Parent Information (12 - 18 months)

Healthy Child Visits by Age

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We encourage all parents to schedule health baby appointments.

Vaccines

View our Immunization schedule.

If your child seems fussy or uncomfortable, we recommend giving a dose of Tylenol. This can be repeated once every 4 hours as needed.

12-months

General Information

Your child is becoming more independent each day. In addition to developing their own preferences, many children begin walking at this age. This adds to their ability to assert themselves. Thus, safety is a primary concern at this stage. Your toddler must be watched constantly, first as she develops stability while walking, and then later as she begins to climb and explore.

Most 12-month-olds can understand “no” and realize that there are certain unacceptable behaviors, such as biting, hitting, and kicking. Firm and consistent discipline is best. Tactics such as saying “no” and social isolation (time out) for 1-2 minutes in a crib or pack-n-play can be very effective. Avoid shouting or spanking. For lesser infractions, such as arguing over toys, distraction is useful.

Temper tantrums may begin at this age. One of the most effective ways to discourage these is to be sure your child is in a safe location and then ignore her during the tantrum.

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Diet

Your toddler’s activity will increase, but you may notice a decrease in her appetite. She may eat very well at one meal, and then just pick at food for the rest of the day. This is normal. Continue to offer healthy, regular meals and snacks. Do not worry if she does not finish all of her food. Continue to avoid small, hard foods and be sure to cut up any round foods such as hot dogs or grapes. Now is the best time to transition completely to a cup. Begin offering a spoon at meals. Continue to limit juice intake to 4 ounces per day or offer none at all. Juice is not a good source of calories and can lead to dental decay. Water is a better alternative.

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Dental Hygiene

Remember to brush your child’s teeth with a soft brush twice daily. Half of all 2-year-olds have signs of cavities! Also, do not put her to bed with a bottle—this leads to bottle caries, or decay of the front teeth. If your child does still take a bottle or nurse at nighttime, it is best to wipe her teeth down with a rag after feedings.

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Safety Reminders

Continue to review your home’s safety. Pay particular attention to ovens/burners, dangling cords, exposed wires, plastic bags, small objects, sharp objects, windows, stairs, water and guns. Think about how heavy items (such as TVs and furniture) are arranged, as they can topple on children. Never leave your child alone in the bathtub. Post the Poison Control Center number (1-800-222-1222) near your telephone.

After 1 year of age and 20 pounds, your child can face forward in her car seat. The AAP recommends your child remains rear-facing til 2-years of age as that is the safest position. If your car seat will tolerate a greater height and weight facing backward, you can wait to turn the seat around until she exceeds those limits. The rear-facing position is the safest. There should only be a finger’s width of space between her collarbone and the harness strap. She should remain in the back seat of your vehicle until age 11.

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15-months

General Information

Your child is becoming more adventuresome, climbing and exploring everything in his environment. He has no sense of danger and needs constant supervision. Often, his desire to try new things, especially if they are too difficult for his current physical abilities or he does not have adequate language skills to communicate his wants, results in frustration. The frustration then boils over into temper tantrums. You can help limit frustration by allowing him to explore safe environments freely. Distraction is also a good tactic when what he is currently focused on would be dangerous or unacceptable. Be calm and consistent with your responses. For unacceptable behaviors such as biting, hitting, or kicking, 1-2 minutes of social isolation (time out) in a crib or similar environment is an effective deterrent. Avoid shouting or spanking.

Most children this age will show an increase in imitative behavior such as sweeping, dusting, and playing with dolls. Support this by providing toys that encourage imaginative play such as stuffed animals, small cars and musical instruments.

Generally, your child will only have a few words in his vocabulary at this point, but he will understand much more. Build your child’s verbal skills by reading to him daily, having him point out pictures in books, and narrating his gestures (for example, "do you want your cup?").

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Diet

Children at this age can be picky in that they will eat well at one meal and then not much at the next. This is normal and should not be a concern as long as your child is growing well. You can combat this pickiness by providing nutritious snacks between meals. Avoid getting into battles over food with your child.

Children at this age should be eating table food. They often enjoy feeding themselves with their fingers or a spoon. Avoid choking hazards such as nuts, bacon, popcorn and chewing gum. Cut up any round foods such as hot dogs or grapes.

Limit juice to 1 cup per day, as it is not a source of good calories. By now, your child should no longer use bottles.

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Media Exposure

For children under two years of age, the American Academy of Pediatrics recommends no television exposure at all. If you do allow your toddler to watch TV, be sure the programming is age-appropriate and limit it to less than 1 hour per day.

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Oral Hygiene

Brush your child’s teeth daily with a soft toothbrush. If you use toothpaste, be sure it is fluoride-free until she can spit on command. Never put your child to bed with a cup or a bottle. This can result in tooth decay. While most children no longer get nighttime feedings at this age, those who do should have their teeth wiped down with a rag afterward to prevent cavities.

There are differing recommendations regarding when to visit the dentist for the first time. Generally, our practice recommends waiting until 2 years of age unless you have concerns regarding your child’s teeth.

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Safety Reminders

  • Keep safety caps on all medicines and toxic household products. Always call the Poison Control Center at 1-800-222-1222 for accidental ingestions. Keep this number posted by your phone in case of emergency.
  • Protect your child from sunburns during warmer months.
  • Never leave your child alone in or near a bathtub. Always drain water from any large container (such as a bucket or the tub) immediately after use.
  • Secure all firearms unloaded. Keep the ammunition locked in a separate location.
  • Your child should be in the back seat of your vehicle. He should remain rear-facing until he is 20 pounds.

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18-month

General Information

Now that your toddler understands the concept of choice, she often asserts her opinion. Providing her with two acceptable options (for example, red socks or blue socks, bananas or cheerios) can minimize conflicts. Set firm, consistent limits that are followed by all caregivers. Both distraction and time out remain good methods of discipline. Time out should take place in a safe environment such as a crib or playpen and last between 1-2 minutes.

While toddlers this age are seemingly independent, they often cling to their parents in unfamiliar environments. Allow your child to warm up slowly in new situations.

Language progresses rapidly at this age. Read to your child every day. Encourage your child to repeat new words. Have her point out or name familiar objects. She should be able to follow simple commands such as "bring me the ball" or "put this in the trash" without a gesture to provide clues about your request.

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Diet

Nutritional requirements remain relatively small at this age. Food likes and dislikes continue to change as your child is progressing through a stage of independence. Do not get into battles regarding your child’s eating, but refrain from limiting menu options to only those foods your toddler likes. Combat pickiness by offering healthy snacks such as fruits and vegetables between meals. Limit juice to 1 cup per day. Offer milk or water instead. For those children who tend to fill up on milk prior to eating their meal, offer table food first. Try to eat meals together as a family without the TV on.

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Dental Hygiene

Brush your child’s teeth once or twice daily with a soft toothbrush. If you use toothpaste, be sure it is fluoride-free until she can spit on command. Never put your child to bed with a cup. This can result in tooth decay.

There are differing recommendations regarding when to visit the dentist for the first time. Generally, our practice recommends waiting until 2 years of age unless you have concerns regarding your child’s teeth.

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Potty-Training

While some children begin to show interest in toilet training at this age, it is important to remember the average age for daytime dryness is 30 months. You can encourage readiness by reading books about the potty, allowing her to follow you into the bathroom to learn the routine, and providing a potty chair for her. Praise her when she is successful.

Here are some signs your child is ready to potty-train:
  • She stays dry for two hours at a time.
  • She is able to pull her pants up and down.
  • She knows the difference between wet and dry.
  • She tells you after she has soiled a diaper.
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Safety Reminders

At this age, all play should be supervised. Make sure toys are age-appropriate to avoid choking hazards.

Continue to inspect your home for potential dangers. Stabilize heavy furniture that could topple if a child climbs on it. Never place containers with hot liquids close enough to the edge of a counter to be within reach of your toddler. Also avoid placing heavy objects or containers of hot liquids on table cloths your toddler could pull down. Shorten cords that dangle from blinds or other window coverings. Hide exposed wires and cover plugs. Keep safety caps on all medicines and toxic household products. Post the Poison Control Center number (1-800-222-1222) by your phone for accidental ingestions.

To prevent accidental drowning, drain water from buckets and bathtubs immediately after use. Never leave your child alone in or near a bathtub. Be sure to apply sunscreen liberally during warmer months. Secure all firearms unloaded and lock ammunition in a separate location. When traveling, your child should always be in an appropriate car seat in the rear of the vehicle.

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Additional Resources

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