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15 Month Check Up

FEEDING:   Your child should be consuming 2-3 servings of dairy products or 16-24 ounces of milk each day for optimal calcium intake.  More milk than this can actually cause children to eat poorly if their stomachs are full of milk and can place them at risk for anemia (low iron).  Most pediatricians recommend whole milk as the best choice between 1 and 2 years, because babies need the added fat for good growth and brain development.   Yogurt and cheese and orange juice with calcium are other options if your child does not drink milk to keep bones strong.  If your child still takes a bottle, try to transition to the cup now, as it becomes harder to wean off the bottle as children get older.  If your child likes to carry a cup around during day, fill the cup with water instead of juice or milk to decrease the chance of cavities in the teeth and to prevent filling up on sugary drinks.  Limit juice intake to less than 6 oz per day.  Children at this age should be eating mostly table foods, but be careful of foods that baby could choke on, including anything that is hard or in large pieces. Common foods to watch out for include whole grapes, carrots, hard candy, popcorn and hot dogs.  Avoid nuts until age 3.  After 12 months, babies’ growth rates slow considerably, so a drop in appetite is normal.  Many toddlers become much pickier about what they eat and will have some days when it seems they’re not eating much at all.  As long as your baby gets some variety in her diet and continues to grow well, she is probably eating enough.

FEVER/ILLNESS:  At this age, fever is defined as a rectal temperature greater than 101.  If your baby is going to be in daycare or around large groups of children, we expect that he or she will get as many as 1-2 colds or viral illnesses each month.  Cold viruses usually cause nasal congestion, runny nose, cough, decreased appetite, and often fever.  Most cold viruses last up to 10 days, but the fever should not last more than 3-5 days.  If your baby has cold symptoms that last longer than 10 days, fever that lasts longer than 3-5 days, or high fever associated with not drinking or sleeping or extreme fussiness, it is a good idea to call the office.  Good handwashing is still the best way to prevent the spread of germs. 

DEVELOPMENT:   Common milestones at fifteen months include walking alone, stacking 2-4 blocks, and drinking well from a cup.  Most fifteen month olds will be able to say 3-10 words, although they usually understand much more than this.  In the next few months, your child likely will learn to use a spoon and to point to several body parts, and his vocabulary will grow quickly.  Continue to talk and sing with your child often and to read books together.  Reading remains the most important activity to stimulate language development and build the foundation for good school performance later!

BEHAVIOR/DISCIPLINE:  Some children at this age may be starting to have temper tantrums, which are usually a sign of frustration or a cry for attention.  Whenever possible try to ignore bad behavior and praise good behavior.  If your child has a tantrum in your house, try to leave the room and return only when he or she is quiet.  If this happens out in public, it is difficult to follow this plan, but often picking your child up and leaving together when possible is the best remedy.   Make rules very simple so your child learns what is expected.  Time-outs are often not very effective until children are 18-24 months old.

DENTAL CARE:  At this age it is very important regularly to clean your child’s teeth, either with water or with toothpaste specially-formulated for young children that does not contain fluoride.  Do not use regular adult toothpaste at this age, as children may swallow it and get too much fluoride.  Even if your child tries to help at this age, it is important for you to go over all the teeth, especially the back teeth, to make sure all are cleaned.  Most pediatricians recommend the first visit to the dentist by age 3.

SAFETY:   Your baby can now safely ride in a forward-facing car seat.  Continue to use gates at the bottom and top of stairways until your child is able safely to go up and down stairs alone.  Children at this age are becoming more mobile and more curious, so be careful not to leave chairs or other furniture in a place where your child could climb up and get onto counters or into cabinets.  Even at this age, never leave your child unattended in a bath or near any water, and do not leave containers of hot liquids or foods near the edge of a table or counter where he or she might pull them off.  Check smoke detectors regularly to assure they are working properly.  Protect your child from the sun by applying sunscreen with SPF greater than 15 when he will be outside in the sun, and try to avoid direct sunlight between 10am and 3pm, when the sun is strongest.  It is still important to make sure that all cabinets and drawers are childproofed, and all chemicals and medicines are locked away.  If your child ever gets into and accidentally swallows anything that might be dangerous (such as cleaning supplies, chemicals, or medications) do not give anything else by mouth and call Poison Control immediately.       POISON CONTROL 1-800-222-1222