The toddler months continue to bring the medical challenges of
colds, cuts, bruises, and other minor emergencies.
But you'll also find yourself dealing with an emerging
personality and increasing conflicts. The new ability to walk means
your child can now become more independent - and might like to
flaunt it!
When Will We See the Doctor?
Some doctors have their own schedule for well-child visits, but
most see kids four times, at 12, 15, 18, and 24 months. If
your toddler has missed any
immunizations
, or if a problem has been detected that needs special attention,
additional visits may be scheduled.
What Will Happen During the Office Visit?
The well-child visits during your child's second year are
similar to those before, although discussions with your doctor
about behavior and habits may become more detailed as your toddler
grows.
Expect these common procedures and questions:
- Measurement of your child's length, weight, and head
circumference. Growth will be plotted on the growth chart, and
you'll be advised of your toddler's progress. A
physical examination checking for normal function of the eyes,
ears, heart, lungs, abdomen, heart, hands and feet, etc. The
doctor may look in your child's mouth for new teeth and signs
for the appearance of others.
- A review of your toddler's physical and emotional
development through both observation and your progress report. Is
your tot trying or starting to walk? Recognizing his or her own
name? By age 2, following simple instructions? Saying a few
words? Combining two words by age 2? The doctor may ask you these
questions and others like them.
- The doctor may go over safety questions such as: Have you
childproofed your home? (You'll need to review your
babyproofing
efforts now that your toddler can stand and reach.) Is your
tot in an appropriate
safety seat
while riding in the car?
- A discussion of your child's eating habits. Is he or she
eating more and more table foods? Interested in finger foods on
the high-chair tray? Using a cup? Being weaned from the
breast or bottle? Most doctors advise a switch from bottle to cup
by the first birthday to be sure the bottle doesn't interfere
with normal tooth development, and to avoid a struggle with a
determined toddler later on. Sleeping with a bottle of juice or
milk will only lead to cavities now. Also, after their first
birthday most kids can have foods that were off-limits before,
such as cow's milk, citrus fruits, and eggs. Your doctor will
discuss these additions with you.
- Advice on what to expect in the coming months.
- Your child will receive immunizations during some visits (see
below).
If they haven't already, kids this age might undergo a
tuberculin skin test, especially those at risk for tuberculosis.
You'll be given instructions on how to monitor the test and
report results to the doctor's office. Your child may also have
a hemoglobin screen to check for
anemia
, and if you are in a high-risk area, a screen to check for
lead poisoning
.
Address any questions or concerns you have, and write down any
specific instructions the doctor gives you regarding special care.
Keep updating your child's permanent medical record, listing
information on growth and any problems or illnesses.
What Immunizations Will My Child Receive?
Kids who have missed immunizations at previous visits because of
illness or scheduling problems will be brought up to date by 18
months of age.
Because your child is coming in contact with other kids more
often, you'll want to make sure all immunizations are given
close to the recommended times. This is especially true if your
child attends childcare.
Because more immunizations than ever are being given to children
before the age of 2 years, doctors are spacing immunizations so
kids won't need more than 3-4 shots per well-child visit.
From the Recommended Immunization Schedule of the American
Academy of Pediatrics (AAP):
A child who did not have them at the 12-month visit will
receive these vaccines at 15 months:
- fourth
Haemophilus influenzae
type b (Hib) vaccine
- measles, mumps, rubella (MMR) vaccine
- fourth pneumococcal conjugate (PCV) vaccine
At the 18-month visit, if not already been given, children
should receive:
- varicella (chickenpox) vaccine
- fourth diphtheria, tetanus, pertussis (DTaP) vaccine
- third hepatitis B vaccine (Hep B)
- third polio vaccine (IPV)
Discuss possible vaccine reactions with your doctor and get
advice on when to call with unusual problems.
When to Call the Doctor
By now you have probably called your doctor's office many
times with questions and concerns about your child's health.
Don't hesitate to notify the doctor if you suspect something is
wrong -
you know your child best
. Be sure to call if your child is especially sluggish or
irritable, has serious problems sleeping, is refusing all food or
drink, is suffering from vomiting or diarrhea, or has a temperature
over 104º Fahrenheit.
Some developmental delays should be reported to your doctor,
although these may or may not signal a problem. By 18 months your
child will probably be able to:
- walk on his or her own, with a regular heel-toe walking
pattern
- speak about 15 words
By age 2 your toddler should be able to:
- put two words together to form a sentence
- follow simple directions
- imitate actions
- push and pull a toy
Again, signs of developmental delay should be brought to the
doctor's attention, but they do not necessarily mean there is
something wrong.
Reviewed by:
Steven Dowshen, MD
Date reviewed: October 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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