Nurturing Care- 2-5 years


Family meals– Eating healthy meals together helps children eat better and strengthens the bond between parents and children.  Model healthy eating by making wise choices yourself. Serve the whole family foods from all of the food groups, especially lean proteins and a wide variety of colorful vegetables and fruits.  Your child should eat 3 healthy meals with 2-3 healthy snacks in between. The portions at mealtimes will be smaller than adults.

Here are some healthy snack ideas for children from 2-5 years:

Mango, apples, oranges, papaya, bananas, baked sweet potato, porridge with nsinjilo, groundnuts, whole grain bread or crackers, zitumbuwa, cucumber slices, peanut butter, yogurt, or eggs.

Avoid fizzy drinks and crisps which will fill children up on unhealthy calories, but don’t have vitamins.  

Instead of white bread, buy whole grain/ brown bread which has more fiber and vitamins. 

Responsive Caregiving

While two-year-olds are testing their independence, four-year-olds want to please their caregivers.  Respond to your child’s needs and teach her how to become more independent.

Children enjoy having a regular routine with clear expectations. Discuss with your spouse the rules for your home.  Agree on how you will teach and train your child to obey.  Encourage and point out positive behavior.  Have a plan for managing “stop” behaviors at this age. Be consistent. Give a clear warning if your child is not obeying you -“that’s one”; a second warning- “that’s two”; and if she doesn’t listen a third time then put her in time-out or some other age appropriate consequence. 

Your child is learning to express her thoughts and emotions.  Make sure that your child knows she is loved by you. Take time to stop what you are doing and listen to your child’s thoughts and feelings. Help your child identify her emotions.  For example: “I see that you are frowning. Are you feeling sad?”

Development for 3 years (from Road to Health by the Department of Health in the Republic of South Africa)

Hearing/communicationVision and adaptiveCognitive/behaviourMotor skills
Child speaks in simple 3 word sentencesSees small shapes clearly at a distance (across the room)Plays with other children and adultsRuns well
  Uses pretend play (e.g. feeds a doll)Eats on own

Development for 5-6 years (from Road to Health by the Department of Health in the Republic of South Africa)

Hearing/communicationVision and adaptiveCognitive/behaviourMotor skills
Speaks in full sentencesNo reported or observed vision problemsInteracts with children and adultsHops on one foot
Caregiver understands child’s speech Understands multiple commands (e.g. go to the kitchen and bring me your plate)Holds with fingers at top or middle of pencil or stick to draw
   Dresses self

Make an appointment to see the pediatrician for further evaluation if your child cannot do these milestones listed above at 3 and 5-6 years of age.  

Opportunities for Early Learning 

Children this age learn by using all of their senses. Playing by imitating others and interacting with friends their age is an important part of their learning.  Choose a preschool or provide a home environment that encourages games, rhymes, stories, songs, free play, movement, and interactive learning.  

Play Help your child count, name, and compare things. Make simple toys for your child. Sample toys: Objects of different colors and shapes to sort. Stick or chalkboard. Puzzle.

Communication– Encourage your child to talk and answer your child’s questions.  Teach your child stories, songs, and games.  Read to your child every day or talk about pictures in books to help your child do better in school.

Security and Safety

Pedestrian Safety– Teach your child how to walk safely along the road, how to avoid busy roads, where to cross, and how to cross safely. Walk your young child to and from school, holding her hand.

Sexual Abuse– Open and honest conversations with your young child about protecting her private areas can reduce the risk of child abuse.  Explain that if someone tries to touch a private area, the child should yell “no” and tell you. Both boys and girls are at risk for sexual abuse. Be mindful of older children and adults that are wanting to spend time alone with your child.  Children who are not being watched by an attentive parent, especially at night, are at highest risk.  Most cases of sexual abuse occur from someone the family knows well.  If you suspect sexual abuse, it’s important to get your child a medical evaluation and treatment. Report the  incident to protect other children.

Car Seats– Children that are safely secured in an age-appropriate car seat in the back seat are three times less likely to die or be seriously injured in a car accident.  When your child no longer fits in a rear-facing car seat, then turn the seat around to face forward. 

Good Health

Teeth– Help brush your child’s teeth twice a day with toothpaste that has fluoride in it (a smear the size of rice under 3 years and pea size after 3). Don’t rinse the mouth after brushing so that the fluoride stays on the teeth.

Bilharzia– Fresh bodies of water in Malawi contain snails that release a parasite into the water. This parasite can enter the body through the skin, laying eggs that can cause problems.  Let your doctor know if your child has been swimming in bodies of water so she can be treated for bilharzia.

Worms–  Intestinal worms lead to malnutrition, abdominal pain, constipation, and sometimes severe abdominal problems.  Your child should take a deworming medicine every 6 months.

Malaria–  If your child gets a fever, test her for malaria. Sleeping under an insecticide treated mosquito net can help prevent malaria.

Rabies– Many animals carry a serious disease called rabies. If your child gets licked, scratched, or bitten by any animal take him immediately to the clinic to be treated for rabies. Be sure that all of your pets are regularly immunized for rabies.

Click on the links above for more detailed articles. Here is a downloadable handout of the above information:

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