than one hour. Any television should be viewed jointly with parents.

SAFETY

  • Make sure that your home is a safe environment for your child. Keep home water heater set at 120° F (49° C).

  • Provide a tobacco-free and drug-free environment for your child.

  • Always put a helmet on your child when they are riding a tricycle.

  • Use gates at the top of stairs to help prevent falls. Use fences and self-latching gates around pools.

  • Continue to use a car seat that is appropriate for the child's age and size. The child should always ride in the back seat of the vehicle and never up front with air bags.

  • Equip your home with smoke detectors!

  • Keep medications and poisons capped and out of reach.

  • If firearms are kept in the home, both guns and ammunition should be locked separately.

  • Be careful with hot liquids. Make sure that handles on the stove are turned inward rather than out over the edge of the stove to prevent little hands from pulling on them. Knives, heavy objects, and all cleaning supplies should be kept out of reach of children.

  • Always provide direct supervision of your child at all times, including bath time.

  • Make sure that your child is wearing sunscreen which protects against UV-A and UV-B and is at least sun protection factor of 15 (SPF-15) or higher when out in the sun to minimize early sun burning. This can lead to more serious skin trouble later in life.

  • Know the number for poison control in your area and keep it by the phone or on your refrigerator.

WHAT'S NEXT?

Your next visit should be when your child is 3 years old.

This is a common time for parents to consider having additional children. Your child should be made aware of any plans concerning a new brother or sister. Special attention and care should be given to the child around the time of the new baby's arrival. Visitors should also be encouraged to focus some attention on the older child when visiting the new baby. Time should be spent, prior to bringing home a new baby, to define where the newborn will sleep. Expect some regression in the 30 month old child when a new sibling comes into the household.