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 a growth chart.

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 3 meals and 2–3 scheduled healthy 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 look of your child's poop (and how often they go) 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 12–14 hours of sleep a day, including naps.

Developing. By 15 months, most toddlers:

• try to say 1 or 2 words other than “mama” or “dada”
• show affection with hugs, cuddles, and kisses
• follow directions that you give using both gestures and words
• look at familiar objects when you name them
• point to ask for something, or to get help
• copy other children while playing
• try to use things the right way, like a phone, cup, or book
• stack at least 2 things, like blocks
• take a few steps on their own
• use their fingers to feed themselves

Talk to your doctor if your toddler is not meeting one or more milestones, or you notice that your toddler had skills but has lost them.

3. Do anexam 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 whole milk (not low-fat or skim milk, unless the doctor says to) until your child is 2 years old.
2. Limit the amount 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 they've had enough.
5. Move from the bottle to a cup. If you're breastfeeding, offer milk in a cup.
6. Serve 100% 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, salt, 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. Limit your child's screen time (time spent with TV, computers, phones, and tablets) to less than 1 hour a day. Choose quality programs to watch with your child. Video chatting is OK.
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. To help prevent cavities, the doctor or dentist may brush fluoride varnish on your child’s teeth 2–4 times a year.
2. Have a regular bedtime routine. If your child wakes up at night and doesn't settle back down, comfort them 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 a feeling of independence by offering two acceptable options to choose from.
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 instead.
6. Continue to keep your child in a rear-facingcar seat in the back seat until 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 from secondhand 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 can't get to the keys.

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