Mt. Ascutney Hospital and Health Center

15 Month Well Child Visit

Your Baby
 

PROFILE:  The average 15 month old toddler can walk well, can stoop to recover a ball, and might already be climbing on furniture.  He can hold a spoon to eat or a crayon to scribble.  He likes to explore and he’s good at it.  He can follow simple commands one at a time, might say a dozen or so words, uses jargon (make-believe talking), and lets you know what he likes or doesn’t like with either gestures or words.  He especially likes to imitate adult things like brushing teeth or holding a telephone.  When he’s frustrated he might yell “no!” or have a temper tantrum.  He’s probably shy and scared of strangers.
 

BEHAVIOR:  Normal toddlers work on their independence by being negative – by saying “No”.  Don’t think of this as being “bad” or angry.  Think of it as working toward their independence.

Your child is more likely to be negative when he’s tired.  Try to keep him on a schedule of naps and regular bedtime.

Offer “limited choices”, like, “Do you want to put your coat on first (point to the coat) or put your shoes on first (point to the shoes)?”  That way, he gets to make a decision, but you get the job done anyway.

Give him more attention when he is being good than when he’s being negative.  When he’s being negative, give enough attention to get done what you want done.  Try to stay confident and cheerful and proceed with your plans.

Tantrums are common at this age.  They are best handled by ignoring them – don’t give him attention when he is having a tantrum.  Remember this is normal behavior, but can become a problem if allowed to get out of hand.  Let your doctor know if you have questions.
 

FEEDING:  A child this age is messy and likes to play with food, but you should let him feed himself with as little help as possible.  Let him use his fingers or his spoon, and let him hold his cup.  If your child is not off the bottle by now, you should get him off as soon as possible.  Toddlers grow more slowly than infants, so expect his appetite to drop off, and don’t try to force him to eat.  Forcing a child to eat causes a lot of stress, and it’s unnecessary.  A healthy child will eat all he needs without being forced or coaxed.  Offer a small serving (1 tablespoonful or so per year of age) from each of the 4 food groups and then give him a little more if he wants more.  Remember, children often need to be exposed to new foods many times before they learn to eat them.

It’s much easier to keep mealtime pleasant if you keep it short.  Take him out of his chair as soon as he loses interest in eating.

Snacks are fine if they are healthy foods and not too close to meals, but remember he’ll eat less at meals if he snacks between meals.  We do not recommend juice as it has no nutritional value and may decrease your baby’s appetite for healthy foods.

Expect your toddler to have strong likes and dislikes.  He might refuse a certain type of food for days at a time, but he doesn’t need to eat a balanced diet every day.  Try, instead, to balance it out over a week or so.  Talk to your doctor if you think your child is not eating enough of a certain food group.

Be careful of foods that cause choking – such as hot dogs (the most commonly choked on food), popcorn, nuts, raw carrots and grapes.  Give hot dogs and grapes only if cut in tiny pieces (lengthwise and crosswise).  Use whole cow’s milk (until age 2), about 16-20 ounces per day.  Vitamin supplements are rarely needed.  Talk to your doctor if you’re worried about vitamins.
 

TOYS AND ACTIVITIES:  A 15-month-old child will play simple games like rolling a ball. He loves to have adults play with him, but he’s too young to want to play with another toddler for very long.  He probably likes to imitate adult things such as “housework” or talking on the telephone.  He will like playing in sand or water, pouring, dumping, stacking and filling containers.  Good toys for this age include balls, cars, trucks, dolls, stuffed animals, pots, pans, homemade picture books, whisk broom and dust pan, toy telephone.

You can help your child learn by reading simple books with him, reciting nursery rhymes, singing songs, listening to children’s tapes and records, and taking him places like the zoo, on walks and to family gatherings.  Toddlers at this age do not need television or videos.
 

SAFETY:  Now that he walks, creeps up stairs, and climbs on furniture a toddler’s curiosity can get him into trouble more quickly than ever.  He needs constant supervision.

Poisons:  Be sure all poisons are locked up, but, just in case, have the poison control number by the phone, 1 (800) 222-1222.

Falls:  Place guard gates on all stairways to prevent falls.  If your child loves “practicing” on the carpeted stairs, put the bottom gate on the 3rd step so she can climb one or two steps.  Lock your windows.  If you open windows, open them from the top or put on window guards so they can’t be opened wide.  Move things he could use to climb up to the windows or to other unsafe areas.  Remember to keep the blind cords tied back so your toddler will not risk strangulation.

Water:  Drowning is the #2 cause of death at this age.  Never leave your child alone around water – and that includes the bathtub and the toilet.  Put a life jacket on him if he’s around a pool, a hot tub or a pond.  Remember to empty buckets after cleaning tasks.  Consider swimming lessons for him.

Automobile:  Always have your child in the car seat and the car seat properly fastened before you drive away.  Toddlers often resist, but you must not give in!  The back seat is safest, but never put a child in the front seat if your car has a passenger side airbag.  Car accidents are the #1 killer at this age.

Fire:  Keep matches and cigarette lighters out of reach.  Flammable liquids are poisons, so they should be locked up.  Don’t use open flame heaters if you can possibly avoid it.  Put guards around floor furnaces, hot floor vents, and fireplaces.  If you have a gas or wood stove, be sure it is vented properly; have your heating and cooling system checked every year.  Make sure you have a working fire extinguisher and smoke and carbon monoxide alarms in your home.
 

TOILET TRAINING:  Please wait until your child is a little older to start toilet training.  Relatives and friends might be telling you to start now, but 15 months is too early.  To be ready for potty training, your child has to be able to recognize the urge, tell you about it, get to the potty, pull down his pants, and then release his urine or stool.  Also, he should want to use the potty.  It’s true that children are ready at different ages, but most are not ready to start until 18-30 months of age.
 

IMMUNIZATIONS:   The MMR vaccine may be given today.  The MMR may have a normal reaction of fever and rash about 5-10 days after the immunization.  Use acetaminophen (Tylenol, Panadol) as needed for fever or discomfort.

FOLLOW-UP:  Your baby’s next visit is at 18 months of age.