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Guide for the Care of Children Online Manual

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Well checkup: 18 months

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Development

At this age, your child may:

  • walk fast, run stiffly, walk backwards and walk up stairs with one hand held
  • sit in a small chair and climb into an adult chair
  • kick and throw a ball
  • stack three or four blocks and put rings on a cone
  • turn single pages in a book or magazine, look at pictures and name some objects
  • speak four to 10 words, combine two-word phrases, understand and follow simple directions, speak two or more wants or needs and point to a body part when asked
  • pull a toy
  • imitate a crayon stroke on paper
  • feed herself, use a spoon and hold and drink from a sippy cup fairly well
  • use a household toy (like a toy telephone) well

Feeding tips

  • Your child’s food likes and dislikes may change. Do not make mealtimes a battle. Give your child a good example with your own food choices.
  • Offer your child a variety of healthful foods. Your child should decide how much he eats.
  • To see if your child has a healthful diet, look at a four- or five-day span to see if he is eating a good balance of foods from the food groups.
  • Limit sweets and fast foods.
  • Do not offer food as rewards.
  • Your child does not need juice.
  • Teach your child to wash his hands and face often.
    This is important before eating and drinking.
  • Your child needs at least 800 mg of calcium and 400 IU of vitamin D each day.
  • Milk is an excellent source of calcium and vitamin D.

Toilet training

  • Your child may show interest in potty training. Signs he may be ready include dry naps, use of words like "pee pee," "wee wee" or "poo," grunting and straining after meals, realizing the need to go, going to the potty alone and undressing.
  • For most children, this interest in toilet training happens between the ages of 2 and 3.

Sleep

  • Your child's nap schedule may vary from no naps to two naps each day. If your toddler does not nap, you may want to start a "quiet time." Be sure to use this time for yourself.
  • Your child may have night fears. Use a night light or open the bedroom door to help calm fears.
  • Choose calm activities before bedtime. A consistent bedtime is best.
  • Continue your regular nighttime routine: bath, brushing teeth and reading.

Safety

  • Use an approved car seat for the height and weight of your child every time he rides in a vehicle.
  • The safest way for your child to ride is in a rear-facing car seat properly secured in the back seat. You are strongly encouraged to keep your child rear-facing until age 2.
  • Be a good role model for your child. Do not talk or text on your cell phone while driving.
  • Protect your child from falls, burns, drowning, choking and other accidents.
  • Tip

    Your child is not too young to start having regular blood pressure checks. High blood pressure (hypertension) may be a sign of an unknown disease. If not treated, high blood pressure can cause serious illness.

  • Keep all medicines, cleaning supplies and poisons out of your child's reach. Call the poison control center (1-800-222-1222) or your health care provider for directions in case your baby swallows poison. Have these numbers handy by your telephone or program them into your phone.
  • Do not leave your child alone in the car or the house, even for a minute.

What your child needs

  • Your child may become stubborn and possessive. Do not expect him to share toys with other children.
  • Give your child strong toys than can pull apart, be put together or be used to build. Stay away from toys with small or sharp parts.
  • Your child may become interested in exploring your home. If possible, let him play with pots, pans and plastic dishes or "help" with simple chores like sweeping.
  • Make sure your child is getting consistent discipline at home and at daycare. Talk with your daycare provider if this isn't the case.
  • Praise your child for positive, appropriate behavior. Your child does not understand danger or remember the word "no." Distract or prevent your child from getting into dangerous or negative behavior.
  • Ignore temper tantrums. Make sure your child is in a safe place during a tantrum, or hold him gently but firmly.
  • Read to your child often.
  • Consider joining a parent child group, such as Early Childhood Family Education (ECFE) through your local school district.

Dental care

  • Brush your child's teeth one to two times each day with a soft-bristled toothbrush You do not need to use toothpaste. If you do, use a very small amount. Let your child play with the toothbrush after brushing.
  • Using bottles increases the risk for cavities and ear infections.
  • Make regular dental appointments for cleanings and checkups starting at age 3 or earlier if there are questions or concerns. (Your child may need fluoride supplements if you have well water.)

 

Source: Allina Health's Patient Education Department, Guide for the Care of Children: Ages Birth to 5 Years Old, fifth edition

To avoid awkward sentences, instead of referring to your child as "he/she" or "him/her," this guide will alternate between "he" or she" and "him" or "her."

First published: 02/01/2010
Last updated: 01/01/2014

Reviewed by: Allina Health's Patient Education Department experts, including the Pediatric Department of Allina Health Coon Rapids Clinic