18 Month Old Check-up - All You Need to Know

What Happens During the 18-Month Checkup Schedule

It was like yesterday that you went for your toddler’s last visit and what a difference just a few months can make! The 18th-month visit will build upon the previous visit, and they are probably due on some immunizations. You may have some new questions about their developmental milestones, sleep, eating habits, or even observations the doctor told you to make. If your little one is due the 18-month pediatrician visit, then here’s all you need to know about what to expect and how to prepare for it.

What Does the Doctor Check During the 1.5 Year Checkup?

By the time your toddler is 18 months, his doctor would be familiar enough with him and have his records. There are several things they will go over to ensure your toddler is developing healthily.

Eating: One of the first things the doctor will ask about is how well your toddler is eating. He might be a finicky eater like many other babies but as long as he is getting adequate nutrition, keep doing what works. If you are concerned that he may not be getting all the nutrition, you could ask about supplements. While you are there, ask about new snacks and feeding ideas, and also introducing new foods. Allergies are also something you need to go over if you are thinking of introducing new foods. The doctor would ask you whether he is bottle feeding or knows how to feed on a spoon. If you are still breastfeeding, you will be given weaning tips.

Sleep: The doctor will ask you how well your toddler is sleeping and any changes you may have noticed in the last few months. Is he getting a proper full night’s rest and one or two daytime naps? Does he become cranky and not sleep despite being tired? It will help if you have maintained a diary of your observation on his sleep patterns so you will have more information during the visit. If your toddler has issues waking up in between sleep, the doctor will offer you tips for routine changes to help him sleep better.

Potty training readiness: Potty training can start as early as a year, and the doctor may want to know if you are making efforts towards it if your toddler is showing signs of readiness. If you think he is ready, you will get some tips or advice on beginning potty training.

Development milestones: Development milestones give your doctor an indication that your toddler is progressing at the proper rate, and the information is useful in diagnosing problems of recommending additional support. Here are some of the developmental milestones your doctor might look for:

  • Does your toddler walk comfortably, and has he developed climbing skills yet?
  • Can your toddler say a couple of words or nod his head to mean ‘no’?
  • Does he understand simple instructions such as “bring me a diaper” or “get your shoes”?
  • Is he able to point to the right body part when you ask him?
  • Does he imitate your actions, such as holding a phone to the ear, playing with utensils, or feeding his stuffed doll?
  • Does he play by himself? Can he scribble with a crayon, or can he drag a stringed toy behind him?
  • Does he point with his hand when he wants attention or to point at objects? Can he hand toys over to other people?
  • Does he show affection to close people and show fear of strangers?

Sometimes toddlers reach milestones at their own pace, and some get there earlier while some do it a bit late, and it is all totally normal.

Behavior: Your doctor might ask about the changes in behavior you would see as your toddler gets older. His increasing self-awareness brings about a sense of independence that makes it harder to control him. Depending on your disciplining methods, you may also encounter challenges with your toddler. Discuss your concerns so the doctor can give you strategies that are age-appropriate to handle your toddler.

General topics: the doctor might want to talk about how your toddler deals with separation anxiety about their health care. Bring up any recent health issues he might have had or any allergies to food, clothing, or materials you might notice. Safety is also an issue as your toddler grows older, and you will have to discuss tips with the doctor on how to keep your toddler safe as he explores the world around him.

Growth and Physical Checkup

18 months old child at the doctor's clinic

The growth and physical check-up is the next step to determine health and confirm any issues you may suspect your toddler has. Here is what it entails:

  • Your toddler’s height, weight, and circumference of the head is measured just like the last visit to compare with standards growth charts. This will tell if your baby has been growing at a healthy rate.
  • Physical examination of the eyes and ears are done to look for any problems.
  • The mouth and teeth are examined, along with the gums of the teeth.
  • The heartbeat and breathing are checked with a stethoscope.
  • Your toddler may also be asked to walk a few steps so his feet and legs can be examined.

Screening Tests

If your toddler has been showing signs of a problem since the last visit or for the very first time on this one, then the doctor will ask for a screening test for conditions such as:

  • Anemia
  • Lead poisoning
  • Hearing problems
  • Vision problems
  • Autism
  • Developmental delays


Here are a few 18-month checkup shots your toddler might receive:

  • DTaP (diphtheria, tetanus, and pertussis) vaccine’s fourth dose.
  • IPV (polio) vaccine, third dose.
  • HepB (hepatitis B) vaccine.
  • HepA (hepatitis A) vaccine. Second dose if the first was given six months earlier.
  • Pneumococcus vaccine, fourth dose.

Questions That the Doctor Can Ask

Here are a few questions your doctor might ask:

  • Is your child sleeping and napping regularly?
  • Does your child have temper tantrums?
  • Does your child talk a lot? Or scribble or point?
  • Does your child understand what you are saying?
  • Did your child have a dentist appointment yet?
  • Does he still drink from the bottle?

Questions You Can Ask Your Doctor

A few questions mentioned below, which you can ask your doctor :

  • Is it okay for my toddler to skip his naps?
  • Why is my toddler afraid of vacuum cleaners, dogs, or other sounds?
  • Sometimes he eats everything on his plate, and sometimes he doesn’t; why is that?
  • How much screen time should I allow for my toddler?
  • Is it okay for him to drop the morning nap?

Important Tips for the Visit

There are a couple of things you need to keep in mind before your toddler’s 18-month doctor appointment. Here is a list:

  • Ensure he is in a good mood by having him well-rested the night before and giving him something to eat before the visit.
  • His clothes should be loose-fitting and easy to remove. Preferably dress him in a two-piece outfit that is easy to remove for a physical exam.
  • Pack his favorite toys and some snacks in case he gets cranky at the visit.
  • Make a note of all the things you want to ask the doctor.
  • Carry all his medical records of previous visits and vaccination schedule.
  • Ask someone to accompany you, maybe a family member or a friend. It would be easier to talk to the doctor with them watching over your toddler.
  • Make every visit a fun memory or a treat. The doctor visit can be coupled with an outing for some ice cream or a visit to your child’s favorite play arena.
  • Be honest with your toddler; try not to make it a surprise. Have him prepared mentally by telling him that this is a visit to the doctor and give him all the information about the visit.
  • Build a positive image of doctor visits in his mind. Read a book to him about doctor visits and tell him that a doctor is a nice person who will make sure that children are healthy.
  • Familiarize him with the clinic by buying him a doctor set and let him play with it with his friends or siblings. This way, he will get used to the instruments and form a more positive association even with the scary bits like shots.
  • Be happy and cheerful about the visit every time, so he feels confident about visiting the doctor.
  • Appreciate his effort at the end of the visit with applause and offer plenty of praise.

The 18th-month check-up is crucial as your little one is developing fast and learning new things. It becomes increasingly difficult to keep up unless you are prepared for it. Make notes about observations you need to discuss and carry all the previous reports and logs of vaccination on your visit.

Also Read:

18 Months Old Baby Growth and Development
Food Ideas for 18 Months Old Baby

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