18 Months to 24 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.

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.

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.
  • 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.
  • Your child does not need juice, unless it's being used to treat constipation.
    • If you do give your child juice, serve all-natural 100% fruit juice

Water

  • Offer your child water freely throughout the day.
  • Don’t worry if they don’t want to drink, this simply means they aren’t thirsty.
    • Please note that 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

  • By 18 months, your child should be taking a few steps without holding on to anyone or anything.
  • Your child may be attempting to climb on and off furniture or other objects.
  • Avoid seats with wheels (e.g. baby walkers).    
    • They are dangerous and also inhibit independent walking.
  • Avoid push walkers, as these can also inhibit independent walking.

Fine Motor Skills

  • Your child is continuing to perfect their pincer grasp.
    • 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 toddlers this age continue to hold utensils in one hand and feed themselves with their fingers of the other hand.
  • Your child may attempt to throw a ball while standing.

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 was about language comprehension.
      • At 18 months of life, your child should understand most everything you say to them.
    • The second half of the second year of life is now about language expression.
      • At 24 months of life, your child will have more than 50 words and will speak in 2-word sentences.
  • At 18 months, some kids try to say 3 or more 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. 
  • 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

  • Around 18 months of age, you may notice your child does the following:
    • Moves away from you, but looks to make sure you are close by.
    • Children at this age strive for independence yet often feel anxious and clingy in new situations and may fear separation from caregivers.
  • Points to show you something interesting. 
  • Puts hands out for you to wash them. 
  • Looks at a few pages in a book with you.
  • Helps you dress them by pushing their arm through the sleeve or lifting up their foot.

Other Guidance

Sleep

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 18 months is to remove bottles if you haven't already (see discussion above).
  • Thumb-sucking and pacifier use are still okay at this age. 
  • 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 viruses.
    • 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. 

Potty Training

  • Many parents start to think about potty training around this time.
  • When To Potty Train?
    • There is no exact age that is best for potty training.
    • Potty training readiness varies greatly amongst children.
    • Some children start showing signs of being ready between 18 and 24 months whereas others show signs closer to 36 months of age.
  • Is your child ready?
    • Here are signs that your child may be ready.
      • Your child is dry for at least 2 hours during the day.
      • You can tell when your child is about to urinate or have a bowel movement.
      • Your child can follow simple directions.
      • Your child can pull clothes down and up.
      • Your child does not like wet diapers and wants to be changed.
      • Your child asks to use the potty.
  • Waiting until your child is truly ready will make the experience much faster and more pleasant for everyone involved!
  • If you think your child may be ready to potty-train, check out these helpful resources from the American Academy of Pediatrics