15 Month Well-Child Visit

• Feeding: Appetite decreases as growth rate slows. Food preferences change at this age, and it is normal for your child to choose to not finish everything on his plate. Mealtime should be pleasant for the whole family, don’t allow food to be a battleground. Your child should be done with bottles at this time; he can meet all of his fluid needs with a cup now. If you need help weaning from the bottle, please ask your doctor for advice. Coordination has improved allowing your child to use a spoon, but remember that it takes a lot of practice to use it well.
• Elimination: Although parents are often pressured by relatives to begin the potty training process, toddlers are rarely ready to learn until they are 24-30 months old. Children are ready to begin the process when they awake from naps with dry diapers, use word signals to indicate that they are wet or have dirty diapers, or when they begin to develop a routine of grunting or straining after a meal. Until these signals appear, your child is not ready to learn about toileting. However, you can take advantage of their natural curiosity at this age and explain the process to him when he follows you into the bathroom. If you have a potty- chair, allow your child to explore it and use it as a chair. At this age it is more of a toy, but getting used to it will ease the process of “potty learning” later on.
• Sleep: Most children at this age are taking 1-2 naps per day. Bedtime routines become especially important. Continued use of a “transition object” such as a special blanket or stuffed toy is appropriate. Occasional bad dreams or night awakenings are normal.

Development: This is a delightful age in your child’s life. Curiosity is intense, often stronger than self-control. He may appear to be a sponge, soaking up new information, words, and physical skills.

• Motor Skills: Your child will begin to show an improved sense of balance and may begin running. He is now able to stoop to pick up a toy, walk backwards, take off his clothes, use a spoon, and may begin to climb stairs. Most children continue to teethe through this period and thumb and finger sucking are common.
• Communication/Socialization: By this time your child may know between 3 and 10 words. Some children will combine these words. Many children are able to indicate their wants by gesturing or using simple words. He will shake his head to yes and no questions. Your child should be developing “joint attention” skills where he points to an object to call your attention to it.

Safety: At this age your child’s curiosity is overwhelming to him. Because they do not yet understand consequences, they are unable to see the danger that lies ahead of them. For that reason they must be watched at all times and distracted when they are heading for trouble.

• Continue to use a car safety seat. Your child should remain rear-facing in the car seat until your child reaches the maximum height and weight recommended for that model, or at least the age of 2.
• Remember that children should be in the back seat if you have a passenger side airbag until they are approximately 12 years old.
• Never leave your child alone in the car, tub, home or yard.
• Make certain that your child’s crib mattress is at the lowest setting.
• If your child has not yet already given up the bottle, ask us about weaning tips.
• Do not allow your child to walk or run with food.
• Remember that poisons remain a serious threat. Lock up all poisonous or dangerous materials and keep the phone number for the Poison Control Center at your phones (1-800-222-1222).
• Choking remains a serious threat to your child. Avoid giving your child nuts, popcorn, hot dogs, grapes, raisins, raw vegetables or chewing gum.
• Remember to protect your child from tobacco smoke exposure.

Parenting: Both the fun and the challenge of parenting are wrapped up in the toddler years. Your child is becoming increasingly curious and independent. It is important to foster both curiosity and independence, but to do so in safe ways. Use simple, consistent rules for your toddler. Being consistent at this stage prevents tremendous challenges down the road. Encourage your child with positive reinforcement for acceptable behavior. Talk with your child’s other caregivers and work together to develop a consistent approach to child rearing.

Play: Pull and push toys are great fun at this age, but your child will be just as happy imitating housework. Repetitive songs, poems and nursery rhymes are a favorite. Continue to read to your child and allow him a chance to look at books on his own. Solitary play is normal, but you may notice that your child is now watching others play.

Next visit is at 18 months of age.