Advice: 12 Months

15204 Omega Drive

Suite #100 Rockville, MD 20850

Tips for 12 months

Nutrition

Toddler Eating Habits

At 1-year most calories should be coming from whole foods rather than milk or formula. Toddlers can eat everything that you eat, being mindful of texture and choking risk
We recommend switching from formula to whole milk (or Ripple Kids, a plant-based milk, if medically indicated for your child). Aim for 12-20 ounces a day, but do not give more than 20 ounces of milk per day. Whole milk has a high fat content which is important for brain development
Kids are surprisingly well-nourished despite ‘finicky’ eating; continue to serve a variety of foods each day despite their protests.
Transition from a bottle to sippy/straw cup at this time.
Set a regular meal/snack schedule to avoid snacking on demand.
Encourage consumption of REAL fruits and vegetables rather than relying on pouches or purees
Avoid nuts, popcorn, hard candies, and chewing gum as these can be choking hazards
We recommend a daily multivitamin such as Poly-vi-sol with iron or Novaferrum with iron, 1 mL orally each day.

Bottles and Pacifiers

Make a goal to wean off bottles in the coming weeks to months. Often babies are more attached to their bottles than their formula. A few tips for this transition:

The younger the better: Prolonged bottle use can lead to dental issues. It can be a difficult transition at any age but often gets harder as toddlers get older.
Separate from sleep: For many toddlers, their bottle is part of their sleep routine. As you are gearing up to drop the bottle, separate the bottle from the sleep routine to minimize impact on sleeping habits. For example, rather than your sleep routine being bath-books-bottle-bed, flip it around to bottle-bath-books-bed.
Cold Turkey: One method to drop the bottle, is to cut it out cold turkey. Often this results in 3-4 challenging days but toddlers typically move on quickly.

Goals with pacifiers are similar. Most pediatricians recommend dropping the pacifier during the second year of life. A few tips here:

The younger the better: This is the same as above. Prolonged pacifier use can lead to dental issues. It can be a difficult transition at any age but often gets harder as toddlers get older.
Crib and Carseat: Take a step-wise approach, first confine the pacifier to the crib and carseat. This allows for soothing when it is needed, but breaks the habit during the day.
Cold Turkey: Pick a date and lose the pacifier. Your toddler may be mad, sad, or have difficultly self-soothing for a few days, but often move on quickly
Language Development: Language skills explore during the second year of life. Using a pacifier throughout the day and significantly delay expressive language skills!

What to expect at your 12 month visit

Check-up: Your provider will complete a comprehensive history and physical exam, review growth curves, answer any questions, and provide age appropriate guidance.

Vaccines:

MMR: Measles, Mumps, Rubella
Hepatitis A
Prevnar: Pneumococcal disease

Vaccine side effects: The majority of babies do not have any side effects from today’s shots, but some may experience pain at the injection site, fever or fussiness for 1-2 days. You can give Tylenol or Motrin if fever develops. MMR can produce higher fevers than other vaccines and fever may develop up to 7-10 days following vaccination

Optional/Seasonal Vaccines

Flu (optional): The first year that babies receive their Flu vaccine, they need 2 doses, spaced by 30-days
COVID-19 (optional): The first year that babies receive a COVID-19 vaccine, they must complete a 3-dose primary series. Dose 2 is 3 or more weeks after Dose 1. Dose 3 is 8 or more weeks after Dose 2.

Labs: There are no routine labs at this visit

Development

Most children this age can understand more words than they can say. 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, so parents need to do little else to promote this development.

Fine motor development is less dramatic, and evident by increasing ability to grasp
and use small objects.

During the next year, your child will show more independence and willfulness. These traits can be fun to watch emerge, but also difficult when they lead to tantrums and meltdowns. It is important to set clear limits on behavior. Most of the time, babies can be distracted to a new activity without too much trouble.

Dental Health

Fluoride varnish may be applied your child’s teeth at check-ups during the second year of life. As soon as saliva meets the fluoride, it will harden and start working. Avoid sticky/chewy foods this afternoon and DO NOT brush teeth tonight. When you brush the teeth tomorrow morning, you will brush off the fluoride and that is okay.

Regular and frequent exposure to small amounts of fluoride is the best way to protect tooth enamel and protect teeth against cavities.

Sugars and bacteria cause cavities in 1 in 4 children. We recommend that you:

Brush teeth with a tiny smear of fluoride toothpaste (the size of a grain of rice) in the morning and before bed as soon as teeth erupt.
Stop bottles now. From this point on, there should only be water in bottles – no milk or juice.
They should be weaned off bottles completed by 15 months (see the tips above)
Do not allow your infant to fall asleep with a bottle, especially one containing milk, formula, or juice.
Minimize exposure to natural or refined sugars (juice) in the infant’s mouth.
Avoid dipping pacifiers in any sweetened liquid, sugars, or syrups.
Avoid putting pacifiers in your own mouth to “clean”.

Toddler Safety

ALWAYS… supervise your child near water, even a partially filled bath tub. Fence in backyard pools.

ALWAYS… wear sunscreen when spending time outside. We recommend SPF 30 or higher.

ALWAYS… guard windows and stairs with railings and gates.

ALWAYS… pay attention to choking hazards such as hot dogs, popcorn, hard candy, and small toys

ALWAYS… lock up all medications and household poisons including cleaners, paint thinners, and drain cleaners.

ALWAYS… know that guns in the home are a danger to the family. If guns are kept in the house, store the gun and ammunition in two separate locations, and keep each of them locked up.

ALWAYS… put the baby in a car seat while driving! The American Academy of Pediatrics recommends that children remain facing backwards until at least age 2. Your baby has outgrown the infant carrier if their head is above the top or their feet protrude below the bottom. Now is the time to get a convertible 5-point harness and install it to be rear facing.

Potomac Pediatrics will always be fully focused on helping your child and you to overcome any healthcare hurdle, with innovative, comprehensive and compassionate care.

Questions?

301-279-6750