Child’s Well Visit – 18 Months: Care Instructions

Your Care Instructions

You may be wondering where your cooperative baby went. At this age, children are quick to say “No!” and slow to follow requests. Your child is learning how to make decisions and test limits. This same “bossy” child may also quickly climb into your lap with a favorite stuffed animal. Offer kindness and love—it will pay off soon.

At 18 months, your child may be ready to throw balls and walk quickly or run. They may say several words, listen to stories, and look at pictures. Your child may know how to use a spoon and cup.

How Can You Care for Your Child at Home?

Safety

• Help prevent choking by offering appropriate foods and avoiding choking hazards.
• Always watch your child near streets or parking lots. Drivers may not see small children. Always check carefully before backing out of your driveway.
• Supervise your child at all times near water, including pools, hot tubs, buckets, bathtubs, and toilets.
• Secure your child in a properly installed car seat that meets current safety standards for every ride. It is best to keep your toddler rear-facing until age 2. For questions, call the National Highway Traffic Safety Administration at 1-888-327-4236.
• Prevent burns by keeping hot pots, curling irons, irons, and coffee cups out of reach. Use plastic plugs on all electrical outlets. Install smoke detectors and check batteries regularly.
• Install locks or guards on all windows above the first floor. Supervise your child around play equipment and stairs. If your child climbs out of their crib, transition to a toddler bed.
• Keep cleaning products and medicines locked away. Keep the Poison Control number near your phone: 1-800-222-1222.
• Inform your doctor if your child spends considerable time in a home built before 1978 due to possible lead paint exposure.

Discipline

• Teach good behavior by catching your child being good and responding positively.
• Use body language, like a sad face, to show disapproval of unwanted behavior. Toddlers this age may misbehave frequently and need repeated instructions and redirection.
• For serious or dangerous behaviors (e.g., hitting), use time-outs with an empty Pak-N-Play:
  1. Calmly and firmly correct your child (e.g., “Hands are not for hitting”).
  2. Place your toddler in the Pak-N-Play and leave the room for 1–2 minutes.
  3. Take deep breaths to calm yourself and plan a replacement behavior.
  4. After 1–2 minutes or when the child calms, return cheerfully.
  5. Show or tell your child the replacement behavior (e.g., “Hands are for gentle touch”—stroke your child’s palm across your face).
  6. Pick up your toddler and engage in an activity together.
• Expect behaviors to worsen before improving (“extinction burst”). Be consistent and avoid emotional reactions as these may reinforce the behavior. Do not use physical punishment, as it models inappropriate behavior.
• If discipline remains challenging, consult your doctor for advice and support.

Feeding

• Offer a variety of healthy foods daily: fruits, well-cooked vegetables, low-sugar cereal, yogurt, whole-grain breads and crackers, chicken, red meat, and fish.
• Feed your child every 3 to 4 hours.
• Avoid choking hazards such as nuts, whole grapes, hard or sticky candy, and popcorn.
• Continue offering healthy snacks regularly, even if initially refused. Suitable snacks include those made from wheat, corn, rice, oats, or other grains—such as breads, cereals, tortillas, noodles, crackers, and muffins.
• Avoid all juices; offer plenty of water throughout the day. Limit milk intake to 18–24 ounces of organic whole milk per day.

When Should You Call for Help?

Contact your doctor if:

• You are concerned your child is not growing or developing normally.
• You are worried about your child’s behavior.
• You need more information about caring for your child or have questions or concerns.

Where Can You Learn More?

Visit http://www.nurturepediatric.com

Care instructions adapted under license by Nurture Pediatrics. This instruction is intended for use with your licensed healthcare professional. If you have questions about a medical condition or these instructions, always ask your healthcare professional.