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Parents often wonder about their child’s health, leading to the frequently asked question: “Is my baby healthy and growing normally?”

These information sheets outline normal and healthy growth and developmental milestones, and common health topics for your baby.

Due to space constraints, some messages are repeated at several ages while others appear once only. Read the complete set of sheets to obtain the entire information.

The Rourke Baby Record (RBR) is a guide that many Canadian doctors and other healthcare professionals utilize for well baby and child visits for babies and children from 1 week to 5 years of age.

photo of a young boy

2 - 3 Years

Feeding & Growth

  • Feed your child following Canada’s Food Guide. Offer 3 meals and 2 to 3 snacks per day.
  • If your child is following a vegetarian diet, get advice to be sure that it is nutritionally complete.
  • Offer 500 mL (16 oz) pasteurized 2%, 1% or skim cow’s milk daily.
  • Avoid sweetened liquids or fruit juices as they can cause tooth decay, problems with weight gain or diarrhea, and can take the place of healthy foods. Encourage water.
  • Avoid processed foods high in sugar and/or salt.
  • Wash all fruits and vegetables that cannot be peeled
  • Remember to let him eat as little or as much as he is hungry for. Never force your child to eat.
  • To prevent choking, avoid small, round, hard, smooth and sticky foods until 4 years of age. Have your child sit when eating or drinking.
  • Be a good role model for healthy eating. Eat together as a family away from the TV or other distractions.

Preventing Injuries

  • Car seat safety: Follow the instructions that come with your car seat to install it properly and keep your child in each stage as long as possible. Maximum height and weight may vary with your car seat model.
  • Both you and your child should wear a properly fitting bicycle helmet when cycling. Replace it if there is a heavy impact, if it shows signs of damage or if it is over 5 years old.
  • To decrease the risk of drowning, supervise your child near water (including in the bathtub), fence any pool completely with self-closing and - latching gates, use life jackets, and take boating and water safety training.
  • Childproof your home. Lock away all medications, cleaning products, and matches. Secure TVs, computers and furniture to prevent them from tipping over. Use window guards and stair gates. Find the hazards before your child does. Have Emergency numbers handy. Use age appropriate safe toys. Be vigilant about hot liquids on countertops.
  • Second-hand smoke (from cigarettes, E-cigs, cannabis) is harmful. Ask for help to quit smoking. Cannabis edibles should be locked away to prevent unintentional poisoning.

Development

  • At 2 years your child should:
    • Combine 2 or more words.
    • Understand 1 and 2 step directions.
    • Walk backward 2 steps.
    • Try to run.
    • Put objects into a small container.
    • Use toys for pretend play.
    • Continue to develop new skills.
  • At 3 years your child should:
    • Understand 2 and 3 step directions.
    • Use sentences with 5 or more words.
    • Walk up stairs using a handrail.
    • Twist lids off jars or turn knobs.
    • Share some of the time.
    • Play make-believe games with actions and words (e.g. pretending to cook, drive a car, etc).
    • Turn pages one at a time.
    • Listen to music or stories for 5 - 10 minutes.
  • Limit TV, video and computer time to less than 1 hour per day, and not within 1 hour of bedtime. Spend time reading and in a variety of activities with your child.
  • Play silly games, guessing games, active games, and make believe.
  • Play sorting games with toys, blocks, and other objects. You can sort by size, colour, shape, etc.
  • Allow some independence such as dressing, helping with household tasks, etc.
  • Help put words to your child's feelings.
  • Make time for your child to socialize and play with other children.
  • Report any concerns about your child’s development, including her hearing and vision, to her physician or other healthcare professional.
  • Warm, consistent and responsive discipline techniques are associated with positive results. Praise good behavior.

Other Advice

  • Your child is usually toilet training at this age. Signs that your child is ready to potty train include interest in toileting, and letting you know when she needs to use the toilet.
  • Under 3 years, brush your child's teeth twice daily with water (if low risk for tooth decay) or with a rice grain-sized portion of fluoridated toothpaste (if high risk for tooth decay). From 3 years, assist his brushing and use a small amount (pea-sized portion) of fluoridated toothpaste twice daily. Start flossing when any of his teeth touch each other. See your dentist for regular check-ups.

Resources

For more information on your baby’s health, the top 5 websites cited by the RBR Parent Resources are:

  1. Canadian Pediatrics Society – Caring for Kids (www.caringforkids.cps.ca)
  2. Hospital for Sick Children – About Kids Health (www.aboutkidshealth.ca)
  3. Parachute - formerly Safe Kids Canada (www.parachutecanada.org)
  4. Dietitians of Canada (www.dietitians.ca)
  5. Health Canada (www.hc-sc.gc.ca)

Support and Acknowledgements

The RBR Parent Resources website and this series of information sheets were created by then Memorial University of Newfoundland (MUN) medical student, Dr. Laura Butler, and the RBR authors (Drs. L. Rourke, D. Leduc and J. Rourke). Two MUN Summer Undergraduate Research Awards and MUN Faculty of Medicine Office of Professional Development supported these projects. Evaluation project by Dr Aimee Holla, MUN FM Resident. 2020 brochure revisions by Dr. Anne Rowan-Legg.

Support for the RBR includes the Government of Ontario and MUN's Dr. W. Ingram Award. Licensing contributions for RBR electronic medical record use go to the MUN RBR Development Fund.

As evidence-based information is constantly changing, the Rourke Baby Record and these recommendations should be used as a guide only.

May 2020