Health Information

Caring for Your 18-Month-Old

Communication and Social Development: Demonstrate for your child how to use words. Help them find words for their feelings (“Are you hungry?”, “You look sleepy”), and label items (“This is a spoon,” “Look at your pretty hair”).

At this age, toddlers like to feel they have some control, but too many choices can be overwhelming. Try offering two parent-approved choices when available, for instance “Do you want the blue shirt or the red shirt?” or “Would you like an apple or a banana?”

Your child may still be anxious around new people. Expect your child to cling to you. Offer comfort when this happens. Do not force the interaction.
Language Development: 18-month-olds often know several words. The more words your baby hears, the faster he or she will learn. Talk to your baby, and prioritize face-to-face interaction. Reading to your child will also promote language skills.

If you want to introduce media, choose high quality programming like what is found on PBS. Limit the viewing to 1 hour or less.

Use media together with your child so you can co-view and talk about what you see. For example video-chat with family together.

Allow your child to be creative with toys and develop their language and problem-solving skills by describing how things work.

Use simple words with your child.
Literacy: Books should be a part of your everyday naptime, playtime and bedtime routine. Your child will point at pictures, turn pages and bring books to you to read. Smile and answer when he or she speaks or points.

If you ask a question, wait for a response from your child. Your child can follow simple stories and will often be calmed or distracted by books when you are waiting or riding in the car.

Find out what type of books your child likes to read.

Ask your child to find people, animals and other familiar things on the page.
Nutrition: At this age, whole (not skim, 1 percent or 2 percent) milk is appropriate for your child, unless your doctor instructs otherwise (16 – 24 ounces per day).

Encourage (but never force) your baby to eat three meals a day, plus two snacks (usually mid-morning and mid-afternoon).

As a parent/caregiver, it is your job to offer age-appropriate healthy food choices at regular mealtimes. It is up to the child to choose what and how much to eat. If your child will not eat what you give him or her, it is suggested not to give him or her other food. He or she will eat at the next mealtime. Avoid giving juice. Do not give soda, tea, coffee, or flavored drinks

Try to encourage regular mealtimes for your toddler, preferably with the family.

Some foods, including nuts, popcorn, hot dogs, whole grapes, and hard, raw vegetables can present a choking hazard for your toddler. Take care to avoid offering these.
Elimination: Regular, easy-to-pass stools at least once daily are normal at this age. Ask your doctor if you are concerned about the consistency or frequency of your child’s stooling.

Wait until your child is ready for toilet training, signs of being ready include staying dry for 2 hours, knowing if they are wet or dry and wanting to learn.

Your toddler may hide in a corner or crouch down when moving his or her bowels. Soon, you will be able to use these signals to help teach your child when and how to use the potty.

Some children between 18 – 24 months have interest in using the potty. Exposure without pressure to the potty is appropriate.
Routines and Discipline: Toddlers are curious about their environment and touch and explore almost everything. Instead of yelling “no” when they touch something inappropriate, try to distract them and redirect their attention to a safer item.

Never slap or hit your child. This teaches children to hit others.

Remember to praise your child for behaving well.

Set reasonable limits, be consistent, and remember that when using discipline, the priority is to teach and protect your child, not to punish.

If your toddler has a temper tantrum, be sure the area is safe and try hard not to give the behavior too much attention. It is best to ignore tantrums.

Time-outs for poor behavior can begin between 18 – 24 months. Identify a suitable location in the home, place the child in time-out only for one to two minutes, and do not talk to him or her. At first you may need to hold the child in place until he or she learns the process.

Predictable routines help your child feel safe. Try to make your toddler’s bedtime around the same time every night, perhaps with a calm bath and a book.

Most 18-month-olds take one mid-day nap.
Oral Health: To best care for your toddler’s teeth, be sure there is fluoride in the water they are drinking. Use a toothbrush to clean your child’s teeth twice a day. Children under 2 years of age should use a “smear” of fluoride toothpaste.

Your toddler should visit a dentist as early as 12 months of age.

Bottles should no longer be used. Pacifiers should no longer be used.
Safety: Toddlers are safest when sleeping in their own space. Be sure that the railing on the crib or bed provides a safe barrier against falls.

Children can drown in only a few inches of water. Drowning is the number one cause of death in children ages 1 – 4. Never leave your child unattended around water, take them out of the water if you need to leave for any reason.

Do not smoke in your indoors. Do not smoke in your care.

Keep small items (choking hazards) and hot liquids (burn risks) away from the toddler.

Chemicals (like lawn and cleaning supplies) and medications can be tempting for little ones to explore. Be sure these are locked away, in original containers, out of reach from your toddler’s curious hands. The number for Poison Control is 1-800-222-1222.

Keep matches, cigarettes and lighters locked safely away.

If you have a gun in your home, be sure the ammunition is kept separately from the weapon and that these are both locked and stored away.

Do not let the handles of pots on the stove hang over the side of the kitchen countertop. From the vantage point of a toddler below, these can be tempting to grab.

Keep your child away from space heaters, fireplaces and fans, as these can all be dangerous.

Be sure that you have safety guards on windows, especially on the second floor or higher.

Be sure your home has working smoke detectors and carbon monoxide detectors. Have a family escape plan.

Toddlers should ride in a rear-facing five-point harness car seat in the back seat of the vehicle until they are at least 2 years old, or they have reached the maximum allowable height and weight limits, printed on the car seat.

Positive Parenting Resources

UH Rainbow Babies & Children’s recommends parents to engage their infants with age-appropriate brain development activities.

Bright Futures
Starting Point
PNC Grow Up Great
Everyday tips, lesson plans and learning kits to discover learning moments in daily routines.

Make time for yourself and your partner.

This document contains general parenting information based on American Academy of Pediatrics recommendations and is not meant to replace the expert advice of your pediatrician.