Know what to expect! Year 1-4

Pediatric Anticipatory Guidance

Growth

• Toddlers learn quickly.
• Your toddler will start talking, running, hopping, skipping, and jumping.
• Teach them ABCs and 123s.
• Talk, read, and sing with your toddler.
• If you have concerns about your toddler, talk with your doctor.

Shots

• Toddlers need shots at 12, 15, and 18 months.
• They might need shots at other times if they missed some.
• Toddlers need flu and COVID shots in the fall.
• At 4 years, children need 2 booster shots.

Food

• Limit junk food and fast food.
• Offer fruits, vegetables, beans, nuts, seeds, and whole grains.
• Try for 5 vegetables or fruits every day.
• Give foods that taste and feel different. It may take 12 tries before a toddler likes
a new food. Keep offering healthy foods!
• Let toddlers eat when they’re hungry and stop when they’re not hungry.
nhcare.org/pediatrics better together

Drinks

• Offer mainly water to drink.
• Toddlers should have only 2 cups of milk a day.
• Limit juice, soda, and other sweet drinks.
• Don’t give toddler formulas. They have too much sugar and fat.

Teeth

• Brush teeth twice a day.
• Use a little fluoride toothpaste.
• See the dentist every 6 months.

Exercise

• Exercise at least 1 hour every day. Do something fun!
• Wear a helmet and pads for biking, skateboarding, scootering, horseback riding, or skiing.

Screens

• Limit screen time (phones, tablets, computers) to less than 2 hours a day.
• Don’t use screens as background noise or to keep toddlers busy.
• Keep screens out of bedrooms. Turn all screens off 1-2 hours before bed.
• Go to www.healthychildren.org to make a plan for your family.

Sleep

• Keep the bedroom cool, dark, and quiet.
• Have a regular, ½ hour, bedtime routine.
• Keep bedtimes and wakeup times the same every day.
• Use sunlight to help wake up in the morning.
• Keep a regular schedule of meals, play, snacks, and sleep every day.

Help

• If you need help, go to findhelp.org.
You can get help with food, housing, medicine, and other things.

Car Seat

• Use https://cert.safekids.org/ to get your car seat checked.
• Car seats should be in the back seat.
• Keep baby facing backward for the first 2 years.
• Toddlers need a car seat until 4 years.

Poisons

• Keep vitamins, medicines, cleaners, and other dangerous stuff locked away.
• Keep the Poison Control Center number (1-800-222-1222) handy.

Tobacco

• Do not use or be around tobacco, e-cigarettes, vapes, Juuls, or other smoke.
• Call 1-800-NO-BUTTS and visit nobutts.org for free help.

Safety

• Set home water temperature to 120F or less to prevent burns.
• Never leave a toddler alone in or around water, even for a few seconds.
• Fence swimming pools on all sides.
• Check smoke detectors twice a year and replace batteries.
• Use safety guards on windows and gates for stairs.

Sun

• Protect your toddler from the sun with long sleeves and long pants.
• Put on sunglasses and a hat.
• Re-apply sunscreen every 2 hours. If swimming or sweating, re-apply every 1 hour.
• Limit time in the sun between 10am and 4pm.

Firearms

• Firearms at home should be unloaded and locked.
• Ammunition should be locked separately.
• If anyone at home has depression or mental illness, keep firearms at a different location.

Know what to expect, Year 1-4