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. Whole or 2% milk is best (or a high-fat form of non-dairy milk if necessary). More than 24 ounces of milk can actually cause children to eat poorly if their stomachs are too full of milk and can put them at risk for anemia (low iron). If your child does not like milk, other options for calcium intake are yogurt, cheese, orange juice with calcium. At this age, children should be taking all their liquids in a cup and not a bottle. If your child likes to carry around a cup to drink during the day between meals, fill the cup with water instead of milk or juice. Toddlers do not need fruit juice and should not have more than 4-6 ounces of 100% fruit juice each day. Children of this age should be eating mostly tables foods, but be careful of foods they can choke on, including anything that is hard or in large pieces. Cut meat and uncooked fruits and vegetables into very small pieces, and be especially careful with the most-commonly choked on foods—whole grapes, carrots, hard candy, nuts, and hot dogs. A drop in appetite after 12 months is normal, because babies’ growth rates slow after 1 year. Many toddlers also become pickier about what they eat and may have some days when they seem to eat very little. Try for at least one good meal each day with several healthy snacks. Eat together as a family whenever possible and try to make mealtime pleasant.
DEVELOPMENT
Common milestones at 18 months include walking well, running, stacking 4-10 blocks, and eating with a spoon. Most 18 month olds will be able to say 10 words, although they should understand much more than this. Usually between 18 and 24 months children learn to put 2 word phrases together such as “want cookie” or “my shoe.” In the next few months, your child will 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. 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 try to 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 clean 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 or until she reaches the maximum weight or height for your car seat. Continue to use gates at the top and bottom of stairways until your child is able safely to go up and down stairs. Even at this age, 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. 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 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