1. Toddler care

Tips for Grandparents of a 2-Year-Old

The third year of a child’s life, encompassing the so-called terrible twos, is often a challenging one for parents and therefore for grandparents, as well. A child at this age is showing increased physical activity, greater mood swings, frequent tantrums or demanding behavior, and testing the limits of all adults.

As a grandparent, you may have forgotten what two-year-olds are like; after all, it’s been many years since you raised your own children through this age.

Here are some guidelines to keep in mind when you spend time with your two-year-old grandchild (although some of these steps are more easily said than done):

  • Make an effort to “keep your cool.” Don’t overreact to outbursts. Try to take them in stride, and realize that much of this behavior is designed to get you to react. Maintain a flexible but firm and loving response.
  • Be consistent in your approach to discipline, and make sure it’s consistent with the disciplinary style of the child’s parents. Never use physical punishment.
  • Reinforce good behaviors with praise and compliments. Become a role model of the way you would like your grandchild to act.
  • Try to encourage self-control.
  • Always be affectionate.
  • Recognize that children of this age are very egocentric (i.e., they are thinking mostly of “me,” not of the others in their lives), so don’t take their lack of interest in you personally. This is normal for a two-year-old, and it won’t last forever.
  • Toilet training will be one of your grandchild’s most important accomplish­ments at this age. Talk to his parents about the stage of training he’s in, and how you can reinforce what he has already achieved, particularly when you’re caring for him—babysitting on a Saturday afternoon or caring for him for the weekend. If he spends time in your home, purchase some extra training pants and have a potty chair identical to the one he is accustomed to at home.
  • Safety in your home remains important, so make sure your home is “child­proofed.” Be especially careful of medica­tions. Never leave them sitting out for his curious eyes or fingers; put them out of reach in a safe place that you will remember. Try to leave the medica­tion there even after they leave, so that your home stays safe, even if they should stop by for a quick, unexpected visit. This is even more important if you cannot “unlock” the child-resistant caps and have chosen to put your pills in other types of containers. When medications are not in childproof contain­ers, they can be easily opened by curious two-year-olds, so be especially vigilant with those.

Finally, always remember to place your grandchild in a car seat in the backseat for every trip in the automobile.

1. Toddler care

Tips for Grandparents of a 1-Year-Old

You have an ongoing role to play in your grandchild’s nurturing and develop­ment. Though you must carefully “re-childproof” your house as a grandparent, there are many wonderful things your grandchildren can do with grandparents.

Here are some activities in which you can participate and some things to keep in mind as you do:

Motor Skills

Help your grandchild practice skills that tie in with your own likes and prefer­ences. For example:

  • Involve him in physical activities (e.g. sweeping, preparing food, or arranging items) around the house in which you can lend a helping hand to ensure his success and safety.
  • Devise and initiate outdoor games and exercises that you and he can enjoy together.

Cognitive Milestones

To help your grandchild develop cognitively:

  • Read special books to him.
  • Play music and sing songs with him.
  • Assist him as he begins to learn his numbers.
  • Play hiding games like hide-and-seek and peekaboo.
  • Mix fantasy play with real play.

Social Development

  • Encourage your grandchild to interact with his peers, but keep in mind that egocentric behavior is normal for this age.
  • Don’t overreact to selfishness or disregarding the feelings of others. Just reinforce that he should be sensitive to the feelings of other children.
  • Do not give her a motorized riding toy.
  • Do not give her a toy with any small parts or sharp edges. Stick with toys that are intended for toddlers, not for older children.

Water Safety

  • Never leave your toddler, even for a few seconds, in or near any body of water without supervision. This includes a bathtub, toilet, wading pool, swimming pool, fishpond, whirlpool, hot tub, lake, or ocean.

Auto Safety

  • The safest place for all children to ride is in their car seat in the backseat.
  • Never let your toddler climb out of his car seat while the car is moving.
  • Keep in mind that this period of self-centeredness will taper off by the age of three.
  • Nurture his self-esteem at every opportunity, but not at the expense of others.

Emotional Development

  • Repeatedly tell your grandchild how special he is to you. Tell him how important your time together is to you.
  • Don’t overreact to the mood swings he goes through—clinging one moment, independent the next, and defiant after that.
  • Don’t reinforce his aggressiveness if it becomes abusive. Set limits, but do not physically restrain or punish him. Follow your own inclinations about the activities or areas that can promote his development.
1. Toddler care

Stuttering in Toddlers & Preschoolers: What’s Typical, What’s Not?

As toddlers and preschoolers become increasingly verbal, they may begin to stumble over their words—raising concerns about stuttering. As a parent, how do you know when disfluencies are a normal part of development and when to be more concerned? Read on.

What are Typical Disfluencies?

It is not uncommon for young children to have disfluencies in their speech (e.g., word or phrase repetitions). In fact, about 5% of all children are likely to be disfluent at some point in their development, usually between ages 2 ½ and 5. It is also very typical for a child to go back and forth between periods of fluency and disfluency. Sometimes, this can occur for no apparent reason, but often this happens when a child is excited, tired, or feels rushed to speak.

Learning language rules:

During this time, children are expanding their vocabularies rapidly and learning complex language rules. These rules allow children to change simple messages (“Mommy juice”) into longer, more complicated sentences that require more motor coordination to produce smoothly (“Mommy put the juice in the blue cup”). It’s only natural that there may be some disruptions along the way.

Is It Truly Stuttering?

For most toddlers and preschoolers, most disfluencies go away on their own after a short period of time. In other cases, disfluencies persist and the signs of stuttering become more obvious. Getting professional help early offers the best chances for reducing stuttering. But how can parents tell the difference between typical disfluency that will go away and the early signs of non-typical disfluencies that may indicate stuttering?

Here are some ways to differentiate typical disfluency from stuttering:

If your child is truly stuttering, he or she may hold out the first sound in a word, saying “Ssssssssometimes we stay home,” or repeat the sound, as in “Look at the b-b-b-baby!” In addition, children who stutter often develop other mannerisms such as eye blinking, tense mouth, looking to the side, and avoiding eye contact.

Risk Factors for Stuttering: 

There are other risk factors that can help predict whether fluency problems will continue for longer than a few months.

  • Family history is the biggest predictor of whether a child is likely to stutter.
  • Gender. Young boys are twice as likely as young girls to stutter, and elementary school-age boys are 3 to 4 times more likely to stutter than girls.
  • Age of onset. Children that start having difficulties at age 4 are more likely to have a persistent stutter than those who begin stuttering at a younger age.
  • Co-existing speech and/or language disorders increase the likelihood a child may stutter.

Getting Help:

If you are concerned about your child’s speech, talk with your pediatrician about getting a speech and language evaluation. A complete evaluation from a certified speech-language pathologist can help you to better determine if the stuttering is likely to persist.

Speech-language pathologists will help parents determine the best course of action (e.g., closely monitoring the child’s fluency, enrolling in treatment services, and/or parent education).  The American Speech-Language-Hearing Association (ASHA) offers a searchable database of these professionals. 

Treatment Approaches for Stuttering:

Early treatment for stuttering is very important, as it is more likely to be eliminated when a child is young (before entering elementary school). There are two main treatment approaches for stuttering:

  • Indirect treatment is when the speech-language pathologist helps the child’s parents on how to modify their own communication styles. Indirect approaches are effective at reducing or even eliminating stuttering in many young children.
  • Direct treatment involves the speech-language pathologist working with the children themselves either one-on-one or in small groups, giving them specific speech strategies for easing into words and reducing tension during stuttering events. In addition, direct treatment may involve helping the child to differentiate between smooth (fluent) and bumpy (stuttered) speech.  

After age 7, it becomes unlikely that stuttering will go away completely. Still, after age 7, treatment can be very effective at helping a child effectively manage stuttering—helping develop skills necessary to handle difficult situations (e.g., teasing and bullying) and participate fully in school and activities. For older children, speech treatment is still beneficial, encouraged, and effective in helping to reduce the severity and impact of stuttering.​

What Parents Can Do:

Here are some ways parents can help:

  • Reduce communication stress. There are different techniques to put less pressure on a child in a speaking situation. Rephrasing questions as comments (using “You played outside today at school. It must have been fun!” instead of “What did you do at school?”) is one effective approach. Parents can also do their best to reduce situations that trigger their child’s stuttering.
  • Talk about it. When children are aware of their stuttering, it is best to be open and talk about it in a positive way. Let them know it is okay to have “bumpy speech.” If a child does not seem to be aware of the problem, there is no need to bring it up until you are seeing a speech-language pathologist.
  • Practice patience. Give children time to finish what they are saying. Don’t rush or interrupt them. Don’t tell them to “slow down” or “think about what you want to say.” Phrases such as those are generally not helpful to children who stutter.
  • Model good speech habits. While telling a child how to talk is generally not helpful, parents can model speech habits that help with stuttering, such as slowing down their own speed when they talk, putting in more pauses between sentences, and speaking in a relaxed manner.
  • Seek a professional. There are many ways to find a speech-language pathologist. A child’s pediatrician can provide a recommendation. Children younger than 3 can receive a free evaluation through their local Early Intervention Program. If a child is older than 3, parents can contact their local public school for a free evaluation. Parents also have the option to seek out a private speech-language pathologist with a child at any age.

Follow Your Instincts:

If you continue to have concerns about your child’s speech, ask for a reevaluation or referral for additional formal testing.

1. Toddler care

Social Development: 2 Year Olds

By nature, children this age can be more concerned about their own needs and even act selfishly. Often they refuse to share anything that interests them, and they do not easily interact with other children, even when playing side by side, unless it’s to let a playmate know that they would like a toy or object for themselves. There may be times when your child’s behavior may make you upset, but if you take a close look, you’ll notice that all the other toddlers in the playgroup probably are acting the same way.

At age two, children view the world almost exclusively through their own needs and desires. Because they can’t yet understand how others might feel in the same situation, they assume that everyone thinks and feels exactly as they do. And on those occasions when they realize they’re out of line, they may not be able to control themselves. For these reasons, it’s useless to try to shape your child’s behavior using statements such as “How would you like it if she did that to you?” Save these comments until your child is older; then she’ll be able to really understand how other people think and feel and be capable of responding to such reasoning.

Because your two-year-old’s behavior seems only self-directed, you also may find yourself worrying that he’s spoiled or out of control. In all likelihood, your fears are unfounded, and he’ll pass through this phase in time. Highly active, aggressive children who push and shove usually are just as “normal” as quiet, shy ones who never seem to act out their thoughts and feelings.

Ironically, despite your child’s being most interested in himself, much of his playtime will be spent imitating other people’s mannerisms and activities. Imitation and “pretend” are favorite games at this age. So as your two-year-old puts his teddy to bed or feeds his doll, you may hear him use exactly the same words and tone of voice you use when telling him to go to sleep or eat his vegetables. No matter how he resists your instructions at other times, when he moves over into the parent role, he imitates you exactly. These play activities help him learn what it’s like to be in someone else’s shoes, and they serve as valuable rehearsals for future social encounters. They’ll also help you appreciate the importance of being a good role model, by demonstrating that children often do as we do, not as we say.

The best way for your two-year-old to learn how to behave around other people is to be given plenty of trial runs. Don’t let her relatively antisocial behavior discourage you from getting playgroups together. At first it may be wise to limit the groups to two or three children. And although you’ll need to monitor their activities closely to be sure that no one gets hurt or overly upset, you should let the children guide themselves as much as possible. They need to learn how to play with one another, not with one another’s parents.

1. Toddler care

Social Development: 1 Year Olds

During his second year, your toddler will develop a very specific image of his social world, friends, and acquaintances. He is at its center, and while you may be close at hand, he is most concerned about where things are in relation to himself. He knows that other people exist, and they vaguely interest him, but he has no idea how they think or what they feel. As far as he’s concerned, everyone thinks as he does.

As you can imagine, his view of the world (technically, some experts call it egocentric or self-centered) often makes it difficult for him to play with other children in a truly social sense. He’ll play alongside and compete for toys, but he doesn’t play cooperative games easily. He’ll enjoy watching and being around other children, especially if they’re slightly older. He may imitate them or treat them the way he does dolls, for example, trying to brush their hair, but he’s usually surprised and resists when they try to do the same thing to him. He may offer them toys or things to eat but may get upset if they respond by taking what he’s offered them.

Sharing is a meaningless term to a child this age. Every toddler believes that he alone deserves the spotlight. Unfortunately, most are also as assertive as they are self centered, and competition for toys and attention frequently erupts into hitting and tears. How can you minimize the combat when your child’s “friends” are over? Try providing plenty of toys for everyone and be prepared to referee.

As we’ve suggested earlier, your child also may start to show possessiveness over toys that he knows belong to him. If another child even touches the plaything, he may rush over and snatch it away. Try reassuring him that the other child is “only looking at it” and that “it’s okay for him to have a turn with it.” But also acknowledge that “Yes, it’s your toy, and he’s not going to take it away from you.” It may help to select a couple of particularly prized items and make them off limits to everyone else. Sometimes this helps toddlers feel they have some control over their world and makes them less possessive about other belongings.

Because children this age have so little awareness of the feelings of others, they can be very physical in their responses to the children around them. Even when just exploring or showing affection, they may poke each other’s eyes or pat a little too hard. (The same is true of their treatment of animals.) When they’re upset, they can hit or slap without realizing they are hurting the other child. For this reason, be alert whenever your toddler is among playmates, and pull him back as soon as this physical aggressiveness occurs. Tell him, “Don’t hit,” and redirect all the children to friendlier play.

Fortunately, your toddler will show his self-awareness in less aggressive ways, as well. By eighteen months, he’ll be able to say his own name. At about the same time, he’ll identify his reflection in the mirror and start showing a greater interest in caring for himself. As he approaches age two, he may be able to brush his teeth and wash his hands if shown how to do it. He’ll also help dress and, especially, undress himself. Many times a day you may find him busily removing his shoes and socks even in the middle of a store or the park.

Because your toddler is a great imitator, he will be learning important social skills from the way you handle conflicts between the two of you. Model for him the way words and listening can, at least on occasion, be used to resolve conflicts (“I know you want to get down and walk, but you must hold my hand so I know you’re safe”). As an imitator, he also will eagerly participate in anything you’re doing around the house. Whether you’re reading the paper, sweeping the floors, mowing the lawn, or making dinner, he’ll want to “help.” Even though it may take longer with him doing so, try to turn it into a game. If you’re doing something he can’t help with because it’s dangerous or you’re in a hurry, look for another “chore” he can do. By all means, don’t discourage these wonderful impulses to be helpful. Helping, like sharing, is a vital social skill, and the sooner he develops it, the more pleasant life will be for everyone.

1. Toddler care

Shoes for Active Toddlers

​​In the early months, babies’ feet develop best if they’re not confined in shoes; socks are all that’s needed to keep their feet warm; however, once children start walking outdoors, they need shoes for protection.

Shoe Shopping Tips for Parents

  • Look for comfortable shoes with nonskid soles, such as sneakers, that will help keep your toddler steady on slippery floors.
  • Buy well-made shoes, but don’t spend a lot of money.
  • At this stage, your child’s feet grow so rapidly that the first pair of shoes won’t last more than 2 or 3 months.

Checking the Fit

You should check the fit about once a month; the top of your child’s big toe should be about finger-width distance from the inside edge of the shoe. It’s better to have no shoes at all than shoes that are too tight.

Common Concerns from Parents

“My 15 month old is showing no signs of getting ready to walk. He shows little interest in moving about.”

  • Possible cause: Developmental delay
  • What parents should do: Talk with your pediatrician to arrange an evaluation of your toddler’s development.

“My child turns her toes noticeably inward when she walks.”

  • Possible cause: Normal developmental stage
  • What parents should do: This tendency usually disappears as your child matures. It rarely interferes with mobility.

“My child is limping. She is complaining of pain.”

  • Possible cause: Injury, infection, arthritis, or another condition that requires treatment
  • What parents should do: If you can’t see and remove an obvious source of pain, such as a splinter, ask your pediatrician to determine the cause of the limp.

“My child limps but isn’t complaining of pain. He walks with a waddling gait.”

  • Possible cause: Neuromuscular weakness or hip joint disorder
  • What parents should do: Talk with your pediatrician, who will examine your child and determine whether he should be seen by another pediatric specialist.

“My child often walks on the balls of her feet after many months of walking.”

  • Possible cause: Habit or a neuromuscular problem
  • What parents should do: Although normal during early walking, walking on the toes or the balls of the feet after 2 years of age should be evaluated. Ask your pediatrician to determine whether your child has a problem that requires treatment.

“My toddler has difficulty walking. He falls a lot and has trouble getting on his feet again. He uses his hands to climb up his legs when trying to stand. He tends to waddle when he walks.”

  • Possible cause: Muscular dystrophy or another neuromuscular condition that requires diagnosis and treatment
  • What parents should do: Call your pediatrician, who will examine your child and may refer you to another pediatric specialist. If the diagnosis is confirmed, your child will need long-term treatment. Your pediatrician will also help you find support groups for children and parents.
1. Toddler care

Safety for Your Child: 2 to 4 Years

Did you know that injuries are the leading cause of death of children younger than 4 years in the United States? Most of these injuries can be prevented.
Often, injuries happen because parents are not aware of what their children can do. Children learn fast, and before you know it your child will be jumping, running, riding a tricycle, and using tools. Your child is at special risk for injuries from falls, drowning, poisons, burns, and car crashes. Your child doesn’t understand dangers or remember “no” while playing and exploring.


Because your child’s abilities are so great now, he or she will find an endless variety of dangerous situations at home and in the neighborhood.Your child can fall off play equipment, out of windows, down stairs, off a bike or tricycle, and off anything that can be climbed on. Be sure the surface under play equipment is soft enough to absorb a fall. Use safety tested mats or loose-fill materials (shredded rubber, sand, woodchips, or bark) maintained to a depth of at least 9 inches underneath play equipment. Install the protective surface at least 6 feet (more for swings and slides) in all directions from the equipment.Lock the doors to any dangerous areas. Use gates on stairways and install operable window guards above the first floor. Fence in the play yard. If your child has a serious fall or does not act normally after a fall, call your doctor.

Firearm Hazards

Children in homes where guns are present are in more danger of being shot by themselves, their friends, or family members than of being injured by an intruder. It is best to keep all guns out of the home. If you choose to keep a gun, keep it unloaded and in a locked place, with ammunition locked separately. Handguns are especially dangerous. Ask if the homes where your child visits or is cared for have guns and how they are stored.


The kitchen can be a dangerous place for your child, especially when you are cooking. If your child is
underfoot, hot liquids, grease, and hot foods can spill on him or her and cause serious burns. Find something safe for your child to do while you are cooking.Remember that kitchen appliances and other hot surfaces such as irons, ovens, wall heaters, and outdoor grills can burn your child long after you have finished using them. If your child does get burned, immediately put cold water on the burned area. Keep the burned area in cold water for a few minutes to cool it off. Then cover the burn loosely with a dry bandage or clean cloth. Call your doctor for all burns. To protect your child from tap water scalds, the hottest temperature a the faucet should be no more than 120°F. In many cases you can adjust your hot water heater.Make sure you have a working smoke alarm on every level of your home, especially in furnace and sleeping areas. Test the alarms every month. It is best to use smoke alarms with long-life batteries, but if you do not, change the batteries at least once a year.


Your child will be able to open any drawer and climb anywhere curiosity leads. Your child may swallow anything he or she finds. Use only household products and medicines that are absolutely necessary and keep them safely capped and out of sight and reach. Keep all products in their original containers.If your child does put something poisonous in his or her mouth, call the Poison Help Line immediately. Attach the Poison Help Line number (1-800-222-1222) to your phone. Do not make your child vomit.

And Remember Car Safety

Car crashes are the greatest danger to your child’s life and health. The crushing forces to your child’s brain and body in a collision or sudden stop, even at low speeds, can cause injuries or death. To prevent these injuries, correctly USE a car safety seat EVERY TIME your child is in the car. If your child weighs more than the highest weight allowed by the seat or if his or her ears come to the top of the car safety seat, use a belt positioning booster seat.The safest place for all children to ride is in the back seat. In an emergency, if a child must ride in the front seat, move the vehicle seat back as far as it can go, away from the air bag.Do not allow your child to play or ride a tricycle in the street. Your child should play in a fenced yard or playground. Driveways are also dangerous. Walk behind your car before you back out of your driveway to be sure your child is not behind your car. You may not see your child through the rear view mirror.Remember, the biggest threat to your child’s life and health is an injury.

1. Toddler care

Safety for Your Child: 1 to 2 Years

​​​​​​Did you know that injuries are the leading cause of death of children younger than 4 years old i​n the United States?

The good news is that most of these injuries can be prevented.

Often, injuries happen because parents are not aware of what their children can do. At this age your child can walk, run, climb, jump, and explore everything. Because of all the new things they can do, this stage is a very dangerous time in your child’s life. 

Because your child cannot understand danger or remember “no” while exploring, it’s your responsibility to protect them from injury. 

Firearm hazards

Children in homes where guns are present are in more danger of being shot by themselves, their friends, or family members than of being injured by an intruder.

It is best to keep all guns out of the home. Handguns are especially dangerous. If you choose to keep a gun, keep it unloaded and in a locked place, with the ammunition locked separately. Ask if the homes where your child visits or is cared for have guns and how they are stored.


Children continue to explore their world by putting everything in their mouths, even if it doesn’t taste good. Your child can open doors and drawers, take things apart, and open bottles easily now, so you must use safety caps on all medicines and toxic household products. Keep the safety caps on at all times or find safer substitutes to use. Contact Poison Help for more information.

Your child is now able to get into and on top of everything. Be sure to keep all household products and medicines completely out of sight and reach. Never store lye drain cleaners in your home. Keep all products in their original containers. Use medicines exactly as directed and dispose of unused medicine safely as soon as you are finished with it.
If your child does put something poisonous into his or her mouth, call Poison Help immediately at 1-800-222-1222. Do not make your child vomit.


To prevent serious falls, lock the doors to any dangerous areas. Use gates on stairways and install operable window guards above the first floor. Remove sharp-edged furniture from the room your child plays and sleeps in. At this age your child will walk well and start to climb, jump, and run as well. A chair left next to a kitchen counter, table, or window allows your child to climb to dangerously high places. Remember, your child does not understand what is dangerous.

If your child has a serious fall or does not act normally after a fall, call your doctor.


The kitchen is a dangerous place for your child during meal preparation. Hot liquids, grease, and hot foods spilled on your child will cause serious burns. A safer place for your child while you are cooking, eating, or unable to give them your full attention is the playpen, crib, or stationary activity center, or buckled into a high chair. It’s best to keep your child out of the kitchen while cooking.

Children who are learning to walk will grab anything to steady themselves, including hot oven doors, wall heaters or outdoor grills. Keep your child out of rooms where there are hot objects that may be touched or put a barrier around them. If you have a gas fireplace, keep children away from it while it is in use and for at least an hour after turning it off. The glass doors get extremely hot and can cause severe burns.

Your child will reach for your hot food or cup of coffee, so don’t leave it within your child’s reach. NEVER carry your child and hot liquids at the same time. You can’t handle both.If your child does get burned, immediately put cold water on the burned area. Keep the burned area in cold water for a few minutes to cool it off. Then cover the burn loosely with a dry bandage or clean cloth. Call your doctor for all burns.

To protect your child from tap water scalds, the hottest temperature at the faucet should be no more than 120°F. In many cases you can adjust your water heater.

Make sure you have a working smoke alarm on every level of your home, especially in furnace and sleeping areas. Test the alarms every month. It is best to use smoke alarms that use long-life batteries, but if you do not, change the batteries at least once a year.


At this age your child loves to play in water. NEVER leave your child alone in or near a bathtub, pail of water, wading or swimming pool, or any other water, even for a moment. Empty all buckets after each use. Keep the bathroom doors closed. Your child can drown in less than 2 inches of water. Knowing how to swim does NOT mean your child is safe near or in water. Stay within an arm’s length of your child around water.

If you have a swimming pool, fence it on all 4 sides with a fence at least 4 feet high, and be sure the gates are self-latching. Most children drown when they wander out of the house and fall into a pool that is not fenced off from the house. You cannot watch your child every minute while he or she is in the house. It only takes a moment for your child to get out of your house and fall into your pool.

And remember car safety

Car crashes are a great danger to your child’s life and health. The crushing forces to your child’s brain and body in a crash or sudden stop, even at low speeds, can cause severe injuries or death. To prevent these injuries use a car safety seat EVERY TIME your child rides in the car. All infants and toddlers should ride in a rear-facing car safety seat until they reach the highest weight or height allowed by their car safety seat’s manufacturer. Be sure that the safety seat is installed and used correctly. Read and follow the instructions that come with the car safety seat and the instructions for using car safety seats in the owners’ manual of your car.

The safest place for all infants and children to ride is in the back seat.

Do not leave your child alone in or around the car. Keep vehicles and their trunks locked. Children who are left in a car can die of heat stroke because temperatures can reach deadly levels in minutes. They can be strangled by power windows or knock the vehicle into gear. Always walk behind your car to be sure your child is not there before you back out of your driveway. You may not see your child behind your car in the rearview mirror.

Remember, the biggest threat to your child’s life and health is an injury.

1. Toddler care

Physical Appearance and Growth: Your 2 Year Old

Although your toddler’s growth rate will slow between his second and third birthdays, nevertheless he will continue his remarkable physical transformation from baby to child. The most dramatic change will occur in his bodily proportions. As an infant, he had a relatively large head and short legs and arms; now his head growth will slow, from 3⁄4 inch (2 cm) in his second year alone to 3⁄4 to 1 1⁄4 inches (2–3 cm) over the next ten years. At the same time, his height will increase, primarily because his legs and, to some degree, the rest of his body will be growing quickly. With these changes in the rates of growth, his body and legs will look much more in proportion.

The baby fat that seemed to make your infant so cuddly in the first months of life gradually will disappear during these preschool years. The percentage of fat, which reached a peak at age one, will steadily decrease to approximately half that by his fifth birthday. Notice how his arms and thighs become more slender and his face less round. Even the pads of fat under the arches, which have until now given the appearance of flat feet, will disappear.

His posture will change, as well, during this time. His pudgy, babyish look as a toddler has been partly due to his posture, particularly his protruding abdomen and inwardly curving lower back. But as his muscle tone improves and his posture becomes more erect, he’ll develop a longer, leaner, stronger appearance.

Although it will happen more slowly now, your child will continue to grow steadily. Preschoolers grow an average of 2 1⁄2 inches (6 cm) annually and gain about 4 pounds (2 kg) each year. Plot your child’s height and weight on growth charts to compare his rate of growth to the average for this age. If you should notice a pronounced lapse in growth, discuss it with your pediatrician. She probably will tell you there is no need to become overly concerned, as some healthy children just may not grow as quickly during their second and third years as their playmates seem to do.

Less commonly, this pause in growth during the toddler or preschool years may signal something else—perhaps a chronic health problem, such as kidney or liver disease, or a recurrent infection. In rare cases, slow growth may be due to a disorder of one of the hormone glands or to gastrointestinal complications of some chronic illnesses. Your pediatrician will take all of these things into consideration when she examines your child.

At the age of two, don’t be surprised if your child is eating less than you think he should. Children need fewer calories at this time because they’re growing more slowly. But even though he’s eating less, he still can remain well nourished as long as you make a variety of healthy foods available to him. Encourage healthy snacks and begin establishing sound and healthful eating habits. At the same time, if he seems overly preoccupied with food and appears to be accumulating excess weight, talk to your pediatrician about ways to help manage his weight. Early eating behaviors can influence the risk of obesity throughout life, so managing your child’s weight in childhood is as important as it is at any stage of life.

1. Toddler care

Physical Appearance and Growth: Your 1 Year Old

By the end of her first year, your baby’s growth rate will begin to slow. From now until her next growth spurt (which occurs during early adolescence), her height and weight should increase steadily, but not as rapidly as during those first months of life. As an infant, she may have gained 4 pounds (1.8 kg) in four months or less, but during the entire second year, 3 to 5 pounds (1.4–2.3 kg) probably will be her total weight gain. Continue to plot her measurements every few months on growth charts to make sure she’s generally following the normal growth curve. As you’ll see, there’s now a much broader range of what’s “normal” than there was at earlier ages.

At fifteen months, the average girl weighs about 23 pounds (10.5 kg) and is almost 30.5 inches (77 cm) tall; the average boy weighs about 24.5 pounds (11 kg) and is 31 inches (78 cm) tall. Over the next three months, they’ll each gain approximately 1 1⁄2 pounds (0.7 kg) and grow about an inch (2.5 cm). By two, she’ll be about 34 inches (about 86 cm) tall and weigh 27 pounds (12.2 kg); he’ll reach 34 1⁄2 inches (87.5 cm) and almost 28 pounds (12.6 kg).

Your baby’s head growth also will slow dramatically during the second year. Although she’ll probably gain only about 1 inch (2.5 cm) in head circumference this entire year, by age two she’ll have attained about 90 percent of her adult head size.

Your toddler’s looks, however, probably will change more than her size. At twelve months, she still looked like a baby, even though she may have been walking and saying a few words. Her head and abdomen were still the largest parts of her body, her belly stuck out when she was upright, and her buttocks, by comparison, seemed small—at least when her diaper was off. Her arms and legs were still relatively short and soft, rather than muscular, and her face had softly rounded contours.

All this will change as she becomes more active, developing her muscles and trimming away some of her baby fat. Her arms and legs will lengthen gradually, and her feet will start to point forward as she walks, instead of out to the sides. Her face will become more angular and her jawline better defined. By her second birthday, it will be hard to remember how she looked as an infant.