12 Months

Feeding and Elimination

  • Time flies when you are having fun – your baby is one year old and ready to start the toddler years!
  • It is now ok to switch the baby formula to whole milk if there are no allergy issues. We recommend whole milk for the next year since the
    baby still requires a higher intake of fat for optimal growth. 1-2% milk is ok starting at the 2nd or 3rd year of life.
  • Allow the baby to be part of your family’s mealtime routine – they should be eating on the family’s schedule (3 meals and 2-3 snacks) with slow elimination of baby foods to all table foods. Encourage self-feeding with a spoon (a fork is still considered a weapon at this age).
  • Try to transition the baby away from the bottle to sippy cup by 15-18 months of age. Instead of cutting out bottles all at once, you can gradually eliminate them from feeding schedule starting with meals.
  • Continue to monitor feedings since the baby still has a significant risk of choking.
  • Some kids don’t like cow’s milk at first because it’s different from the breast milk or formula that they are used to. You can mix whole milk with breast milk/formula and gradually adjust the mixture so that eventually it is 100% cow’s milk.

General Care and Concerns

  • Now is the time to establish routines. Toddlers, by nature, are creatures of habit so consistent routines for meals, bedtime, and bath time help them manage their day.
  • Discipline is an important way to help a toddler decipher right from wrong. Some general ruses are as follows:
  • Be clear and concise with both the misbehavior and desired behavior (i.e. “don’t push your brother, play with blocks”.)
  • Rules should be appropriate for the child’s age and understanding.
  • Ignore unimportant or irrelevant behaviors (swinging legs) to stop yourself from offering constant criticism.
  • Time-out is used to interrupt unacceptable behavior by removing the child from the scene to a boring place like the corner of the room. They should last about one minute per year of age and not more than five minutes.
  • Consistency, consistency, consistency – a behavior cannot be acceptable in one circumstance and not in another – the child has no way of discerning the difference. This is probably the hardest and most important step that a parent needs to take.
  • Do not forget to praise positive behaviors – A parent’s positive attention is usually the best reward for children. Seek out good behavior and praise it and you will likely see more of it.
  • Encourage self-care and self-soothing behaviors.

Development

  • Your baby can now pull to stand, cruise holding onto furniture and possibly taking steps alone. Safe exploration is the name of the game.
  • Your baby is probably saying 2-4 words besides mama and dada. Let the baby imitate sounds, listen to music, and convey their feelings of happiness, frustration, anger, and fear.
  • Make sure the mattress height of the crib is lowered since the baby will soon be able to step over stuffed animals to climb out.

In office Procedures

  • At this visit, we will draw blood to check your baby’s hemoglobin and lead levels. Hemoglobin is an important part of red blood cells, whose main job is to deliver oxygen to different parts of the body. A low hemoglobin may be indicative of anemia – a lower than usual number of red blood cells. This is usually caused by too little iron in the diet, so the blood work will help us decide whether the baby needs supplementation in their diet. Lead levels are screened routinely to make sure that your baby has not had unsafe exposure to lead. High lead levels in the baby’s blood can lead to neurological and other serious medical conditions.

Safety

  • Be sure to lock away medications and all cleaning, automotive, laundry, and lawn products out of sight and out of reach. Climbing toddlers can reach even high shelves.
  • Keep your toddler away from hot objects that are able to be touched, including oven doors and heaters, or put a barrier around them.
  • Now that your child will be beginning to walk, get down on the floor yourself and check for hazards.
  • Keep plastic bags, latex balloons, or small objects, such as marbles, away from your toddler’s reach. Be sure there is not dangling telephone, electrical, blind, or drapery cords in your home.
  • Make sure televisions, furniture, and other heavy items are secure so that your child can’t pull them over.
  • Keep sharp objects, such as knives and scissors, out of your toddler’s reach.
  • Never leave young sibling in charge of their baby sister or brother. Allow them to help with daily tasks, like feeding, under the supervision of a responsible adult.
  • Use gates at the top and bottom of stairs and watch your toddler closely when they are on the stairs. To prevent from children ever falling out of windows, keep furniture away from windows and install operable window guards on second and higher story windows.
  • Never place your child’s rear facing seat in the front seat of a vehicle with a passenger air bag. The back seat is the safest place for children to ride.
  • The rear facing position provides the best protection for your child’s neck and head in the event of a crash. It is recommended that children remain rear facing until 2 years of age.
  • Watch your child constantly whenever they are near water. A supervising adult should be within an arm’s reach, providing “touch supervision.”
  • Empty buckets, tubs, or small pools after you use them. Also, be sure that all community pools have self-latching and self-closing gates.
  • Children should always wear approved life jackets when on boats or other watercrafts.
  • The best way to keep a child safe from injury or death from guns is to never have a gun in the home. If it is necessary to keep a gun in your home, it should be stored unloaded and locked with ammunition locked separately from the gun.

Immunizations

  • Immunizations are a critical part of the baby’s well-being. Immunizations protect us from illnesses that have historically caused significant illness and death in children. Multiple studies are completed on the importance and safety of vaccines before they are added to the state’s mandatory list. Particular information on each vaccine is available on our website. The vaccines that are administered at the 12 month visit are the following:
    • MMR (measles/mumps/rubella) – these viruses can cause rash and swollen glands that can lead to pneumonia, meningitis, and hearing loss.
    • Varicella (chicken pox) – the bacteria can cause rash, itching and fever that can lead to skin infection, scars, pneumonia or even death.
    • Hepatitis A – is a virus can cause fatigue, nausea/vomiting, severe stomach pain, diarrhea, and jaundice.
    • MMR and Varicella are both live vaccines and may have a delayed response. A fever in 2-3 days should be mild
    • Your child may experience mild redness or tenderness at the injection site. Again, this should be mild. If the reaction is more severe, the office should be notified.