The 2.5 years review with your Health Visitor

Your child will be offered a growth and development review between 2 and 2.5 years of age. Here you will find out more about the topics and advice covered at this review. If your child is at nursery or a childcare setting, the staff there will also complete a 2 year review. It is useful to share this with your Health Visitor at your appointment.

You may have been asked to fill in two questionnaires about your child’s development. These are called Ages and Stages Questionnaires (ASQ) and will focus on your child’s communication, physical, emotional and social development.

You know your child best and will be best placed to answer the questions, but if you are struggling or need further help, your health visitor is there to support you.

For more information about the ASQ’s click here:

Speech and language

You may have noticed that you child is now saying a number of words, however, some may not be clear and this is normal. They may have started to put 2 words together to start forming sentences. Rhymes and songs continue to be important to help their speech along, and you may notice that your child can now sing or hum along to familiar songs. Alongside the ASQ’s, health visitors use a tool called the Early Language Identification Measure (ELIM) which helps identify children who need additional support with speech, language and communication skills. This tool uses a list of words to assess your child. Children are not expected to say every word on the list and your child may be saying words that are not included on the list. Your Health Visitor will discuss any concerns with you.

You can learn more about speech development here:

It is never too early to start reading to your child, this is a great way to strengthen your bond with them. Babies that love books are more likely to grow into children and adults who love books, giving them skills for life, supporting their communication skills, speech development and social interaction. Bookstart aims to encourage the love of books, stories and rhymes in children from as young an age as possible. Further information can be found at:

Vision and hearing

If you have any concerns about your child’s vision or hearing, or if there is any family history of vision or hearing problems, please talk to your health visitor or GP. Identifying vision and hearing problems early is important to get early support and treatment. For more information please visit: 

Free NHS eye tests are also available at opticians for children under 16. Find out more here:

General development

The Tiny Happy People website has a lot of ideas of activities for you and your child to promote healthy development:

Or you can find more activity ideas here:

Behaviour and expectations, routines and boundaries

Toddlers are curious and headstrong. Tantrums and expressing their views through shouting and crying is completely normal and is a way of communicating with you. It can be useful to create routines and boundaries now to give your child clear messages. The following links may be useful:

Most children are ready for toilet training around the age of 2 years. Some may be ready a little sooner and some a little later. For advice on signs of readiness and how to start please visit:

It usually takes children longer to be dry at night-time. Once they wake up with a dry, or almost dry, nappy a few mornings in a row then they may be ready for trying without a nappy at night. Make sure that they use the toilet before bed and having a waterproof mattress protector might be useful.

At birth your baby has billions of brain cells but not many connections (synapses) between these cells. In your baby’s first years of life, connections develop very quickly. Your love, affection and closeness can help link up the connections. From birth to age two your child will form 700 new connections per second!

Further information can be found at:

For ideas and tips for activities and play ideas to support your baby’s development visit: 

Quality sleep for children promotes healthy growth and development as well as having a positive impact on the whole family. Establishing a good bedtime routine is important to help children to settle and sleep well. Hints and tips for bedtime routines can be found here:

Like adults, all children have different sleep patterns. Try not to compare your child’s sleep with other children that you know. Some children will be sleeping through the night by this age, but it is completely normal if they are not. 2 year olds typically need 12-13 hours of sleep per day including 1  daytime nap or 1-2 hours. They may stop napping in the daytime altogether. At this age sleep becomes more linked to behaviour and life events (such as toilet training or family holidays). You may notice your child starts to resist bedtime, wake up in the night or suffer from nightmares. Their bedroom environment and bedtime routine are important at this stage.

For further support around sleep and sleep problems visit:

Your health visitor will monitor your baby’s growth and development. They will discuss with you when your baby’s growth needs measuring again. Generally, if your baby is feeding well, weeing and pooing and growing out of their clothes then they do not need routinely weighing after 1 year of age.

If you are ever concerned about your child’s weight then you can contact Derbyshire Family Health Service on 01246 515100 to arrange a health visitor home visit or to book onto one of our bookable clinics. For more information, including how weight is plotted in your red book, please visit:

 Children need a variety of foods in their diet including fruit and vegetables; carbohydrates (pasta, bread, rice, potatoes); milk and dairy; protein (pulses, fish, meat, eggs); and fats. Children do not need salt or sugar added to their food during or after cooking. Salty food is not good for their kidneys and sugar can cause tooth decay. Sugar easily adds up throughout the day. Here is a handy calculator to see how much may be in snacks and treats:

Start for Life has over 120 healthy and easy to prepare recipes and meal ideas:

For more advice around what to feed your growing child visit:

For more advice around what to feed your growing child visit:It is also important to think about portion sizes. For children, the amount that they should eat depends on their size and age. As a rough guide, one portion is the amount that they can fit in the palm of their hand.

Breastfeeding will continue to benefit your child for as long as you wish to carry on. After 1 year of age your child no longer needs formula milk and they can have whole or semi-skimmed cow’s milk as a drink from 1 year of age:

As your baby takes more solid foods, the amount of milk they will want, and need, will reduce. This is different for all children and some will stop drinking milk altogether much sooner than others.

You can offer water in a cup or beaker from 6 months of age. Baby bottles should be discouraged, even for milk, from 1 year of age as this will be healthier for your baby’s growing teeth:

Toddlers need to be physically active for at least 3 hours per day. Find out more here:

Physical activity ideas can be found here: 

It is important to know your rights in the workplace regarding breastfeeding when returning to work. For hints more information visit:

We understand that finding childcare can be daunting and stressful. You can search for registered childcare in Derbyshire by visiting:

Your child may be eligible for financial support for childcare. For more information visit:

In Derbyshire, all families are entitled to up to 570 hours of free early education from the term following your child’s third birthday.

Vaccinations are the most effective way to prevent serious, infectious diseases. All children in the UK are offered routine immunisations to protect you, your child and the wider community from potentially deadly diseases. Your child’s next routine vaccinations will be offered at 3 years and 4 months of age.

To learn more about the vaccination schedule, how they work, their safety and any potential side effects please visit the following pages:

For tips on helping yourself and your child through vaccinations and what to expect after they have been vaccinated visit:

From 2 years of age until, at least, the end of primary school, children are offered an annual flu vaccination. This is a nasal spray which is proven to be safe and effective. Children can catch and spread flu very easily. Vaccinating them helps to protect them from flu and the related risks (bronchitis and pneumonia) as well as helping protect others who are vulnerable to flu. For more information visit:

It is important to remember that children benefit from having healthy parents and prioritising your own health and wellbeing is also important. Now is a good time to prioritise yours, and your family’s, health. Health visitors can advise and signpost you to further specialised support regarding wider health including:

  • Physical health problems 
  • Diet, exercise, and nutrition
  • Dental Health 
  • Stopping smoking
  • Substance misuse 

Live Life Better Derbyshire can offer further support through their website or programmes which you can self-refer to or talk to your GP about:

Health visitors routinely use assessments tools when considering mental health. All health visitors have completed mandatory training on Emotional Wellbeing Visits (EWV). This new evidence-informed intervention framework guides the mental health support health visitors provide to families. Emotional Wellbeing Visits are a package of care offered by health visitors to mothers at risk of, or experiencing, mental health problems. When support is needed, care is tailored to the unique needs, preferences, and circumstances of individual parents.

If you feel you are struggling, you can also talk to your GP and referrals to specialist services can be considered. In a mental health crisis, you can call 0800 028 0077. Further mental health support including crisis support can be found on the following pages:

Domestic abuse can happen to anyone, regardless of their circumstances or gender. Your health visitor may ask you questions about your relationship and are there to support you if needed. If you or others are ever in immediate danger, please call 999. If you have any concerns, need support or want to know more information about what domestic abuse is and how to recognise it please visit:

For specific support in Derbyshire, you can visit:

It is important to start caring for your child's teeth as soon as they appear. You can brush them straight away with a small smear of fluoride toothpaste (twice a day). For more information and useful tips visit:

First teeth usually appear within the first year, but, when it comes to teething, all babies and children are different. For more information about what to expect visit: 

For tips on how to manage teething visit: 

​​​​​​​If you are concerned, you can get further support by calling 111.

NHS dental care is available free for children however not all dentists provide free NHS care. You can take your child to the dentist as soon as their first teeth appear. Try to make this positive and fun to prevent the trip to the dentist becoming too worrying for them. To find an NHS dentist near you visit:

Keeping your growing child safe from harm is a priority and health visitors can support you to make sure that you have considered safety factors in your home.

For further information about safety topics please visit:

Smoke alarms and carbon monoxide detectors

We are constantly learning from experience and health visitors will discuss with you specific safety topics relevant to your child’s age to help you create the safest environment for your family. It is important to have working smoke alarms and carbon monoxide detectors and you may be eligible for a Safe and Well Visit from the local fire service. Visit:

Pets

It is important to keep your baby safe around your pets, particularly dogs. Luckily, most dog bites are preventable with close supervision at all times.  You can also start preparing your dog for the baby’s arrival during pregnancy, for more information please look at the following:

Blind cords

Shockingly around 2 children every year are strangled to death after being tangled in a blind cord. This can happen silently and very quickly. For advice on how to ensure your blinds are safe please visit:

Button batteries

Button batteries can badly hurt or even kill a small child if swallowed. For more information look at:

It is your responsibility to ensure that you have a safe and legal car seat for your baby. The following websites can help you understand the law around car seats and help you to choose the correct one for your child:

Children can become very unwell, very quickly, in hot weather as a result of dehydration, heat exhaustion, heat stroke and sunburn. Try to keep your child out of direct sunlight as much as possible, use sunscreen and a sunhat. For advice on keeping your child safe in hot weather visit: 

We understand that the cost-of-living crisis and the current financial situation is putting increasing pressures on families. If you need any support with finances including debt issues, benefits, employment concerns or pay and many other topics you can visit:

If, at your visit, you and your health visitor agree that further support is required, they will arrange a further contact. If you do not require further support, your next visit will take place in your child’s pre-school year to discuss school readiness. This visit usually takes place with a community nursery nurse who is part of the health visiting team:

Please follow this link for ideas on how to support your toddlers development:

You do not need to wait for your next visit for advice and support. To find out the different ways that you can contact the health visiting team visit our ‘contact us’ page at