Health review: 18-month-old baby check-up

This is a big and important visit. Your child is due for a lot of immunisations, his growth should be evaluated, and sleep and discipline issues are usually on parents' minds. From the provider's perspective, this visit is expected to be the most challenging. Don't be surprised if your toddler isn't the least bit cooperative. Wiggles and cries are expected.

Here's how to prepare for this visit

• Your baby may need booster injections for vaccines he's already had, in addition to some new vaccines. Check your immunisation schedule and double-check with your provider to make sure that your baby's injections are up to date.

• Dress your toddler in a two-piece outfit that comes off easily. Plan to keep him on your lap for most of the examination. Bring one or two familiar toys. Snacks will also help you to get through this visit.

At this visit, your provider will probably:

• Weigh and measure your child.

• Give you insights into your toddler's development and emotional growth.

• Go over his development to be sure he's on track.

• Talk about discipline issues.

Your provider will want to know:

• Has your baby seen another healthcare provider since the last visit? If so, why? What was the outcome of that visit, and was any medication or treatment prescribed?

• How are your baby's walking, running and climbing skills? Can he walk backwards?

• How are his language abilities? What's he saying? Is he putting words together yet? How many words does he have?

• Does he understand one-step commands such as 'Get your shoes' or 'Bring me a nappy'? Can he listen to and follow a simple story? Does he look at the pictures in a book?

• Does he respond to simple requests or simple games like peek-a-boo?

• How does he play? The type of play a child engages in tells us about cognitive abilities. Does he imitate you at household tasks? Can he stack blocks?

• Can he use tools such as a spoon or a fork or use one toy to get another?

• Is he starting to say 'no' and have temper tantrums? These are good signs of emotional and cognitive growth.

• Can he pull a toy along the ground?

• Can he use a spoon and drink from a cup?

• Can he point to any body part when asked?

Talk it over

Most parents are concerned about three things at this age: diet, discipline and getting their child to bed. These confusing and troublesome issues are all related to your baby's growing sense of independence. Other concerns may include how to manage 'no!', temper tantrums and how to get your child to eat.

• Diet Let your provider know what your child is eating these days. If your baby is still taking a bottle, talk about weaning him from it. If you think your baby is such a finicky eater that he isn't getting proper nutrition, talk it over with your provider. Appetite and rate of growth fall off in the toddler years. He should use a spoon, and at least drink from a beaker. Ask about vitamins and fluoride.

• Discipline Let your provider know if your toddler seems hard to control. Discuss the steps you take when you discipline your child.

• Sleep Sleep issues are common at this age. Try keeping a diary of your child's sleeping patterns for at least three days and bring it to the visit. Your provider will be able to suggest solutions for you. Helping kids to settle down means developing good patterns.

Speak up!

Let your healthcare provider know:

• If your baby has a wandering eye that still wanders, even once in a while.

• If your baby gets very close to things to see them better, especially if poor vision at early ages runs in the family.

• If your baby seems especially sensitive to light or sound.

• If your baby isn't walking yet, is walking on his toes, or limps or tilts to one side when he walks.

• If your baby seems to be using only one hand when he plays, handles things or reaches for objects. If your baby is already very right-handed, or left-handed, he will use one hand more often when he eats and points. But he should use both hands equally when he plays.

• Can't put two objects together in play, or still playing with one object at a time.

• If he doesn't take a spoon when you offer it to him.

• If he doesn't feed himself.

• If he's lost skills that he had before.

• If he has no real words.

Although every baby is different and reaches developmental milestones at unique times, it's still good to let your provider know about any issues or concerns about your baby's development