Ready for the last major round of vaccinations before kindergarten? Your toddler's 12 to 18 month appointment is going to be one of the toughest yet. Your doctor will finish off the rest of the major vaccinations, which should total four, as long as you've kept up-to-date with your kid's immunization schedule. If not, you might need to add two more vaccines to the list. Regardless, your 12 to 18-month-old is a lot wiser than he used to be, which might mean a bigger fight at the doctor's office.

Never fear, it happens to everyone. Unless your toddler has superhuman strength and zero worries, some tears will inevitably be shed. But as long as you're calm and collected during the process, you should both be able to weather the storm. Gone are the days when you could do the doctor's office covertly; your tiny explorer will want to know where you're going and what you're doing there. And while he might not yet have a huge vocabulary, he'll definitely voice his displeasure through screams, crying and tantrums.

Want to take the fight out of this last major round of shots? Keep the end in sight—a last toddler appointment where only one shot is administered. Here are some tips to make the ordeal more bearable.

  • Be honest. Your toddler is smarter and better able to understand the whole concept of going to the doctor's office equals pain. Avoiding the issue or simply showing up to the appointment without advance warning is definitely going to cause a problem. Instead of operating in stealth mode, try being upfront about the appointment. Tell your little guy that you need to go to the doctor's and it'll hurt for a minute, but it will go fast. He might shed a few tears at the thought, but at least you haven't betrayed his trust and caused future issues.
  • Make him laugh. A 2007 Pediatrics study found that toddlers completely responded to their parent's reactions to vaccinations. In fact, the study states that "during the injection, parental demeanor clearly affects the child's pain behaviors. Excessive parental reassurance, criticism, or apology seems to increase distress, whereas humor and distraction tend to decrease distress." Since all parents are susceptible to guilt and overcompensation when their kids are in pain, you may be making the whole experience worse. Instead of using baby talk and apologizing for the pain, make your toddler laugh! Younger kids love to see their parents "play dumb," so try grabbing a tongue depressor and pretending to stick it in your ear. You'll get your child so focused on giggling that he forgets about the impending pain.
  • Ask for simultaneous injections. Since your brave baby is probably getting at least four shots (Hib, MMR, PCV and Varicella) having the injections done one at a time is a recipe for whimpers and water works. If your doctor's office has a couple of free nurses, ask if the vaccinations can be done simultaneously. That way, your toddler only has to make it through two subsequent rounds instead of four. It also means the injections are done in roughly the same area, limiting the amount of soreness your little one experiences later in the day.
  • Stimulate skin. One of the reasons that immunizations are so painful is that they're a sudden sensation—ouch! Stimulating your child's skin in other ways during the process means he focuses less on the pain at the injection site. For instance, you can lightly pinch or tickle his arm, as long as he isn't squirmy for the nurse. Or, try lightly blowing on his face and eyes. He'll have more than one sensation, making the needle less of an agonizing shock.
  • Let him cry. No, you don't need to let your little one "cry it out" after having shots—but Theresa Kledzik, a pediatric developmental specialist suggests plenty of cuddles and time to let the tears out. "Hold/cuddle/console afterward, giving the baby enough time to get her outrage out but not encouraging her to make it more than it was." Don't get impatient with your toddler if he's sobbing after the vaccinations. Hold him, give him props for being brave and let him be upset. Don't overcompensate, but offer sympathy equal to the pain.
  • Offer a reward. It wouldn't be much of a trip to the doctor's if it didn't end in a treat, right? Make sure that your child associates the doctor's office with some type of positive reinforcement so you can diffuse future fights. Now that your little one is over a year, just about any food is fair game, unless he's shown sensitivity to nuts or dairy. Some fast food places serve up kid-sized ice cream cones, which are perfect for little hands and messy faces after a trip to the doctor's. If you feel squeamish about rewarding bravery with food, opt for a small puzzle or snuggly companion instead.

Congrats! You're finished with the last major round of vaccinations until it's time for kindergarten shots. The next immunization your tough toddler gets is a singular shot at the 18 to 24 month appointment, so you're almost to the finish line. As a parent, the vaccination schedule can be almost as harrowing for you as it is for your tot, but staying on track and keeping calm means your little guy is fully immunized and has less to worry about in the future. Way to go, Supermom!