Your Toddler At 15 Months

At 15 months, your toddler continues to become more independent.  He or she will begin to imitate what you do after watching you do it.  He or she will crawl upstairs after you.  Your 15 month old will speak several words and what sounds like short sentences in toddler jargon.  At this age your child will probably begin feeding him or herself. (Not necessarily a pretty sight.)  He or she may start to scribble and point at specific things.

Your Toddler’s Safety

Remember, kids can’t fly.  It is important to increase your awareness of your toddler’s safety as he or she becomes more mobile and more independent.  You may want to consider putting window guards on upstairs windows, and adjusting the crib mattress to keep your toddler from climbing out.  Be on “hot alert” at all times.  Coffee cups, range burners, pot handles, oven doors, irons, curling irons, and heaters can all be very hazardous to your 15 month old.  Also be on “splash alert” at all times.  Bath tub, toilet, even a five gallon paint can, believe it or not, can cause serious injury and even death.  It’s a jungle out there for a fifteen-month-old child.  Always use the car seat.

Other safety tips include:

• Place gates at all staircases and be aware of your child’s ability to climb.
• Move all poisonous chemicals, medications, poisonous plants and breakables out of the reach of your child. 
• Because your child can now climb, keep poisonous chemicals and medications not only out of reach, but behind a latch or lock that your child cannot defeat.
• For any poison ingestion, call Poison Control first at 1-800-222-1222.  If your child is unconscious or in distress, call 911 immediately. 

Immunizations:

The immunizations your child may receive at this age have been discussed.  By now, you have read the information about them that we have supplied you.  Most babies do not have a reaction to these immunizations.  If there is a reaction, most likely it is a slight fever or fussiness.  You may give your toddler Tylenol or other acetaminophen products for these symptoms.  If you feel the Tylenol has not helped or you are concerned about other symptoms let us know.  If your toddler’s temperature exceeds 104 degrees F. rectally, let us know.

Your Next Appointment:

Your toddler’s next appointment will be at 18 months.  We will continue to evaluate your toddler’s development and discuss additional information.  He or she will also be due for the next round of immunizations at that time.

Appetite Slump in Toddlers

Definition
Characteristics of a child with a normal decline in appetite:

• It seems to you  that your child doesn’t eat enough, is never hungry, or won’t eat unless you spoon feed him or her yourself
• Your child is between 1 and 5 years old
• Your child’s energy level remains normal.
• Your child is growing normally.

Cause
Between 1 and 5 years of age many children normally gain only 4 or 5 pounds each year even though they probably gained 15 pounds during their first year.  Children in this age range can normally go 3 to 4 months without any weight gain.  Because they are not growing as fast, they need less calories and they seem to have a poorer appetite (this is called physiological anorexia).  How much a child chooses to eat is governed by the appetite center in the brain.  Kids eat as much as they need for growth and energy.  Many parents try to force their children to eat more than they need because they fear that poor appetite might cause poor health or a nutritional deficiency.  This is not true, however; forced feedings interfere with the normal pleasure of eating, decrease a child’s appetite and can turn them into a picky eater.

Expected Course

Once you allow your child to be in charge of how much is eaten, the unpleasantness at mealtime and your concerns about his or her health should disappear in 2 to 4 weeks.  Your child’s appetite will improve when he or she becomes older and needs to eat more.

Helping a Poor Eater Rediscover his or her Appetite

1. Put your child in charge of how much he or she eats.  Trust your child’s appetite center.  The most common reason for some children never appearing hungry is that they have so many snacks and meals that they never become truly hungry.  Offer your child no more than two small snacks of nutritious food each day, and provide them only if your child requests them.  If your child is thirsty between meals, offer water.  Limit the amount of juice your child drinks to  6 ounces each day.  Let your child miss one or two meals if he or she chooses and then watch his or her appetite return.  Skipping a meal is harmless.
2. Never feed your child if he or she is capable of feeding himself or herself.  The greatest tendency of parents of a child with a poor appetite is to pick up the spoon, fill it with food, smile, and try to trick the child into taking it.  Once your child is old enough to use a spoon independently (usually 15 to 18 months), never again pick it up for him or her.  If your child is hungry, he or she will feed him or herself.
3. Offer finger foods.  Finger foods can be started at 8 to 10 months of age.  Such foods allow your child to feed himself or herself at least some of the time, even if he or she is not yet able to use a spoon. 
4. Limit milk to 16 to 18 ounces each day.  Milk contains as many calories as most solid foods.  Drinking too much milk can fill kids up and dull their appetites. 
5. Serve small portions of food; less than you think your child will eat.  A child’s appetite is decreased if he or she is served more food than he or she could possibly eat.  If you serve your child a small amount on a large plate, he or she is more likely to finish it and gain a sense of accomplishment.  If your child seems to want more, wait for him or her to ask for it.  Avoid serving your child any foods that he or she strongly dislikes (such as some vegetables).
6. Consider giving your child daily vitamins.  Although vitamins are probably unnecessary, they are not harmful in normal dosages and may allow you to relax about your child’s eating patterns.
7. Make mealtimes pleasant.  Draw your children into the conversation.  Avoid making mealtimes a time for criticism or struggle over control.
8. Avoid conversation about eating.  Don’t discuss how little your child eats in his or her presence.  Trust your child’s appetite center to look after his or her food needs.  Also, don’t praise your child for eating.  Children should eat to please themselves.
9. Don’t extend mealtime.  Don’t make your child sit at the dinner table after the rest of the family is done eating.  This will only cause your child to develop unpleasant associations with mealtime.
10. Prevention.  By the time your child is 8 to 10 months old, start giving him or her finger foods. By 12 months of age, your child will begin to use a spoon, and he or she should be able to feed him or herself completely by 15-18 months of age.
    

Call Our Office During Regular Hours if

• Your child is losing weight.
• Your child has not gained any weight in 6 months.
• Your child has associated symptoms of illness (such as diarrhea, fever).
• Your child gags on or vomits some foods
• Someone is punishing your child for not eating.
• This approach has not improved mealtimes in your house within 1 month.
• You have other questions or concerns.
  

Instructions for Pediatric Patients, 2nd edition, 1999 by WB Saunders Company.  Written by Barton Schmitt, M.D., pediatrician.