Your 18-Month-Old

Your 18-month-old is a wonderful combination of energy, enthusiasm, expanding language and obstinance. Children this age are learning all about the world and how they function in it, and every day is a new day of learning and discovering. Your child will try to do many new things, explore everything in sight and copy everything you do. Because your child is now learning so much, this is an important time for teaching your values.

Nutrition

Your 18-month-old will not gain much weight over the next six months, and his or her appetite may decrease. Your child will enjoy "grazing" — eating small amounts of food frequently — and will probably prefer carbohydrates like bread, bagels, crackers, pasta and cereal. Your role at mealtimes is also changing. You are no longer in charge of actively feeding your toddler; instead, your responsibility is to prepare and offer the food. Your toddler will choose whether or not to eat.

A few nutrition guidelines:

  • If your toddler has molars, consider giving him or her a chewable multivitamin with minerals, particularly calcium and iron. Most children's multivitamins instruct you to give a 2-year-old one tablet a day. Since your child is not yet 2, give one tablet every other day.
  • Iron and calcium are very important in the second year of life. If you can, give your child iron-fortified infant cereal by mixing it into other foods. Calcium is found in dairy products such as cheese, cottage cheese, yogurt and milk, and also in calcium-enriched orange juice. Your toddler needs at least 500 mg of calcium each day.
  • Limit your toddler's juice intake to no more than 4 ounces a day.
  • Your toddler will change likes and dislikes very quickly, so don't buy too much of any item.
  • Keep offering a variety of food.
  • Remember, your toddler will learn good food habits by watching you eat.

Your toddler is beginning to learn how to use utensils, but will probably spill a lot of food. Don't expect to teach your toddler table manners quite yet. Children this age are still learning how to use the small muscles in their hands, and cannot be very coordinated.

Brush your toddler's teeth at least once a day, especially before bedtime. If you use toothpaste, make sure it does not contain fluoride.

Toilet Learning

Your child is just beginning to feel when he or she is having a bowel movement, so it is too early for potty training. Your child may be interested in the toilet, however, and may want to flush it. Talk to your child about toileting and say, "You may want to use the toilet when you are a big boy (or girl)." If you don't already have a toddler toilet, now's a good time to buy one. You can let your toddler sit on it, even when clothed — your child should find it fun to "practice."

Toddlers don't eat enough fiber to keep their bowel movements soft, and often develop constipation. If your child has firm, hard stools, he or she may associate toileting with pain and become afraid to use the toilet. For that reason, it's important to keep your child's bowel movements soft.

To keep stool soft:

  • Encourage your toddler to drink water.
  • Give your child 2 to 4 ounces of prune juice a day.
  • Offer your child the "P" fruits — peaches, plums, pears, prunes — which help soften bowel movements.

Sleeping

Toddlers this age are so excited about exploring the world that they don't want to stop, and often resist going to bed. A nighttime routine will help your child make the transition from busy day to quiet time and sleep. The routine might include reading a story, singing a song or giving a massage — anything soothing will be helpful. You may also find that your child will go to bed more easily if he or she can listen to a story or songs on CD.

Your child can also take a "transition object" — such as a stuffed animal, blanket or pacifier — to bed. Transition objects help toddlers adjust to new situations and provide comfort.

Your toddler may wake at night. This may be due to nightmares, which may start at this age, other fears such as fear of the dark, or it may just be your child's way of rehearsing all the new things he or she learned during the day. You may find a nightlight helpful at this age.

Behavior and Development

Your child may appear agitated, frustrated or angry more often. Toddlers can get upset over little things that are not done quite right, or will say no to an offered item and then cry when you put it away. What happened to your previously delightful, happy little one?

At 18 months, your child is experiencing a number of internal conflicts:

  • Your toddler desperately wants to be just like you. He or she wants to copy everything you do — brushing teeth, shaving, sweeping the floor, dressing — but at the same time, your toddler needs to prove that he or she is a very different person from you.

    Up until the first birthday, toddlers see themselves as part of you. Now, their developmental task is to learn that they are unique people. The best way for toddlers to show they are different is to tell you "no." Toddlers will say no even when they mean yes.

    You can help your toddler through this difficult stage by offering several choices. Instead of asking if your child would like a cheese sandwich — to which the toddler will usually say "no" — ask, "Would you like a cheese sandwich or a turkey sandwich?" This will reduce your toddler's need to say no.
  • Your toddler wants to explore everything. Toddlers this age can run and climb, and know they can go exploring by themselves. They are learning, however, that the world they're exploring can sometimes be frightening and dangerous. The dog they see can bark and scare them; they can trip and fall on the slide. So, although your child will often run ahead and seem to ignore you, he or she will also come back to you frequently to make sure you are still there. You may even find your child becoming a little more clingy than in the past.
  • Toddlers believe the world revolves around them. They are the most important people in their world. (Most 2-year-olds' favorite word is "mine.") However, they need to learn that there are rules they must obey and things they cannot do because they hurt other people.

All these conflicts contribute to the "terrible twos." Toddlers will try many different behaviors — including hitting, kicking, biting, spitting and pushing — to see if it helps them get what they want. They may also begin to throw temper tantrums to demonstrate their displeasure. It is your responsibility as a parent to teach your child which behaviors are acceptable and which behaviors you dislike.

Temper Tantrums

Temper tantrums happen for three main reasons:

1. When your child is tired or hungry. If this is the reason, help meet your child's needs.

2. When your child is frustrated. If your toddler can't put the puzzle piece in properly, for instance, help by saying, "Let's try it a different way."

3. When your child is angry over not getting what he or she wants. This is a great time to walk out of the room. You can say, "I can't hear you when you act that way" or "I can't talk with you when you aren't listening." Ignoring your child during a temper tantrum is the quickest way to teach that the behavior isn't acceptable and doesn't work to get your attention.

Your toddler desires your attention more than anything else. If you want your toddler to quickly learn that a behavior is unacceptable, don't give him or her your time, your face or your attention. Toddlers learn what is right and wrong by the immediate response of their parent. Turning your face away demonstrates your displeasure and your toddler will learn that the behavior is wrong.

Sharing

Toddlers do not naturally share with other children — they would rather have everything for themselves. Please do not expect your child to share with others. You can teach sharing by giving your child two pieces of food and asking him or her to share the other piece with another parent or child. Your child should always have one item for him or herself before being asked to share with someone else.

Television, Videos and Computers

Please do not allow your toddler to spend more than 30 to 60 minutes a day in front of a TV or computer screen. Too much screen time can cause many problems later: Children who spend more than an hour a day in front of the TV or computer can have shorter attention spans, be less creative and interested in exploring their world, and often spend less time exercising, raising the likelihood of obesity. Also, they are often more aggressive when playing.

18-Month Checkup

Immunizations

If your toddler has not yet had a fourth DTaP vaccination, he or she may receive it at the 18-month checkup. The fourth and fifth doses of the DTaP may cause quite a bit of redness and swelling on your child's leg. This reaction may look like an infection, but it rarely is. Usually no treatment is needed, and the redness and swelling should disappear within two to three days.

Blood Tests

If you would like your toddler's iron and lead levels checked, ask your child's pediatrician. Iron is needed to make red blood cells in the body. When people don't have enough iron, they become anemic. Our office can check for anemia with a simple finger prick in the exam room.

Lead is a poison and can also cause anemia. If you would like to have your child's lead level tested, please ask your child's doctor for a lab requisition, as your child must have blood drawn in the lab for this test. Please call your child's doctor one week after the test to get the results.

Used by permission of Jane E. Anderson, M.D.

 

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.