Well Child Visit: 18 Months

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 healthcare 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 child'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 healthcare 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 child'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 toddler'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 toddler is still taking a bottle, talk about weaning her from it. If you think your baby is such a finicky eater that she isn't getting proper nutrition, talk it over with your provider. If you're giving your child good food, her diet is probably fine. Her weight gain will tell your provider if she's eating enough. Appetite and rate of growth fall off in the toddler years. She 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 healthcare provider know:

  • If your toddler has a wandering eye that still wanders, even once in a while.

  • If your child gets very close to things to see them better, especially if poor vision at early ages runs in the family.

  • If your child seems especially sensitive to light or sound.

  • If your child isn't walking yet, is walking on her toes, or limps or tilts to one side when she walks.

  • If your toddler seems to be using only one hand when she plays, handles things, or reaches for objects. If your child is already very right- or left-handed, she will use one hand more often when she eats and points. But she should use both hands equally when she plays.

  • If she can't put two objects together in play — is still playing with one object at a time.

  • If she doesn't take a spoon when you offer it to her.

  • If she doesn't feed herself.

  • If she's lost skills she had before.

  • If she has no real words.

  • If she 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 at times, as every parent knows. If you're feeling stressed out, talk it over with your child's healthcare provider.

This is extremely important if you:

  • Feel out of control.

  • Hit your baby or child when you feel out of control.

  • Leave a mark or bruise on your child with spanking.

  • Are experiencing a lot of changes in your family or day care situation. These can really affect young children.