18-Month-Old Well Child Check


Family meals are important for your child and help him or her learn to eat. Let your child eat with a spoon and drink from a cup. It is important for your child’s growing sense of autonomy. They will gain self-feeding skills more rapidly and will hopefully be less messy! It is normal for the toddler’s appetite to decrease as the growth rate and nutritional requirements decline. Do not use food as a reward or bribe for good behavior. This can lead to poor eating habits. Let your child eat when hungry, about 3 small meals and 2 snacks per day. You may want to use multivitamins and we usually recommend ½ Flinstone vitamin daily. We may need to prescribe fluoride if you have well water which is tested negative for fluoride and there is no other fluoridated water in the daily diet.

Development and Behavior

At this age, most noticeable in your child’s development is language. Your child should be learning new words rapidly. Their most favorite word may be “no”. You can help by naming lots of things for your baby and reading picture books together. Toddlers typically have lots of different feelings and demonstrate them strongly at times.

You may already be seeing temper tantrums which reflect your child’s frustrations when confronted with their many limitations. Remove your child from a problem situation or distract him or her with an interesting object. You can help shape your child’s behavior by letting him or her know when you approve of things you like. Help your child begin to understand feelings by naming them and helping him or her find a way to respond appropriately. Keep lots of books on hand. Make an effort to encourage reading. The AAP discourages TV viewing under the age of 2.

Children respond to and prefer routines. Set regular bedtimes, mealtimes and nap times for your child. A special blanket or stuffed animal can help children who have difficulty getting to sleep. If your child uses a pacifier, you should begin limiting it to the crib/sleep only.

Look for signs of toilet training readiness in the next few months: reporting a wet or dirty diaper; curiosity about bathroom use; and waking up from naps dry. Introduce children to the toilet by flushing bowel movements down the toilet. It is best to wait until your child is ready to start toilet training. Your child’s muscles are not developed enough to successfully toilet train at this young age. Avoid putting too many demands on the child or shaming the child. When your child uses the toilet successfully, let him or her know how proud you are.


You should use a rear-facing car seat in the back seat every time you travel in the car until your child is two years of age. Make sure you are using your car seat correctly! Never place your child in a seat with an airbag. If you have questions about installing your seat, you can have it checked at your local fire or police department. Never leave your child alone in the car. Be a good role model, and wear a seat belt yourself. Supervise all outside play and closely observe water play. As your child learns to climb, you may want to move your child to a youth or twin bed with rails.

Toddlers are very curious and love to explore. If the environment is child-proof, let your child explore freely. This is the way they learn new things. Keep plastic bags, balloons, and small objects out of reach. Lock all medicines, vitamins, cleaning supplies and poisons away. Keep the poison control center number 1-800-848-6946 next to your phone. Remember, we no longer recommend Syrup of Ipecac or Activated Charcoal for poisoning. Remember to check batteries regularly in your smoke and carbon monoxide detectors. Keep your car and home smoke free.

In the kitchen, cook on the back burner with pan handles out of reach. Never cook with children underfoot. Children love to explore the outdoors. Make it safer by fencing the yard and keeping children inside when lawn mowers or other machinery are used. Always supervise your child in the bathtub or wading pool. Check the stability of drawers, tall furniture and lamps. Make sure windows are closed or have screens that cannot be pushed out. Don’t underestimate climbing ability.

Health Maintenance and Shots

At this age, the booster DTaP and Hepatitis A vaccines are due.

Next Appointment

At 24 months your child will receive a checkup, and be measured for height, weight and head circumference. No immunizations will be given if your child is up-to-date. Your child’s blood may be tested for anemia and lead. Call our office at any time if you have any questions or concerns.