Well Child Care at 12 Months

12 month milestones

Nutrition

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 (meats, fruits, vegetables, grains, and dairy products). 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.

If you are still breastfeeding, you may choose to continue breastfeeding or may wean your baby at this time. When a child is 1 year old, you can start using whole milk. Almost all toddlers need the calories of whole 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).

Development

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

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.

Reading and Electronic Media

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.

Dental Care

  • After meals and before bedtime, clean your baby’s teeth with a clean cloth. Don’t worry too much about getting every last bit off the teeth.
  • You may want to make an appointment for your child to see the dentist for the first time.

Safety Tips

Choking and Suffocation

  • 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.

Fires and Burns

  • Check your smoke detector. 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).

Falls

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

Car Safety

  • Never leave your child alone in the car.
  • Use an approved toddler car seat correctly and wear your seat belt.

Water Safety

  • 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.

Poisoning

  • Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away. Dispose of them safely.
  • Install safety latches on cabinets.
  • Keep the poison center number on all phones.

Smoking

  • 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.

Immunizations

At the 12-month visit, your child may receive shots.

Children over 6 months of age should receive an annual flu shot. Children during the first year of getting a flu shot should get a second dose of influenza vaccine one month after the first dose.

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.
  • Your child has a fever that lasts more than 36 hours.

A small number of children get a rash and fever 7 to 14 days after the measles-mumps-rubella (MMR) or the varicella vaccines. The rash is usually on the main body area and lasts 2 to 3 days. Call your healthcare provider within 24 hours if the rash lasts more than 3 days or gets itchy. Call your child’s provider immediately if the rash changes to purple spots.

Next Visit

Your child’s next visit should be at the age of 15 months. Bring your child’s shot card to all visits.

Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2012.2 published by RelayHealth.
Last modified: 2011-09-21
Last reviewed: 2011-09-20
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

References
Pediatric Advisor 2012.2 Index