Constant supervision is required at all times—especially around animals, water, and small objects which could pose a choking hazard.
Nutrition
Feedings
Milk - Commercially prepared formula may now be replaced by whole cow's milk (or two percent). One percent and skim milk are not recommended because children need extra fat at this age for their development. The volume taken will vary and may be supplemented with dairy products such as yogurt or cheese. If your child's milk intake decreases, do not be alarmed. Your child needs just 700 mg a day of calcium which is easy to achieve. Please review this link regarding calcium in your child's diet, to make sure your child receiving enough calcium. Milk intake should not exceed 16 to 24 ounces per day as you transition to whole milk. Encourage use of a cup and promote total weaning from the bottle between twelve and fifteen months. Babies may continue to breastfeed for as long as is desired by mother and baby.
Solids - Expect a decrease in appetite as your child's rate of growth slows. Maintain three meals a day on a regular schedule. Pureed or junior foods may be continued, and soft table foods gradually added as tolerated. Eating becomes interesting and very messy as finger foods are added. Your infant will become more opinionated about their diet. Do not worry. Keep trying but do not force them to eat. Variety is well tolerated and generally all foods may be given. Choking is a major concern. Avoid firm airway-sized foods such as hotdogs, peanuts, candy, grapes, popcorn, etc.
Juices - Juices should not exceed four to six ounces daily (even natural fruit juices); quench thirst with water.
Vitamins
The American Academy of Pediatrics recommends supplementing exclusively breastfed babies with vitamin D. One such supplement, Poly-vi-sol with Iron, can be purchased over the counter; give one mLl daily. Nursing mothers should continue their prenatal vitamins. Formula-fed infants receive adequate vitamin supplement from commercially prepared formula.
Fluoride
Fluoride is very important for the development of your child's teeth and it is recommended to begin fluoride supplements at six months of life. Fluoride is not in formula or human milk and must come through water or supplements. Although most municipal water supplies add fluoride, some do not. If you are uncertain, you can check with your local utility company.
Development
At this age most children can:
- Stand momentarily.
- Pull self up and walk holding onto furniture or maybe walking alone, may fall frequently.
- Get into everything,especially cabinets and open closets.
- Hold and drink from a cup. May attempt to feed themselves (picks up food with his fingers).
- Babble a lot and may say a few words such as "mama", "dada" or "baba".
- Make gestures such as pointing, imitate behavior or wave bye-bye.
- Press buttons on phone or toys.
- Enjoy being read to.
- Locate sounds by turning their head.
Indicators for concern:
- Does not use single words like "mama" or "dada."
- No eye contact.
- No pointing or other gestures such as waving "bye-bye."
- No babbling.
- Difficulty crawling.
- Needs to use hand to maintain sitting.
Vaccinations
At this visit, your child is scheduled to receive Varicella, Pneumococcal Conjugate, Hepatitis A, and MMR immunizations.
Common Issues And Concerns
Medications
To see information on Acetaminophen (Infant Tylenol) dosage, click here. Remember to always dose based on the weight of your child.
Sleep
(Helpful hints for preventing problems)
- Your child should be sleeping in his own bed and sleeping through the night.
- A bedtime ritual is important at this age. Children need a familiar routine. Both parents should hug and kiss the child "good night".
- Keep security objects, such as favorite stuffed animals, nearby.
- Once put in bed, your child should stay there.
- Overlook tantrums and protests and leave the room. It is important to enforce bedtime at this age.
Dental Care
Brush your infant's teeth with a soft toothbrush twice daily. Please see information regarding Tooth Decay Prevention.
Behavior and Discipline
- To set limits and discipline toddlers use distraction, gentle restraint, removal of object from toddler, or move toddler away, and help him get interested in something else.
- Use discipline as a means of teaching and protecting, not as punishing; toddlers should never be spanked.
- Limit your toddler's TV time; you may sometimes let him watch a show developed for his age (Sesame Street, etc.).
- Do not allow hitting, biting, or other harmful behavior.
- Praise, sing songs, read, hug, cuddle, smile, and talk to your child often.
- Continue to play interactive games.
- Reading books to your child helps him learn new words.
- Your child is learning so much; encourage free play with blocks, toys, and stuffed animals or dolls. Play both indoors and outside.
Walking
- Legs, feet and shoes - Please see A Guide to the Foot and Leg and the handout on shoes.
Safety
Your infant is becoming more mobile and constant supervision and safety precautions are critical. Please review the advice on Healthychildren.org.
Recommendations
- Watch your toddler closely, especially near dogs, lawnmowers, driveways, overhead garage doors, and streets.
- Supervise your toddler constantly when around water, buckets, toilets, and bathtub.
- Use sunscreen, but also limit your child's exposure to direct sunlight.
- Keep all poisonous substances/hazards locked in a safe place, and out of toddler's sight and reach. Keep the phone number for the Poison Control Center near your phone or program it into your cell phone.
- Keep cigarette lighters, matches and alcohol out of toddlers sight and reach.
- Do not give toddlers plastic bags, latex balloons, or small objects such as marbles, coins, batteries, or magnets.
- Switch to a toddler car seat in the back seat; car safety seats should remain rear facing until age 2 years of age or the highest weight or height allowed by their car seat manufacturer according to AAP recommendations.
- Know CPR.
- Continue to keep toddler's environment free of smoke.
- Recheck your house for safety.
Tests Today
Hemoglobin - a blood test to check for anemia usually caused by low amounts of iron in the body.
Next Well Child Visit
Your child's next well child visit will be at fifteen months of age.
