Well Check-Up / 18 Months

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 than 24 ounces of milk can cause children to eat poorly and puts them at risk for anemia (low iron). Whole or 2% milk or a high-fat non-dairy milk is best. If your child drinks during the day between meals, fill her cup with water (and not milk or juice). Toddlers do not need any fruit juice and should not have more than 4-6 ounces of 100% fruit juice each day.

Continue to be careful with foods they can choke on and to cut meat and raw fruits and vegetables into small pieces. Be especially careful with the most-commonly choked-on foods—grapes, carrots, hard candy, nuts, and hot dogs.

A drop in appetite between age 1 and 2 is normal, and many toddlers become pickier and sometimes have days when they seem to eat very little. Try for at least one good meal each day with several healthy snacks. Toddlers should not eat a lot of processed, fried, or junk foods. Parents should provide enough healthy food and then allow toddlers to feed themselves. It is not necessary to force toddlers to clean their plates after they stop eating or to make them separate meals from the rest of the family.

DEVELOPMENT

At 18 months toddlers can usually walk well, run, stack 4-10 blocks, and eat with a spoon. Most 18-month-olds can say 10 words, although they understand much more than this. Sometime between 18 and 24 months, they learn to put 2-word phrases together. Soon your child should learn to open doors, climb steps alone, and scribble with a crayon, and his vocabulary will grow quickly. Continue to talk and sing with your child often and to read books together. Avoid screen or tablet time as much as possible before age 2. Reading remains the most important activity to stimulate language development and build the foundation for good school performance later.

TEMPER TANTRUMS

Most children at this age at least occasionally have temper tantrums, which are usually a sign of frustration or a cry for attention. Whenever possible ignore bad behavior and praise good behavior, and step in quickly if your child is starting to get upset or frustrated. If your child has a tantrum at your house, try to leave the room and return only when he or she is quiet. If this happens in public, it can be difficult to follow this plan, but picking up your child and leaving together is often the best remedy. Other strategies include distracting your child by giving him something new to hold on to or allowing him to choose between two acceptable options. Whenever possible tell your child what to do instead of what not to do. (For example, if your child is reaching for things on the shelf in the grocery store, you could tell her to put her hands on her lap instead of telling her to stop reaching.) Make rules very simple, so your child learns what is expected. Time-outs can begin to be an effective tool for some children between 18 and 24 months when used consistently with the general rule being one minute of time out for each year of age. Remember that this will get better!

DENTAL CARE

At this age, it is very important regularly to brush your child’s teeth at bedtime, using a very small amount (the size of a grain of rice) of toothpaste with fluoride. Even if your child wants to help brush his own teeth, it is important for you to go over all the teeth, especially the back teeth, to make sure all are cleaned. This is a good age to visit the dentist for the first time if you have not already been there.

SAFETY

Your baby should continue to ride in a rear-facing car seat until she is at least 2 years old. Never leave your child unattended in a bath or near any water, and do not leave cups or containers of hot liquids when he could reach them. Check smoke detectors regularly and change the batteries twice a year. Childproof cabinets and drawers and lock up all chemicals and medicines. If your child ever accidentally swallows anything that might be dangerous (such as cleaning supplies, chemicals, or medications) call Poison Control immediately.

POISON CONTROL 1-800-222-1222