Growth & Development: 15 Months

15 Month Old Developmental Milestones

Your child will start to display certain physical and mental developmental skills, also known as developmental milestones. Please keep in mind, development is slightly different for every child. If you have concerns about your child’s development, please talk to your child’s healthcare provider. At 15 months, most children can:

• Walk and run well, stop and recover objects
• Build a tower of two cubes
• Scribble by imitation
• Use jargon and babble plus four to six words
• Point to one to six body parts
• Indicate wants by pointing with their index finger or by vocalizing
• Creep upstairs

Diet & Feeding

Diet

Choose your child’s meals from the basic food groups.

• Milk & Dairy. At least two to three servings daily., 4 - 8 ounces (½ - 1 cup) servings of milk. Use whole milk until age 2. Limit the milk to 20 - 24 ounces per day as more than that can lead to anemia. Other equivalent sources are cheese 1 ½ - 2 slices or 2 (1”) cubes of cheese, 9 ounces of yogurt or 1 cup of calcium fortified orange juice.
• Proteins. Two servings daily. Serving size is 1 ounce (2 tablespoons) and includes beef, chicken, pork or liver. Substitutes are 2 tablespoons of creamy peanut butter, 1 ounce of cheese, ½ cup beans or peas or one egg.
• Fruits. Two to three servings daily. Serving size is ½ cup small fruit or ¼ cup canned or chopped fruit. Serve one serving of a fruit high in Vitamin C such as orange, grapefruit or tomato juice (3 - 4 ounces). Apple, grape and other juices should be avoided or limited to 4 ounces per day as their nutritional value is much lower.
• Vegetables. Two to three servings daily. Serving size is ¼ cup. Serve one serving of vegetables high in vitamin A, such as broccoli, carrots, squash, sweet potato or spinach. Be sure that the vegetables are cooked or soft to avoid choking.
• Bread & Cereals. Four servings daily. A serving size is ½ slice of bread or ½ cup of cereal. Serve whole-grain or enriched breads and iron-fortified cereals. Substitutes include: a roll, biscuit, crackers, cornbread, rice, macaroni, spaghetti, vermicelli and cooked or ready-to-eat cereals (do not use sugar-coated cereals).

Your baby should be drinking everything from a cup by 15 months of age. Wean off the bottle, and no night time bottles or cups after bed and teeth brushing. Although your child can have most of the same foods as the rest of your family, there are a few exceptions. Avoid highly spiced or fried foods.

How to Prevent Choking

Avoid nuts, fruits with seeds, grapes that are not diced into small pieces, raw carrots, popcorn, hard candy, gum or hot dogs until your child is at least 4 years of age when he or she can chew better. Do not give large pieces of food. Eating time should be quiet and structured whenever possible. No walking, running or talking while chewing. Supervise all meals and snacks.

The actual nutritional requirements are quite small at this age, and children thus tend to be picky eaters now. Your child’s appetite may vary from day to day. Keep servings small and try foods again at a later date.

• Do not battle with your child over eating. Have them eat only at meal times and scheduled snack times.
• Resist giving your child desserts, puddings, sweets, chips, juice/punches or soft drinks.

Toilet Training

Your baby may show a passing interest in the potty chair or even tell you when he or she is wet; however, toilet training will be much easier if you wait until your baby is ready, usually at around 2 to 2 ½ years of age. Some families may start this early, but it will require patience, dedication, and keeping realistic expectations.

Behavior

Your toddler will be active and on the go most of the time. He or she continues to want to show independence but needs a safe place to explore and needs constant supervision. Imitative behaviors such as sweeping, dusting, playing with dishes and dolls will increase at this age. Hitting and biting also can begin, especially if they are seeing these behaviors in other children or adults.

Discipline

Discipline is a form of teaching and guiding your child to help him or her learn self-control, to respect other’s rights and to live by society’s rules. Toddlers need reasonable limits set to help them learn what is expected of them and to protect them from harmful situations.

Be Consistent. Most 15-month-olds understand the meaning of “no.” You must be consistent to teach your children that “no” means “no” for the same thing all of the time. Sometimes they do not listen to verbal commands so they may need to be removed from the particular situation and shown what “no” means. Also, “choose your battles” and ignore minor behaviors; save “no” for key priorities.

Be Proactive. Anticipate problems and avoid situations or activities that might harm or frustrate your child. Try to avoid outings during nap time, late at night, or noise/crowds that can overwhelm young toddlers.

Avoid Hitting and Yelling. If your toddler breaks a rule, remove him or her from the problem area and encourage some other activity. Avoid slapping or spanking at this age, since your toddler will find this action hard to understand. If parents show loss of control by hitting or yelling, they will be teaching their children to display similar behavior when they are frustrated.

Use Time Outs. Time out is a healthy discipline strategy that can be used as early as 15 - 18 months of age. It can be used each time your child breaks a serious or known rule. An example of a behavior necessitating time out is biting others. Being consistent is one of the keys to effective discipline.

You should discipline your child each time he or she breaks a predetermined rule. This instills a sense of security for your child. The time out place can be a chair or room. Ideally, it should not be a fun place where toys or TV are accessible. Studies show less time is required if the child cannot see the parent. Time out can also mean simply removing attention or objects from your child.

To be effective, time out should be about one minute for each year of age. However, the time starts after he or she has calmed down. After the time out is over, reassure your child that you love him or her and the “specific behavior” is the reason why he or she was in trouble. At this young age, you may use redirection to other activities, or time out to remove them from a situation of danger or defiance. Keep it very brief as a ‘break’ in their negative behaviors. Most 15 month olds will not sit on a chair or do typical ‘time out’ yet.

Research shows you can expect your child to attempt to escape from time out about 70 percent of the time during the first week. If you are consistent with time out, escape attempts will occur hardly ever by the fourth week. Once the undesirable behavior has decreased, you may use time out intermittently.

Praise Correct Behavior. Praising good behavior may prevent your child from learning to misbehave in order to gain your attention. Say things like, “I like it when you help me pick up your toys.” Think ‘time in’ and play with them, give attention when they are being good too.

Manage Temper Tantrums. As children realize there are rules to follow, they sometimes respond with acts of frustration and anger, such as holding their breath, temper outbursts and full-blown temper tantrums.

At this age, temper tantrums are very common and are children’s response to frustration. In these situations, you may try to engage your child in other activities before his or her anger escalates. For example, if your child tends to cry for sweets at the store, do not go down the snack aisle. When a full-blown temper tantrum begins, ignore it and walk away. In these instances, toddlers may bang their heads; however, no more harm than a bruise will occur. Do not laugh or make fun of your child. When the tantrum stops, give your child your attention. This is hard to do when they make a scene, or fall to the floor, but the less attention or over-reaction, the sooner these tantrums will improve.

Sleeping

It is recommended for toddlers to sleep in their own beds and, if possible, in their own rooms. Establish a consistent time for bed and routine.

• Be firm when it comes to going to bed.
• Create a good sleep environment and routine (do not use TV, loud music, etc.)
• If your child awakens during the night, do not allow him or her into your bed. Instead, ensure your child is safe and comfortable in his or her own bed.
• Do not encourage nighttime playing or snacking.
• No bottles or sippy cups in bed, especially with juice.

Safety

According to the Centers for Disease Control and Prevention (CDC), unintentional injuries are one of the leading causes of death in children 1 – 4 years of age in the United States. Most of these injuries can be prevented. At this age, children can walk, run, climb and explore. However, they do not understand danger adequately. The following tips will help you keep your child safe.

Prevent Pedestrian Injuries. If your baby plays outside, a fenced yard and constant supervision are necessary. Streets and driveways are very dangerous.

Practice Poison Safety. Check storage cabinets for fuels, paints, cleaning products and medicines. Either lock them up out of reach or throw them away. It is no longer recommended to have syrup of ipecac on hand. If your child ingests or is splattered by a product that may be dangerous, call the American Association of Poison Control Centers immediately at 800.222.1222. Tell them what and how much your child swallowed.

Practice Water Safety. Never leave your child alone in the bathtub or near a pool of water even for a second. Children can drown in two inches of water. They are not capable of learning to swim at this age. When children are near water, they should always wear an approved life preserver and be supervised by an adult. Wait until your child is closer to 5 years of age to get a pool. If you already have a pool, install a fence that separates the house from the pool. The pool should be fenced in on all sides with a 4-foot high fence. The gate should be self-closing and self-latching with latches higher than your child’s reach. Drowning is the most common fatal injury at this age, and it usually occurs when a toddler is not adequately supervised around water.

Prevent Burns. Check smoke detector batteries every month and replace them at least one to two times a year. Turn the hot water heater down to 120°F. Make sure your child does not have access to lighters or matches. The kitchen is a dangerous place for toddlers, especially when you are cooking. Turn handles of skillets away from the edge of the stove. Do not leave hot liquids on counters or tabletops. Also, do not carry them near your child or carry them while holding your child. Place hot foods out of the reach of small children. Teach them the meaning of “hot.” Try to keep your child in a safer place while you are cooking such as in a playpen, high chair, crib or under the supervision of another adult. If your child does get burned, put cold water ONLY on the burned area immediately, loosely cover it and call your child’s doctor.

Car Safety. Because motor vehicle accidents are the number one killer of children ages 1 - 14, it is important to transport children in the safest way possible. This sobering statistic reminds us that even if you are a careful driver, you cannot eliminate the possibility of an auto accident. Child safety seats are made to properly restrain a child in the safest way possible. Below are some of the most common tips:

• Select a car seat based on your child’s age and size, and choose a seat that fits in your vehicle and use it every time.
• Always refer to your specific car seat manufacturer’s instructions (check the height and weight limits) and read the vehicle owner’s manual on how to install the car seat using the seat belt or lower anchors and a tether, if available.
• To maximize safety, keep your child in the car seat for as long as the child fits within the manufacturer’s height and weight requirements.
• Children are safest in a rear-facing car seat until 2 years of age.
• Keep your child in the back seat at least through age 12.
• Never leave your child alone in the car.

Prevent Household Accidents. Secure doors that lead to stairways, driveways or storage areas. Use guards on windows, wall heaters, stoves, fireplaces and electric outlets. Remove sharp-edged furniture and breakables from your child’s play area.

Avoid Tobacco Smoke. At this age, your child is more at risk for developing respiratory and ear infections. Passive smoke in your child’s environment is proven to be linked to more frequent respiratory and ear infections.

Learn cardiopulmonary resuscitation (CPR) for children and infants. CPR is a procedure that can be done to save a child’s life if their heart or breathing stops due to events such as choking, drowning, electrical shock, serious trauma or suffocation. This is offered in many local organizations to family members.

Firearm Safety. It is best to keep guns out of the home. Handguns are especially dangerous. If you choose to keep a gun, keep it unloaded and in a locked place separate from the ammunition. Also ask about guns in the homes that your child may visit.

Sun Safety. Sunburns at any age increase the risk of skin cancer. Protect your child with sunscreen, SPF 30 or greater, and/or protective hats and clothing. Apply sunscreen 30 minutes before sun exposure and then reapply every two hours if outside for a long period of time. However, sunburn can occur even with sunscreen—avoid the hottest parts of the day or stay in shade whenever possible.

Immunizations

Depending on your provider, at the 15 month wellness visit your child may receive a series of immunizations. You may give Tylenol® or Motrin® if your child is fussy or has a fever.

In addition, the flu vaccine is recommended annually for everyone 6 months and older as soon as it is available. The vaccine protects against influenza, which causes severe respiratory symptoms along with a high fever for four to five days.

Wellness Visits

Your child’s next wellness visit should occur at 18 months of age.