15 Months to 18 Months

Eating and Drinking

Formula

• If your child is still taking formula, please remove it from their diet.
  • Simply finish whatever you have left in the home, and then don’t buy any more.
  • Toddler formula is not recommended.
    • It will blunt your child’s appetite.
    • All the nutrition they need will come from regular food.
• Remove bottles if your child is still using them. 
  • Bottles are a known source of tooth decay in babies.
  • The longer you wait to stop the bottle, the more difficult the transition will be for your child. 

Breastfeeding

• If your child is still breastfeeding, please feel free to continue for as long as you want!
  • Continue the daily vitamin D supplement for your child.
    • Your child now needs 600 IU of vitamin D per day.

Nutrition

• Provide a well-rounded diet with all the food groups.
• Make sure the diet meets the age-based requirements of nutrients each day.
• Encourage high iron-containing foods in the diet to prevent iron deficiency.
• Honey and cow’s milk are now safe for your child.
  • Honey is an effective cough suppressant when your child has a cold virus.

Cow’s Milk

• Wait to introduce cow’s milk until each of the following has occurred:
  • Formula is done.
  • Breastfeeding is done.
  • Starting cow's milk while they're still getting a lot of breast milk calories can decrease the appetite for solid foods.
• Cow’s milk is not necessary, but whichever option you choose (see below), be certain it is fortified with vitamin D.

Vitamin D

• Your child now needs 600 IU of vitamin D per day.
  • The vitamin D will come from vitamin D-enriched milk (cow, goat, almond, soy, pea, etc).
• 16 ounces per day of whole cow’s milk provides the required vitamin D your child needs.
  • If your child won’t take all 16 ounces of milk per day from the sippy cup, don’t reintroduce the bottle.
  • Instead, just give a vitamin D supplement that evening before bed.
• Limit milk to 20 ounces per day. Drinking more than 20 ounces per day will negatively affect your child’s appetite, which can cause nutritional deficiencies.
  • Receiving too much cow’s milk per day is a known cause of anemia.
• The milk should be given in a sippy cup.
• The milk should be given throughout the day with meals and snacks, just like big kids and adults drink it.
  • First food of the day is breakfast, not milk.
  • Last food of the day is dinner, not milk.
• Your child does not need juice.
  • If you do give your child juice, serve all natural 100% fruit juice and limit it to 4 oz/day.

Water

• Your child can now drink water freely.
  • Offer water throughout the day.
  • Don’t worry if they don’t want to drink, this simply means they aren’t thirsty.
• Please note, the amount of water needed daily may vary by individual and may need to be adjusted depending on levels of activity and environmental conditions like heat and humidity.

Mealtime

• We recommend 3 meals and 1-2 snacks per day.
• Avoid letting your child “graze” on food throughout the day.
  • This will negatively affect the appetite and can worry parents that their child “doesn’t eat enough” at mealtimes.
• Eat meals together as a family when possible.
• Avoid distractions during mealtimes, which many parents use to get their child to eat more.
  • We want your child to pay attention to their own hunger level, rather than eating out of distraction.
• Common distractions to avoid: TV, screens (phone/iPad), pets, music.
  • The most common distraction is often the caregivers themselves.
    • Imagine how distracting it would be to have Mom on one side and Dad on the other, both trying to convince you to eat more!
    • Instead, we recommend caregivers eat their own meals and converse with each other, allowing your child to pay attention to their own hunger level, and eat accordingly.
• If your child cleans their plate, offer more!
  • Provided there are no distractions, you can trust your child to eat when hungry, and stop when full.
• Avoid small, hard foods that can cause choking—nuts, popcorn, hot dogs, grapes, and hard, raw veggies.

Strategies For Picky Eaters

• Most caregivers will experience concerns about picky eating between 12 and 36 months of life.
• See our article on picky eating for more information.

Development

Gross Motor Skills

• Your child may be pulling up to stand and standing alone. 
• Some children may be holding on to furniture and taking a few steps, commonly called “cruising.”
• By 18 months, we would like to see your child take a few independent steps. 
• Tips to encourage gross motor development at this age:
  • Find a safe way for your child to pull up to a standing position, and encourage them to do so.
  • Avoid using push walkers to “teach” your child to walk, unless instructed to do so by a medical professional (e.g. if your child sees a physical therapist).
    • They inhibit independent walking.
• Avoid seats with wheels (i.e. baby walkers)
  • They are dangerous and also inhibit independent walking.

Fine Motor Skills

• Your child is perfecting their pincer grasp and picking up small objects with two fingers. 
  • To further encourage this skill, allow your child to feed themselves at mealtimes, even if it means a bigger mess.
  • Offer your child a baby fork and baby spoon at meals.
    • Remember, this is just for practice, and we don’t expect them to use these correctly.
    • Most 18-month-olds are holding the spoon in one hand and eating with the other.
• Demonstrate stacking two large blocks and then encourage your child to help you.
• Encourage your child to put an object in a container, such as a block in a cup.

Language Skills

• There are two “language explosions” in the second year of life (12-24 months).
  • The first half of the second year of life is about language comprehension.
    • At 18 months of life, your child will understand everything you say to them, but may not have many spoken words.
  • The second half of the second year of life is about language expression.
    • At 24 months of life, your child will have more than 50 words and will speak in 2-word sentences.
• At 15 months, some kids try to say 1 or 2 words other than "mama" or "dada." 
  • Sign language and animal sounds count as words.
  • Your child may have their own “word” that they consistently use for something and that counts as well. 
    • An example of this is “ba” for bottles. 
• Nonverbal communication is more important than speaking at this age.
  • You’ll notice your child looking at your face in unfamiliar situations, for example when they meet a new person.
    • These “check-ins” represent your child reading your facial cues to determine if they should be afraid or not.
  • You may notice your child does the following.
    • Looks at a familiar object when you name it.
    • Follows directions you give with both a gesture and words. (i.e. gives you a toy when you hold out your hand and say, "Give me the toy").
    • Points and grunts to ask for something or to get help.
    • Waves "bye-bye" or claps when excited.
• Talk to your child all the time.
  • She should hear as many words as possible from the people she cares about.
    • This is best accomplished through interactive play with caregivers.
  • Reading books is always encouraged, but most babies will lose interest quickly, and that’s ok too!
  • Avoid “baby talk.”
    • Instead, pronounce words correctly, to teach your child to make sounds correctly.

Social/Emotional Skills

• Your child will learn social cues from interactive play with caregivers
• Children this age do not need social interaction with kids their age, but it sure is cute!
  • They are learning all the social skills they need from their attentive and loving caregivers.
• Between 15 and 18 months you may notice your child does the following.
  • Copies other children while playing, like taking toys out of a container when another child does.
  • Shows you an object that they like.
  • Claps when excited.
  • Hugs a stuffed doll or other toy.
  • Shows you affection.

Other Guidance

Sleep

• Please see our guide to sleep in the second year of life for detailed recommendations.

Dental Care

• Once your child’s first tooth appears, start brushing!
  • Dental decay in baby teeth can negatively affect permanent teeth and lead to future dental problems.
• Apply a grain-of-rice-sized amount of fluoride-based toothpaste to a soft toothbrush.
  • Press the toothpaste into the bristles to prevent your child from sucking the toothpaste right off of the brush.
• Most toothpaste specifically labeled for “babies” does not contain fluoride. 
  • Please make sure you buy toothpaste that does contain fluoride, even if labeled for “children.”
• Brush teeth once in the morning and once before bed. 
• It is normal for your child to resist having their teeth brushed. The following strategies may be helpful:
  • Allow your child to brush their teeth first then follow up by brushing their teeth for them. 
  • Make up a silly song about brushing teeth. 
  • Some children resist brushing less if brushing teeth while their siblings or parents are doing so as well.
  • If these methods fail, don’t be afraid to bring in another caregiver to restrain your child while you brush their teeth.
    • Sometimes it needs to be a two-person operation!
• The best thing you can do to keep your child’s teeth healthy at 15 months is to remove bottles if you haven't already (see discussion above).
• Thumb-sucking and pacifier use are fine.
  • These may cause the teeth to jut forward, requiring braces when your child gets their adult teeth.
    • If you're ok with that, so are we!
• Plan your child’s first visit to the dentist at 2 years of age. 

Common Illnesses and Injuries

•  In the first two years of life alone, most children have eight to ten colds.
  • Each cold can last for up to 3 weeks. 
• Vomiting and diarrheal illnesses are common as well. 
• Fever will accompany many of these illnesses. 
• Falls and head injuries are the rule, not the exception.
• Teething may continue to bother your child on and off.

Safety

• Keep your child’s car safety seat rear-facing until your child is 2 years of age or until they reach the highest weight or height allowed by the car safety seat’s manufacturer.
• Please review our guide on childproofing for ways to keep your baby safe in your home.
• Please review our guide on water safety for young children.