Well Check-Up / 12 Months
FEEDING
After 12 months it is ok to give your baby cow’s milk instead of formula or breast milk, although nursing mothers may choose to continue nursing. Pediatricians recommend whole or 2% milk, because babies need the added fat for good growth and brain development until age 2. Babies should have 16-24 oz. per day of milk or 2-3 servings of other dairy, such as yogurt or cheese. Try to start transitioning baby to using a cup only, with the goal to be off the bottle by around 15 months. A good way to do this is to gradually change to milk from a cup with meals. For bottle fed babies the nighttime bottle is often the last to go. Babies do not need fruit juice, but if you do offer this, limit to no more than 4 oz per day of 100% juice. Offer many different foods, so baby can get used to a varied diet, but limit processed and packaged foods (such as chips, crackers, cookies and candy). Be careful with foods that baby can choke on, including anything that is hard or in large pieces, and always supervise eating. Common foods to watch out for due to choking risk include whole grapes, raw carrots, popcorn, nuts, hotdogs and other meat, and hard candy. After 12 months, babies’ growth rates slow considerably, so a drop in appetite is normal. Many babies become much pickier about what they eat and will have some days when it seems they’re not eating much at all. As long as your baby gets some variety in her diet and continues to grow well, she is probably eating enough.
FEVER/ILLNESS
Fever is defined as a temperature greater than 101. Fevers are usually caused by viral illnesses, such as colds, and they show that baby’s immune system is working to fight the illness. However, if your baby is excessively fussy, is not drinking or keeping fluids down, has difficulty breathing or significant pain, or has fever for over 72 hours, please call the office. If you are not sure if your baby needs to be seen, please call the office and we will help you decide the best plan.
DEVELOPMENT
At one year of age most babies can pull themselves to a standing position and stand alone, and many have taken their first steps. If your baby has not yet begun to walk at his first birthday, do not be alarmed, as the normal age range for this milestone is anytime between 9 and 15 months. Most babies can now stack 2 blocks, and one year olds can usually feed themselves finger foods and use a cup well. Although they usually understand many more words, most 1 year olds can say 2-3 words with meaning. To encourage language development, continue frequently to talk or sing to your child and read to him often. Even at this age, reading helps provide the language framework that your child will use later to learn to read himself.
DENTAL CARE
If you have not already started, it’s a good idea to begin cleaning or brushing your baby’s teeth at bedtime. You can use a very small amount of toothpaste with fluoride (a “smear” or rice-sized amount) on a toddler tooth brush. After brushing, do not offer anything else but water until the morning. Babies should not be allowed to fall asleep while nursing or taking a bottle with milk or to sip on milk during the night. Most babies will get their first set of molars (back teeth) between 12 and 15 months old, and after this point, regular nighttime brushing is crucial. We recommend the first dental appointment by this age as well—either with a family dentist or pediatric dentist.
SAFETY
Babies should still ride in rear-facing car seats until they are at least 2 years old or until they reach the maximum height and weight for their seats. Be sure your car seat is installed correctly in your car in the backseat. Use gates at the bottom and top of stairways. Never leave baby unattended in a bath or near any water, and do not leave containers of hot liquids or foods near the edge of a table or counter where baby might pull them off and get burned. Check smoke detectors regularly to assure they are working properly, and make sure you have a fire escape plan for your home. Protect your baby from sunburn by using sunscreen with an SPF higher than 30 on exposed areas and avoiding the sun between 11 a.m. and 3 p.m. Consider using sun-protective clothing and hats as protection as well. It is still important to make sure that all cabinets and drawers are childproofed and all chemicals and medicines are locked away. If your child ever accidentally swallows anything that might be dangerous (such as cleaning supplies, chemicals, or medications) do not give anything else by mouth and call Poison Control immediately. POISON CONTROL 1-800-222-1222.