Your Child's Checkup: 15 Months

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your child's weight, length, and head circumference and plot the measurements on the growth charts.

2. Ask questions, address concerns, and provide guidance about how your toddler is:

Eating. By 15 months, most toddlers are eating a variety of foods and are better able to handle textures. Offer your toddler three meals and two or three scheduled nutritious snacks a day. Growth slows down in the second year of life so don't be surprised if your child's appetite has decreased. Your child can drink from a cup and may be able to use a spoon but probably prefers to finger-feed.

Pooping. As you introduce new foods and whole milk, the appearance and frequency of your child's poopy diapers may change from day to day. Let your doctor know if your child has diarrhea, is constipated, or has poop that's hard to pass.

Sleeping. There's a wide range of normal, but generally toddlers need about 12 to 14 hours of sleep a day, including one or two daytime naps.

Developing. By 15 months, it's common for many toddlers to:

• say three to five words
• understand and follow simple commands
• point to one body part
• walk alone and begin to run
• climb on furniture
• make marks with a crayon
• imitate activities, such as housework

3. Do a physical exam with your child undressed while you are present. This will include an eye exam, tooth exam, listening to the heart and lungs, and paying attention to your toddler's motor skills and behavior.

4. Update immunizations. Immunizations can protect kids from serious childhood illnesses, so it's important that your child receive them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

Looking Ahead

Here are some things to keep in mind until your child's next checkup at 18 months:

Feeding

1. Give your child whole milk (not low-fat or skim milk, unless your doctor recommends it) until 2 years of age.
2. Limit your child's intake of cow's milk to about 16–24 ounces (480–720 ml) a day.
3. Serve iron-fortified cereal and iron-rich foods, including meat, poultry, well-cooked leafy greens, beans (white, black, and kidney), and tofu.
4. Serve a variety of foods, but let your child decide what to eat and when he or she has had enough.
5. Transition from the bottle to a cup. If you're nursing, offer milk in a cup.
6. Serve juice in a cup and limit it to no more than 4 ounces (120 ml) a day. Avoid sugary drinks like soda.
7. Avoid foods that are high in sugar and fat and low in nutrients.
8. Avoid foods that may cause choking, such as hot dogs, whole grapes, raw veggies, nuts, and hard fruits or candy.

Learning

1. Toddlers learn best by interacting with people. Make time to talk, read, sing, and play with your child every day.
2. Consider limiting your child's screen time. TV, videos, phones, tablets, and other media are not recommended for children younger than 18 months old.
3. Have a safe play area and allow plenty of time for exploring.

Routine Care & Safety

1. Brush your child's teeth with a small toothbrush and a small bit of toothpaste (about the size of a grain of rice). Schedule a dentist visit if you haven't already done so.
2. Have a regular bedtime routine. If your child wakes up at night and doesn't settle back down, comfort your child but keep interactions brief.
3. Tantrums are common at this age, and tend to be worse when children are tired or hungry. Try to head off tantrums before they happen — find a distraction or remove your child from frustrating situations.
4. Give your child that much-wanted feeling of independance by offering two choices between acceptable options.
5. Praise good behavior and ignore behavior you don't like. Don't spank your child. Children don't make the connection between spanking and the behavior you're trying to correct. You can use a brief time-out to discipline your toddler.
6. Continue to keep your child in a rear-facing car seat in the back seat until age 2 or whenever your child reaches the weight or height limit set by the car-seat manufacturer.
7. Apply sunscreen of SPF 30 or higher on your child's skin at least 15 minutes before going outside to play and reapply about every 2 hours.
8. Protect your child fromsecondhand smoke, which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.
9. Make sure your home is safe for your curious toddler:
   • Keep out of reach: choking hazards; cords; hot, sharp, and breakable items; and toxic substances (lock away medicine and household chemicals).
   • Keep emergency numbers, including the Poison Control Help Line number at 1-800-222-1222, near the phone.
   • Use safety gates and watch your toddler closely when on stairs.
   • To prevent drowning, close bathroom doors, keep toilet seats down, and always supervise your child around water (including baths).
   • Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids cannot access the keys.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.