Eighteen Month Well Child Visit

Vaccines

Side Effects

  • Some side effects include fever, irritability and fussiness, excessive crying, vomiting, sleepiness and swelling at injection site among others.
  • Give 1.2 ml (1 ½ dropper) of Tylenol Infants’ Drops twice if needed.

Feeding

  • Wean from bottle.
  • Offer whole milk (16-24 ounces/day).
  • No 2% or skim milk until two years of age.
  • Offer three meals and three snacks daily.
  • Let child decide how much to eat, you pick the foods.
  • Set a good example - eat healthy!
  • Eat as a family.
  • Encourage self-feeding even if messy.
  • Always supervise eating.
  • Avoid choking foods (nuts, popcorn, carrots, raisins, hard candy).

General Care and Safety

  • Use safety seat in the back seat of the car.
  • Childproof your home.
  • Encourage safe exploration.
  • Supervise baby at all times especially near water, pets, cars, stoves and tablecloths.
  • Brush baby’s teeth with a soft toothbrush and water.
  • Limit sun and use sunblock.
  • Praise good behavior.
  • Set limits and routines, be consistent and reasonable.
  • Delay toilet training.
  • Children may have nightmares.
  • Discourage aggressive behavior.
  • Use discipline such as “time out” to teach a lesson – not to punish.

Play

  • Talk, sing, and read together.
  • Play interactive games.
  • Offer simple and fun tasks.
  • Create routines such as a bedtime story.
  • Start naming parts of the body and the environment.
  • Do not use baby talk.
  • Avoid using the word "No".
  • Allow self-expression and choices.
  • Don't expect child to share all toys.
  • Go on short family outings.

Eighteen Month Child Milestones

Physical and Moter Skills

  • Walks well and runs.
  • Climbs up stairs and onto furniture.
  • Stacks two or three blocks.
  • Throws a ball overhand.
  • Places and removes items from containers without demonstration.
  • Uses a spoon and a cup.
  • Able to take off some clothing.

Sensory and Cognitive Skills

  • Says about fifteen to twenty words.
  • Imitates words.
  • Uses two-word phrases.
  • Names objects and points to some body parts.
  • Understands one-step commands.
  • Listens to a story and looks at pictures.
  • Imitates household tasks.
  • Shows affection, gives kisses.

Developmental Health Watch

Although each child develops in her own individual way and at her own rate, failure to reach certain milestones may signal medical or developmental problems requiring special attention.

If you notice any of the following warning signs in your infant at this age, discuss them with your pediatrician.

  • Not walking well.
  • Uneven walk or limping.
  • Frequent falling forward when walking.
  • Does not make eye contact or gestures (pointing, etc).
  • Uses less than five to ten words.
  • Does not try to feed self.
  • Loss of previously known skills.