Twelve Month Old Visit

Diet

Twelve month-old children are rapidly gaining fine motor skills. They should be encouraged to use a cup and spoon and to eat finger foods. Children should be weaned from the bottle by twelve months as prolonged bottle use can result in dental caries. Children can switch to whole milk at 12 months old. They will generally consume between twelve and sixteen ounces daily. Avoid small, hard food on which your child may choke. Cut rounds foods (eg, hot dogs, raw carrots or grapes) into thin slices. Include your toddler in family meals by having them in a high chair or booster seat. Toddlers should be receiving three meals a day and two to three nutritious snacks. Children can often consume the same meals the rest of your family is having ensuring that the food is prepared properly and cut into small pieces. Most children at this age are no longer doing jarred foods.

Elimination

Toddler’s bowel movements may vary from multiple times a day to once every couple of days. Children can go for a couple of days without a bowel movement as long as they are having soft stools. If your child is having hard stools, increasing water and fruits and vegetables in the diet may be helpful.

Sleep

Routine continues to be essential for healthy sleep habits at 12 months. Children at this age require a period to relax prior to going to sleep. This should include some type of routine (bedtime story, bath, teeth brushing) which ends with your child soothing him/herself to sleep in their crib. Make sure the space nap times so that your child is tired at bedtime. Often children sleep for 12 hours overnight and take one to two naps daily. Some children are able to climb out of their cribs at this age. Be sure that the crib mattress is at the lowest rung.

Development

Children often start to walk at twelve months. You will notice that your child may become increasingly independent at this age and will prefer to do things for him/herself. Often children are playing interactive games (“peek-a-boo,” “pat-a-cake”). They will imitate activities, wave “good-bye” and be noted to have a strong attachment with a parent or particular caregiver. Children at twelve months should also be able to point to a desired object, imitate sounds, speak one to two words, follow simple directions, identify persons on request, and bang two blocks together. They can generally pull themselves to stand and stand alone momentarily if they are not yet walking. Temper-tantrums may start at this age. When unwanted behavior occurs, “time-outs” may be used. These can take place in a playpen, crib or designated area to protect child from injury and should be brief (one to two minutes).

Safety

Twelve month old children may switch to a forward facing car seat IF they are at least twenty pounds. The newest recommendations, however, encourage that you keep your child rear-facing for as long as possible as this remains the safest position for young children. Make sure to check the specifications of you child seat as the various height and weight limits vary from model to model.

As you child become more mobile, ensure that you home is a safe environment for an infant. Outlets should have safety covers on them and cabinet doors should have safety locks. It is also important to have smoke alarms and carbon monoxide detectors in you home to protect your infant as well as the rest of your family. You should use safety gates at the top and bottom of stairs. To prevent children from falling out of windows, keep furniture away from windows and install window guards on higher-story windows.

Health Tips

Immunizations may be given today. Your child may have a fever and be fussy for twenty-four hours after the vaccines. You may give Tylenol or Motrin as needed according to the dosing chart to help with any discomfort. They injection site may get red or swollen. Ice can help. You should have received a prescription at your last visit to have your child’s blood drawn to test his or her lead level and complete blood count. These are standard tests we do at one and two years. If you have not already gone, you can take this prescription to any lab to have the blood drawn.

Next appointment is at 15 months.