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18 Months


The Hepatitis A booster will likely be given today. If your child is behind, we will try to update him/her as well.



Growth is slower now than at younger ages, so it may appear that your child is not eating enough. Be relaxed at mealtime and avoiding making eating a battle. Toddlers may choose only certain foods some days, but if given healthy food options, they will typically get enough from each of the food groups on average…

milk & dairy (2 servings/day)
meat & protein (4 servings/day)
fruits & veggies (4 or more servings/day)
bread & cereal (4 servings/day)

It may take some creativity to get some of these food groups in your child depending on current “food jags”. Don’t distress, but talk to your provider if you need more suggestions. Your child should not drink more than 24 oz of milk/day.


Teeth:  Dental care is very important. By this age your child should definitely be off the bottle. Continued use of the bottle will cause tooth decay as will sipping on juice or milk all day long or through the night. Continue daily tooth care by wiping teeth with a cloth or using a toddler tooth brush twice a day. It is okay (but not necessary) to use a pea-sized amount of tooth paste. Always assist to get back teeth and on the inner aspect of the teeth. A child is not capable of brushing teeth adequately until s/he has the dexterity it takes to tie shoes!

Sleep:  On the average, your child should be sleeping 12 hours at night with an afternoon nap. If s/he awakens at night, go to the beside and let him know you are there. BUT don’t reinforce the wakefulness by rocking, giving a drink, or continually going to his room. Do not let your child sleep in your bed or your room. S/he needs to learn that parents have a relationship that does not include him/her. Children will typically sleep as much as they need, so if your child sleeps less than 12 hours but is alert and active, s/he has slept enough.

Elimination: The muscles for bowel and bladder control are not yet fully developed. Your child may begin showing an interest in toilet training, however, do not push too hard or you may frustrate your child (and yourself). Your child needs to be ready, mentally & physically, before training begins. To be ready for toilet training, your child has to be able to recognize the urge, tell you about it, get to the toilet, pull down pants, and then release urine or stool. In addition, s/he should want to use the toilet. It is often best to have a potty chair for your child.

You may consider buying the book, Toilet Learning, by Alison Mack, published by Little, Brown, and Co., 1978. It is a good book to read to your child to help with understanding about proper elimination. Remember to teach your child to wash their hands after each use of the bathroom.


Toddlers need to spend a lot of time with their parents, because they learn by copying their parents’ examples (be sure your child has a good example to copy). Do not leave your toddler unattended as s/he is fast and can get into trouble before you know it. Your child does not yet have the common sense to know what’s dangerous.

Toddlers like simple things like a ball to kick and throw, toys made to ride, large crayons, building blocks, simple puzzles, naming games, and simple picture books. Your child may also like music to listen to and dance to. It is still very important to read to your child.

Most television programs are not appropriate for children. They understand and misunderstand much more than you might think!! Sesame Street and other educational programs help children learn, however, most other shows demonstrate violence, even many cartoons. Before turning on the television, think about what your child may see. Limit television viewing to 1 hour or less a day.



  • Continue to use a car seat when traveling. A 5-point harness is needed until 40 pounds. The back seat is always safest for children under 12 years of age, and they must be in the back seat if the car has a front passenger side air bag.

  • Be burn cautious!! Check hot water temperature, keep pot and pan handles turned in, and don’t leave hot liquids near table edges.

  • Don’t let children play with plastic bags or balloons.

  • Dangerous substances (medicines, chemicals, etc) need to be out of reach of exploring hands, and remember that your child may surprise you with his or her ability to climb! You may need to lock them up.
    Poison Control 1-800-222-1222.

  • Be careful with children around mowers, snow blowers, and other power tools.

  • Prevent drowning!! Never leave your child unattended near the bathtub or pool.

  • Supervise children when near the street or parking lot and continue street safety instruction.

  • Remember SUNSCREEN DAILY!!!




Provide safe settings for your child to develop balance and climbing skills.


  • walks up stairs with one hand held

  • kicks and throws a ball

  • stacks 3-4 cubes

  • scribbles

  • uses cup well; starting to use a spoon


It is normal for your child to be anxious in new situations. Be reassuring and take on adventures together!

  • puckers lips and kisses; shows affection spontaneously

  • imitates house or yard work

  • laughs in response to others

  • explores alone if parent is in close proximity


Continue reading and singing with your child and talk about what you are seeing and doing together.

  • advancing vocabulary, at least 4-10 words

  • starting to combine words

  • able to follow simple directions


Next appointment at 2 years of age!!

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