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Safety Considerations Your child is exploring his or her environment at this age. Toddlers open drawers, cupboards, and even bottles. Make sure there are childproof caps on all medications and that medications and poisons are out of reach. Falling is still a big concern. Do not leave chairs near a table or counter where a child could climb to a dangerous height. Toddlers have large heads and are top heavy. They can fall into a bucket or tub and be unable to get out. Protect your child from burns by keeping them safely in a high chair or playpen while you are cooking. Once your child outgrows the rear-facing seat, install a forward-facing seat in the back of your car. Most child car seats are not installed correctly. For free help with this, call the Cortland County Sheriff’s Department at [PHONE REDACTED]. Parents or guardians wishing to purchase a low-cost car seat should call the Traveling Tots Program at [PHONE REDACTED]. Revised 04/2014 … a childhood immunization project Aimed at a healthier community. IN COOPERATION WITH: YOUR CHILD AT 24 MONTHS Development This is an exciting time for you and your toddler. Your toddler is experiencing huge physical, intellectual, and social-emotional changes and has a growing desire to show independence. By 24 months of age your toddler should begin to: Recognize and point to familiar pictures in a book Recognize and point to body parts and articles of clothing Use 2-4 word sentences Use pretend and make-believe play Build a tower of 4 or more blocks and sort blocks by color and shape Use a spoon and fork to eat Run and climb with alternating feet Frequently say “no” and have increased temper tantrums Know his or her name Immunizations Due Normally, there are no immunizations due at this well child visit. Influenza vaccine is recommended every year before flu season. If this is the first time, two doses are necessary, given at least one month apart. Second lead test: During the second year of life, your child will be exploring his or her environment with more mobility and less supervision. Lead can be found inside and outside of many homes in Central New York, so your child’s risk for being lead poisoned increases dramatically during this time. Your child is also growing physically and developmentally, so she/he is more susceptible to the damaging effects of lead. It is very important that your child be tested for lead poisoning some time this year even if your child had a normal lead test at age 1. The New York State Department of Health and American Academy of Pediatrics support the requirements that all one and two-year-olds are tested for lead poisoning as part of their routine care. Testing at other ages should be considered if there are concerns about possible new exposure. ---PAGE BREAK--- HELPFUL HINTS You may want to take this newsletter to your child’s 24-month check up to use as a reminder list of immunizations that are due or topics that may need discussion. Play is critical to child development. Let your child’s imagination lead his or her play. Children at this age enjoy dress-up play, dolls, sand toys, large beads or macaroni for stringing, blocks, musical instruments, and art materials. Take walks outside and ask your toddler about what she or he sees. For more advice on play check out the following website: www.zerotothree.org Toddlers usually have small appetites. Eating only certain kinds of foods in smaller amounts is common at this age. This behavior will usually pass fairly quickly if mealtimes are not power struggles. Make sure to offer healthy snacks such as fresh fruits, vegetables, and small sandwiches. Avoid letting your child fill up on junk food. Temper tantrums may increase. As your toddler grows and learns, he or she wants to be in control but is unable to. Temper tantrums often increase. It is best to ignore them, if possible. Keep a routine that is soothing to your child. Avoid over-stimulation and set firm limits. This will also help your child cope with the demands of this stage of development. Your child naturally loves words and enjoys reading books with you. Bring your child to the children’s section at the library. You might help your child learn to love reading. Do not use the TV or computer as a babysitter. Limit the time your child spends in front of the TV or computer and be careful about what your child is watching on TV. Poisoning is a major threat to children of this age. Post the phone number of your Poison Control Center (1-[PHONE REDACTED] for Cortland County) in a convenient place. In the event of a poisoning, always call and get advice before starting treatment. Health Insurance. All children need health insurance. Child Health Plus is an insurance program that provides coverage for well and sick care of children. It also provides basic dental care. The cost is determined by your income. For some families, there will be no cost. Whatever your income, the premiums are lower than those of other insurance companies. To apply call the official Health Plan Marketplace at 1-[PHONE REDACTED] or visit For in person assistance, visit website, click Get Help and Navigator locations. Developmental Concerns: Parents know their children best and are in the best position to observe and report what their child is doing. If you are concerned about your child’s development, contact your doctor or call the Cortland County Children with Special Needs Division at 607- 753-5028. For more information about Cortland County Health Department programs visit our website at: www.cchd.cortland-co.org Reproduction of this newsletter is not permitted without authorization from the Cortland County Health Department. Revised 04/2014