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Your Checkup Checklist: 18 Months Old

At a year-and-a-half old, your toddler is excited to be learning more skills. Having mastered walking, they may now be climbing onto chairs and other short pieces of furniture without help. You may find them beaming and clapping for themselves after these impressive feats, looking to you for praise.

Your 18-month-old may insist on going wherever they want one moment, then cling to you the next. They do this to remind themselves of their secure emotional base, which gives them the confidence to explore. Extra patience and a sense of humor can help you with the tough task of setting limits and then regularly reinforcing them.

At the 18-month wellness visit, the pediatrician will perform a complete physical exam and check your child's progress toward important milestones. Here's what else you can expect at this checkup:

✅ Immunizations

Depending on vaccines your child received at their previous visits, they may be due for a dose of HepA (hepatitis A), for example, or DTaP (diphtheria, tetanus and pertussis). If it's flu season, your doctor will also recommend an influenza (flu) vaccine. See "Vaccines Your Child Needs by Age 6."

✅ Screenings

Based on your child's risk factors or any symptoms or concerns, your pediatrician may screen and recommend tests for anemia, lead poisoning, blood pressure, hearing or vision problems. They will also screen for autism spectrum disorder. Unless your child has already visited the dentist, your pediatrician will check for any new teeth that need an application of fluoride varnish. Teeth that were treated with varnish at least 6 months ago get another application.

✅Behavior & Development

Your pediatrician will measure and weigh your baby to make sure their growth is on track. They will also observe their development and behavior and perform a physical exam.

Questions your pediatrician may ask

  • Does your child engage with others for play? Have they started to enjoy scribbling or pretend play?

  • Do they help dress and undress themselves?

  • Do they point to pictures in a book, or to show you something interesting?

  • Do they try to copy some of your actions, like sweeping with a broom?

  • Do they turn and look at you if something new happens?

  • Do they use words to ask for help?

Questions you may have

  • How will I know when my child is ready to begin toilet training?

  • Is it OK to use time-outs?

  • What's the best way to calm them when they're upset?

  • What are some ideas for ways to play with them?

  • Should my child watch TV or videos or use other digital media?

  • How often should I read to my toddler?

❓ Did you know
The 18-month old's all-purpose response, "No!" is how they express newly formed understanding of choice and autonomy. So, what may seem like defiance or grumpiness is actually a normal sign of their developing sense of self-identity.

✅Feeding & Healthy Nutrition

Your pediatrician will nutritious foods and beverages for your child, and how expressing independence through food likes and dislikes is completely normal.

Questions your pediatrician may ask

  • Does your child drink water every day?

  • How many ounces of dairy milk do they drink most days? Is it whole milk or lower fat milk?

  • Do you offer a variety of vegetables, fruits and other nutritious foods?

  • How do you feel if your child doesn't eat what you have prepared for them? What do you do?

  • Have they started trying to use a spoon?

Questions you may have

  • If my child doesn't want to eat what I prepared, should I offer them something else?

  • Should I give them juice?

  • What if my child doesn't eat three full meals each day?

  • What are some good snacks to give them?

  • Their appetite seems to be less than it used to be. Is this normal?

✅Safety

Your pediatrician will talk with you about ways to help keep your child safe from injury and other harms.

Questions your pediatrician may ask

  • Have you secured furniture to the wall so it can't tip and fall onto your child?

  • Do you use gates at the top and bottom of stairs, and keep furniture they can climb on away from windows?

  • If there are firearms in your home, are they stored unloaded and locked in a case, with ammunition stored in a separate locked location?

  • How do you keep hot liquids out of your toddler's reach?

Questions you may have

  • How long should my child continue riding in a rear-facing car safety seat?

  • What's the best sunscreen to use for kids, and when do they need it?

  • How old should my child be before we get a pet?

  • What should I do if my child has a poisoning emergency?

✅ Communication Tips

Never hesitate to call your pediatrician's office with any questions or concerns—even if you know the office is closed. If your pediatrician is unable to see you but believes your baby should be examined, they will advise you on the most appropriate place for your baby to receive care and how quickly your baby should be seen.

More information

Last Updated
4/22/2022
Source
Adapted from Bright Futures, 4th Edition (American Academy of Pediatrics Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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