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Advice: 18 months

Tips for 18 months

Nutrition

  • Kids are surprisingly well-nourished despite ‘finicky’ eating; continue to serve a variety of foods each day despite their protests
  • Toddlers should not drink more than 20oz of whole milk a day. Ripple Kids is a plant-based alternative if needed.
  • Set a regular meal/snack schedule to avoid snacking on demand.
  • Encourage consumption of REAL fruits and vegetables rather than relying on pouches or purees
  • Avoid nuts, popcorn, hard candies, and chewing gum as these can be choking hazards
  • We recommend a daily multivitamin such as Poly-vi-sol with iron or Novaferrum with iron, 1 mL orally each day.

Development

You can stimulate your child’s language development by reading books, singing, and talking about what they’re seeing and doing. Encourage your child to repeat words, and make sure you respond with pleasure at attempts to imitate words. Your child will soon learn to climb stairs, walk backwards, point to objects, and help get themselves dressed/undressed. He or she will also start engaging in pretend play! Fine motor skills include using a spoon, scribbling, and throwing a ball.

What to expect at your 18-month visit

Check-up: Your provider will complete a comprehensive history and physical exam, review growth curves, answer any questions, and provide age appropriate guidance.

Vaccines: 

  • No Routine Vaccines
 
Optional/Seasonal Vaccines
  • Flu (optional):  The first year that babies receive their Flu vaccine, they need 2 doses, spaced by 30-days
  • COVID-19 (optional): The first year that babies receive a COVID-19 vaccine, they must complete a 3-dose primary series.  Dose 2 is 3 or more weeks after Dose 1.  Dose 3 is 8 or more weeks after Dose 2.

 

Labs/Screening tests:

  • No Labs
  • MCHAT – Autism screening questionnaire

Behavior

Has your toddler ever said “No”? Most likely you hear this often and are watching as your sweet baby becomes more willful and independent. Parents need to realize that this is normal development and there’s no need to despair. Temper tantrums and things like hitting and biting are just signs of frustration that will gradually disappear when the child learns more self-control and is able to communicate better.

You can help your toddler learn self-control by being consistent with your rules and being flexible about things that are not important. Remind them when their behavior is not what you’d like to see, and always model the kind of actions and language you are looking for. Always try to offer an alternative when you say no the child, so that they can transition into another activity without having a meltdown. Sometimes offering simple choices can make the day go smoother.

Looking for some book recommendations? You can check out Raising Good Humans, No Drama Discipline, Tiny Humans, Big Emotions or Hunt, Gather, Parent.

Now is the time to take control of screen time! Limit TV watching and tablet use to under 30 minutes per day.

Dental Health

Fluoride varnish may be applied your child’s teeth at check-ups during the second year of life. As soon as saliva meets the fluoride, it will harden and start working. Avoid sticky/chewy foods this afternoon and DO NOT brush teeth tonight. When you brush the teeth tomorrow morning, you will brush off the fluoride and that is okay.

Regular and frequent exposure to small amounts of fluoride is the best way to protect tooth enamel and protect teeth against cavities.

Sugars and bacteria cause cavities in 1 in 4 children. We recommend that you:

  • Brush teeth with a tiny smear of fluoride toothpaste (the size of a grain of rice) in the morning and before bed as soon as teeth erupt.
  • Do not allow your infant to fall asleep with a bottle, especially one containing milk, formula, or juice.
  • Minimize exposure to natural or refined sugars (juice) in the infant’s mouth.
  • Avoid dipping pacifiers in any sweetened liquid, sugars, or syrups.
  • Avoid putting pacifiers in your own mouth to “clean”.

Toddler Safety

ALWAYS… supervise your child near water, even a partially filled bath tub. Fence in backyard pools.

ALWAYS… wear sunscreen when spending time outside. We recommend SPF 30 or higher.

ALWAYS… guard windows and stairs with railings and gates.

ALWAYS… pay attention to choking hazards such as hot dogs, popcorn, hard candy, and small toys

ALWAYS… lock up all medications and household poisons including cleaners, paint thinners, and drain cleaners.

ALWAYS… know that guns in the home are a danger to the family. If guns are kept in the house, store the gun and ammunition in two separate locations, and keep each of them locked up.

ALWAYS… put the baby in a car seat while driving! The American Academy of Pediatrics recommends that children remain facing backwards until at least age 2. Your baby has outgrown the infant carrier if their head is above the top or their feet protrude below the bottom. Now is the time to get a convertible 5-point harness and install it to be rear facing.