Fifteen Month Visit
A 15 month old is an active and curious toddler and they are about to begin a whole new phase of development. They may have a vocabulary of 3-6 words, be able to point to one or more body parts and understand simple commands. They may be walking well and even be able to run, stoop and climb stairs; they can probably stack two blocks, feed themselves with fingers and drink from a cup well by now. Your toddler plays peek-a-boo, pat-a-cake, waves bye and probably loves to sit and listen to a story or look at books.
Play is a way of learning social behavior. Spend some time playing and reading with your toddler each day. Consider joining a parent-toddler play group. Aggressive behaviors such as hitting or biting are common. Help your toddler express such feelings as joy, anger, sadness, fear and frustration in an acceptable form and discipline your toddler so they learn not to hit or bite.
Discipline is a means of teaching and protection, not punishment. To set limits and discipline a toddler, use distraction, gentle restraint, removal of objects, and time outs. Praise the toddler for good behavior and accomplishments. Reach agreement with all family members on how to support their emerging independence while maintaining consistent limits. Temper tantrums often begin now. Try to ignore tantrums-leave the room briefly. If you are out in public, gather your toddler up and carry them to a safe place where they can work it out. Tantrums are an expression of the toddler’s drive towards independence and their desire to control their environment. The differences in temperament between toddlers become more evident now. Try not to compare your child’s style to another-just enjoy their individuality.
At 15 months, a growing sense of autonomy and independence can make mealtime an increasing challenge. Expect your toddler to eat a lot at one time and not much the next. “Food jags” are common. Some toddlers graze on small meals throughout the day; others eat one good meal at most. Their weight gain will be much slower than in the first year. Encourage your toddler to eat at family mealtimes and give her 2-3 nutritious snacks per day. Make mealtimes pleasant and encourage conversation. Encourage the toddler to feed themselves using a spoon and a cup as they should be off a bottle. Let them experiment with a variety of foods from each food group by touching and mouthing them repeatedly. They may become more aware of and suspicious of new foods, but do not limit the menus only to foods they like. Do not get into battles about the quantity of food since children will eat what they need. Avoid giving foods that may cause choking (popcorn, hot dogs, carrot sticks, celery sticks, whole grapes, corn, hard candy, tough meat). Peanuts are easily aspirated and should never be given to children under 3 years old
The AAP recommends vitamin D supplementation for all infants, children, and adolescents. After reviewing the literature, it certainly looks like many children may benefit from vitamin D, although not everyone necessarily needs it. Some children are more at risk for vitamin D deficiency than others. Risk factors for vitamin D deficiency include dark skin (African-americans, Indians, Hispanics), time spent indoors and not out in the sunlight (particularly in the winter months), low amount of milk consumption (less than 16 oz a day), and exclusively breastfed infants. The recommended dose is 400 IU (international units) once daily. This can be bought over the counter in either a single drop form, or with a larger dropper. Read the label carefully when dosing this to your child. Too much vitamin D can be harmful.
We will give measles, mumps, rubella (MMR), varicella (chickenpox) and prevnar today. There is an occasional low grade fever and rash occurring 7-10 days after the MMR has been given. This can last for a day or two, no treatment is needed.
- Continue to use a toddler seat and make sure it is properly secured each time it is used.
- Continue to test the water temperature with your wrist to make sure it is not too hot before bathing your toddler. Supervising your toddler constantly whenever they are in or around water, buckets, the toilet, or the bathtub. Young siblings should not be left alone to supervise toddlers. Continue to empty buckets, tubs, or small swimming pools immediately after use. Ensure that swimming pools have a four sided fence with a self closing, self latching gate.
- Continue to use protective clothing and sunscreen on the toddler before they go outside to play.
- Continue to keep the toddler’s environment free of smoke. Keep the home and car non-smoking zones.
- Do not leave heavy objects or containers of hot liquids on tables with tablecloths that a toddler may pull down.
- Turn pan handles toward the back of the stove.
- Keep the toddler away from hot stoves, fireplaces, irons, curling irons, and space heaters.
- Keep cigarettes, lighters, matches, and alcohol out of toddlers sight and reach.
- Ensure that electric wires, outlets, and appliances are inaccessible or protected.
- Exclude poisons, medications, and toxic household products from the home or keep then in locked cabinets. Have safety caps on all medication. Call poison control at 1-800-222-1222 immediately for any possible ingestion.
- Never underestimate the ability of a 15 month old to climb. Some children may climb out of the crib at this age. Ensure that the crib mattress is on the lowest rung.
- Continue to use gates at the top and bottom of stairs and doors, especially at a child facility, unless they are under close supervision.
- Keep your toddler away from moving machinery, lawn mowers, overhead garage doors, driveways, and streets.
- Ensure that a toddler riding in a seat on an adult’s bike is wearing a helmet. Wear a helmet yourself.
- Teach the toddler to use caution when approaching dogs, especially if the dogs are unknown or eating.
- Choose caregivers carefully. Discuss with them their attitude about and behavior in the relation to discipline. Prohibit corporal punishment.
Your child should be sleeping all night and probably taking one nap a day. Night time waking is common, but he should be able to soothe himself and go back to sleep.