Age: 18 Months

July 06, 2020

Eighteen months can be a challenging age of balancing a child’s growing independence and confidence with his or her limited ability to communicate. This leads to frustration and temper tantrums that are typical for this age. Patience, consistent boundaries, gentle transitions, and improving verbal abilities will help significantly during this time.

Safety

  1. Car: Use a Convertible Car Seat in the back seat of the vehicle, rear-facing.

    1. Important Note: As of 11/2018, the American Academy of Pediatrics (AAP) recommends car seats remain rear facing as long as possible, until the child reaches the highest weight or height allowed by the seat. This replaces the previous age specific milestone of 2 years and 30 lbs. The recommendations are based on scientific studies showing that rear facing is safest in a crash.

    2. For help securing the seat make an appointment with a Nationally Certified Child Passenger Safety Technician (to find a location nearest you visit https://highwaysafety.utah.gov/seat-belts-and-car-seats/car-seat-safety/).

  2. Sleep:

    1. The crib is the safest place; slats less than 2 3/8 inches apart; place the mattress at the lowest setting of the crib.

    2. You may put mesh/breathable bumpers back into the crib if your baby is a wild sleeper and arms and legs are getting stuck outside of the slats.

  3. Childproofing: Injuries are a big concern at this age. Toddlers this age will manage to get into everything and usually don’t have innate fear of getting hurt to stop them. Toddlers can climb onto and fall off of anything.

    1. Use outlet covers.

    2. Be very cautious about stairs. While they are getting more adept and going up and down at this age, we still see many injuries from falling down the stairs.

    3. Store matches/chemicals/medications/cleaners/toxic household products out of reach or locked.

    4. Burns are common at this age, both by pulling hot things down onto themselves (e.g., cords from curling irons, handles from pots) and touching hot surfaces (e.g., fireplaces, grills, stovetops, etc.)

    5. Lock guns with ammunition separate and in a gun safe

  4. Water: Don’t leave unattended in the bath tub and keep water heater at less than 120 degree F (to prevent scalding).

  5. Smoking: Do not smoke in the home or in your car.

  6. Sun: Limit sun exposure, use sunscreen when outside.

  7. Helmet: Wear a helmet on all things a kid can ride (e.g., bicycles, tricycles, scooters, ATVs, as passengers on adult bicycles, etc.).

Nutrition

  1. Continue whole milk from 1-2 years of age. If your child doesn’t tolerate/care for whole milk just ensure your child is getting enough calcium and vitamin D from other sources (e.g., almond milk, milk products, supplements, etc.).

  2. Should be eating all table foods (no baby style foods). The only diet limitations are foods that seem to cause your child grief/allergies.

  3. No bottles at this age. Use a cup (can by sippy style) for fluids.

  4. Ensure your child is getting plenty of water.

  5. Limit juice to no more than 4 oz. a day (no juice is the best).

  6. May need supplementation of a multivitamin (with or without iron depending on how good your child is about eating a balanced diet).

Sleep

  1. Should be sleeping through the night and in a crib still.

  2. Usually transitioned to one nap a daily instead of two.

  3. Total sleep should be 11–14 hours in a 24 hour time period (including naps).

MILESTONES

  1. Running everywhere.

  2. Climbing on everything (can navigate pushing a chair up to a counter/table to climb on top).

  3. Twenty words with lots of babbling that imitates speech (e.g., voice inflection).

  4. Understands and follows commands (e.g., go get the ball).

  5. May be independent one minute and clingy the next.

  6. Points with index finger.

  7. Feeding self, good at using a fork and spoon.

ORAL HEALTH

  1. Brush teeth twice daily with a non-fluoridated toothpaste.

  2. May need fluoride supplementation (depending on the content of your local water source).

Illness

At this age you may treat fever and minor illnesses at home as long as your child looks and acts ok. Bring your child to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.) or you are concerned.

YOUR NEXT VISIT

Your child’s next well child check is at 2 years of age. If all shots are caught up, there shouldn’t be any routine vaccines. Depending on the time of year, your child may need a flu shot (remember, the first time your child gets a flu shot, he/she will need a booster/2nd dose 30 days later).

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