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Well Baby Visit: 18 Months

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This is a big and important visit. Your child is due for a lot of immunizations, his growth should be evaluated, and sleep and discipline issues are usually on parents' minds. You don't want to miss this one or settle for a "shots only" visit. From the provider's perspective, this visit is expected to be the most challenging. Don't be surprised if your toddler isn't the least bit cooperative. Wiggles and cries are expected.

  • Your baby may need booster shots for vaccines he's already had in addition to some new vaccines. Check your immunization schedule and double-check with your provider to make sure your baby's shots are up to date.
  • Dress your toddler in a two-piece outfit that comes off easily. Plan to keep him on your lap for most of the examination. Bring one or two familiar toys. Snacks will also help you get through this visit.

At this visit, your provider will probably:

  • Weigh and measure your child. Click here to see our growth chart.

  • Give you insights into your toddler's development and emotional growth.

  • Go over his development to be sure he's on track.

  • Talk about discipline issues.

    Your provider will want to know:

    • Has your baby seen another health care provider since the last visit? If so, why? What was the outcome of that visit, and were any medications or treatments prescribed?
    • How are your baby's walking, running, and climbing skills? Can he walk backward?
    • How are his language abilities? What's he saying? Is he putting words together yet? How many words does he have?
    • Does he understand one-step commands such as "Get your shoes" or "Bring me a diaper"? Can he listen to and follow a simple story? Does he look at the pictures in a book?
    • Does he respond to simple requests or simple games like peekaboo?
    • How does he play? The type of play a child engages in tells us about cognitive abilities. Does he imitate you at household tasks? Can he stack blocks?
    • Can he use tools such as a spoon or a fork or use one toy to get another?
    • Is he starting to say "no" and have temper tantrums? These are good signs of emotional and cognitive growth.
    • Can he pull a toy along the ground?
    • Can he use a spoon and drink from a cup?
    • Can he point to any body part when asked?

    Talk It Over

    Most parents are concerned about three things at this age: diet, discipline, and getting their child to bed. These confusing and troublesome issues are all related to your baby's growing sense of independence. Other concerns may include how to manage "no's" and temper tantrums, and how to get your child to eat.

    • Diet. Let your provider know what your child is eating these days. If your baby is still taking a bottle, talk about weaning him from it. If you think your baby is such a finicky eater that he isn't getting proper nutrition, talk it over with your provider. If you're giving your baby good food, his diet is probably fine. His weight gain will tell your provider if he's eating enough. Appetite and rate of growth fall off in the toddler years. He should use a spoon, and at least drink from a sippy cup. Ask about vitamins and fluoride.
    • Discipline. Let your provider know if your toddler seems hard to control. Discuss the steps you take when you discipline your child — what works and what doesn't.
    • Sleep. Sleep issues are common at this age. Try keeping a diary of your child's sleeping patterns for at least three days and bring it to the visit. Your provider will be able to suggest solutions for you. Helping kids settle down means developing good patterns. No bottles in bed, please.

    Speak Up!

    Let your health care provider know:

    • If your baby has a wandering eye that still wanders, even once in a while.
    • If your baby gets very close to things to see them better, especially if poor vision at early ages runs in the family.
    • If your baby seems especially sensitive to light or sound.
    • If your baby isn't walking yet, is walking on his toes, or limps or tilts to one side when he walks.
    • If your baby seems to be using only one hand when he plays, handles things, or reaches for objects. If your baby is already very right- or left-handed, he will use one hand more often when he eats and points. But he should use both hands equally when he plays.
    • Can't put two objects together in play — is still playing with one object at a time.
    • If he doesn't take a spoon when you offer it to him.
    • If he doesn't feed himself.
    • If he's lost skills he had before.
    • If he has no real words.
    • If he shows no affection. If you no longer have health insurance for your child. There are programs available to get that coverage. Raising children can bring great joy, but it's also very challenging, as every parent knows. If you're feeling stressed out, talk it over with your child's health care provider.
    This is extremely important if you:

    • Feel out of control.
    • Hit your baby when you feel out of control.
    • Leave a mark or bruise on your baby with spanking.
    • Are experiencing a lot of changes in your family or day care situation. These can really affect young children.

    Click here to return to Well Baby Introduction.


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