15 Month Well-Child Visit

By 15 months, your toddler is becoming quite the individual with his or her own distinct personality. Independence is something that is desired but not fully achieved, which can lead to tantrums and meltdowns. What can you expect at this visit with the Pediatrician?

Vitals – Heart rate and respiratory rate will be counted, temperature is taken.

Growth measurements – Children grow more slowly from 1 to 5 years of age compared to the first year. Length, weight, and head circumference are updated at the fifteen month visit. These are plotted on a growth chart that is specific to your child’s gender and will be compared to the previous measurements to make sure growth occurs appropriately and proportionally. Remember, the goal is for your child to grow consistently on the curve. Growth curves are measured in “percentiles” where 50th percentile is the average measurement for age and gender. Children who fall above the 50th percentile are “above average” for that measurement, while those who fall below the 50th percentile are “below average.” Keep in mind that many factors affect where your child falls on the curve – genetics, feeding patterns, prematurity.

Development –

• Social: They interact more with family and others. Social and separation anxiety continue to develop. They will look for objects that are asked for by name. 
• Speech & Language: They say approximately 3-5 words in addition to Mama and Dada. They babble frequently. They follow directions from parents well. 
• Gross (large) motor: They walk very well, even running. They can walk backwards and squat down to pick up objects.  
• Fine motor: They scribble and draw messily with a crayon. They can drop objects into a container and bring them back out. 

Questions from the Pediatrician – your child’s doctor will ask questions about feeding, sleeping, voiding (urination) and stooling (bowel movements), and development.

Nutrition – Continue to offer your toddler a variety of fruits, vegetables, proteins, dairy, fats, and carbohydrates. Promote family meal times with snacks in between. Allow your toddler to decide how much to eat at once.  Avoid fruit juices or other sweetened beverages. 

Healthy Teeth – brushing your toddler’s teeth before bed should be an important part of the nighttime routine. Clean teeth and avoidance of any bottles or sippy cups before bedtime can help prevent cavities even in very young children. It is recommended that children by seen by a dentist before their second birthday. 

Exam – your child will have a head-to-toe exam at every well-child visit. 

Vaccinations – The CDC recommended vaccination schedule continues between 12-24 months of age, though the timing of specific vaccines is more of a range rather than specific dates. Your Pediatrician will discuss these in detail with you at your visit. Your toddler will likely receive Varicella (Chicken Pox), Pneumococcal, or Hib (Haemophilus influenza type B) booster vaccines if they were not given at 12 months. I discuss toddler vaccines in depth in another post if you would like more detailed information. 

Questions from you – you will likely have questions about proper developmental milestones, nutrition, sleep habits, and behavior. Bring your questions to the visit and never hesitate to ask your child’s Pediatrician about your concerns.

Safety information – part of every well-child visit is discussion of safety that is appropriate for age. For toddlers, this includes:

• sleep practices – toddlers should continue to sleep in the crib, with the mattress dropped down to the lowest setting to prevent them from climbing out. Avoid using bottles or sippy cups at bedtime. 
• car seat instructions – toddlers should continue to be in their car seats, in the back seat, facing backwards. If they meet weight requirements, they can transfer to a convertible upright carseat instead of the infant bucket seat. Never leave your child in the car alone. 
• water safety – toddlers should never be left alone in the water, even if it is only a few inches or only for a short amount of time. Drowning occurs quickly. 
• fall risks – Use baby gates to block stairs. 
• choking – toddlers will not always chew foods well so make sure foods are cut into tiny pieces. Avoid contact with small objects and plastic bags. 
• child-proofing – make sure all cleaning supplies, medications, and chemicals are up high or locked away. Check your floors and lower cabinets/shelves for small objects. Use outlet covers and hide electrical cords. Place barriers around space heaters and fireplaces. 
• sun exposure – avoid direct exposure during the middle of the day as much as possible. Use hats and long sleeves. Use sunscreen with a high SPF. 

Next visit: 18 months

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