Parents often wonder about their child’s health, leading to the frequently asked question: “Is my baby healthy and growing normally?”
These information sheets outline normal and healthy growth and developmental milestones, and common health topics for your baby.
Due to space constraints, some messages are repeated at several ages while others appear once only. Read the complete set of sheets to obtain the entire information.
The Rourke Baby Record (RBR) is a guide that many Canadian doctors and other healthcare professionals utilize for well baby and child visits for babies and children from 1 week to 5 years of age.
18 Months
Feeding & Growth
- You can continue to breastfeed your child until 2 years and beyond while continuing to give you and your child Vitamin D 400 IU per day
- Offer a maximum of 500 - 600 mL (16 - 20 oz) 3.25% cow milk per day in an open cup. More than 750mls (24 oz) per day will decrease your child’s appetite for solid foods and increase the risk for iron deficiency and anemia.
- Wash all fruits and vegetables that cannot be peeled
- Avoid processed foods high in sugar and/or salt and avoid sweetened liquids or fruit juices. Encourage water.
- If your child is following a vegetarian, vegan, or alternative diet, get expert advice to be sure that it is nutritionally complete.
- To prevent choking, avoid small, round, hard, smooth and sticky foods until 4 years of age. Have your child sit when eating or drinking.
- You may notice that your baby`s appetite is smaller at this age. It is normal for him to gain weight more slowly now. Remember to let him eat as little or as much as he is hungry for. Never force your child to eat.
- Aim to offer 3 meals and 2 to 3 snacks at regular times during the day.
- Be a good role model for healthy eating. Eat together as a family away from the TV or other distractions.
- Find out if your child is a healthy eater using Nutri-eSTEP at www.nutristep.ca
- Offer her a variety of foods from all food groups from Canada’s Food Guide.
Preventing Injuries
- As your child grows, continue to childproof your home. Keep medicines, cannabis edibles, cleaners and other toxic substances locked up and out of children’s reach. Cover electrical outlets and tape down cords. Secure TVs, computers and furniture to prevent them from tipping over. Use window guards and stair gates. Be vigilant about hot liquids on countertops. Find the hazards before your child does. Have Emergency numbers handy 1-844-POISON-X (1-844-764-7669). Use safe toys for your child`s age.
Other Advice
- Do not use over the counter cough/cold medications.
- Within 6 months of your child’s first tooth, or at 1 year of age, take him to his first dental appointment.
- You should wean your child from her pacifier now.
- Second-hand smoke (from cigarettes, E-cigs, cannabis) is harmful to your child. Ask your healthcare provider for help to quit smoking. Cannabis edibles should be locked away to prevent unintentional poisoning.
- Some children are ready to begin toilet training at 18 months of age; but many will not be ready until 2 - 4 years of age. Signs that your child is ready to potty train include an interest in toileting, telling you when he needs to use the toilet, and the ability to balance or walk.
- It’s normal if your child cries or fusses when you leave her in her crib for the night. Keep your bedtime routine consistent and predictable and allow her to find ways of comforting herself to fall asleep on her own.
- Having a healthy lifestyle yourself with healthy eating and physical activity will provide a good role model for your child.
- Empathetic, consistent and responsive discipline techniques are associated with positive behavior outcomes. Praise good behavior.
Development
- At 18 months, your child should:
- Walk alone.
- Feed herself with her fingers and try to use a spoon.
- Point to several body parts.
- Follow a 1-step direction. E.g. Bring me your shoes.
- Take off his hat or socks by himself.
- Say 10 or more words. Words do not have to be clear.
- Say 4 consonants. E.g. B, D, G, H, N, W
- Turn and respond when her name is called.
- Try to get your attention to show you something.
- Point to what she wants and look back and forth between you and it.
- Be interested in other children.
- Come for comfort when he is upset.
- Usually be easy to soothe.
- Continue reading to your child and let her hold the book and turn the pages. Avoid TV, video and computer time to allow more time for reading and for physical activity with you.
- Play games with singing, rhyming, clapping. Use actions when giving instructions.
- Make sure he has times to socialize and play with other children.
- Report any concerns about your child’s development, including her hearing and vision, to her physician or other healthcare professional.
Vaccinations
- After the vaccinations, your child may have no reaction, or may be fussy or sleep more or less than usual. He may have a mild fever or a little redness or swelling where the needle was given. If needed, you can give him ibuprofen or acetaminophen. Call your doctor if his fever reaches 40oC (104oF), if he is crying/fussy for more than 24 hours, is unusually sleepy or unresponsive, or has swelling at the needle site that is worsening.
Resources
For more information on your baby’s health, the top 5 websites cited by the RBR Parent Resources are:
- Canadian Pediatrics Society – Caring for Kids (www.caringforkids.cps.ca)
- Hospital for Sick Children – About Kids Health (www.aboutkidshealth.ca)
- Parachute - (www.parachutecanada.org)
- Dietitians of Canada – UnlockFood (www.unlockfood.ca/en/default.aspx)
- Health Canada (www.hc-sc.gc.ca)
Support and Acknowledgements
Financial support for the Rourke Baby Record has been provided by the Government of Ontario. In-kind support from the Canadian Paediatric Society, College of Family Physicians of Canada, and Dietitians of Canada. 2024 brochure revisions by Dr. Anne Rowan-Legg. As information is constantly changing, the Rourke Baby Record and these brochures should be used as a guide only.
August 2024