Clinical Reference Systems: Pediatric Advisor 10.0
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Well Child Care at 18 Months
Nutrition
Family meals are important for your baby. Let him eat with
you. This helps him learn. Don't make mealtime a battle.
Let your baby feed himself. Your child should use a spoon
and drink from a cup now.
Development and Discipline
Children at this age should be learning many new words. You
can help your child's vocabulary grow by showing and naming
lots of things. Children have many different feelings and
behaviors such as pleasure, anger, joy, curiosity, warmth,
and assertiveness. It is important at this age to praise
your child for doing things that you like. Make an effort
to catch your children being good.
Toddlers often seem out of control, or overly stubborn or
demanding. At this age, children often say "no" or refuse
to do what you want them to do. Here are some good methods
for helping children learn about rules and to keep them
safe:
- Child-proof the home. Go through every room in your
house and remove anything that is either valuable,
dangerous, or messy. Preventive child-proofing will stop
many possible discipline problems. Don't expect a child
not to get into things just because you say no.
- Divert and substitute. If a child is playing with
something you don't want him to have, replace it with
another object or toy that he enjoys. This approach
avoids a fight and does not place children in a situation
where they'll say "no."
- Teach and lead. Have as few rules as necessary and
enforce them. These rules should be rules important for
the child's safety. If a rule is broken, after a short
and clear explanation, punish immediately by having the
child sit alone for 2 minutes. It is very important that
punishment come immediately after a rule is broken.
- Be consistent with discipline. Don't make threats that
you cannot carry out. If you say you're going to do it,
do it.
At 18 months, most toddlers are not yet showing signs that
they are ready for toilet training. When toddlers report to
parents that they have wet or soiled their diaper, they are
beginning to be aware that they prefer dryness. This is a
good sign and you should praise your child. Toddlers are
naturally curious about the use of the bathroom by other
people. Let them watch you or other family members use the
toilet. It is important not to put too many demands on a
child or shame the child during toilet training.
For more information see:
Normal Development: 18 Months
Discipline Basics
Safety Tips
Avoid Choking and Suffocation
- Keep plastic bags, balloons, and small hard objects out
of reach.
- Cut foods into small pieces.
- Store toys in a chest without a dropping lid.
Prevent Fires and Burns
- Keep hot appliances and cords out of reach.
- Don't cook with your child at your feet.
- Keep hot foods and liquids out of reach.
- Keep matches and lighters out of reach.
- Turn your water heater down to 120 degrees F (50
degrees C).
Pedestrian Safety
- Hold onto your child when you are near traffic.
- Provide a play area where balls and riding toys cannot
roll into the street.
Prevent Drowning
- Always watch your child around any water, including
toilets and buckets. Keep toilet seats down and store
buckets upside down.
- Never leave an infant or toddler in a bathtub alone --
NEVER.
Avoid Falls
- Check the stability of drawers, furniture, and lamps.
- Make sure windows are closed or have screens that
cannot be pushed out.
- Don't underestimate your child's ability to climb.
Poisons
- Keep all medicines, vitamins, cleaning fluids, etc.
locked away.
- Put the poison center number on all phones. The poison
control number is _____________________.
- Ask your doctor about syrup of Ipecac. Use it only if
you are told to do so.
- Purchase all medicines in containers with safety caps.
- Do not store poisons in drink bottles, glasses, or
jars.
Immunizations
At the 18-month visit, your baby may receive shots. Your
baby may run a fever and be irritable for about 1 day after
the shots. Your baby may also have some soreness, redness,
and swelling in the area where the shots were given. You
may give your child acetaminophen drops (1 and 1/2
dropperfuls, or 1.2 ml, every 4 to 6 hours) to prevent fever
and irritability. For swelling or soreness, put a wet, warm
washcloth on the area of the shots as often and as long as
needed for comfort.
Call your child's physician if:
- Your child has a rash or any other reaction to the shots
besides fever and mild irritability.
- Your child has a fever that lasts more than 36 hours.
Next Visit
Your child's next visit should be at the age of 2 years.
Please remember to bring your shot card.
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