Well Baby Report - 18 Month Guide

What to expect at your 18-month visit
Topics you and your doctor may discuss at your child's 18-month visit include:

• Safety issues. Safety is a major concern. Read "toddler safety issues" (later in this document) and discuss concerns with your doctor.
• Temper tantrums. Your child may now be having occasional temper tantrums. Remain calm and let your child get over them on his/her own. If tantrums become a frequent issue, discuss this with your doctor.
• Toilet training. Your 18-month-old infant is not ready for toilet training, no matter what everyone else is telling you!
• Sharing. As your child spends more time with peers, don’t expect him/her to be good at sharing yet.
• Body curiosity. Your child may become curious about body parts, including genitals.

• DTP series (#4) (15-18 months)
• HBV Hepatitis B virus(#3) (6-18 months)
• Chicken pox (Varicella Zoster) (12-18 months)
• Polio vaccine (#3) (6-18 months)

Today’s Report For Your 18-Month-Old Infant

Child’s name  

Examined by Dr.  

Weight  

%

Length  

%

Head  

%

Hepatitis B (#3)

Chickenpox (#1)

Polio vaccine (#3)

DTP series (#4)

• Milk-- Give about 16 to 24 oz of whole milk a day. Don’t give your baby skim, 1 percent or 2 percent milk yet. The extra fat in whole milk helps brain cells develop.
• Water
• Juice – Four oz a day is enough.
• Table foods -- Every baby needs:
  -2 servings of protein. (Choose what baby likes from meat, fish, poultry, cheese, eggs, and beans.)
  -4 servings of cereal, bread, or other starch
  -4 servings of fruits or vegetables

Developmental milestones
Keep in mind that children develop at their own pace. These milestones are common to infants at this age, but it is completely normal for your child to reach some quickly and others at a slower rate

• Walks quickly or runs stiffly
• Listens to stories; can follow pictures and name them
• Can throw a ball
• Shows affection, gives kisses and hugs
• Points to some body parts
• Has a vocabulary of 15 to 20 words
• Uses two-word phrases
• Follows simple directions
• Uses a spoon and cup

Separation: It’s so hard to say goodbye. If you must be separated from your child (for example, for a hospitalization), here are some tips for what you can do to ease your child’s concern:

• Talk about changes that occur, and your child’s feelings of anger, sadness, and fear.
• Encourage your child to express him/herself, reassure him/her by saying "I will miss you" and "I know this is hard for you"
• Assure your child you will always return and when you will return. "I will be here when you wake up."
• Avoid telling your child "Be good" or "Don’t cry"
• Be confident when saying goodbye, give your child hope by saying things like, "We’ll feel better."
• Let your child know that having strong feelings, including anger and sadness, is healthy and normal. Assure your child that its "OK to miss mommy and daddy" or that "It’s all right to be angry with mommy for bringing the new baby home."

• Always use gates to block stairs, and lock or put safety bars on upper-story windows.
• Be on your guard for falls. Children love to be little mountain climbers and will scale anything in their paths.
• Poison-proof the home, paying special attention to cabinets at a child's level. Never store toxic substances in bottles or jars that can be mistaken for food products.
• In the event your child ingests a potentially harmful substance, keep the container and call the poison control center at 1-800-222-1222.
• Avoid giving your child raw carrots, unpeeled apples, nuts, hard candies, and other foods that present a choking hazard. Better choices are ripe avocado, mashed potatoes, tomatoes, crackers, and peeled or cooked fruit cut into bite-size wedges.
• Make sure that electric wire outlets and appliances are inaccessible or protected. Put plastic plugs in electrical outlets, and install safety locks on cabinets and drawers. Keep plastic bags out of reach.
• If there is a swimming pool in your neighborhood, make sure it is surrounded by a tall four-sided fence and has a gate that latches or locks. Never leave water in a bucket or tub.
• When outside, keep your toddler away from moving machinery, such as lawn mowers and overhead garage doors, and away from driveways and streets. Put sunscreen on your child before allowing to go outside to play.
• Continue to use a car seat appropriate for your baby’s weight, placed in the middle of the back seat. Carefully follow manufacturer’s guidelines for use.

• Sandbox with shovels, buckets, and molds
• Puzzles with two to six large pieces with knobs
• Wide watercolor markers, nontoxic fat crayons, and large sheets of blank paper
• Pounding bench
• Geometric or cardboard blocks
• Wood or rubber people, animals, and vehicles
• A soft cuddly doll or stuffed animal
• Mobile with parts visible from baby’s position

When should I call the doctor?
Call your doctor if your toddler displays any of the following:

• Becomes sluggish or inactive
• Will not eat
• Coughs
• Develops an unusual rash (not prickly heat or diaper rash)
• Has a fever at any age
• Vomits repeatedly
• Has frequent loose, watery bowels
• Breathes rapidly, wheezes, or has any difficulty in breathing

Before you call your physician or nurse, write down your child’s symptoms. Take his/her temperature. Have your pharmacy’s phone number on hand to tell the doctor. Keep a notepad on hand to write down any instructions.