Well Child Care 12 Months

Table foods that are cut up into very small pieces are best now. Baby food is usually not needed at this age. It is important for your toddler to eat foods from many food groups (fruits, vegetables, grains, and dairy products). If your family eats meat, please include it on a regular basis.  Most one year olds have 2-3 snacks each day. Cheese, fruit, and vegetables are all good snacks. Serve milk at all meals. Your child will not grow as fast during the second year of life. Your toddler may eat less. Trust his appetite.

Although you may not feed your child anything he or she may choke on, it is reasonable to begin peanut butter.  However, peanut butter on bread still presents a choking hazard.  Instead, put a small dab of peanut butter on cut up pieces of a soft fruit such as banana.

If you are still breastfeeding, you may choose to continue breastfeeding or may wean your child at this time. When a child is 1 year old, you can start using 2% milk. Almost all toddlers need the calories of 2% milk (not low-fat or skim) until they are 2 years old. Some children have harder bowel movements at first with whole milk. This is also the time to wean completely off the bottle and switch to an open-rimmed cup (not a Sippy cup).

Many doctors now recommend Vitamin D supplements even for healthy children who are good eaters.  Since Western Pennsylvania has many days with heavy cloud cover, long winters and we use sunscreen during the summer, many doctors feel the sun does not shine on our skin enough for our body to manufacture adequate Vitamin D for healthy bones.  Although milk is Vitamin D fortified, it does not contain enough.

If your doctor recommends Vitamin D supplementation your child should take 400 IU of Vitamin D every day.  Name-brand vitamin supplements usually contain other vitamins that your child most likely does not need, but will not hurt your child.

Here is a suggestion, but feel free to substitute and please get into the habit of reading labels: Children under the age of 2 years should take Tri Vi Sol every day.

Remember – in order to make strong bones your child needs a good source of Calcium in the diet in addition to Vitamin D.  Every day your child requires 4 servings containing Calcium (milk, cheese, yogurt, cottage cheese, Calcium fortified orange or apple juice).

Every child is different. Some have learned to walk before their first birthday. Most 1-year-olds use and know the meaning of words like “mama” and “dada.” Pointing to things and saying the word helps them learn more words. Speak in a conversational voice with your child and give them lots of encouragement to use their voice. Smile and praise your child when he learns new things. Allow your child to touch things while you name them. Children enjoy knowing that you are pleased that they are learning.

As children learn to walk they will want to explore new places. Watch your child closely.

Shoes protect your child’s feet, but are not necessary when your child is learning to walk inside. When your child finally needs shoes, choose shoes with a flexible sole.

Read to your child every day. Children who have books read to them learn more quickly. Choose books with interesting pictures and colors. Choose television shows carefully. Limit their total time and watch the show with your child. More importantly, use the time to turn off the TV and interact and play with your child.

·     Brush your child’s teeth 2-3 times a day including before bed. If you decide to use toothpaste be very stingy with it because you child will not spit after brushing.

·     Fluoride supplementation is important to make teeth stronger and prevent decay.  If the water in your community is fluoridated you will not require an additional supplement.  If there is no fluoride in the water your doctor will recommend a fluoride supplement for your child.  Since your child is receiving fluoride in either the water or by supplement please limit toothpaste that contains fluoride.

·         Avoid foods on which a child might choke easily (candy, hot dogs, popcorn, peanuts).

·         Cut food into small pieces, about half the width of a pencil.

·         Store toys in a chest without a dropping lid.

·         Check your smoke and carbon monoxide detectors. Replace the batteries if necessary.

·         Put plastic covers in unused electrical outlets.

·         Keep hot appliances and cords out of reach.

·         Keep all electrical appliances out of the bathroom.

·         Don’t cook with your child at your feet.

·         Use the back burners on the stove with the pan handles out of reach.

·         Turn your water heater down to 120°F (50°C).

·     Make sure windows are closed or have screens that cannot be pushed out. Don’t underestimate your child’s ability to climb.

All infants and toddlers should ride in a REAR-FACING car seat until they are 2 years old or until they have reached the highest weight or height allowed by the manufacturer.  (Babies typically ride in a rear-only car seat.  Once your child outgrows the rear-only car seat, he or she should be switched to a convertible seat facing the rear of the car.) Never leave your child alone in the car.

·     Never leave an infant or toddler in a bathtub alone — NEVER.

·     Stay within arm’s reach of your child around any water, including toilets and buckets. Keep lids to toilets down, never leave water in an unattended bucket, and store buckets upside down.

·     Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away. Dispose of them safely. Install safety latches on cabinets.

·     Keep the POISON CONTROL number (1-800-222-1222) on all phones

·     Children who live in a house where someone smokes have more respiratory infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home. If you smoke, set a quit date and stop. Ask your healthcare provider for help in quitting. If you cannot quit, do NOT smoke in the house or near children.

Children over 6 months of age should receive an annual flu vaccine (also called influenza vaccine). Children during the first year of getting a flu vaccine should get a second dose of influenza vaccine one month after the first dose.   We will begin flu vaccines in late September so mark your calendar.

Your child may run a fever and be irritable for about 1 day after the vaccines and may also have soreness, redness, and swelling in the area where the shots were given.

You may give your child acetaminophen drops in the appropriate dose to help to prevent fever and irritability. For swelling or soreness, put a wet, warm washcloth on the area of the shots as often and as long as needed for comfort.

Call your child’s healthcare provider if your child has a rash or any reaction to the shots other than fever and mild irritability or your child has a fever that lasts more than 36 hours.