What Happens During a Toddler Well Check at 18 Months Old

As your child reaches 18 months of age, it’s time for another well-child examination at our Cumming pediatric office. From the latest immunizations to an examination of social skills development, there’s a lot to get through during well checks for an infant or toddler. Here is a brief overview of what to expect during an appointment with our caring pediatric team.

Key Milestones of a Well-Child Visit at 18 Months Old

Toddlers at this age are progressing quickly, usually demonstrating new communication skills. While some children are developing well, others may not show the same speech and learning abilities. The well check at 18 months is the perfect time to discuss any concerns you may have with your pediatrician.

Feeding Your Toddler

• Toddlers this age are moving from the eating habits they had as infants toward a diet more like your own. Your job is to keep introducing new flavors and textures. Food preferences are set early in life, so help your child develop a taste for healthy foods now.
• Your toddler will continue to explore self-feeding, first with fingers then with utensils at around 15 to 18 months of age. The use of a cup (with the elimination of the bottle) should be established by now.
• Allow your toddler to respond to internal cues for hunger and fullness but set the boundaries – don’t make meals a battle. Remember, you decide what variety of healthy foods to offer at a meal and your child decides which of those foods to eat, how much to eat and whether to eat at all.
• Avoid foods that could present choking hazards, like popcorn, hard candy, hot dogs, raw vegetables and hard fruits, whole grapes, raisins and nuts. Supervise your child at all times when eating.
• Offer your child three meals and two or three healthy snacks a day, but keep in mind that it’s common for toddlers to skip meals. Don’t push food on a child who’s not hungry, but kids shouldn’t be allowed to eat on demand all day either.
• Milk is an important part of a toddler’s diet because it provides calcium and vitamin D, which help build strong bones. Kids under age 2 should drink whole milk for dietary fats needed for normal growth and brain development.

Toddler Growth & Development

• During this second year of life, growth slows down. Your toddler may gain about 5 pounds (2 kilograms) and grow about 4 or 5 inches (10 to 12 cm). By 2 years, children have achieved about half of their adult height and 90% of adult head size. Boys tend to weigh about a pound more than girls but average about the same height.
• Body proportions are beginning to change. They become more muscular because of increased activity and will begin to look more like preschoolers than babies.

Toddler Sleep Patterns

• Toddlers are increasingly aware of their surroundings, so distractions might disrupt them at bedtime. Their growing imaginations can start to interrupt sleep. A simple and consistent bedtime routine is a parent’s best tool for getting a sleepy toddler into bed.
• Most toddlers between the ages of 1 and 2 require about 10-13 hours of sleep a day. Whether all these hours are slept at night or split up between nighttime sleeping and daytime naps is up to you.
• Most likely, your 1- to 2-year-old will still be sleeping in a safe, secure crib. Remember do not put any extra-large, soft toys, stuffed animals or items with ties or strings that could wind up around your toddler’s neck in the crib. Watch out for objects your child might be able to reach from a standing position in the crib such as curtains, window blind pulls, pictures or wall hangings. If you have an active climber who is getting out of the crib and suddenly appearing in the living room, you might want to consider moving him or her to a bed.
• Dreams and nightmares can begin to affect toddlers. They may have a difficult time distinguishing these from reality. Be mindful of any videos or books he or she sees just before bedtime, and keep the content mild. Look around for any environmental cause for your toddler’s nighttime awakenings. Toddlers are notorious for not staying covered at night, so in the colder months, you might want to dress your child in heavy pajamas for warmth. Toddlers will learn to sleep with some noise, but a loud TV or too much conversation close by can be disruptive.
• Get used to setting the rules and sticking to them. This not only helps your child get more sleep now but also helps you later if other, more serious, discipline problems arise. If your toddler awakens in the middle of the night, you’ll want to quietly provide reassurance that everything is OK and you are close by. However, too much interaction can backfire, so keep your nighttime “visits” brief and boring for your toddler.

General Concerns for Your 18-Month-Old Toddler

• Language – Kids this age make major strides in understanding language and figuring out how to communicate. During year two, a toddler’s vocabulary increases slowly over the first 6 months and then expands quickly during the second 6 months when many start to use simple two-word sentences. By the second birthday, they usually say 150-250 words and are using 2-3 word phrases.
• Playing – Hand-eye coordination and manual dexterity will also improve. Toddlers have better control over their fingers and hands and can explore toys and surroundings more than before. Your toddler now is aware of the function of objects so is more likely to stack blocks, listen or talk into a toy phone or push a toy car. In addition, the concept of pretend play starts to emerge.
• Play Dates – Many parents introduce play dates now. Toddlers enjoy having other kids around but don’t expect them to “play” cooperatively with each other or to be enthusiastic about sharing toys. Have plenty of toys for everyone and be prepared to intervene when they don’t want to share. Older siblings can serve as role models when it comes to teaching, sharing and taking turns.
• Emotions – Tantrums are more common in the toddler years, so expect your child to get frustrated from time to time. If you see a tantrum coming on, try to create a distraction with a book or interesting toy. Emotional outbursts can occur for various reasons – hunger, tiredness, the inability to accomplish a task and so on. A toddler’s two-year-old checkup is important for monitoring how these tantrums progress, and whether the toddler is becoming better at moderating their emotions.
• Learning – Games that your child might enjoy include peek-a-boo, pat-a-cake and chasing games. Toddlers love to imitate adults and are fascinated with housework. Reading continues to be important. Your toddler can follow along with a story and point to objects in the pictures as you name them. Encourage your little one to name things he or she recognizes.

Suggested Immunizations at the 18 Month Well Check

• Your child will receive their 4th DTaP and 2nd Hepatitis A vaccine.
• At 18 months of age, the following key immunizations are available for your child during a well check visit.

Contact Us for Well-Child Visits in Cumming

At Vickery Pediatrics, we are available for pediatric care and treatment in Cumming, Buford, Dawsonville, Gainesville, Johns Creek, Sugar Hill, Suwanee and Forsyth County. Our expert team offers reliable well-child exams, sick care assistance, camp and sports physicals, nutritional guidance and ongoing developmental care. For more information, call (678) 990-2501 or request an appointment today.