Nutrition
Many toddlers will eat less and have slower weight gain during this time.  The quantity of whole milk should be 12 to 20 ounces a day.  Children do not need daily juice.All bottles should be packed away, thrown away, or given away at this time.  You should be thinking in terms of the food pyramid and offering foods that are lower in salt and sugar.  Nuts, hard candies, chewing gum, and hard raw fruits and vegetables are choking hazards and should be avoided.

It is normal for a child’s appetite to diminish at this age and to become pickier.  You should set a regular meal/snack schedule and avoid snacking “on-demand”.  No good comes of food battles.  Your job is to offer the food, the child’s job is to decide to eat it or not.  All children will ultimately eat when they are hungry.  The American Academy of Pediatrics recommends that all children receive a daily multivitamin – we recommend Polyvisol with iron, 1 ml per day.

Safety

  • Always put the baby in a car seat while driving!  The American Academy of Pediatrics recommends that children remain rear facing until 2 years.
  •  Lock up all medications and household poisons including cleaners, paint thinners, and drain cleaners.  Do not store these products in containers that resemble food containers.
  • Windows and stairs should be guarded with railings or gates.
  • Constant attention to choking hazards (hot dogs, popcorn, hard candy and small toys), as well as poisons is an even harder job now that the babies are mobile.
  • It is a good idea to use sunscreen every day.  Choose a product that is hypoallergenic and protect the baby’s skin from sunlight.
  • Infants should be accompanied when in or near water at all times, even a partially filled bathtub.
  • Backyard pools need to be completely fenced in.
  • Call the Poison Control Center if you suspect your child ate a poison: 800-222-1222.  Do not administer syrup of ipecac until speaking with the Poison Control Center first.

Development
You can stimulate your child’s language development by reading books, singing, and talking about what they are seeing and doing.  Encourage your child to repeat words and respond with pleasure to the child’s attempts to imitate words.

Your child will soon learn to climb up and down stairs, to run, walk backwards, and to kick and throw a ball.  These achievements are inherently reinforcing for the child and parents need to do little else to promote this development.  Fine motor development includes the ability to use a spoon, scribble with a crayon or marker and stack blocks.

Temper tantrums are to be expected at this age.  Sometimes they can be avoided by offering alternatives or distractions, but often they just happen.  The parent sometimes just needs to offer sympathy and walk away saying “I’ll be in the other room when you want me” and allow the toddler to begin to learn some self control.

Discipline is really setting limits and reminding the child the kind of behaviors that are expected.  Effective disciplinary actions include distraction, a stern restatement of the forbidden actions (“hitting is not allowed”) or a brief period of non-interaction (“time-out”).  Always find ways to give plenty of positive reinforcements throughout the day.  You can build the toddler’s self-esteem, an important gift to any developing child.

TODAY’S IMMUNIZATIONS: Some of these immunizations may be combined.

  • DTaP#4
  • Varivax #1
  • HIB #4

(Please see the CDC website for the Vaccine Information Sheet  http://www.cdc.gov/vaccines/hcp/vis/index.html?s_cid=cs_748 )

Less than twenty percent of babies will feel any effects from today’s shots.  If you see any signs of a sore leg or fever, it is okay to give your child Tylenol.   It is not uncommon for there to be a delayed reaction by 7-10 days for today’s immunizations.  Mark your calendar so that you are not surprised if your child has a fever and/or a rash next week.  For the fever, we offer acetaminophen or ibuprofen as needed.  The rash typically does not itch or hurt and therefore needs no special treatment.  If your child has a fever of greater than 103 degrees, cries excessively or has any unusual behavior, please call us.

NEXT VISIT:    Your toddler’s next routine visit is at 18 month of age.

NEED DAYCARE FORMS? Don’t forget to drop off your health forms at the front desk or submit them after your check-up here.