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Well Child Care > Well child care: 18 Months

Well child care: 18 Months

Information regarding developmental goals, safety, immunizations, and nutrition information.

Developmental Goals

  • Toddlers climb; be sure to keep poisons and other dangerous items out of reach. Make sure furniture is stable.
  • At 18 months toddlers can point to objects in books and name them.
  • Spoon and fork use is improved, but many prefer using fingers to feed for many years!
  • Helps with housework by bringing objects to you.
  • Removes their clothing and points to body parts. Practice naming body parts.
  • Vocabulary of 15-20 words. Teach colors, animal sounds, alphabet, counting, shapes... the more you talk about, the more they learn!
  • Begins to kick a ball, throw overhand and should walk well.
  • Reading is essential at this age!
  • Screen time: If you choose to allow your toddler to use screen media, look for high-quality age appropriate programming and games. Watch programs with your children to help them understand what they're seeing. Use the Family Media Use Plan tool from the AAP.
  • Click here for information on potty training.
  • See also Speech Development

Sleep

  • At this age, children sleep 11-12 hours at night and nap for 2 hours once a day commonly.
  • Resisting bedtime is common.

Health

  • Continue to wipe or brush child’s teeth daily.
  • We offer fluoride varnish at well visits until you establish care with a pediatric dentist.
  • For more on dental care, see our dental pages.
  • Smoking in enclosed places allows smoke dust to settle on clothes and hair. When held, the child inhales the smoke dust and can develop allergies, asthma and ear infections. Never smoke around your child or in the home or car - even if the child is not present at the time.
  • If you choose to stop the pacifier, there are many methods. Some parents choose the cold turkey method. Others keep it in the crib only for a few weeks, then stop it. Some will cut off the tip, so the child loses interest. See our Thumbsucking and Pacifier page for more information.
  • For fever, use Acetaminophen (Tylenol) or Ibuprofen as directed. Dosing chart is on our medication page.

Immunizations

  • Fever is common after shots for 1-2 days. Only give Acetaminophen every 4-6 hours as needed for symptoms. It is no longer recommended to prevent the fever due to the fact that it might lessen the effectiveness of the vaccine.
  • Bring your shot record each visit.
  • Review the VIS (Vaccine Information Sheet) before visits.
  • Flu (Influenza) shots are recommended each Fall.

Discipline

  • Ignore tantrums. Do not show that tantrums bother you.
  • Reward good behavior frequently with smiles, compliments and hugs.
  • They are too young to expect social perfection - set appropriate expectations.
  • When sick or tired, expect more difficult behavior.
  • Keep consistent routines.
  • Time out can begin when a child is verbal enough to understand.

Safety

  • Continue keeping medications/poisons locked and out of reach.
  • Toddlers fall frequently so watch them carefully. Cold compress reduces swelling of head bumps.
  • If child loses consciousness, vomits after a head injury, pupils are different sizes or child does not recognize you, take to the emergency room.
  • Remove sharp edged furniture or cover edges with safety bumpers.
  • Avoid burns by monitoring stoves, iron, curling iron, and fires.
  • Keep water temperature below 120° F.
  • Keep cigarettes, matches and lighters out of sight and reach.
  • Child can drown in less than 2 inches of water. Never leave unattended around any water, including toilets and buckets.
  • Keep guns unloaded and locked up with ammunition locked up separately.
  • Use sunscreen frequently.
  • Continue to use car seat (never in front of an air bag). It is recommended to keep kids rear facing until 2 years and 30 pounds. See our Car Seat page for more information!
  • Avoid lawn mowers, farm equipment, garage doors, and streets.
  • Do not pour unused medication into drains or toilets. For information on how to safely dispose of medications, click here.
  • All parents should learn CPR and refresh skills every 2 years. For a list of CPR classes for both non-medical and medical professionals, use a search engine to look for "CPR" with your zip code.
  • We recommend keeping toddlers rear facing in the car seat until 2 years and 30 pounds.
  • Keep bulky clothing off the child in the car seat, it does not allow proper fit of the seat belt. Use blankets for warmth as needed.
  • Click here for more over all safety information (i.e. bug safety, sun safety, internet safety, etc.)!

Diet

  • Offer a variety of food.
  • May have less appetite as growth slows.
  • Never force your child to eat.
  • Limit sugary snacks and pop - a child never needs soda pop! Don't start bad habits now.
  • Limit juice and minimize sugary snacks. Juice offers little nutrition and has a lot of sugar! The American Academy of Pediatrics (AAP) recommends no fruit juice for children under 6 months of age and limiting 100% fruit juice intake to 4-6 ounces per day for children ages 1-6 years and 8-12 ounces per day for those ages 7-18 years. 
  • If your child is still on a bottle, stop it now. The longer they continue it, the harder it is to break the habit. Your child is a toddler, not a baby anymore! Bottles are not healthy at this age for many reasons.
  • Continue whole or 2% milk, up to 24 oz. a day. You may use toddler formula if preferred. If your child doesn't like milk (or is allergic to it) he or she can get plenty of calcium and protein from other sources, so there is no minimum they need to drink. 
  • All children are recommended to take a Vitamin D and iron supplement. Click here for more information on Vitamin D.
  • Click here for more age-specific feeding recommendations.

Be sure to obtain any required health forms at your well visit!

WIC (Women, Infant, and Children) provides nutrition counseling, breastfeeding support, and food to families who have needs. In 2011 a household of 2 who earns a gross income of less than $26,955/year or a household of 4 who earns less than $40,793/year may be eligible. For more information click here.

Click here to request an appointment for your child's 18 month well care appointment.

Insurance

Review your insurance contract to see who is responsible for payment of specific things within your well visit. Many companies do not require a co pay for well care visits, but if additional topics are discussed (such as ill topics or refills of medications) they might require a payment from you. They might also require you to pay for all or part of any labs or testing done at well visits.

If you have questions about how your insurance handles codes performed at the time of well visits, please visit our insurance pages on patient responsibility with billing and Why am I being billed? I have insurance!

Find health information quickly in our parent toolkit.

Illnesses & Symptoms