18-Month-Old Well Child Check

Your toddler is expressing himself through several simple words. He can also walk, jump and dance.



Your child should be eating three balanced meals a day and may still require nutritious between meal snacks. Most children have enough teeth for chewing at this age, but caution against choking should continue. Remember, firm or airway sized food should be avoided; such as hot dogs, peanuts, hard candy, raw carrots, grapes, popcorn, etc. Allow your toddler to eat with his hands and with a utensil. Also, allow him to drink from a cup; if you haven't already, you must wean your child from the bottle now. Milk and dairy products are still required, but should be limited to 16-24 ounces per day as they are high in calories. Ask your provider if your child may switch to 2% milk instead of whole. Avoid sweets and high fat snacks like sodas, candy, and chips.

Vitamins & Fluoride

Continue as directed at the fifteen month visit. If you have recently moved, check the fluoride status of your water and contact our office if it has changed.


A developmental assessment and a screening for signs of autism will be done at your child's visit.

At this age most children can:

  • Understand and follow simple directions or commands
  • Sing, jump and dance
  • Feed themselves
  • Hold a regular cup or glass without help and drink from it without spilling much
  • Locate body parts correctly
  • Walk without support or help all the way across a large room without falling or wobbling much from side to side.
  • Climb stairs
  • Communicate with several simple words
  • Identify sizes and shapes
  • Put simple puzzles together (3 to 4 pieces)
  • Help undress himself and put on some clothing

Indicators for concern:

The results of the developmental assessment and screening for signs of autism will be discussed with you at the visit. Please review this information regarding the autism screening and additional autism resources. 


At this visit, your child is scheduled to receive Hepatitis A immunization.

Common Issues And Concerns


To see information on Acetaminophen Tylenol) dosage,click here. Remember to always dose based on the weight of your child.


As your infant grows and is exposed to other children (particularly if in daycare), upper respiratory infections may be frequent. Treatment is discussed in our handout on colds and congestion.

  • Your child should be sleeping in their own bed and through the night. If not, please review these tips on sleep.
  • Bedtime should be enforced after a familiar routine is complete.
  • If your child is trying to climb out of the crib, make sure to lower your toddler's crib mattress to the lowest rung. They can be placed in a toddler bed if they continue to climb out.
  • If your child comes out of his room, return him quietly without conversation, skip the hug and kiss. Hold the bedroom door closed for a few minutes if necessary. Consistency will prevail.
Behavior & Discipline
  • Continually praise your toddler for good behavior.
  • Consistency and structure in your child's day are very important. Decide what limits are important. Be specific when setting these limits and consistently enforce them.
  • Remember their mental development is ahead of what they can speak. They will get frustrated often because they can't communicate as well as they would like.
  • When disciplining your toddler it is important that you speak in a firm, calm tone.
  • The best discipline to use at this age is redirection, distraction, gentle restraint, and removal of the object from your toddler. Use discipline as a means of teaching and protecting, not as punishing.
  • Toddlers should never be spanked. Spanking does not usually work and is not a good kind of punishment for a young child.
  • Toddlers will sometimes get on your nerves. They are just learning about their world and not necessarily getting on your nerves on purpose.
  • A "time-out" period is often effective if your toddler's behavior cannot or should not be ignored. Many times just 15-30 seconds is enough time to reinforce your point. At this age you would not leave your child in "time-out" for any longer than two minutes.A good rule is one minute for each year of life.
  • Encourage language development by talking about the things you are doing and seeing together, reading books, repeating words and phrases, and singing
  • Let your child practice their skills by giving them plenty of time to romp and play.
Dental Care

Brush your toddler's teeth with a soft toothbrush twice daily. Please see information about Tooth Decay Prevention.


Your infant is becoming more mobile and constant supervision and safety precautions are critical. Please review the advice found on Healthychildren.org.

  • Keep the Poison Control Center phone number by the phone or programmed into your cell phone.
  • Examine your home to be certain it is childproofed. Ensure electrical wires, outlets, and appliances are inaccessible or protected
  • Keep cigarettes, lighters, matches, alcohol, and electrical tools locked up and/or out of sight and reach
  • Continue to keep child's environment free of smoke, and keep the car and home nonsmoking areas
  • Never leave a toddler alone in the car or in the house. Do not expect young children to supervise a toddler in the house or the yard
  • Limit TV and make sure your toddler only watches shows made for her age.
  • Avoid foods that may cause choking including hard candy, gum, large pieces of meat or hot dogs, nuts, popcorn, raisins, and raw vegetables
  • Guns in the home are a danger to your family. If a gun is kept at home, the gun and the bullets should be locked up in separate places.
  • Continue using the toddler car seat on every outing in the car. Do not put the child in the front seat. 
Next Well Child Visit

The next routine physical examination is at 2 years of life.