Twenty-Four Month Well Child Visit

Vaccines

  • No vaccines are needed at nine months unless your child needs to catch up on any missed vaccinations.

Feeding

  • Absolutely no more bottles!

  • You may begin to offer low-fat milk (16-24 ounces/day).

  • Offer three meals and three snacks daily.

  • Let child decide how much to eat, you pick the foods.

  • Set a good example - eat healthy!

  • Eat as a family.

  • Child should feed themselves, provide child-sized utensils.

  • Do not force eating.

  • Always supervise eating.

  • Avoid choking foods (nuts, popcorn, carrots, raisins, hard candy).

General care and safety

  • You may begin potty training if your child:

    • Tells you after urinating or stooling.

    • Has increased daytime dryness.

    • Shows an interest in the toilet.

  • Use a safety seat in the back seat of the car.

  • Childproof your home.

  • Supervise child at all times.

  • Begin using a small amount of fluoridated toothpaste.

  • Use sunscreen and insect repellent if needed.

  • Praise good behavior.

  • Reinforce limits, be consistent and reasonable.

  • Expect temper tantrums.

  • Children may have fears and nightmares

  • Discourage aggressive behavior.

  • Use discipline such as “time out” to teach a lesson – not to punish.

play

  • Talk, sing, and read together. Explain stories and pictures to your child.

  • Play interactive games.

  • Include toddler by offering simple and fun tasks.

  • Create routines such as a bedtime story.

  • Encourage imaginative play.

  • Do not use baby talk.

  • Avoid using the word "No".

  • Allow self-expression and choices.

  • Don't expect child to share all toys.

  • Go on short family outings.

Twenty-Four Month Child Milestones

Physical and motor skills

  • Runs well.

  • Walks up and down stairs.

  • Kicks ball.

  • Stacks five to six blocks.

  • Uses a spoon and a cup.

  • Takes off clothes and helps get dressed.

  • Washes hands.

  • Can draw horizontal lines and circular shapes.

Sensory & cognitive skills

  • Says about twenty to fifty words.

  • Understood by strangers ½ of the time.

  • Uses two-word phrases.

  • Names objects and body parts.

  • Understands two-step commands.

  • Points to pictures in a book.

  • Enjoys imaginary play.

Developmental Health Watch

Although each child develops in her own individual way and at her own rate, failure to reach certain milestones may signal medical or developmental problems requiring special attention.

If you notice any of the following warning signs in your infant at this age, discuss them with your pediatrician.

  • Not running well.

  • Uneven walk, limping, or frequent falling forward when walking.

  • Does not make eye contact or gestures (pointing, etc).

  • Uses less than twenty words.

  • Loss of previously known skills.