18 Months Checkup

Height: ____  Weight ____  Head Circ: ____

FEEDING: By now, your child should be eating most of the same foods that you are. Still avoid choking hazard foods (nuts, hard candy, popcorn, gum, raisins). Your child may still alternate between eating well one day, and being picky the next. This is still normal. The bottle should be gone by this age.

ELIMINATION: Bowel movements will vary from several per day to one every 3-4 days. Frequency is not as important as consistency of the stool … they still should be soft and easy to pass. Some children are ready to begin toilet training at this age. However, they must be able to recognize the urge to hold and to go, and be able to communicate this to the parents. Also important is that the sensation of a “dirty diaper” is recognized as negative to the child. If not, they have no real reason to want to go in the toilet. Try not to rush the process, and allow the child to watch the same sex parent use the toilet, and mimic if desired. There are numerous “potty books” that are good to add to your reading routine at this age to introduce the idea.

SLEEP: Sleeping needs will decrease gradually, but 8-10 hours solid is the norm for this age group. He should sleep in his own bed and bedroom. Naps vary from none to one, or even two short ones. A consistant bedtime routine is important. Providing time to help the child slow down is recommended an hour before bedtime. Quiet activities include: reading stories, playing in the bath, listening to music or appropriate TV. We do not recommend having a TV in the child’s bedroom.

DEVELOPMENT:

• Runs clumsily, falls often
• Pulls and pushes toys, throws ball overhand
• Knows 10 or more words, wants caregiver to “label things”
• Builds a tower of 3-4 cubes
• Knows names of common objects, and can retrieve them even if not actually saying the words yet.
• Some ownership awareness begins to develop… “my toy”

PLAY:

• Stacking blocks, push-pull toys
• Read stories
• Large balls to kick, throw, and run after
• Fill and dump toys, play telephone
• Let child help dress and undress herself
• Mimics “chores”… may want to help wash, cook, clean up

SAFETY:

• Use outlet covers, hide wires, lock cabinets.
• Use an approved car seat … forward facing if one year and 20 pounds!
• Have Poison Control Number on hand (589-8222). Syrup of Ipecac is NO LONGER RECOMMENDED BY THE AMERICAN ACADEMY OF PEDIATRICS
• Never leave child unattended around sources of water: Bathtub, toilet, swimming pools, bucket of water
• Administer medications as a drug, not as candy
• Teach the meaning of HOT!

SMOKING: Do not smoke around your baby, or even in the house or the car. Exposure to cigarette smoke has been linked to numerous illnessess: crib death, ear infections, pneumonia, bronchitis, allergies, and growth retardation. Keep in mind, too, that you are your child’s most trusted role model. Do you really want your child to smoke?

CARE OF TEETH: Use child size toothbrush and small amount of non-fluoride toothpaste. Let child brush, then the parent finishes the job.

DISCIPLINE: There are as many theories about discipline as there are for toilet training. The essential ingredients are: firmness and consistency. Discipline for toddlers involves saying “no” when they perform an unpermitted act. Correction must follow immediately after the wrongdoing, not hours later. Remove valuable, breakable articles, and reduce the number of “trouble spots” to minimize the need to correct “curious” behavior.

Toddlers say “no” to many things. This is a necessary assertion of self-control. Reduce the opportunities for him to say “no”. Instead of asking “Do you want to go to sleep now?” positively state, “Let’s get ready for bed.”

Parents are role models for children. They learn by watching, listening, and mimicking. Be sure what you are saying and doing is actually what you want them to learn!!!

Temper tantrums: Toddlers assert independence by violently objecting to discipline, including laying on the floor, kicking, screaming, and holding their breath. Tantrums often peak at this age. The best approach is to ignore the episode … even negative attention is attention, and that is what they seek. Even scolding gives the child a form of attention. After the tantrum is over, the child needs to feel some control and security. A different toy or favorite activity can be substituted for the ungranted request.