Pediatric Group

18 Month Well Child Visit

Vaccines:

Hepatitis A: Food-borne version of Hepatitis disease

    Side effects: Some side effects include fever (100-101F), irritability and fussiness, excessive crying, vomiting, sleepiness and swelling at

    injection site.  Ask for a CDC vaccine information sheet if you need more information.

    Give 1.2 ml (1 ½ dropper) of Tylenol Infants’ Drops twice if needed 

              FEEDING  

·         Wean from bottle! (if not already done)

·         Offer whole milk (16-24 ounces/day)

·         No 2% or skim milk until 2 years of age

·         Offer 3 meals & 3 snacks daily

·         Let child decide how much to eat, you pick the foods

·         Set a good example - eat healthy!

·         Eat as a family

·         Encourage self-feeding even if messy

·         Always supervise eating

·         Avoid choking foods (nuts, popcorn, carrots, raisins, hard candy) 

                GENERAL CARE / SAFETY  

·         Use a safety seat in the back seat

·         Childproof your home

·         Encourage safe exploration

·         Supervise child at all times especially near water, pets, cars, stoves, and tablecloths

·         Brush child’s teeth with a soft toothbrush and water

·         Keep poison center number handy – (800) 222-1222

·         Limit sun and use sunscreen

·         Use insect repellant if needed

·         Praise good behavior

·         Set limits & routines, be consistent and reasonable

·         Discourage aggressive behavior

·         Use brief discipline such as “time out” to teach a lesson – not to punish

·         Delay toilet training

·         Set a good example with your behavior

·         Children may have nightmares

·         Never smoke around children

·         NEVER SHAKE A CHILD!

                    PLAY

You can encourage development through play

• Talk, sing, and read together
• Play interactive games
• Offer simple and fun tasks
• Do not use baby talk
• Create routines such as a bedtime story
• Avoid using the word “NO”
• Allow self-expression and choices
• Don’t expect child to share all toys
• Go on short family outings

DEVELOPMENTAL MILESTONES

                    PHYSICAL & MOTOR SKILLS

• Walks well & runs
• Climbs up stairs and onto furniture
• Stacks 2-3 blocks
• Throws a ball overhand
• Places and removes items from containers without demonstration
• Uses a spoon and a cup
• Able to take off some clothing

                        SENSORY & COGNITIVE SKILLS

• Says about 15-20 words
• Imitates words
• Uses 2-word phrases
• Names objects & points to some body parts
• Understands 1-step commands
• Listens to a story & looks at pictures
• Imitates household tasks
• Shows affection, gives kisses

Developmental Health Watch

Although children develop at different rates, failure to reach certain milestones may signal a problem.  If you notice any of the following warning signs in your infant, discuss them with your pediatrician.

·         Not walking well

·         Uneven walk or limping

·         Frequent falling forward when walking

·         Does not make eye contact or gestures (pointing, etc)

·         Uses less than 5-10 words

·         Does not try to feed self

·         Loss of previously known skills

Talk with your doctor if you have any concerns about your child’s development

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