Well Child Visit Handout - 15 Months

FIFTEEN MONTHS
 
Date of Visit:  ___________
Weight:           ___________
Height:            ___________
HC:                 ___________
 
NORMAL DEVELOPMENT:    
 The following are characteristics of toddlers 15-18 months, but remember each child grows and develops at his/her own unique pace.
 
PHYSICAL:
•  Walks alone.
•  Can reach for, grasp, and let go of small objects with greater ease.
•  Feeds him-/herself with fingers and with spoon.
•  Can drink from a cup.
•  Can scribble if given a crayon.
•  Can stack 2 blocks.
•  Points to items he/she wants.
•  Imitates parents or other adult’s activities.
SOCIAL & EMOTIONAL:
•  Gives and takes food or toys.
•  Throws objects in play.
•  Communicates affection, pleasure, and excitement.
•  Begins to understand limits.
LANGUAGE:  
•  Uses 5-15 single words.
•  Uses much jargon.
•  Points to 2 body parts.
•  Understands simple commands.
•  Points to pictures in books.
 
DIET:
•  The major achievement of walking will probably interfere with the interest in eating as your toddler is experiencing new independence.  Definite likes and dislikes may become apparent and meals may be refused.  One good meal per day with 4-5 foods eaten is typical.
•  Your child should be able to feed him-/herself finger foods.  Participation by parents may cause a negative reaction.
•  AVOID foods that are easily choked on: hot dog rounds, raw carrots, popcorn, peanuts, and hard candies.
•  Encourage the use of a cup and spoon.
•  Continue to wean your child from the bottle.
•  Your child should be drinking whole milk by now.  The goal is for 20-24 ounces for the entire day.
•  Expect messiness—this is how your child learns.
 
HYGIENE:
•  Teeth may be cleaned with a soft child’s toothbrush and tooth and gum cleaner without fluoride.  A child’s fluoride toothpaste can be introduced at two years of age.
•  Don’t start toilet training.  Your baby is too young to toilet train (necessary muscle control is lacking).

SAFETY:
•  Use a car safety seat appropriate for toddlers every time your child is in a car.  Place the child safety  seat in the back seat.  The car seat can now face forward if the child weighs at least 20 lbs.
•  Keep all poisons, medicines, cleaners, vitamins, and iron supplements out of reach and with childproof  caps where possible.  Keep the POISON CONTROL CENTER phone number handy (1-800-222-1222).  If your child ingests something harmful, call the Poison Control Center immediately.
•  Childproof the house of dangling cords, hanging tablecloths, hot irons, curling irons, or space heaters.
•  Cover electrical outlets with safety caps.
•  Place safety gates at the top and bottom of stairs.  Be sure all windows have screens.
•  Install smoke alarms on every floor and change batteries twice a year.
•  Place all heavy or sharp objects out of your baby’s reach.
•  Check electrical cords so your baby cannot pull appliances or lamps over onto him-/herself.
•  Keep cigarettes and hot beverages out of his/her reach.
•  Do not leave your baby alone in the bathtub or near a pool or bucket of water even for a minute.  Children drown even in shallow water.  Even with swimming lessons, your child is never drownproof.
•  Keep your baby away from the stove and turn pot handles away from the edge of the stove.
•  Set the hot water heater thermostat to less than 120 degrees Fahrenheit.  Fence a space heater so your child cannot get to it.
•  Toys should be carefully inspected for small loose parts that might be swallowed or inhaled.  Children under age 4 years should not be given toys with parts smaller than a ping pong ball.
•  Keep household plants out of your baby’s reach—many are poisonous.
•  Do not leave your child alone or with a young sibling.
•  Watch your child carefully when visiting friends and relatives, and keep visitors’ purses out of your toddler’s reach.
 
STIMULATION:
•  Talk and sing to your baby as much as possible so your baby can begin to imitate your speech sounds.
•  Board books with colorful pictures are good choices to read with your baby—it is never too early to read to your child.  
•  Babies at this age love to play “Patty-Cake” and “Peek-a-Boo.”
•  Supply your baby with pots, pans, and wooden spoons for a “kitchen orchestra.”  You baby will love creating and manipulating sounds.
•  Brightly colored balls of all sizes are fun for your baby to chase, clutch, and roll around.
•  Stacking blocks, rings, and push-pull toys are also fun at this age.
•  Age appropriate busy boxes encourage various kinds of manipulation and aid development of dexterity.
•  Your baby will continue to love huggable dolls and stuffed animals and may want to sleep with one.
•  Colorful, sturdy cars and trucks are also fun.
 
HEALTH MAINTENANCE:
•  IMMUNIZATIONS:  DTaP, Hib, IPV (see vaccine information sheets).
•  ACETAMINOPHEN DOSAGE:  Acetaminophen (i.e., Tylenol, Tempra) can be given for fever every 4-6 hours (See Tylenol Dosing Handout).  Tylenol is dosed according to your baby’s weight.
 
ANTICIPATORY GUIDANCE:  (Information credited to Brazelton’s Touchpoints)
•  Parenting responsibilities:  The constant demands of keeping your child physically safe are intensified by the personal demands on the part of the child to be independent.  Try to remand flexible while at the same time establish control over the child’s behavior when it is truly necessary.  
•  Shifting attachments:  The opportunity to begin playing more regularly with other children may be an appropriate channel for the child’s increased capacity for new relationships.  This is a wonderful time to involve your child in playgroups if he/she is not already in a group childcare setting.