15-18 MONTH CHECK UP  

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DIET

Please use whole milk (3% fat), because your child needs a high fat diet (50% of calories from fat compared to 30% for an adult) until 2 years of age. If your child just won't take whole milk, then use 2% or skim or even none if milk allergic, but add a lot of extra fat in the diet by giving a lot of cheese, peanut butter, butter on all foods, etc. There is good evidence that feeding oranges, peanuts, oatmeal and shellfish may cause allergies in a child who has a strong family history of allergies, therefore avoid them until 1 to 2 years in that case. Continue to give your child foods that are thicker so that he or she may be on table foods at 12 to 15 months. Most dentists agree that the bottle should be removed by 12 to 15 months, but so long as your child is not sleeping with the bottle in the mouth, then a little extra time can be taken to remove the bottle. Pacifiers should be taken away by 2 to 3 years or sooner if the front teeth appear to be molding to the shape of the pacifier. Vitamins are only necessary if your child does not get a balanced diet. Many children, who donít seem to get a balanced diet, actually do get one if you average what they eat over a few days. In other words, they eat meats well one day, and fruits and vegetables well the next. You may still give a vitamin if you wish. Only give liquid vitamins until you are sure your child will not choke on a chewable. Vidalyn and Polyvisol are two liquid brands. Make sure to get the one with iron, and follow the directions on the box for the dose. If you have well water, please let the doctor know.

 COMMON ILLNESSES & PROBLEMS

                If your child is not already walking, then he or she soon will be. Your child will be able to reach over 2 feet tall and may soon be climbing. Thousands of children each year are injured or die from electrical outlets, choking on small objects, falling down stairs, pulling things like cords, table cloths and pot handles onto themselves, etc. Accidents are now the most common potential cause of death for your child, therefore, go over every inch of your house, and always watch your child closely.

                Temper tantrums and behavior problems are a common concern at this age. There are probably more opinions on this subject than there are grandparents in the world. I will give you some basic pointers, but ultimately, you should listen to all those opinions (mine included) and as parents decide how you want to proceed with child rearing. The pointers:

 SAFETY

        Most children can now eat thicker and bigger bites of foods. Children are still very prone to choking on food. The most likely things for a child to choke on are; hot dogs, bologna chunks, grapes, nuts, and pieces of meat. Make especially sure to crush hot dogs and bologna.

 NEXT VISIT

We schedule check ups at 18, 24, and 30 months, then every year starting at 3 years of age.  Your child should not need another vaccine until they are 4 years old (except for foreign travel and any newly developed vaccines).

 2005 Joe Matusic, MD