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18 Months of Age

What to Expect at the 18-Month Well Visit:

  • Fourth DTaP vaccine
  • Second hepatitis A (HepA) vaccine
  • Blood test for hemoglobin level may be done at the 18-month or 2-year well visit

See the full immunization schedule ›

Safety:

  • Continue to use a rear-facing car seat secured in the backseat of the car until 2 years of age.
  • Never drink hot liquids while holding your baby or near your baby to avoid burns from accidental spills. Turn pan handles toward the back of stove.
  • Keep toddlers away from hot surfaces like stoves, fireplaces, irons, and space heaters.
  • Make sure your water heater temperature is set to a maximum of 120° F.
  • Use a sunscreen with an SPF of 30 or higher, reapplying every 2 hours, and avoid peak sun intensity of 10 am to 3 pm.
  • Lower the mattress to lowest level. Consider transitioning to a toddler bed.
  • Review handouts provided at the visit in the Safety Packet, especially childproofing your home.
  • Keep the Poison Control Number in your phone or readily available: 1-800-222-1222
  • Children can drown in a few inches of water. Supervise your child in baths, buckets, pools or near toilets (consider a toilet lock).
  • Toddlers are climbers. Keep chemicals, medicines, and other poisons out of reach.
  • AAP recommends insect repellents should be less than 30% DEET and used for infants 2 months old and older. Wash off skin with soap and water when done. Wash clothes before wearing again. Do not use combination DEET and sunscreen products. Apply permethrin for ticks to clothes, not to skin.

Development:

  • Says 10 to 50 words.
  • Uses cup and spoon well. Only uses a cup to drink liquids.
  • Can draw vertical lines.
  • Can identify 4 body parts.
  • Temper tantrums are normal. Avoid paying attention to them, as not to reinforce the behavior.
  • Need to establish continuity and discipline. Physical punishment not advised. Praise good behavior.
  • Can help to undress.
  • Walks well and is starting to run; may walk up and down steps.

Diet:

  • Repeatedly offer healthy table foods cut in pieces to avoid choking.
  • Introduce cow’s milk (preferably whole or 2%) in a sippy cup. Limit to maximum of 24 oz. a day.
  • Give yogurt and cheese if baby is refusing milk.
  • Give Poly-vi-sol with iron if the diet seems inadequate.
  • Avoid juice.
  • Use cups only. Eliminate baby bottles.
  • Allow use of utensils even if it is messy.
  • Your child will become picky and the amount they eat will differ from day to day.
  • Family meal times are opportunities to foster good nutritional habits through parental modeling by sitting at the table, interacting socially, turning off the television, and making healthy choices.

Watch Out For:

  • Contact your provider if your child is not walking, is not gaining new words, loses skills they once had, or doesn’t say at least 6 words.