Mt. Ascutney Hospital and Health Center

12 Month Well Child Visit

Your Baby

PROFILE:  Your 1 year old will soon be a toddler.  He’ll be able to walk well, stoop to pick things up, get to a standing position from a squat, and creep up and down stairs.  He still depends on you but he is developing the independence he needs to explore, and the “sense of self” he needs to let his own individual personality show.  He is probably shy around strangers and a loving, easy-going child around people he knows, but expect some rebellion and maybe temper tantrums soon.  He probably says a few words, and he understands a lot more than he says.  He can help you dress him, and he can feed himself (it’s messy, but it’s best to let him do it).  He’s old enough to learn by trial and error, so let him do things, and let him make mistakes; just make sure he doesn’t really get hurt!

FEEDING:  It’s time to switch from formula to regular whole milk, or in some instances 2% milk.  Skim milk or 1% is not usually recommended for children less than 2 years old.  Children this age need the fat for important neurological development.

Mealtimes can be frustrating because toddlers often have small appetites and they are very picky.  Serve healthy foods and let him learn to feed himself.  Put small amounts on his plate – a teaspoonful or 2 of each food – and let him eat what he wants.  Children may be “picky” at this age and often need to be exposed to a food 10-14 times before they learn to eat it.  One snack between each mealtime is fine, but don’t let your child “graze” on food all day long.  If he doesn’t eat very much between meals, and gets no more than 16 ounces (2 cups) of milk a day, he is more likely to eat at mealtimes.  Toddlers especially need foods rich in iron, such as liver, hamburger, chicken, iron-fortified cereal or bread, eggs, peanut butter, kidney beans, etc.  Their bodies will absorb the iron better if they drink fruit juice or eat foods rich in Vitamin C at the same time.

WEANING:    It’s time to stop the bottle.  With a spill-proof cup and a little help he can get all he needs to drink from the cup.  There is no one right way to stop the bottle.  You choose the method that will work for you.

*You could do it “cold turkey”.  One day, just put away all the bottles.  Give lots of TLC, all he wants to drink from a cup, but no bottle.  He’ll be very unhappy, but he’ll adjust, and it’ll be all over in a few days.

*You could take away one of his daily bottles every week or so, until he’s off the bottle altogether.  He’ll initially be less unhappy, but the process takes longer.

TOYS AND ACTIVITIES:  Play learning games with your child.  Teach her simple one-word names for things by pointing to body parts, toys, or pictures and saying the name.  Read simple books to her every day, sing nursery rhymes and talk to her about things that you are doing.  Good toys for a child this age are blocks, pull toys (not push toys – they’re much harder to use), shape-matching or color-matching toys, a pounding bench, cars, trucks, dolls, pots, pans, spoons, lids, plastic cups, measuring cups, milk carton blocks, an empty oatmeal-box drum, books with pictures, a big cardboard box to be a tunnel or playhouse, a sandbox (keep animals out of the sandbox).  Your one-year old does not need to watch any television or videos, even educational programs.  Non-TV activities provide much better stimulation for the developing child.

SAFETY:  Your baby is pulling up, starting to climb, and may be walking.  She can go almost anywhere and hasn’t yet learned to be afraid, so you have to watch her closely to prevent accidents.  At this age, the most common types of accidents are poisoning, hot water scalds, drowning and falls.

*Poisoning:  Most homes have medicines, insect sprays, paint, thinner, and dishwasher detergent.   Read labels to find other poisons.  It’s better to keep poisons locked up in a cabinet and kept up high.

*Scalds:  Set your water heater at 120-125 F (low setting).  Turn pot handles to the back of the stove.  Stop using tablecloths so your toddler can’t pull on the cloth and spill hot liquids on himself.  Don’t hold your toddler on your lap while drinking hot drinks.

*Electrical Burns:  Keep safety plugs in wall sockets and keep electric cords out of reach.  Take the cord out of the wall whenever you finish with an electric appliance.

*Drowning:  Toddlers sometimes drown in swimming pools, but they also drown in bathtubs, buckets and in toilets.  Consider a toilet lock.  Don’t let her be in the bathroom alone!  Empty buckets of all fluid when finishing cleaning tasks.

*Falls:  Put gates across stairways.  Make sure window screens can’t be pushed out from inside.  Don’t put chairs, stools, etc. next to high things like tables, counter tops, and dressers.  Buy baby socks or shoes with non-skid soles.  Keep toys and pillows out of the crib and put the crib mattress in the lowest position so your child can’t climb over the side and fall.

*Choking:  Toddlers may choke on things that go completely into the mouth – especially round things such as grapes and hot dogs.  Hot dogs choke more children than any other food – slice them into tiny pieces (across and lengthwise) for your child.  Toddlers inhale small things, like raisins, chewing gum, some dry cereals, chewing gum, and some candies.  Peanuts, popcorn, and raw carrots are especially bad.  Choking is more likely if a child eats while playing, walking, running or lying down.  Toddlers should eat when they can concentrate on eating, preferably at the table.

*Car Seats:  Your child may be in a forward facing car seat now if she also weighs at least 20 pounds.  She should stay in a full car seat (not booster seat) until she is 4 years AND forty pounds.

DISCIPLINE:  It is time to start thinking about discipline.  Often Moms and Dads find they have very different views on the subject.  Talking about this helps you understand each other better.  Discipline is not the same as punishment.  Discipline means teaching your child to follow rules.  At this age it helps to keep things simple.  Put up things she shouldn’t get into.  Focus on safety rules at this age.  If she is doing something dangerous, say a firm and simple “NO!” and physically move her out of harm’s way.  If she has aggressive behaviors (hitting, biting), you can use the same strategy.  Consistency is a very important element of disciplining at all ages.  It’s important to pay attention to your child when she is being good.  Tell her how much you love her every chance you get.  It will make your “NO’s” more effective, and she won’t test you as often if she doesn’t have to test you to get attention. 

FAMILY ISSUES:  Life with a toddler can be physically exhausting.  Parents need to plan time for themselves away from the children, to recover energies for their marriage and for child rearing.  Now that you have passed the first year mark, take time to rethink how you are setting your priorities!

IMMUNIZATIONS:   The varicella (Chicken Pox) vaccine, HepA and the final pneumococcal vaccine may be given today.

FOLLOW-UP:  Your baby’s next visit is at 15 months of age.