Eighteen Month Visit  mark-shand-foot-outside


As your baby moves from their first to second birthday, they rapidly pick up mobility and independence, to the point where it becomes hard to call them a baby anymore.  This transition toward a more self-sufficient state should be a real source of gratification to parents.  At the same time, great patience and understanding are called for, and parents must have sound discipline principles in mind as they steer the rapidly-changing toddler in the right direction.

Learning is rapid at this age, and reading should be part of the daily routine.  Books full of pictures of animals, and familiar objects are good for this age.  Pull toys, large balls, and simple climbing equipment, either at home or at a playground, are enjoyed.  The average 18 month old toddler has about 10 words in their vocabulary-some say more and some haven’t started saying much of anything.  Understanding what is said occurs to a much greater extent.  Don’t expect, however, to reason with them very much, but instead guide them through your actions and attitudes.  Praise them when they respond appropriately, give them minimal attention when they decide to throw tantrums.  Don’t get overly excited when they remove books from bookcases or turns on the TV.  Just distract them or move them to another area.  If they persist, a “cooling off” period in a chair may be effective.

This “time out” technique is very effective and works for most behavioral problems at this age.  Reserve more forceful no’s and reprimands for instances that involve safety, such as the child reaching for a hot pan on the stove.  If parents are not careful, they may find themselves constantly saying no at this age.  It makes more sense for parents to realize that his fast growing little person is trying a variety of ways to relate to the rest of the world.  By rewarding the appropriate behavior and demonstrating that inappropriate behavior produces little attention, parents can influence children more naturally and with less tension.

An 18 month old interested in brushing their own teeth should be encouraged to do so, but they will need help to ensure thorough cleaning.  A small brush with soft bristles that are cut straight across should be used.  Put only a pea sized amount of toothpaste on the brush.  Too much fluoride is harmful to developing teeth.

Toilet training may be started at this age if your child seems interested, though many experience parents wait until two.  Put them on the potty chair a few times a day especially after meals, but don’t expect miracles.  Meaningful toilet training is a lot like walking or talking, nature does most of the work.  Children must first understand the concept of using the toilet.  Then they must achieve the muscle control to hold and release urine and stool.  Last of all, for successful autonomy they must want to work at this new skill.  As this is an age when independence is expressed negatively, too much pressure on the toilet training can result in resistance, stool withholding, and a battle of wills.


Your child often doesn’t care much about eating at this age.  They can be growing and active on far less food then you think and if you offer them balanced meals, but don’t force, and give little or nothing between meals, you have done everything humanly possible.

The AAP recommends vitamin D supplementation for all infants, children, and adolescents.    After reviewing the literature, it certainly looks like many children may benefit from vitamin D, although not everyone necessarily needs it.   Some children are more at risk for vitamin D deficiency than others.  Risk factors for vitamin D deficiency include dark skin (African-americans, Indians, Hispanics), time spent indoors and not out in the sunlight (particularly in the winter months), low amount of milk consumption (less than 16 oz a day), and exclusively breastfed infants.   The recommended dose is 400 IU (international units) once daily.  This can be bought over the counter in either a single drop form, or with a larger dropper.  Read the label carefully when dosing this to your child.  Too much vitamin D can be harmful.


Your child will receive a Pentacel and Hepatitis A booster today.


  • 18 month olds are active and fast
  • Continue to check the environment for possible hazards
  • Call poison control at 1-800-222-1222 if you suspect your toddler has ingested something toxic
  • Review the 15 month handout for additional safety tips


Present day parents are often confused as to how to discipline their children.  Many parents strive to raise their children with an all encompassing love which will overcome any problems.  Love, however, must be accompanied by discipline.  Without firm limit setting and reasonable expectations clearly communicated and consistently enforced, children grow up to expect society to cater to them, when tantrums bring results, children expect the community to respond in a like manner.

Setting limits, that is, determining a set of rules and expectations in your home to which you expect your child to conform is the first step in effective discipline.  We often do this unconsciously, but to effectively communicate guidelines to children, parents must be clear in their own minds what they are asking.

Any limit setting can generate tension, but it is through successful resolution of conflicts that the emotional growth necessary for adult maturity occurs.  A 2 year old will struggle against bedtime because they must assert their own independence; however they will eventually learn that they must go to bed and when given praise for their efforts, they will be a happy and secure in their new found accomplishment.  The key is consistency.

A good parent resource for discipline is www.positiveparenting.com.