Your 18 Month Old

Developmental Milestones*

• Three to six word vocabulary plus mama and dada.
• Walks well forwards, can take steps backwards.
• Runs.
• Can feed him/herself with the use of a spoon.
• Removes clothes.
• Stacks four blocks.
• Throws (overhand) and kicks a ball.
• Feeds doll.
• Points to pictures in books.
• Scribbles well.
• Gives kisses.
• Knows 2-3 body parts.

*All babies develop differently.  If your 18-month-old hasn't yet reached these milestones, rest assured that she will soon. If you have concerns about your baby's development, please schedule an appointment.

Feeding

No more than 24 ounces of whole milk per day is necessary.  In fact, 16-18 ounces per day is preferable. 

Remember that nutrition is a very important component of your child’s health.  By now your toddler should be eating according to your schedule.  Snacks are important.  It is normal if your toddler is becoming more and more of a picky eater.  Continue to offer new and exciting choices.  Encourage your child to try something new.  He or she may surprise you.  Keep the definite foods on the backburner; however, you still need them to eat enough calories—even if it is the same thing for breakfast, lunch, and dinner!  Please inform us if you believe your child is not gaining weight or eating enough. 

We still only recommend pear or prune juice for the treatment of constipation.  No other juices are necessary and can lead to tooth decay. 

Calcium fortified orange juice can be beneficial if your baby does not like milk.  Cheese, yogurt, and ice cream are also helpful substitutes. 

Even though your child is becoming a more competent eater, there's still a chance he may choke on his food.  Continue to avoid common choking hazards like popcorn, grapes, and hot dogs.  Cut foods into small pieces and discourage your child from doing anything that might distract him from his meal.
Please continue to administer a multi-vitamin with fluoride daily. 

Sleep

Most babies require around 10-12 hours of sleep per night.  Naps are variable.

At this time, babies should be sleeping through the night.  There is no need for anything to eat or drink overnight.  

Your child may remain in his or her crib for as long as it is safe.  Once they start to climb out, they are safer in a low-lying toddler bed.  Be sure to utilize safety gates at night to prevent them from falling down stairs. 

Bowel Movements/ Urine

• Please inform us if the stools are watery, mucousy, hard as pebbles, red, or tarry black.
• Babies will continue to have on average 6-8 wet diapers per day.

Toilet Training

It seems like just yesterday that you changed your baby's first diaper, and now you're wondering if it's time to start toilet training.  There's no magic age at which children are ready to give up their diapers.  Most children will be developmentally ready between 2 and a half to 3 years old.  Some may be ready as early as 18 months while others are not interested in potty training until they're closer to 3, or even 4.

Keep in mind that starting before your child is truly ready doesn't mean you'll finish sooner — it's more likely that the process will just end up taking longer.   We cannot stress this enough.  This is one of those things that just cannot be rushed.  Children who struggle with constipation fare much better if they train a little on the later end. 
 
Use the checklist below to measure your toddler's progress toward readiness:

• Urinates a fair amount at one time.
• Has "dry" periods of at least three or four hours
• Dislikes the feeling of wearing a wet or dirty diaper.
• Shows interest in others' bathroom habits
• Wants to wear “big boy/girl” underwear.
• Asks to use toilet or learn how.
• Gives a physical or verbal sign when he's having or is about to have a bowel    movement.

Activity                                                

• It is preferable to have discontinued the use of pacifiers and bottles by eighteen months. If you have not already, try to do so soon as the longer they are around the more attached your baby will become.
• Don’t forget to brush your baby’s teeth and/or gums. Still, no toothpaste.  Twice a day preferably but at least once a night before bedtime.  If you notice any stains or discolorations on your baby’s teeth, please let us know.
• A car seat is very important.   Most eighteen-month old babies are in forward facing cars seats.  Babies must be at least 20 pounds and 12 months old before they can be forward facing.  The car seat must be in the back of the car.
• Avoid sun exposure since your baby’s skin is delicate and more likely to burn. Sunscreen can safely be used.  Try to use a sunscreen made for babies and be careful around their eyes.  Take advantage of SPF clothing and wide brimmed hats.  
• Monitor your child at the pool or beach at all times.  Educate your children never to swim unsupervised.  It is never too early to start teaching them this.  Strongly consider purchasing a pool safety fence or cover for your home pool.  Lock all hot tub covers. 
• Insect repellent may be used.  Deet-free brands are preferable.  To be safe, only apply insect repellents to exposed skin. Do not apply it under clothing, on a child's hands, near the mouth or eyes, or over cuts and irritated skin.  Wash off insect repellents once it is no longer needed. Combination sunscreen/insect repellent products should be avoided because sunscreen needs to be reapplied every two hours, but the insect repellent should not be reapplied. 
• Have this number handy (although we hope you never need it): POISON CONTROL 1-800-222-1222.

Vaccines

Your baby will receive immunizations during his/her 18-month visit.  Please visit the vaccine section of this website for more information on specific vaccines and their administration schedule. 

Please note that we will not administer vaccines to any child whose parent or guardian is not present for the visit.  This is our office policy.  We understand that parents have busy schedules but no exceptions to this rule will be made.

Medicines

Tylenol and Motrin can be safely given to your child for teething or fever.  You can safely use both medicines together as long as you adhere to their separate dosing schedules.  For most babies, however, one or the other will be just fine.  Please ask for our dosing chart or follow the instructions on the bottle.  Let us know if you have any questions.  If you are using either medication regularly, please notify our office.  We do not recommend the use of Baby Orajel or other teething/gum numbing agents.  Please ask us before using administering any other medication to your child.