16-18 Months

18 Month Immunisations

It is time for your child's next round of immunisations.

Remember to take your red book with you to the appointment.

Your child will receive the following vaccines:

1. The Six-in-one vaccine helps protect your baby against diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and hepatitis B (HepB).
2. MMR helps to protect your baby against measles, mumps and rubella (German measles).

The immunisation pages of NHS Inform includes information on when and why you should immunise your child, and what to expect after immunisation.

Public Health Scotland have produced a Protect your child against serious diseases guide. This booklet is provided by your Health Visitor within the first two weeks of your baby being born and will help you over the next five years of your child’s own immunisation journey. This is also available in other languages.

It is common at this stage for children to start rejecting foods they liked and to refuse new foods. This is a normal part of development called the Neophobic phase. It is important to continue to offer a variety and try to keep meal times fun and relaxed! 

Below are some top tips to reduce stress at mealtimes. 

• If you are relaxed and having fun your child will be too. 
• Turn off the TV, tablet and phones, make mealtimes fun without distractions. 
• Eat together if you can, be a good role model. 
• Keep mealtimes to no longer than 30 minutes. 
• Getting messy is really important, using all the senses to explore food helps children to try new foods. 
• Give them foods you know they will eat with something new on the side. 
• Get them involved in shopping and preparing food, it can be as simple as washing the fruit and vegetables before you chop them or choosing a new fruit or vegetable to try at the shops. 
• Keep offering three regular meals and two or three healthy snacks. 

You can continue to breastfeed for as long as you and your childlike. All other drinks should now be offered from a free-flow or open cup. Tap water and pasteurised full fat cow’s milk are the best drinks for your child. If you are thinking about using an unsweetened calcium fortified milk alternative (such as soya, nut, oat, hemp, coconut based milk alternatives) as a main drink then great care is needed as these are lower in energy and other nutrients than animal milk. You should seek advice from a Health Visitor or GP before using these as the main milk drink. Rice milk should not be given until your child is over four and a half years old. For more information try Infant Milks from the First Steps Nutrition Trust website.

You can find more tips and ideas using the links below:

• Parent Club Tips if your toddler is a fussy eater.
• First Steps Nutrition Trust Eating well in the early years
• British Dietetic Association
  • Healthy eating for children
  • Cooking at Home
  • Cooking with children of different ages
  • Cooking safely with children

When your toddler is looking at a book they will turn several pages at a time. It takes lots of practice to learn to turn one page at a time. Your toddler is starting to use both hands together more. They will use one hand to hold an object steady and use the other to control it. Your toddler is now able to post items into holes. If they don't have a shape sorter let them post toys into empty plastic cups.

Your toddler can hold a pencil/crayon in either hand to scribble and make dots.

You can play games together to help your toddler to develop their hand skills. Play with bubbles, get your toddler to pop the bubbles, they could clap or point to pop them. Give your toddler short chunky crayons to scribble on paper or short chunky chalks to scribble on the pavement. Sing action and clapping songs like "Tommy Thumb", "Incy Wincy Spider", "Wind the Bobbin Up" or "Round and Round the Garden". You could even make a Ribbon Pull Toy, find out more from CBeebies Parenting DIY Ribbon Pull Toy

Walking will start to be the main way of getting around. Your toddler will be gaining speed and confidence in changing direction. They may start to try stepping up on to stairs with their hands held and two feet to a step. They will still be coming down backwards or bumping down on their bottom. They may be starting to pull a toy along on a string while walking.

Your toddler may now be standing with feet closer together, and reaching out for objects! Falls still happen. Your child may be able to start getting back up again using furniture rather than relying on you! They will be more stable when squatting to play with a toy and should be able to kneel without support. Your toddler can climb into an adult chair and turn around to sit.

Now that your toddler has mastered walking, they will start to be able to kick a ball with one foot. Their aim may not be great! You can start practicing ball skills with our activity ideas.

Dressing

Your toddler can help with getting dressed by pushing their arm through their sleeve or offer a leg for trousers. Now is the time to start teaching them how to undress. They can take of their hat, socks and shoes (depending on the fastening) so you know they can pull things off. Now get them to help with the last step of taking their other clothes off.

Teaching the last step first is a teaching technique, called backward chaining, that can help children learn how to do complicated tasks. Backward chaining is when you break a task down into it's different steps and then teach the last step first. Once the child can do the last step you teach the second last step and so on until they can do every task. It works great for teaching dressing skills.

If we think about a taking off a t-shirt to start with you would follow these steps:

1. you would help them get their arms out of the sleeves
2. you pull the t-shirt up to their neck
3. you pull the t-shirt over their head most of the way
4. you get your child to pull it off.

You repeat this until your child pulls the t-shirt off their head every time. They might learn this quickly or it might take some time. Keep practicing every time you are changing your child. Then choose another garment and do the same. So for trousers, undo any fastenings and pull them down to your child's ankles and over their heels. Get your child to pull them off. 

Eating and Drinking

Keep letting your toddler practice using a spoon. Use any opportunity to play with spoons too. Give your toddler a spoon while you are cooking. Involve them in simple food preparation, baking and cooking activities. Toddlers love to copy their care givers. There are ideas about Cooking at Home at different stages on the British Dietetic Associations website. Shopping is a great time to explore food too. Find out more from CBeebies Parenting Fun at the supermarket with baby. 

Going to the toilet 

Your toddler may be beginning to show signs that they need a pee, becoming restless or squirming. They may also let you know if they have a wet or dirty nappy. You can find lots of information about toilet/potty training on our toileting page. It is still quite early but there are some things you can start doing now (if you aren't already) to make the journey easier.

• Change their nappy in the bathroom.
• Look at books about going to the toilet together.
• Let them see you using the toilet.
• When possible put their poo into the toilet and flush the toilet together so they know what happens.
• Teach them about washing their hands after going to the toilet.

Teeth Brushing

Brushing your teeth is an essential part of looking after your body. You should be brushing your child's teeth at least twice a day. You can find out more from:

• The British Society of Paediatric Dentistry (BSPD) A Practical Guide to Children's Teeth
• Childsmile Oral health for babies: birth to 3 years old

Listening and Understanding 

Your toddler will use a few words together that they have learned from you in familiar situations, like 'all done'.

Talking  

Your toddler will chatter all the time and will also try to sing familiar songs and rhymes. 

Interacting 

Your toddler points to share interests and as a way to start interaction – this is known as joint attention. Your toddler will play alongside other children but not with them.

Find out more from Parent Club Top tips for chatting together with your baby.

Your toddler is developing an awareness of size and is starting to recognise big and small. 

Your toddler can now point at different body parts when you ask them "where are your eyes?" they will point to their eyes. Find out more from CBeebies Parenting Learning about faces with baby.

Your toddler is starting to enjoy messy play. Add a variety of textures and objects to their toy box including soft cloths, washing up sponges and even paintbrushes! Your toddler doesn't need expensive toys!! Just touching and exploring different textures is enough but getting even messier is great. Remember that your toddler is still putting everything in their mouths so make sure anything you choose to get messy with is safe to go in their mouth. Getting outdoors is another great way to get messy and your toddler is 100% washable. Just remember that their clothes might not be so dress them in something you don't mind them getting muddy in. Find out more from CBeebies Parenting Exploring texture and Adventure Challenge.