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Well Baby Visit: 2 Years

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Suzanne Dixon
By Suzanne Dixon M.D., M.P.H.
"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."

Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R.

Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals.

Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.

Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women's health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists
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This visit will probably go more smoothly than the 18-month one because your 2-year-old will be more interested in the whole business. It's easier and more enjoyable for her to talk to the doctor or nurse who examines her. She's also probably a little less worried about being touched by strangers, although she'll want to be on your lap or have you next to her every step of the way. Early appointments are better than afternoon ones. Avoid naptime.



At this visit, your provider will probably:
  • Weigh and measure your baby. Click here to see our growth chart.
  • Provide insights into your child's physical and emotional development.
  • Answer any questions you may have about surviving the "terrible twos."
  • Discuss toilet training, preschool, and child care.
Your provider will want to know:
  • Has your baby seen another health care provider since the last visit? If so, why? What was the outcome of that visit, and were any medications or treatments prescribed?
  • How many words does your baby know? Can she use two-word phrases?
  • Does she imitate you? Does she play with trucks or dolls?
  • Can she kick a ball? Can she walk up and down the stairs using both feet or one foot at a time?
  • Is she shy around strangers, at least at first?
  • Can she follow a story and name pictures in a book?
  • Can she follow a two-step command?
  • Is there a family history of heart attacks before age 50? If so, there may be some testing of your child's fat balance that needs to be done at this time.
  • If your child is extremely fearful and/or has a hard time with other children.
Talk It Over
  • Although most 2-year-olds are not toilet trained (no matter what your mother or mother-in-law says), you may have started the training process. Talk over any difficulties you're having or any pressures you may be feeling. Keep in mind that you shouldn't rush toilet training. Forcing the matter usually ends up frustrating everyone, and doesn't get the diapers off any sooner.
  • Dental care is a big concern at this age. Ask for a referral to someone who works well with children. Ask about fluoride.
  • If you're having a hard time limiting TV or find yourself using it as a babysitter. Ask for some help. Habits are shaped now.
  • If your child is extremely fearful and/or has a hard time with other children. Ask for advice.
  • If you no longer have health insurance for your child. There are programs available to get that coverage.
  • Major changes can stress you and affect your toddler. If you're moving, having a new baby, going back to work, or dealing with a loss or serious illness, your child may be affected. Talk it over with your provider, who can tell you how such things could affect your child's development and what to do. Your provider may also be able to suggest resources for you and your family to help with the situation.

Raising children can bring great joy, but as every parent knows, it is also very challenging. If you're feeling stressed out, talk it over with your child's health care provider.

This is extremely important if you:
  • Feel out of control.
  • Hit your baby when you feel out of control.
  • Leave a mark or bruise on your child.
There are many programs that can help you cope with the challenges you face with a growing child. Your provider can help you find one. Parenting classes, preschool groups, play groups, and mothers' mornings out are all examples of these community resources.

Speak Up!

Your busy toddler will probably bruise her shins and bump her head. But you should ask your child about bruises anywhere on her body that can't be reasonably explained. If you have any concerns about your child's injuries, tell your provider immediately. She or he can look at the bumps and bruises and tell you whether they appear to be from normal activities. Do this before you let any day care provider or babysitter take care of your baby again.

Also, let your health care provider know if your child:
  • Isn't putting together two-word sentences or phrases.
  • Doesn't point at pictures in books and name at least some of the pictured objects.
  • Doesn't run or is very unsteady on her feet.
  • Doesn't understand two-step commands such as "Get your shoes and bring them to me."
  • Doesn't throw or kick a ball.
  • Can't stack more than two blocks.
  • Doesn't know how to scribble on paper with large crayons. Most kids can draw a crude circle at this age.
  • Still has trouble swallowing table food.
  • Can't be understood or get her message across to strangers half of the time.
  • Is very fearful generally, or in particular situations or with particular people.
  • Is doing anything that you think is odd or unusual.
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