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section 7

Hygiene and health in 2 year-olds

2 years

40 meeting

Let’s review:

Once the meeting starts, welcome everyone and ask the participants: • Who can help us remember what we talked about in our last meeting? • Who was able to do the activity at home that we asked you to do at the end of the meeting? How did it go? • Does anyone have questions or concerns after doing the activity?

What are we going to learn?

We are going to reinforce the importance of daily bath, regular teeth brushing and review immunization scheme for two year-olds. LET’S TALK ABOUT IT: We are going to look at some pictures, so we can talk about what we all know about this topic.

What vaccines should a two-year-old child have?

When is the best time to bathe a two-year-old child? What is the best way?

As a parent how have you tried to teach your children to brush their teeth? Share a funny story with the group.

section 7 / 2 years • meeting 40



“Taking care of health” Let’s review the importance of daily cleanliness and vaccinations for the health of the children.

What we’ll need: • • • •

Water in basins Hand soap Toothpaste Toothbrushes for children

WHAT WE’LL DO: • Before the meeting ask the participants to bring their child’s vaccination cards. • Remind participants that many of the illness that children of this age get can be prevented with good hygiene and nutrition. However, vaccines are a necessary defense against serious illness like polio and measles. • Together review the vaccines that two year-old children need (Meeting 17) and review the vaccination cards of the children present to see how they are doing with their schedule of vaccinations. • Next have parents practice washing the hands and teeth of the children present, allow the children to play with the soap and water while they are being washed and have them make lots of foam while they are brushing their teeth. When each child has brushed their teeth and washed their hands give them a star or smiley face sticker. • At the end of the meeting gather the group together and ask the participants to think of some obstacles or difficulties that they have in being able to bathe and brush their child’s teeth daily. What can they do to overcome these obstacles? How can the community help?

Summing up:

What did we learn today? Now, we’ll review what we discussed today. • How do you feel after this meeting? Why? • What are the two most important things you’ve learned today? • What will you do differently based on what you learned during the meeting? • What did you like the most? Are there things you didn’t like? • Do you have any remaining concerns or questions about what we talked about? To finish: what would you recommend to improve today’s meeting when we do it again with another group. (Explain that replying this question will help the meeting be even better in the future for parents with small children.)

Facilitator’s Manual


To do at home:

• Tell parents to set a day to get the vaccinations that their children still need. • Tell parents to let their two-year-olds bathe and brush their teeth alone (with supervision).

Basic information for the facilitator: Learning more about hygiene and health: 1- Review lessons learned:

• A two-year-old should be washing his/her hand by now at critical times (after using the toilette, after playing, before eating). The correct way to wash hands is by rubbing both hands with soap and rinsing with running water, air-dry hands (wave hands in air) if no cloth or napkin is available. • They should brush their teeth after each meal and use dental floss. • They should take a daily bath. • They should continue learning how to feed themselves. • “Potty training” should have started by now. Potty training could start as soon as the child can sit by himself.

2- Immunization scheme: (check the immunization protocol in your country) but for

purposes for this age group, the booster vaccines include: • BCG: is given at birth. • DTaP: the DTaP vaccine protects children against three diseases: diphtheria, tetanus, and pertussis (whooping cough). This vaccine is normally given at 2, 4 and 6 months of age. Then booster doses should be given between 15 and 18 months, between 4 and 6 years old and 11 or 12 years of age. These booster doses help the body keep enough defenses to fight back these diseases. • OPV: given at 2, 4, 6 months of age and a booster dose before entering school. Many countries combine now the DTaP, polio and HiB or hemophilus influenza vaccines in one. • Hib: the Hib vaccine protects the child from a germ which can cause severe swelling in the throat that makes it hard for the child to breathe, a serious form of lung infection and a disease called meningitis. Recommended doses: at 2 months, at 4 months and 6 months; booster doses between 12 and 15 months. • MMR: the MMR vaccine protects your child against three diseases: measles, mumps, and rubella (German measles). Rubella can cause congenital (birth) defects when the disease affects a pregnant woman during the first three months of pregnancy, when the organs of the baby in the womb are being formed. Hence it is particularly important that girls are immunized

section 7 / 2 years • meeting 40

60 against it before they get pregnant. Many parents now choose the MMRV vaccine instead of the MMR. MMRV is the same as MMR, except that it includes protection against the varicella virus, which causes chicken pox. It should be given between 12 and 15 months and the second dose between 4 and 6 years old — although the second dose can be given at any time as long as it’s at least 28 days after the first.

3- Nutrition in two year-old toddlers: toddlers at age two are “explorers” who like to “try” and

“test” feeding themselves, first with fingers and then with utensils, like a spoon. Parents should give toddlers opportunities to practice these skills, but be supportive when toddlers get frustrated and throw the spoon. As skills develop, step back and let the child take over. • Toddlers also like to assert their independence, and the table is one place where parents should give them some sense of control and direction. Remember: Parents should decide what variety of healthy foods to offer at a meal and the child decides which of those foods to eat, how much to eat, and whether to eat at all. Always have a “combo” meal of “grow”, go” and “glow” foods. A word about milk: milk is an important part of a toddler’s diet because it provides calcium and vitamin D, which help build strong bones. Children should drink whole milk for the dietary fats needed for normal growth and brain development. Iron intake: it is important to watch out for iron deficiency after a child reaches his/her first year. It can affect their physical, mental, and behavioral development, and can also lead to anemia. To help prevent iron deficiency: • Limit the child’s milk intake to 16 to 24 full ounces (480-720 milliliters or two large coffee cups) a day. • Increase iron-rich foods in the child’s diet, like iron-fortified snacks, meat, poultry, fish, beans, and tofu. • Continue serving iron-fortified cereal until the child is 18 to 24 months old. Foods to avoid: although children at this age can start eating some of the foods previously not allowed (cow’s milk, citrus fruits, whole eggs), watch for allergic reactions. Be sure your doctor or nurse know if a close family member has a food allergy, and consider delaying introducing that food and those commonly associated with food allergies, such as peanuts and seafood. Parents may need to wait until the child is 2 or 3 years old to offer some foods, or the doctor may recommend allergy testing. Avoid foods that could present choking hazards, like popcorn, hard candies, hot dogs, raw vegetables and hard fruits, whole grapes, raisins, and nuts. * Parents should supervise children when eating at all times.

Facilitator’s Manual