Educational Materials for 18 Month Well-Visit

The topics listed below are based on American Academy of Pediatrics national recommendations about the kinds of things that are important to discuss or get more information about for children your child's age.

Click on the info to get education and tips from pediatric health care experts about each topic.

Your child and family:

Making sure you have somewhere or someone to turn to for emotional support More Info
Making sure you have somewhere or someone to turn to for emotional support
What is this and why is it important?

At 18 months your child is on the move, most likely having mood swings and in need of constant attention. You might think that now that you don’t have a little baby so you don’t really need help. But the support you need takes a different form.

 It can be a challenge to meet the needs of your child and still have time for yourself, your partner and other family members.  Even though toddlers usually are lovable, most parents have moments of frustration, and even anger, with their child. Feeling this way is common and normal. Support from family, friends and your health care provider can help you through rough times. It’s important to have someone – friend or professional – who can really listen to you. It’s also important to make time to get out, to resume friendships and the activities you were interested in before the birth of your child.

Your child’s health care provider can talk with you about how you are handling the role of being a parent and ways to balance that role, while also making sure that your own needs are met.

What are common questions I can ask my health care provider?
  • It’s amazing how much time toddlers take! How can I make more time for myself?
  • I still feel tired so much of the time. Is this normal? How can I get more rest?
  • How do I balance work and being a parent?
  • I am with my child most of the time and feel very isolated. Is this normal?
Where can I find more information about this topic?

Family Support a Priority at the 18 Month Visit (AAP)

How Becoming Parents Can Affect Your Relationship (KidsHealth)

Replenish thyself: Steering clear of parent burnout (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of family time and eating meals together More Info
Importance of family time and eating meals together
What is this and why is it important?

Family Time
Family time is an important topic for parents of an 18-month-old. It’s more important than ever for your family to spend time together. This helps your toddler feel close to you. Family time also gives you the opportunity to begin to understand what he’s thinking.

To make the most of family time, consider these activities:

  • Talk and play together. Meal times and outings are great opportunities for special family time.
  • Plan outings. Keep such activities short and simple. Go for an hour to a park. Longer outings will likely tire out your toddler and lead to fussiness. Outings could be a walk, a trip to the store, going to visit relatives. Use these opportunities to help your child explore the world; talk about what you are both seeing. Remember to be prepared for a variety needs- snacks, water, toys, etc. And consider a nap beforehand if it will make the outing more enjoyable for all. 
  • Help older children. Let your older children have toys that they don’t have to share with your toddler. Give them a place to store the toys out of reach of the little one.
  • Don’t take sides. There will be conflicts between your children. Help your children work out these problems, but don’t take sides. For example, if two children are fighting over a toy, remove the toy. Don’t favor one child by giving him the toy. And don’t expect your toddler to share toys.
  • Play one-on-one. Just as important as family time is spending individual time with each member of the family.

Mealtimes
Mealtime is a social event. Include your child at family meals, and develop the habit of eating together as a family. Starting this habit now sets the stage for continuing family mealtimes as your toddler grows into a child and teen. Preschool children exposed to three household routines -- regularly eating family meals, getting adequate sleep, and limiting screen-viewing time -- had a roughly 40 percent lower prevalence of obesity than those exposed to none of these routines.
 
Eating meals together has been shown to help parents direct their child toward positive activities and behavior, and reduce the likelihood that they will get involved with alcohol, tobacco, and/or illegal drugs.  It’s a time for the family to share their day and just be together.  The sense of belonging is important for everybody, and your 18-month old will learn to identify with your family and his special place in it. It’s a way of learning to look for common interests and to understand and appreciate differences. It can also provide a secure base for exploration and a source of comfort.  Turn off the television during meal times, as this time should be used to talk with and listen to your children. Remember, mealtime at this age can be messy – and that’s ok!  Put on a bib and lay down some newspapers under his high chair.

You can talk to your child’s health care provider about the importance of family time, eating meals together and how to “fit them in.”

What are common questions I can ask my health care provider?
  • Dinnertime for us can be tricky if one of us is working late or going to the gym. Does breakfast count as eating together?
  • We like to go camping. Anything special we should consider with an 18 month old?
Where can I find more information about this topic?

Family Support a Priority at the 18 Month Visit (AAP)

Make Mealtime a Family Time (USDA)

Turning Family Time into Active Time (AAP)

References

American Academy of Pediatrics (AAP). Effects of Family Meals, Sleeping and Screen Time On Obesity in Preschoolers. Retrieved 4/1/2010 from http://www.healthychildren.org/English/news/Pages/Effects-of-Family-Meals-Sleeping-and-Screen-Time-On-Obesity-in-Preschoolers.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your child’s moods and emotions More Info
Your child’s moods and emotions
What is this and why is it important?

Just when you think you’ve gotten to know your toddler, he changes! Sometimes it may seem like you have a completely different child. As a toddler, your child’s needs , moods and emotions  are changing.  It is not uncommon for an 18-month old to swing back and forth from between fiercely independent to  clinging to you.

As your 18-month-old goes through a surge of independence and exploration, he will start to test boundaries.  Negative attitudes and behaviors, such as using the word “no” and not listening to instructions, are normal at this age as your child is learning to deal with his own growing sense of independence.  Your child’s feelings can be hard for him to handle sometimes and so he may start having tantrums and will need your help to calm down. It can be helpful to understand that negative behaviors are an opportunity for you to help your child sort out his own independence.  In his search for independence, you can help him learn his limits. Tantrums are a reflection of how passionate your child is and how he needs help in learning how to deal with and master his feelings and emotions.

Despite this independence, this is an age where your child might return to clinging. This is because he is learning that you won’t always be right there at his side. That can be a very painful lesson. But your child is also benefiting from these first steps of relative independence, and learning how to use the memory of routine to reassure himself emotionally.

Protest is a healthy way for your child to handle separations; it is related to the strength of his will and his confidence to assert himself . Start preparing your child ahead of time about an upcoming separation.  For example, you might say, “We are going to do some errands.  We’ll be home before your snack, and then we’ll show you what we bought!”  Then, you should be ready to accept a healthy outburst.  Third, you should promise to return, and upon doing so, remind him that you did return.  This is the basis of future trust.

You can talk to your child’s health care provider about his moods and emotions.

What are common questions I can ask my health care provider?
  • What is the best way to deal with temper tantrums?
  • My child says “NO” all the time! How do I guide my child to do things that he doesn’t want to do?
  • My baby used to be so easy to deal with, but now he gets upset whenever it is time to get dressed or go home from his grandmother’s or to go to bed. How do I handle this without yelling?
  • My partner thinks we should be letting the baby take the lead on what he wants. Won’t we end up spoiling him ?
Where can I find more information about this topic?

Emotional Development: 1 Year Olds (AAP)

Emotional Development: 2 Year Olds (AAP)

Your Toddler’s Changing Behavior: Child Development and the 18 Month Visit (AAP)

How to Help Your Toddler Begin Developing Empathy (Zero to Three)

Your Child's Development: 15 to 18 Months (Zero to Three)

References

American Academy of Pediatrics (AAP). Soothing Your Child's Separation Anxiety. Retrieved 4/1/2010 from http://www.healthychildren.org/English/ages-stages/toddler/pages/Soothing-Your-Childs-Separation-Anxiety.aspx

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

Sibling rivalry More Info
Sibling rivalry
What is this and why is it important?

Having a toddler as well as older children means there will be lots going on that the toddler will want to be part of. This certainly means your toddler will be learning about language and play, but children may need help to play well according to their own ages and interests. And your children will all want your attention and approval. The age difference between siblings can affect their relationship. Often the older sibling is developmentally ready for games and activities that the younger one isn’t. And often the younger one imagines he is just as able to do all the things his older sibling does. 

There will be conflicts between your children and times when you’ll need to intervene in disagreements, of course, but try not to take sides. Instead help your children work out these problems.  For example, if two children are fighting over a toy, remove the toy. Don’t favor one child by giving him the toy. And don’t expect your toddler to share toys.  But do not allow hitting, biting, or other aggressive behavior. Brief time-outs are a good way to tell your toddler these behaviors are not appropriate. You may have to step in sometimes and distract your younger child so your older child can have time to do “big kid stuff.” Let your older children have toys that they don’t have to share with your toddler. Give them a place to store the toys out of reach of the little one.  It is also important to create times that your children can engage in cooperative play when and where appropriate.  In other words, set them up with some play that you do not think they will fight in, such as chasing games or crafts.

Parents can help build healthy relationships between siblings by spending "special time" alone with each child and looking for things to do that all members of the family enjoy. Family vacations are great opportunities to enhance the positives of their relationship and at the same time give each their own activity and special time.

You can talk to your child’s health care provider about sibling rivalry.

What are common questions I can ask my health care provider?
  • My older child isn’t very patient with the toddler. They start to play together but it ends up with lots of fighting. Should I try to keep them apart?
  • My older child wants time with me too, but I have to keep an eye on my toddler every minute. How can I help my older child understand the situation better?
  • We have a younger child and my 18-month-old is not gentle with him and resents the time I spend with him . What are some tips for helping my 18-month learn how to play with my infant?
Where can I find more information about this topic?

Dealing with Sibling Rivalry (AAP)

Family Support a Priority at the 18 Month Visit (AAP)

Sibling Rivalry (KidsHealth)

Controling Sibling Rivalry (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

New baby on the way? Preparing your other children More Info
New baby on the way? Preparing your other children
What is this and why is it important?

You may be expecting the birth of a new baby, which is a big event in your family’s life!  Your child will benefit from being a part of the planning and preparation.  As adults, we can understand that the newborn has needs that require immediate—and concentrated—attention. An 18-month-old doesn’t understand that, and will have needs of his own. It’s also important to begin to prepare the little one who has been the baby for the past 18 months.

Some tips to prepare your toddler include:

  • Read books about families who have a new baby.
  • Point out babies in the neighborhood or play with a favorite doll. 
  • Enroll him in a big brother class at the local hospital. This will help him to know where you will be when you have the baby.
  • Tell him who will stay with him while you are at the hospital.
  • Continue to give him a lot of love and attention.
  • Try not to make any big changes right before the baby is born.
  • Understand that your child might go back to some earlier behaviors when the baby comes, like wanting to use a bottle.

Your child’s doctor will know how to help with this too.

Once your baby is born, try giving your 18-month-old special jobs to help you with the baby can be helpful (like getting a diaper during changing’s, for example). At the same time, it’s important that the 18-month-old not be given responsibilities he is not ready for. It is important to teach your toddler what a newborn is like and that it will likely be a while before the baby is really able to play..

You can talk to your child’s health care provider about preparing your other children for a new baby.

What are common questions I can ask my health care provider?
  • My child seems very confused about the idea of a baby in my tummy - how can I prepare him for the birth of a sibling?
  • Where can I find help with the costs of a second baby: food, clothes, a second crib?
Where can I find more information about this topic?

Family Support a Priority at the 18 Month Visit (AAP)

Preparing Your Child for a New Sibling (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of consistent routines and expectations of your child More Info
Importance of consistent routines and expectations of your child
What is this and why is it important?

By now, your child (and your family) has probably settled into predictable daily routines for eating, sleeping, napping and playtime. If not, now is a great time to start! Consistent daily routines have been shown to have a positive impact on a child’s sleep and overall behavior. Toddlers who have consistent and predictable daily routines are able to develop their own self-regulation, which leads to better self-regulation later.  While it can be tricky sometimes, strive to have a regular daily schedule for your child – eat around the same times, nap at the same times, allow for regular playtime and a bedtime routine. Continuing to provide regular structure and routines for your child will increase his sense of security.

As your 18-month-old grows more independent, he will be testing his boundaries – a lot!  Reinforce limits and appropriate behavior.  Be consistent. Work with your partner and other caregivers to show your child what you expect and what will happen if he goes beyond those limits. Make sure everyone is on the same page. Your toddler doesn’t know what to do with mixed messages.. Remember to look for opportunities to enforce good behavior.

If you’re not sure about your child’s routines or how to establish them, your child’s health care provider can help you learn your child’s cues and can suggest ways you can help your child settle into routines.  You can talk to your child’s health care provider about strategies for establishing and keeping a consistent daily routine and its impact on behavior.

What are common questions I can ask my health care provider?
  • My toddler has a day care provider some days of the week. The day care provider doesn’t follow my schedule very well and he sometimes ends up really tired and out of sorts. How can make sure we are being consistent?
  • Some days my toddler can skip a nap but after 2 days it’s really clear he’s too tired to stay awake through dinner. How do I make the decision on whether to stop the naps?
Where can I find more information about this topic?

Your Toddler’s Changing Behavior: Child Development and the 18 Month Visit (AAP)

Disciplining Your Toddler (KidsHealth)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

The value of parent-toddler playgroups More Info
The value of parent-toddler playgroups
What is this and why is it important?

This is an age where your child benefits from playing with peers. One or two regular playmates are enough. Playing with other children helps your child learn from them by imitation.  Life skills are learned when children play and that can help them to make and keep friends. As a parent you can encourage your child to take part in healthy playtime by taking your child to a park to play with other children or by joining an organized play group.

Playing With Others is Important Child's Work

  • Support play by making your home a good place to play.
  • Teach the skills needed to play well with others.
  • Learning to play well with others is not a one-time lesson. It takes time and practice.
  • Important life skills are learned when children play. These skills will help them make and keep friends.

When young children play with children close to their own age, they learn:

  • How to cooperate
  • When to lead and when to follow
  • How to solve problems

Create Play Opportunities

  • Invite other children to your home or to play in the neighborhood park.
  • The first visit needs to be short (about 1 hour) and is best with only one other child.
  • When playing without parents, children do best with a small number of children.
  • Plan to end before everyone gets too tired.
  • Know how to contact the other child’s parent.

Go to another child’s home

  • For the first visit, you may want to stay until you know your child is comfortable being there without you.
  • Get to know the other child’s parents. You might be able to help each other out!

You can talk to your child’s health care provider about the value of parent-toddler playgroups.

What are common questions I can ask my health care provider?
  • What is the right number of kids for a play date for an 18-month-old? How many children are too much or too little?
  • My toddler loves to be at our playgroup with the other kids. The others aren’t always careful about sharing and playing safely. How can I tell them to play nicely together without annoying the other parents?
  • I notice there are on-line chat groups or forums for parents – what do you think of these?
Where can I find more information about this topic?

Young Children Learn A Lot When They Play (AAP)

Games for Toddlers (KidsHealth)

Child’s Play: It’s Serious Business (AAP)

References

American Academy of Pediatrics (AAP). Young Children Learn A Lot When They Play. Retrieved 4/1/2010 from http://www.healthychildren.org/English/ages-stages/toddler/fitness/Pages/Young-Children-Learn-A-Lot-When-They-Play.aspx

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Issues related to feeding your child More Info
Issues related to feeding your child
What is this and why is it important?

Toddlers have many ideas about what they like and what they don’t – and foods will likely be part of this pattern. Your toddler may become more aware and suspicious of new or strange foods, but do not limit the menu to foods he likes. Try not to get into struggles at mealtime. You’ll feel better if your child has healthy foods to choose from. You can offer a choice of cheese or yogurt for the same meal, or cereal or toast.  Keep offering good snacks during the day. This will help your toddler stay nourished so you won’t worry if he doesn’t eat much at one meal or rejects what’s being offered. Even if he does reject new foods, keep offering them – sometimes it takes several tries.

If you are still breastfeeding, you can feel comfortable continuing to do so as for as long as you and your child both want to. 

Infants who sleep with a bottle containing milk, juice, soda, or other sweetened liquids are at a high risk of developing tooth decay. It is recommended that the bottle be given up entirely at around age one and almost certainly by eighteen months. As long as your baby is drinking from a cup, he doesn’t need to take liquids from a bottle. If you must give him a bottle, limit the contents to plain water.

Unfortunately, weaning your baby from the bottle may not be as easy as it sounds. To help things along, eliminate the midday bottle first, then the evening and morning ones; save the bedtime bottle for last, but remember to limit the contents to plain water. If your baby will not take a bottle with plain water initially, slowly over a short period of time dilute the formula or other contents with water so that after a week or two the bottle contains only water.

It’s easy to get into the habit of using a bottle to comfort a child or help him sleep. But at this age, he no longer needs anything to eat or drink during the night. If you are still feeding him at that time, you should stop. Even if he demands a bottle and drinks thirstily, nighttime feedings are a comfort rather than a nutritional necessity. The bottle soon turns into a crutch and prevents his learning to fall back to sleep on his own. If he cries for only a short time, try letting him cry back to sleep. After a few nights he’ll probably forget all about the bottle. If this doesn’t happen, consult your pediatrician.

Incidentally, giving your toddler a drink or other snack before bedtime is acceptable— provided you brush his teeth afterward. In fact, it may help him fall asleep. A short breastfeeding, a drink of cow’s milk or other liquid, or even some fruit or another nutritious food will do. If the snack is a bottle, gradually phase it out by substituting a cup.

You can talk to your child’s health care provider about issues related to feeding your child.  You can also ask your child’s health care provider about resources or referrals for food and/or nutrition assistance if you need help.

What are common questions I can ask my health care provider?
  • I’m trying to get my toddler to eat what we eat instead of baby food, but he isn’t willing to try anything. Should I just stop offering baby food and wait until he is hungry enough?
  • We never had a problem with my child at mealtime but now he won’t let us feed him . There’s food everywhere, is he getting enough to eat?
  • When should my child stop drinking from a bottle?
Where can I find more information about this topic?

Optimizing Nutrition for Toddlers (AAP)

Help Me Be Healthy: 1 to 1 1/2 Years (AAP)

Toddlers at the Table: Avoiding Power Struggles (KidsHealth)

Follow a Meal and Snack Schedule (USDA)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

American Academy of Pediatrics (AAP) Healthy Children. http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Discontinuing-the-Bottle.aspx. Accessed 1/1/10.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your developing child:

Behaviors to expect in the next few months More Info
Behaviors to expect in the next few months
What is this and why is it important?

At this age, toddlers spend all day trying new things.  Rather than walk, your child will run everywhere, and his excitement as he explores overwhelms whatever limited impulse control he has.  Climbing into everything is more and more exciting.  But he cannot be relied upon to worry about heights, so parents and caregivers must protect him .  

He might show anxiety when separated from a parent but might be willing to leave a parent to play with others, checking back often. Your child is becoming more of a social creature or is at least interested in being around other young children.  This is important to your child’s development and a good time can be had by all but expect some unwanted behavior such as hitting, pulling hair or biting.  Learn more about how to deal with this behavior in the Ways to guide and discipline your child section.

He can tell you what his needs by pointing to things, telling you with simple words or with noises that make sense to you or by showing you. You will also see your child’s speech and communication skills grow.  A two-year-old will be using verbs to make short sentences and is beginning to use simple adjectives: “Go to store.” “Pretty dress.” “I want that. It’s nice.” Encourage this language development by using simple words, repeating what you heard from your child and asking him questions.  Your child uses some words, but not nearly enough to tell you how he feels or what he wants. He will be frustrated - and frustrating! Remember that even during those frustrating times with your child, you are his favorite person. You want to do all you can to show him love and guide him in the right direction.

Your 18-month-old is becoming more aware of him “self.”  For example, when looking in a mirror, if there is something on his nose, he will touch his nose rather than the mirror.  Self-exploration at this age becomes heightened.  A toddler is fascinated with his eyes, his nose and his mouth.  When he gets a chance, he is fascinated with his navel and his genitalia.  Little boys at this age are excited by their penises when they are undiapered.  Girls begin to to touch their vaginal area.  These parts of their bodies must be very special to them when they are finally uncovered since they are clothed and out of sight for so much of their experience.  Parents and caregivers needn’t try to stop this exploration.  These are important parts of children’s bodies, and they need to get familiar with them.  Your 18-month-old might be getting more interested in using the potty in the next few months.  Read the Toilet Training section to learn more about understanding readiness.

You can talk to your child’s health care provider about behaviors to expect in the next few months.

What are common questions I can ask my health care provider?
  • What are some key behaviors I can expect to see in the next few months?
  • Are there parent support groups I can join for parents of toddlers? He isn’t 2 yet but it feels as if “the terrible two’s” have struck!
  • I want my toddler to have some choices, but I can’t always let him have what he wants. How do I get my toddler to not just scream for what he wants?
  • Is it normal for my child to be interested in his genitalia at this age?
Where can I find more information about this topic?

Your Toddler’s Changing Behavior: Child Development and the 18 Month Visit (AAP)

From Baby to Big Kid: Month 18 (Zero to Three)

Your Child's Development: 18 to 24 Months (Zero to Three)

Growth Milestones: 18 Months (KidsGrowth)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How your child might start to cling to you again or more More Info
How your child might start to cling to you again or more
What is this and why is it important?

Despite your 18-month-old’s growing independence, this is an age where your child might return to clinging. This is because he is learning that you won’t always be right there at his side. That can be a very painful lesson. But your child is also benefiting from these first steps of relative independence, and learning how to use the memory of routine to reassure himself emotionally.

You might also notice that when your child is unsure of himself , he’s more likely to cling to you. You’re his safe spot. This is normal. Protest is a healthy way for your child to handle separations; it is related to the strength of his will and his confidence to assert himself . Start preparing your child ahead of time about an upcoming separation.  For example, you might say, “We are going to do some errands.  We’ll be home before your snack, and then we’ll show you what we bought!”  Then, you should be ready to accept a healthy outburst.  Third, you should promise to return, and upon doing so, remind him that you did return.  This is the basis of future trust.

You can talk to your child’s health care provider about how he reacts in new situations and strategies you can use to make the transitions easier.

What are common questions I can ask my health care provider?
  • My 18-month-old has suddenly returned to being clingy – why?!
  • The day care center doesn’t understand why he is now objecting to my leaving him in the morning. What can I say to help them support me when I have to leave?
  • I don’t like leaving my child with sitters and now my family is saying I spoil him and he should stay with others. When will the crying fits get stop?
Where can I find more information about this topic?

Soothing Your Child's Separation Anxiety (AAP)

Separation Anxiety (KidsGrowth)

References

American Academy of Pediatrics (AAP). Soothing Your Child's Separation Anxiety. Retrieved 4/1/2010 from http://www.healthychildren.org/English/ages-stages/toddler/pages/Soothing-Your-Childs-Separation-Anxiety.aspx

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways to guide and discipline your child More Info
Ways to guide and discipline your child
What is this and why is it important?

Toddlers at this age suddenly seem to know so much. They can follow your lead, bring a toy or diaper to you when asked, and understand far more words than they can speak. Guidance and discipline become very important in his second year of life.  However, it must be seen as a long-term teaching project.  Understanding your child’s need for learning limits is the most important step for parents and caregivers and is the basis for discipline decision. 

It is important to have realistic expectations for your child’s behavior and know that he learns from trial and error.  A child at this age will respond to your attempts to re-direct unwanted behavior but will likely repeat the action. This is not an act of disobedience, just natural curiosity and exploration.  You won’t be able to force your child to act exactly as you want and you are bound to have moments that he is just plain unruly.

Discipline should be a teaching effort, not a punishing one. It should be focused on important undesirable behaviors so that your strategies are more meaningful when you use them. Below are a few tips and strategies for guiding and disciplining your child:

  • Give your child lots of praise for good behavior and for things you want to encourage.
  • When he’s doing things you don’t like, or that might be dangerous, try brief explanations - “Don’t pull the kitty’s tail; that hurts the kitty.” When you see your child approaching an unsafe situation, remove him , and say "NO" firmly. Give priority to enforcing the limits that keep him safe.
  • Try distracting your child away from an unwanted behavior or activity – for example, remove the item he is not supposed to touch and hand him a new toy.  Reading to your child is a great distraction. He wants to be near you and hear your voice.
  • Eliminate as many temptations as possible, he needs freedom to explore in an area that is not filled with a number of “no, no's."
  • Keep discipline brief and positive. A child won’t understand a long scolding or a long time-out. Use simple words to tell him what he’s done wrong. Try to be positive. Be consistent. Teach, rather than punish. Try understanding your child’s point of view. This helps make discipline more effective.
  • If things are really getting out of hand, you might want to try a brief time-out (1 to 2 minutes). Spanking, shouting, and long explanations are not the best ways to teach your toddler.
  • Try a class or group. Parenting classes and parent support groups are great places to learn. You might also check out books and pamphlets or call a parenting advice hotline in your community.

You can talk to your health care provider about ways to guide and discipline your child.  Your child’s health care provider can help you identify strategies that match your child’s temperament and style of learning.

What are common questions I can ask my health care provider?
  • I was spanked as a child and I grew up fine. What is wrong with spanking my child?
  • How long is an appropriate for a time-out for an 18-month-old? Should I stay with my child during the time-out or should he be out of sight?
  • Where can I find parenting classes in our community?
  • Are there books or other resources you recommend for guiding and disciplining children this age?
Where can I find more information about this topic?

Discipline Tips: Key Messages for Parents (AAP)

Aggressive Behavior (AAP0

Disciplining Your Child (KidsHealth)

Finding Appropriate Discipline (Touchpoints)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Television – why the experts say no TV More Info
Television – why the experts say no TV
What is this and why is it important?

National recommendations discourage TV, DVD and video watching for children under the age of two.  No study has shown benefits to viewing and several have found that early TV viewing is associated with delayed language and shorter attention spans. Do your best to avoid letting your child watch TV or videos. If others in your household are watching, try to move your toddler to another room or distract him with toys or games.  You can also restrict TV time for others to when your toddler is napping or in bed for the evening.

You can talk to your child’s health care provider about why the experts say no TV watching for your child.

What are common questions I can ask my health care provider?
  • Is public television okay? What about videos that are made for toddlers to enhance their learning and development?
  • It’s very hard to keep my child from watching TV when others are watching, what are some tips to avoid this?
  • My toddler really seems to pay attention and become engaged with some of programs, isn’t this good for him ?
Where can I find more information about this topic?

Where We Stand: TV Viewing Time (AAP)

How TV Affects Your Child (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Promoting your child’s communication:

Importance of using simple words, asking simple questions, and repeating what you heard from your child More Info
Importance of using simple words, asking simple questions, and repeating what you heard from your child
What is this and why is it important?

At this age, your 18-month-old is learning to say about ten to twenty different words.  They will probably be words he understands, words that he hears often and words that are meaningful and important to him .   For example, he might be able to imitate a new word he hears you say. Typical first words often include family member and pet names; labels for familiar objects such as “ball,” “bottle,” “juice”; action words such as “go,” “look”; greetings such as “Hi” and “Bye” and so on.

You can help promote your child’s language development!  Using brief, clear, specific words and gestures over and over will help your toddler better understand what you are saying and feel like he can try to use them too, such as “eat,” “shoe,” “more milk.” When he speaks and you understand him , repeat the words. He’ll feel pleased about having made his point. Communicating and being understood is a universal need.

When your child talks, repeat what he says often so that he experiences being heard.  Respond to the meaning and not the exact words that are spoken. Ask questions and wait for an answer. Don’t focus on correcting the words. Giving kids questions to answer and time to respond enhances language development.

Using simple words and phrases is also important when asking your child to do something or giving directions. Tasks that seem simple, like getting dressed in the morning, actually have many steps.  If your child “can’t” or “won’t” do something, it may be that he still needs to learn the steps.  Explain steps one at a time and then offer praise.  For example:

  1. “Please go get that ball.  It is by the couch.”
  2. “Ok, now bring the ball to the toy basket.”
  3. “Now put it in the basket.”
  4. “Thank you!  You did a good job helping clean.”

Take time to remind your child about each step rather than just doing it yourself or getting upset.  It will take longer at first but is well worth it for you and your child!

You can talk to your child’s health care provider about the importance of using simple words, asking simple questions and repeating what you heard from your child.

What are common questions I can ask my health care provider?
  • My child is the only one in playgroup not talking. Should we be testing him now or just wait and see?
  • We speak another language at home. Which one should I use with my toddler or can we use both?
  • My toddler is saying some words like “wawa” for water. Should we say “wawa” or should we use the real word?
  • My older child doesn’t speak clearly. Will that make it hard for my toddler to learn to speak?
Where can I find more information about this topic?

Talking about Talk: Language and Hearing at the 18 Month Visit (AAP)

How Babies Communicate (KidsHealth)

Your Childs Development: 18 to 24 Months (Zero to Three)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways to read to your child that promote his language development More Info
Ways to read to your child that promote his language development
What is this and why is it important?

Reading helps with language and speech development, which will be especially important for your child over the next year.  It’s not just the story itself that’s important, but how your child becomes engaged with it.  It’s okay to read the same story many, many times.  Children this age are learning to love repetition – they love when they can anticipate what will happen next.  You don’t have to be a great reader to share books . Look at the pictures and talk about them. Ask your child questions – “Where’s the big dog?” “See, it’s raining – does the little boy have an umbrella?” Use simple words to describe what’s going on.

You can also see what your child is interested in and can then talk about those things, such as fire trucks or babies, and relate them to your child’s life, beyond what is in the story – “Yes, that’s a baby like Aunt Kathy’s baby, Maya.”  Talk about how people in the pictures feel. Do they look happy or sad? This helps your child learn about emotions.
All of this promotes language development. 

And because reading involves physical closeness, as you hold your child on your lap or sit next to her, it strengthens the bond you have with your child. Interesting things to look at, love and individual attention – what could be better! Reading to your child has so many benefits – try to do it every day.

You can talk to your child’s health care provider about ways to read to your child that promote language development.

What are common questions I can ask my health care provider?
  • How often should I read to my child?
  • I feel like we’re reading the same story over and over and over. Is this okay? Should I vary the stories more?
  • We don’t always make it through some of the books we read –does that matter?
  • How does reading promote language development?
  • How do I know which books “age-appropriate” for my child?
Where can I find more information about this topic?

Talking about Talk: Language and Hearing at the 18 Month Visit (AAP)

Toddler Reading Time (KidsHealth)

Importance of Reading Aloud (Reach Out and Read)

Reading Tips for Parents and Educators (Reach Out and Read)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How your child talks More Info
How your child talks
What is this and why is it important?

Most babies say their first words between one and two years of age, though some start even sooner and others don't start until they're nearly 2-years-old. A baby who is preoccupied with learning to walk may push talking to the back burner; it's not unusual and is nothing to be alarmed about.

Babies this age might have learned fragments of dozens of words that probably won't be recognizable yet. When they get around to talking, though, they'll probably progress quickly and soon be able to point at something familiar and say its name, and recognize names of familiar people, objects, and body parts.

By 2 years old, babies may use phrases and even two- to four-word sentences, although your doctor will only expect to hear that your child is putting two words together.

No matter when babies say their first words, it's a sure bet they are already understanding much of what is said to them before that. Your child should be able to respond to commands ("Roll the ball to Mommy") and should be fully aware of the names of familiar objects and family members.

You might find yourself struggling with your toddler to do as you say, only to have him ignore you or scream in protest. Toddlers like testing limits and their degree of control. By 18 months, most have mastered saying "no" with authority, and by age 2 may throw a tantrum when they're unwilling to do something. They'll also show signs of possessiveness — expect to hear "mine" or see tears if something is taken away or you show attention to someone else.

Between 15 and 18 months, your baby will probably begin to enjoy language games that ask him to identify things, such as: "Where's your ear?" and "Where is Mommy?" Your child's vocabulary will grow quickly, but pronunciation isn't likely to keep pace. Resist the temptation to correct your baby's pronunciation; most babies mispronounce their words. Instead, emphasize the correct pronunciation in your response.

Should I Be Concerned?
Some babies don't talk until their second birthday and choose instead to get by with the use of gestures and sounds. Vocabulary varies widely at this age, too; some babies say dozens of words, others only a few.

Most babies this age have these communication milestones in common:

  • speak about 15 words by 18 months
  • put two words together to form a sentence by age 2
  • follow simple directions by age 2

Hearing problems may become more apparent during this stage because of the emergence of speech. Don't hesitate to report any concerns you have to your doctor immediately, especially if you feel your child is not babbling or responding to your speech patterns. Sometimes chronic ear infections can leave kids with excessive fluid buildup that can interfere with normal hearing. Special tests can check for hearing loss.

You can talk to your child's health care provider about how your child talks.

What are common questions I can ask my health care provider?
  • How many words should my child be saying now?
  • I can't understand what my child is saying, is this normal at this age?
  • My child seems to understand everything I am saying to him but he doesn't say very many words, is this normal?
Where can I find more information about this topic?

Communication and Your 1- to 2-Year Old (KidsHealth)

Talking about Talk: Language and Hearing at the 18 Month Visit (AAP)

Toddler Reading Time (KidsHealth)

References

KidsHealth from Nemours. Communication and Your 1- to 2-Year Old. Retrieved from www.KidsHealth.org on 1/1/2010.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Toilet training readiness:

Toilet training More Info
Toilet training
What is this and why is it important?

Determining the best time to begin toilet training is not easy—not only because readiness occurs at different ages for different children, but because your child may be ready in one area of development but not in another. The average age for a child to be toilet trained during the day is 30 months.

Signs of readiness
Even if grandma or Aunt Sofia think it’s time, your child isn’t ready to be toilet trained until:

  • He can stay dry for periods of about 2 hours
  • He knows the difference between wet and dry
  • He can pull his pants up and down
  • He seems interested in learning about toilet training
  • He shows or tells you when he’s about to have a bowel movement

Steps to prepare and to pre-potty training include:

  • Reading books together about using the potty.
  • Letting a daughter observe a mother or sister using the bathroom (Let a son watch the father or a brother).
  • Getting a potty chair that sits on the floor, as some children may be fearful of falling into or off a regular toilet. With boys, encourage them to sit down for both toilet functions until they master pooping in the potty chair.
  • Praising your child for sitting on the potty, even with his clothes on.
  • Going on a special trip to pick out “big kid” underwear to wear later on when he’s ready to stop using diapers during the day.

Review the resources below and visit the AAP’s website to get more tips about toilet training.  And remember that you can talk to your child’s health care provider about toilet training readiness and strategies

What are common questions I can ask my health care provider?
  • What are some ways that I can tell that my child is ready to start to toilet training?
  • My child needs to be potty trained to go to preschool, so shouldn’t I start working on it now?
  • Is it better to train him on a kid’s potty or the same one we use?
Where can I find more information about this topic?

Toilet Training: Looking Ahead at the 18 Month Visit (AAP)

Toddler Toilet Training Resources (AAP)

References

American Academy of Pediatrics (AAP) Healthy Children. http://www.healthychildren.org/English/Pages/default.aspx. Accessed 4/1/2010.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your child’s safety:

Preventing injuries indoors and outdoors More Info
Preventing injuries indoors and outdoors
What is this and why is it important?

As your child gets older, he can move more quickly, climb higher and get away from you faster than you thought possible.  At 18-months, your child thinks he can do more than you will think is safe!  No matter how safe you think your house is, children this age need constant watching, unless they are in a playpen or crib.

Plan ahead to minimize potential dangers.  An 18-month-old who is able to move around on his own can get into, onto and around things that might not be safe. Parents and caregivers have to keep an eye on these toddlers, but also try to make your home and other play areas, inside and out, as safe as possible.  This includes grandparents’ homes or anywhere your child visits. Try getting down on your child’s level to see if there are dangers you may have missed.

Teach your child the meaning of the word "hot." Use the back burners on the stove, and turn handles toward the back. Anticipate that some children will climb out of a crib at this age. Lower the crib mattress. Prevent falls by using gates at the tops and bottoms of steps. Watch closely when he is going up or down the steps. To prevent your child from falling out of a window, keep furniture away from windows and install window guards that can open easily in case of a fire.

When outside, hold on to your toddler whenever you are near streets, parking lots and driveways, even in quiet neighborhoods. Make sure there is sand, woodchips, or other soft surfaces under outdoor play equipment. A fenced yard is preferred for outside playing. 
 
You can talk to your child’s health care provider about preventing injuries indoors and outdoors.

What are common questions I can ask my health care provider?
  • My toddler loves to climb on furniture. I try to keep an eye on him , but I’m afraid he is going to get hurt. What can I do?
  • My parents want to take care of my toddler while I work, but their house has a lot of things that I don’t think are safe for an 18-month old. Is there a checklist I could give them?
  • We try to childproof our house, but when we go to visit friends and family they don’t understand why I start moving things. Am I being too cautious?
Where can I find more information about this topic?

Toddler Safety: Topics at the 18 Month Visit (AAP)

Preventing injuries: at home, at play, and on the way (Safe Kids USA)

Making Your Home Safe for Your Child

Safety Outside

Home Safety: Here's How (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

Installing the car-seat correctly More Info
Installing the car-seat correctly
What is this and why is it important?

Studies show that up to 80% of car safety seats are not installed or used correctly. It is best for children to ride rear-facing as long as possible to the highest weight and height allowed by the manufacturer of their car seat.  When your child has outgrown the seat rear-facing, he should use a forward-facing seat with a full harness as long he will fit in it (usually called a “convertible seat” or “forward-facing car seat”). Do not put toddler car seats in the front seat. This is especially dangerous if the car has an airbag on the passenger side.  Your 18 month old is not ready for a booster seat, which is  for older children who have outgrown their forward-facing car safety seats. A booster seat and shouldn’t be used until your child is about 4 years old and 40 pounds.

Make sure the harnesses are not too loose. There should be no more than a finger’s width of space between his collarbone and the harness strap. It’s important that you insist on using the car seat every time without exception. Don’t let your child think you will let him out of the seat when driving.  Do not start your vehicle until everyone is buckled up – children watch everything their parents do.

This is a good time to double check the manufacturer’s instructions (remember, most people have the car seat installed wrong).  Contact the Child Safety Seat Inspection Station locator to find the nearest certified inspector who can check the installation and make any corrections needed.   You can find this information at www.seatcheck.org or by calling 1-866-SEAT-CHECK.

You can talk to your child’s health care provider about installing the car seat correctly.

What are common questions I can ask my health care provider?
  • My child is pretty small for his age. How long do I have to wait to turn his car seat to facing front?
  • My child is always unhappy in his car seat. Do you think he suffers from car sickness or is he just cranky? What do other families do!
Where can I find more information about this topic?

Toddler Safety: Topics at the 18 Month Visit (AAP)

Car Safety Seats: Information for Families for 2012 (AAP)

Car and Booster Seats for Your Toddler (Children's Hospital of Philadelphia)

Child Safety Seat Inspection Station Locator

References

American Academy of Pediatrics (AAP). Car Safety Seats: Information for Families for 2010. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families-2010.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Tombrello, S. When should my child switch from a car seat to a booster seat? Retrieved 4/1/2010 from http://www.babycenter.com/404_when-should-my-child-switch-from-a-car-seat-to-a-booster-sea_1384636.bc

Setting a positive example for your child by always using your seat belt More Info
Setting a positive example for your child by always using your seat belt
What is this and why is it important?

Do not start your vehicle until everyone is buckled up – children watch everything their parents do and love to copy them so it is important for you to model safe behaviors by always wearing your safety belt. The best way to get your child to accept car seats as a natural way to travel is to use your seatbelt yourself every time you are in a car. Your good habits keep everyone in the car safer.

You can talk to your child’s health care provider about setting a positive example for your child by always using your seat belt.

What are common questions I can ask my health care provider?
  • On short trips I might not use my seat belt but I do put the baby in his car seat. Isn’t that good enough?
  • What can I say that will convince my parents to wear their seat belts when they have my child with them?
Where can I find more information about this topic?

Encouraging Seat Belt Use (NSA)

Buckling Up (Advocates for Highway & Auto Safety)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Preventing falls from stairs, windows and other dangerous places More Info
Preventing falls from stairs, windows and other dangerous places
What is this and why is it important?

Many toddlers are excellent climbers – and find so many interesting things to get into! They also love to look out of windows, but the weight of a child who leans against a screen is enough to push the screen out and cause the child to fall.  Open windows from the top if possible. Install window guards on windows that are on the second floor or higher that only an adult or older child can open from the inside. Never put chairs, sofas, low tables, or anything else a child might climb on in front of a window. Doing so gives him access to the window and creates an opportunity for a serious fall.

Stairs are another ready-made—but potentially dangerous—obstacle course. Although your child is probably getting pretty good at going up and down stairs, you should not allow him to play on them alone during this time.  Watch closely when he is going up or down the steps.

18-month-olds move quickly and even if parents are nearby, there often isn’t time to prevent a fall. You can talk to your child’s health care provider about keeping your child safe from falls.

What are common questions I can ask my health care provider?
  • What childproofing tools can be used to prevent a child from falling out of a window? Is the screen on the window enough to stop my child from falling?
  • I have a deck – what precautions should I use so that my child doesn’t fall off the deck?
  • Is a playpen a bad idea at this age? He doesn’t mind it for a short time and I just have to do things and know he is safe.
Where can I find more information about this topic?

Toddler Safety: Topics at the 18 Month Visit (AAP)

Falls Prevention (Home Safety Council)

Safe Kids USA - How to Install a Window Guard

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Fire safety, such as insuring smoke detectors are working and planning escape routes More Info
Fire safety, such as insuring smoke detectors are working and planning escape routes
What is this and why is it important?

Your toddler is just learning that objects can be hot. But he still doesn’t understand that he can get burned. Protect him by taking these steps:

  • Don’t leave heavy objects or hot liquids on a table with a tablecloth. Your child could tug on the cloth and cause the object to fall on him .
  • Turn panhandles toward the back of the stove and use only the back burners.
  • Keep your child away from
    • Hot stoves
    • Fireplaces
    • Irons
    • Curling irons
    • Space heaters
    • small appliances
    • Electric cords.

Fire Safety:
One of the most important steps you can take to protect your family against fire is to install smoke alarms and keep them in good working order. You can buy smoke alarms at most home and hardware stores, and they often cost $10 or less. Check with your fire department to see if they give out and install free smoke alarms.

  • Install smoke alarms outside every bedroom or any area where someone sleeps. Also install them in furnace areas. Be sure there is at least 1 alarm on every level of your home, including the basement, or at each end of a mobile home. 
  • Place smoke alarms away from the kitchen and bathroom. False alarms can occur while cooking or even showering.
  • Test smoke alarms every month by pushing the test button. It is best to use smoke alarms that have long-life batteries, but if you do not, change the batteries at least once a year, such as when you change your clocks in the fall. 
  • Replace smoke alarms every 10 years.
  • Never paint a smoke alarm.
  • Clean (dust or vacuum) smoke alarms once a month. 
  • Use smoke alarms equipped with a flashing light and an alarm in homes with children or adults who are hard of hearing or deaf.

Fire Drills - Be Prepared! 

  • Have an escape plan and practice it with your family. Determine when and how you will grab your 18-month-old and continue out. This will help you and your family reach safety when it counts. When a fire occurs, there will be no time for planning an escape. 
  • Draw a floor plan of your home. Discuss with your family 2 ways to exit every room. Make sure everyone knows how to get out and that doors and windows can be easily opened to permit escape. If you live in an apartment building, never use an elevator during a fire. Use the stairs!
  • Agree on a meeting place. Choose a spot outside your home near a tree, street corner, or fence where everyone can meet after escaping. 
  • Practice, practice, practice. Practice your exit drill at least twice a year (including how/when you grab your 18-month-old). Remember that fire drills are not a race. Get out quickly, but calmly and carefully. Try practicing realistic situations. Pretend that some exits or doorways are blocked or that the lights are out. The more prepared your family is, the better your chances of surviving a fire.

You can talk to your child’s health care provider about fire safety.

What are common questions I can ask my health care provider?
  • Should I buy an escape ladder for our house since we sleep on the second floor?
  • My partner smokes and I worry about cigarettes and matches left around. How can I encourage my partner to stop smoking?
Where can I find more information about this topic?

Toddler Safety: Topics at the 18 Month Visit (AAP)

Fire Safety: Planning Saves Lives (AAP)

Installing and Testing Smoke Alarms (Home Safety Council)

References

American Academy of Pediatrics (AAP). Fire Safety. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/all-around/Pages/Fire-Safety.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

What to do if your child swallows poison and when to call the poison control center More Info
What to do if your child swallows poison and when to call the poison control center
What is this and why is it important?

Many substances that seem safe can be dangerous for children, including soaps, shampoos, pet products and medicines. A safe home means one where your child can’t reach foods, cleaning agents and other kinds of products that could be dangerous for him . You can lock or block cabinets where you keep unsafe products or move them to high locked cabinets instead of keeping them under the counters. Be aware that many of these items come in colorful containers that may attract your child.  Make sure all medications have safety caps, and lock them out of sight. Never talk about medicine as candy. And because your child wants to do what you do, don’t take your medicine in front of your child.

If you suspect that your child has swallowed something poisonous, FIRST call the National Poison Control Center at 1-800-222-1222 and follow their instructions.  (The Poison Control Center should be called before your child’s doctor’s office when you are concerned about what poisoning). Place the Poison Control Center Number, 1-800-222-1222, near each telephone. Call right away if you think your child ate, drank, smelled, touched or played with something poisonous. Don’t make your child throw up - Syrup of Ipecac is no longer recommended nor is anything else to induce vomiting. The center will tell you what to do.

Some plants are poisonous, so avoid them or make sure they’re out of reach.  If you are unsure about any of the plants in your house or yard, call your local Poison Help Line (1–800–222–1222) and request a list of poisonous plants common to your area. If you have any poisonous plants, either replace them or securely fence and lock that area of the yard away from your child.

You can talk to your child’s health care provider about what you should do if your child swallows poison.

What are common questions I can ask my health care provider?
  • If I think my child has eaten or drunk something I am not sure is safe should I call you or the poison control center?
  • Should I make my child vomit if he drinks something dangerous?
Where can I find more information about this topic?

Toddler Safety: Topics at the 18 Month Visit (AAP)

Tips for Poison Prevention and Treatment (AAP)

Keep Your Home Safe From Poisons

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Gun safety in your home and places where your child visits More Info
Gun safety in your home and places where your child visits
What is this and why is it important?

More than 44 million Americans own firearms and research shows guns in homes are a serious risk to families.  In 2006 alone, 31 American kids under the age of 10 were killed in unintentional shootings and 187 were injured. 18-month-olds are curious creatures! If you or someone in your house does have a gun, be sure to store it unloaded under lock and key, with the ammunition stored (and locked) in a separate place.  Make sure to hide the keys to the locked boxes. 

Also make sure the places where your child visits or receives childcare do not have guns or at a minimum, that they are safely stored.  Given that over 40% of homes with children have a gun, and many of those guns are left unlocked or loaded this a common risk to your child’s safety.

You can talk to your child’s health care provider about gun safety in your home and in places where your child visits.

What are common questions I can ask my health care provider?
  • It is awkward to ask if there are guns in the home before I have a play date. What are some ways I could go about asking it?
  • How do I convince my friends and family that this is not about hunting or self-protection, but about child safety?
  • Is it against the law to have guns that are not locked up?
Where can I find more information about this topic?

Home Safety: Here's How (AAP)

Toddler Safety: Topics at the 18 Month Visit (AAP)

Making Your Home Safe for Your Child: Gun Safety (CCW)

Preventing injuries: at home, at play, and on the way (Safe Kids USA)

References

American Academy of Pediatrics (AAP). Gun Safety: Keeping Children Safe. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/all-around/Pages/Gun-Safety-Keeping-Children-Safe.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Centers for Disease Control and Prevention (CDC). Injury Prevention & Control: Data & Statistics (Web-based Injury Statistics Query and Reporting System [WISQARSTM]). Retrieved 4/1/2010 from http://www.cdc.gov/injury/wisqars/index.html

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

PAX / Real Solutions to Gun Violence ASK (Asking Saves Kids) Campaign. Is there a gun where your child plays? Retrieved 4/1/2010 fromhttp://www.paxusa.org/ask/index.html