Nutrition
Feedings
Milk - Human milk and/or commercially prepared formula are still required. Although your infant may be less interested in the breast or bottle as solids are introduced, she should be drinking around 24 ounces per day. Try to introduce a cup if you have not already done so.
Solids - By nine months, your infant should be eating a variety of pureed foods; including cereals, fruits, vegetables, and meats. These should be given as three meals per day, and on a regular schedule. Ask your provider about introducing peanut protein.
Finger Foods - Finger foods will be of interest to your baby as hand-eye coordination develops. These finger foods should be small and soft to avoid choking. Do not give your baby foods that could cause choking such as; nuts, popcorn, carrot sticks, whole grapes, raisins, whole beans, hard candy, tough meat, hot dogs or chunks of peanut butter.
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 mL 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
A developmental assessment will be done at the nine month visit. Your child's provider will go over the results with you.
At this age most infants:
- Look for hidden toy
- Throw toys or objects
- Feed self finger foods such as cereal
- Imitate sounds like "ooh" and "aah".
- Pull themselves to a standing position and may begin to cruise around furniture
- Go from a sitting to lying position
- Act happy or sad, just like Mom and Dad
- Understand a simple direction and sometimes do it (and sometimes pay no attention to it)
- Wave bye-bye; crawl or scoot around well
- Repeat sounds you make.
Indicators for concern:
- Unable to sit by self
- Difficulty picking up objects
- Not imitating or babbling
Vaccinations
At this visit, your child is scheduled to receive the Hepatitis B immunization.
Common Issues And Concerns
Medications
To see information on Acetaminophen (Tylenol) dosage, click here. Remember to always dose based on the weight of your child.
Sleep
(Helpful hints for preventing problems)
- Infants should be sleeping through the night. If not, please review previous recommendations.
- Development of a predictable bedtime ritual is important.
- Once in bed, your child should stay there. Try to ignore protests and leave the room.
- Limit naps to two hours or less.
Walking
Legs, feet and shoes - Please see A Guide to the Foot and Leg and information regarding shoes.
Eating Habits
It is quite common for eating habits to be variable at this age. Provide a well-balanced diet, but be patient and do not force feed.
Dental Care
Brush your infant's teeth with a soft children's toothbrush twice daily. Please review the information regarding Tooth Decay, and Prevention. Ask your child's provider about in-office fluoride varnish application.
Discipline
Distraction and redirection works well as a discipline for a young child. Be patient.
Safety
Your infant is becoming more mobile and constant supervision and safety precautions are critical. Please review the the advice found on Healthychildren.org.
Recommendations
- Make sure you are using your car seat correctly at all times.
- Take a course and be prepared to use infant CPR.
- Never leave your baby unattended.
- Do not use a baby walker. Walkers can cause injury and delay learning and development.
- Install safety devices on drawers, low cabinets, gates at the top and bottom of stairs, and safety devices on windows. Be sure there are no hanging window cords near your baby's crib.
- Latex balloons are a dangerous choking hazard - do not let your infant play with balloons, magnets, or batteries.
- Keep small objects out of reach.
- Check the thermostat on your hot water heater and set at 120 degrees or lower.
- Lower your baby's mattress as he pulls to stand.
- Never leave cords within baby's reach.
- Be patient and do not scold.
- Play with your baby.
Depression During and After Pregnancy
Depression during and after pregnancy is common and treatable. Having a baby is challenging and every woman deserves support. We will screen for caregiver depression at your child's well-child visits through the first year. Talk to your child's healthcare provider or your healthcare provider if you are experiencing symptoms. Please review this information from the CDC regarding postpartum depression. There are also resources available. Contact the Postpartum Support International Warmline and a trained helpline volunteer will call/text you back to identify a local coordinator and resources in your area:
- Call 1-800-944-4773, #1 en Espanol or #2 English
- Text 503-894-9453
Next Well Child Visit
The next routine physical examination is at twelve months of life. Your child will be checked for anemia at the twelve-month visit.
