Healthy Kids
THE PERMANENTE MEDICAL GROUP

Your child’s next appointment

Your child’s next well check is usually at 18 months. In some cases, your doctor may recommend a slightly different visit schedule. Please plan to schedule that appointment online; once we are closer to the date you’d like to come in you can request an appointment time that’s convenient for you. Here’s what to expect:

  • We may recommend a blood test for anemia or lead.
  • We will assess your child's growth and development, and do a complete physical exam.
  • We will discuss sleep, nutrition, safety, discipline, and toilet training, as well as any questions or concerns you may have. 
  • Your child should receive recommended immunizations.

Take time to review what immunizations your baby will receive during the visit. You can also keep track of your child’s immunizations online with “View Health Reminders.” If you haven’t already, you'll need to link your child to your kp.org account by signing up to Act for a Family Member. You can also print your child’s shot record for daycare or your own reference.

Mealtimes and activities

Get moving

  • Play along with your child to show him how much fun physical activity can be. Dance, roll a ball, or chase a balloon.
  • Running, jumping, skipping, and hopping let kids burn off energy and feel good.
  • Hang out at the playground.

Eat smart

  • If you have a picky eater, mealtimes can be challenging. Your job is to give your child healthy food choices. His job is to choose which foods and how much to eat. If you try to control his choices, you’ll just start a battle over eating that no one will win. You want to raise a child that eats only when he is hungry, not one who overeats. One way to do this is to let him decide how much and what he eats. Keep in mind that his serving sizes are much smaller than yours – about 1 tablespoon per year of age. Learn more about feeding your toddler. 
  • You do not have to completely change the way you eat to have a healthy diet. There are lots of healthy choices in every kind of cuisine. For more ideas, see Healthy Eating for Toddlers.

Pull the plug

  • Set up a safe space where your child can explore.  For example, fill a bottom kitchen drawer with plastic containers, wooden spoons, and other safe items. Let your child build, explore, and create.
  • Turn on music instead of the TV and encourage your child to dance. Watch your child’s inner star emerge.

Drink well

  • How long to continue breastfeeding is a very personal choice. You should continue as long as it is working for both you and your baby.
  • Getting children turned on to the taste of water at a young age can really help prevent bad habits from starting. Remember to offer water as a beverage choice regularly and enthusiastically.

Development milestones

Your child is developing new skills every day. Much of this development spurt continues to be in her language. Suddenly, she may seem to understand everything you say; causing you to become more skilled in spelling words that you may not want her to hear. (Do we have time to stop at the P-A-R-K?)

Most children at this age can:

  • Imitate activities – which makes for a lot of fun.
  • Express wants by pulling, pointing, or grunting.
  • Say 1 to 3 words, as well as mama and dada.

Your child may be ready to:

  • Say 3 to 10 words and understand simple commands.
  • Point to parts of her body.
  • Walk well and climb stairs.
  • Recognize herself in a mirror.
  • Scribble. (Look out for those walls!)

You can find more information about your child's development on kp.org.

Keep in mind that children develop at different rates. So, if your little one is not doing all of these things just yet, you will likely see them soon. If you are concerned about your child's development, talk to your pediatrician at your next well-check, or send a secure message with your question.

Successful parenting

Fifteen months can be a challenging age. Your child is mastering movement and starting to display his independence. This can be difficult for both of you. You will notice that your toddler gets easily frustrated when things do not go his way. And it seems that he will push your buttons often – perhaps even on purpose. For example, your son may look over his shoulder to make sure that you are watching before he gets into mischief. This is his way of testing how his behavior can influence your reaction.

How you respond to his behavior can change how he acts. Instead of getting upset when he takes your cell phone, ignore or distract him. Then quietly put the phone out of reach.

Giving him attention for negative behavior just serves to make that behavior much more exciting to him. Instead, give him attention when he behaves well. Your attention and praise encourage positive behavior. The lack of attention to unwanted behavior will help stop it. As your child continues to learn through trial and error, you can help guide his behavior by being patient and consistent.

Temper tantrums

Almost all children have temper tantrums at times. They are a normal part of growing up. Tantrums are a child’s way of expressing anger, frustration, and disappointment. They:

  • Often occur from 1 to 3 years of age and usually stop by age 4.
  • Are more common when a child is tired, hungry, or sick; avoid tantrums by anticipating your child’s needs for snacks and naps.

Tantrums are less likely when children learn:

  • That they will not get attention (or get their way) by having them. Never give in to a tantrum.
  • How to express themselves with words. Help your child learn the words she needs. Examples include “No,” “My toy,” and “Stop.”

If your child has a tantrum, it does not mean that you are a bad parent or that your child is bad. You can help avoid tantrums by:

  • Letting your child know what is expected of her ahead of time. Before going into the store, tell her that you are not buying any candy and that you expect her not to make a fuss.
  • Letting her know the consequences of throwing a tantrum. “If you make a fuss, we will leave.”
  • Telling your child what will happen each day. Talk about your plans ahead of time so she will know what to expect.
  • Giving her warnings about upcoming changes. “Bath time is over soon. Two more minutes until you get out and then we will read a book.”
  • Giving choices when you can. “Do you want me to brush your teeth now or after we read?”

Learn more about temper tantrums in toddlers and preschoolers.

Stay safe

Toddlers are in constant motion. How many times today did your child run from the kitchen to the bedroom or switch from playing with blocks to chasing a ball? Their energy and curiosity never seem to stop.

All of this is healthy for your toddler’s developing body and mind. But it can pose safety risks. You need to find a balance between letting your kid be a kid – busy moving and busy learning – and teaching and setting limits to keep him safe.

There are 3 essential components to keeping your child safe: prevent, teach, and supervise.

Prevent

Preventing harm is the goal of all safety measures. It helps to think like a toddler. Look at each part of your home and yard and ask yourself: If I were 15 months old, what would I want to touch? Where would I try to climb? How could I get to something I want to play with?

Organize your child’s environment to eliminate as much risk as possible. Make your home a place where your child can be as active as he wants and still be safe.

Prevent poisoning by keeping cleaning products and medicines in locked cabinets out of your child’s reach.

Prevent burns by:

  • Making sure that your child can’t grab hot pots, curling irons, or coffee cups.
  • Installing smoke detectors and checking the batteries regularly.
  • Placing plastic plugs in all electrical sockets.
  • Turning the hot water heater down to less than 120° to prevent scalding burns.

Prevent drowning by being aware that:

  • Toddlers can get stuck in mop buckets and drown; the same goes for bathtubs.
  • If you have a pool or spa, be sure it is fenced and covered. The American Academy of Pediatrics has specific guidelines on Water Safety.

Prevent falls by making sure he cannot fall from high places, trip over objects, or fall against furniture or other objects that lead to injuries.

Teach

Teaching your child about danger and risk is a lifelong job for every parent. Start by teaching him concepts like “hot” to prevent burns and “stop” so he will freeze in place so you can come to his aid.

Remember that long explanations and trying to reason with a toddler don’t work. Keep your rules simple and your safety talks short. Learn more about teaching your child self-control on the KidsHealth Web site.

Supervise

No matter how much you try to prevent accidents and teach your toddler about safety, just being a toddler can put him in danger’s way. Most drownings occur with parents just steps away. Same with most burns and falls. Child safety gates can limit access to the kitchen, but almost every toddler will figure out a way over them. Do not assume that your toddler will not try.

Make sure an adult watches your toddler at all times. This means you need a plan: Who’s on patrol duty?

When you are at home alone with your toddler:

  • Bring him with you when you need to use the toilet - give him a toy or a book.
  • Put off showers until another adult is at home and can watch your toddler.
  • When you put him in a playpen, make sure you can see and hear him. He may be upset, but crying will not hurt him the way falling off a kitchen counter can.

You do not want to eliminate all risk while your child grows up. He needs to learn natural consequences: if you run too fast you can fall. However, toddlers do not connect activity and curiosity with being cautious. Paying close attention to prevention, teaching about safety, and supervising him is a big part of parenting your toddler. Your constant eye to safety must match his constant motion and curiosity.