Nutrition
At this point we recommend switching from formula to whole milk.  If your child has had a difficult time handling cow’s milk in the past it would be reasonable to try soy milk.  The quantity of milk should be 12 to 20 ounces a day.    You should transition your child from a bottle to a sippy cup at this time.  You should be thinking in terms of the food pyramid and offering foods that are lower in salt and sugar.  Nuts, hard candies, chewing gum, and hard raw fruits and vegetables should be avoided.  The American Academy of Pediatrics now recommends a vitamin supplement for all children.  We recommend POLYVISOL with iron, 1ml orally each day. Pick up your child’s vitamin drops at InstyMeds right here in our office.

It is normal for a child’s appetite to diminish at this age and to become pickier.  You should set a regular meal/snack schedule and avoid snacking “on-demand”.  No good comes of food battles.  Your job is to offer the food, the child’s job is to decide to eat it or not.  All children will ultimately eat when they are hungry.

Safety

  • Always put the baby in a car seat while driving! The American Academy of Pediatrics recommends rear facing until 2 years.
  • Lock up all medications and household poisons including cleaners, paint thinners, and drain cleaners.  Do not store these products in containers that resemble food containers.
  • Windows and stairs should be guarded with railings or gates.
  • Constant attention to choking hazards (hot dogs, popcorn, hard candy and small toys) as well as poisons is an even harder job now that the babies are more mobile.
  • It is a good idea to use sunscreen every day.  Choose a product that is hypoallergenic.
  • Infants should be accompanied when in or near water at all times, even a partially filled bathtub.
  • Backyard pools need to be completely fenced in.
  • Call the Poison Control Center if you suspect your child ate a poison: 800-222-1222.  Do not administer syrup of ipecac.

Development
Most children this age have a receptive vocabulary greater than their expressive vocabulary and can follow simple commands.  Language skills develop quickly during the next 6 months.  You can facilitate this development by speaking to your child in simple sentences and “labeling” commonly encountered items and actions with clear words and phrases.

Your child will soon begin to walk, then climb, then run.  These achievements are inherently reinforcing for the child, and parents need to do little else to promote this development.  Fine motor development is less dramatic and is evident by the increasing ability to grasp and manipulate small objects, to use a spoon, and to scribble with a crayon or marker.

During the next year, your child will show more independence and more willfulness.  These traits can be fun to watch emerge, but also difficult when they lead to tantrums and “melt-downs”.  It is important to set clear limits on behavior.  Remember that consistency is required for children to understand rules.  Pick the most important rules to enforce, usually those that deal with safety, and ignore the little things. Most of the time, babies can be distracted into a new activity without too much trouble.

TODAY’S IMMUNIZATIONS/TESTS: 

  • MMR  #1
  • Pneumoccal #4   
  • Hepatits A# 1

If you see any evidence of a sore leg or fever, give your baby tylenol or motrin.

(Please see the CDC website for the Vaccine Information Sheet  http://www.cdc.gov/vaccines/hcp/vis/index.html?s_cid=cs_748 )

We will also place a PPD test on your child’s arm.  This is a test for Tuberculosis exposure.  Given how international our community is, children are being exposed in atypical places.  You will be asked to examine your child’s arm in 48 hours to detect a reaction.  If you see any evidence of a reaction (redness or swelling at the injection site), please call the office immediately.

NEXT VISIT:    Your baby’s next routine visit is at 15 months of age.

NEED DAYCARE FORMS? Don’t forget to drop off your health forms at the front desk or submit them after your check-up here.