Advanced Pediatrics

100 East Street SE, Suite 301

Vienna, VA 22180
(P) 703.938.5555

(F) 703.319.8580


18 Months Old

At a year and a half, most children speak a dozen words (or more) clearly. Besides "Mama" and "Dada," favorite words include "bye-bye," "milk," "cookie," "car," "oh!," and "my." Many 18-month-old toddlers can also link two words together to form rudimentary sentences — sentences without linking verbs or other connecting words. She may say "All gone," "Want ball," or "Me up."


At this stage, it's better to applaud what your toddler can say rather than try to correct "mistakes." For instance, if your child says, "Want cacka," don't correct with, "No, say cracker." Say, "Okay! Here's a cracker!" Modeling the correct use of a word yourself helps kids learn faster than if you correct them outright. And not being constantly corrected will help boost your 18-month-old’s self-confidence and her eagerness to learn and try out new words.







Vaccinations for this visit

We recommend the following vaccines:


  • Hepatitis A

​Recommended Tests

The following tests are only done based upon risk factors being present.  Please take a few moments to help us determine whether these tests are warranted for your child:




What to Expect

​Sleep


  • Sleep Routine:  Establish a nightly bedtime routine that begins with quiet time for your child to relax before bed, and ends with your child soothing himself in his own crib. Reading and singing to your child will help him get to sleep. A favorite toy or a nightlight also can help. Make sure to space nap times so that your child is tired at bedtime.
  • Naps:  Toddlers should continue to have at least one nap during the day. It is important to establish a regular nap time routine.
  • Quantity of sleep:  A 1-year-old should be sleeping 12 to 14 hours a day. Bedtime should be at the same time each night and should become a nightly routine.

Sleep


  • Toddler rebellious behavior:  At this age, your child may be reluctant to take naps and he may be rebellious at bedtime. One thing you can consider with this would be to make his bedtime a little later, that way he’ll be more tired when it’s time to go to sleep.
  • Early rising:  He may tend to wake up very early in the morning (5-6 am) – this can be normal and often will not change regardless of the bedtime.
  • Dropping one nap:  It might be about time to get rid of the morning nap, as your toddler no longer needs the nap at this hour. Be patient about this change, and maybe incorporate things like “morning quiet time” instead of “morning nap time”
  • Quantity of sleep:  Make sure, that your child is getting 12 to 14 hours of sleep each night. One way of doing this would be to log his sleep hours daily.

Feeding


  • Fat is needed in the diet of toddlers.  In the first 2 years of life, you need to avoid placing any restrictions on the amount of fat your child consumes.  Your toddler actually needs fat in his diet to ensure proper growth and brain development, and those first few years of life are particularly crucial. Dietary fat serves a number of other important functions as well, including providing energy and promoting wound healing. It also helps your child absorb certain vitamins.  How much fat is enough? During his first 2 years, about half of his calories should come from fat. Then after age 2 years, you can modify his diet gradually until his dietary fat makes up about one third of his caloric intake.
  • How many meals per day?  As he moves through the second year of life, he should be eating 3 meals daily, along with 1 to 2 snacks, prepared and served at regular times. You should also discourage grazing (this means your child has access to and grabs food all day long).
  • What is a serving size?   For a toddler, a serving size should be approximately one fourth of the portion appropriate for an adult. A serving of vegetables for a toddler would be about 1 to 2 tablespoons. For meat, a serving might be about the size of their palm.

 

Development


  • Your child may be very rebellious and impatient at this age.   He now knows the word “No” and is not afraid to use it!
  • Toddlers often like experimenting with different tones and pitches, so he might be screaming a lot.
  • Your child wants to be the center of attention, so he may interrupt your phone calls or conversations with other adults to get your attention.  You may want to start showing him how to be polite by example.
  • He should now be able to pick up small objects without a problem.
  • He can identify himself in a mirror
  • He may show a serious attachment to a comfort object, such as a blanket or his thumb that he sucks on.
  • He can now throw things, and will throw anything and everything that he can get his hands on.
  • He will also be able to use force to do things like open the refrigerator door.


Safety

  • Corners and edges: The sleek coffee table with the glass top jazzed up the living room décor last year, but now that your toddler is walking, it’s looking more ominous than glamorous. Cushion the table corners and edges with bumpers (available at baby stores) that can soften the impact if your toddler knocks into them. The same bumpers work on any sharp edges throughout the house (such as fireplace hearths and low windowsills). Bumps will happen, so make sure you're prepared to treat head injuries (though kissing boo-boos is usually the best remedy). 
  • Hazardous substances: It’s no longer enough to stash antifreeze (looks like green Kool-Aid) or birth-control pills (candy!) on high shelves, especially if your toddler has the climbing skills of a little monkey. So while childproofing your home, store these and other household products (such as cleaning supplies, medications, and alcohol) in locked cabinets.
  • Stairs and doorways:  Keep your wobbly walking tot away from stairways by installing sturdy safety gates at the top of the stairs and at the bottom (consider putting the lower gate three steps from the bottom, so your child has a small area to practice stair-climbing skills). Seal off high-hazard rooms such as the bathroom (which contains water dangers and electrical appliances like hair dryers) and the office (which may have child safety hazards like computer wires and staplers) with hard-to-turn plastic doorknob covers (you can find them at baby stores or hardware stores). Or install a lock high above your child’s reach.
  • Windows:  Make sure your child can’t take a tumble out the window by installing metal window guards that screw into the sides of the window frame and have bars no more than four inches apart. If you have blinds, it’s vital to keep the cords (which are strangulation hazards) out of your toddler’s reach. For information on how to shorten and secure cords when childproofing your home, check out www.windowcoverings.org. Better yet, consider cordless window coverings — especially in your child’s room. (It’s not too late to put those finishing touches on the nursery!)
  • Hot spots:  When your little guy started crawling, one of the first baby proofing tips you heard was to cover your electrical outlets (“Hey, those holes fit my fingers!”). But now that he’s cruising or walking, you need to guard against electrical appliances and burns on a new level. For instance, in the kitchen, use knob covers on the stove to block your toddler from turning on burners. And while you cook, use back burners whenever possible. If you have to use the front burners, turn cookware handles away from the front of the stove, so your child can’t reach up and grab them. Other items you want to make sure your toddler doesn’t grab? Electrical gadgets on counters. So be sure to keep appliances (like the toaster and food processor in the kitchen, and the hair dryer and curling iron in the bathroom) away from the edge of counters so that they’re beyond your toddler’s grasp. Remember – accidents happen, so make sure you learn about treating skin burns.
  • Standing water: To your child, a toilet looks like a tiny pool or a dumping ground for found objects. Ban him from the porcelain bowl — and preserve your plumbing — with a plastic safety latch. Just make sure to teach guests how to open it, too.

Activities


  • Toddlers love to play in water.  Put “squeezing” objects in the bathtub, such as sponges or squeeze bottles, along with dump-and-pour toys (cups, bowls).
  • Play Hide and Seek.  Your toddler can hide with another person or by himself for you to find.  Than take your turn to hide and let your toddler find you.
  • Toddlers love movement.  Take him or her to the park to ride on rocking toys, swings, and small slides.  You may want to hold your toddler in your lap on the swing and on the slide at first.
  • Toddlers are excited about bubbles.  Let your toddler try to blow bubbles or watch you blow bubbles through a straw.  Bubbles are fun to pop and chase, too.
  • Pretend play becomes even more fun at this age.  Encourage your toddler to have a doll or stuffed toy do what he or she does - walk, go to bed, dance, eat, and jump.  Include the doll in daily activities or games.
  • Sing action songs together such as “Ring Around the Rosey,” “Itsy-Bitsy Spider,” and “This is the Way We Wash Our Hands.”  Do actions together.  Move with the rhythm.  Wait for your toddler to anticipate the action. 
  • Play the “What’s that?” game by pointing to clothing, toys, body parts, objects, or pictures and asking your toddler to name them.  If your toddler doesn’t respond, name it for him or her and encourage imitation of the words.
  • Your toddler may become interested in “art activities.”  Use large nontoxic crayons and a large pad of paper.  Felt-tip markers are more exciting with their bright colors.  Let your toddler scribble his or her own picture as you make one.