One Year Visit

1 Year Old Child

DEVELOPMENT

If your baby is not already walking by his first birthday (about 50% are), they soon will be.  Thus, they enter a new stage of development: the toddler and the age of exploration.  An important thing to remember is that in their explorations, your toddler should be building their self-confidence.  They should be allowed to play and explore freely without a lot of hand slapping and a stream of “no-no’s”.  This means that now is the time to child-proof your home.   Make a systematic and slow trip through your entire house (try it on your hands and knees to see things at their level) to remove any poisons and other objects that could harm them.  Reserve the “no-no’s” for things like hot stoves-the real hazards that cannot be removed from their environment.  An effective way to discipline your toddler is to distract them or physically move them to another room.

You can stimulate language development by playing the “labeling game”.  Point to objects and name them for your child while you are dressing, feeding, and playing with them.  Continue to read to your toddler and allow them to explore books.  The cloth and heavy cardboard variety that have pictures along with single words are especially suited to this age group.

A word about a child’s attitude toward their body: when your toddler discovers and plays with their sex organs, it should be treated no differently then when they discovered their ears, nose or toes.  Teach your toddler the names of sex organs the same as you teach them the name of other parts of their body.  By doing this, they will have positive feelings of acceptance for these parts of their body.

Your child will probably exhibit temper tantrums as part of their development towards independence; at the same time still having some separation anxiety.

SLEEPING

Your toddler should definitely be sleeping through the night, getting themselves to sleep and napping 1-2 times a day.

FEEDING

They should be drinking from a cup (with and without a cover) and eating table foods with their fingers or grabbing for the spoon.  Put a sheet of plastic under their high chair and let them develop this skill of feeding himself.  Your toddler may have a definite decrease in appetite and become more fussy and finicky about their food.  They are growing at a much slower rate, so respect their appetite without cajoling and urging them to eat.  Avoid nuts, pretzels, popcorn, potato chips, grapes, apples, raw carrots, hot dogs, and any other food on which they can choke.  Around a year of age, most babies are less interested in the bottle.  Be alert to the clues and gradually eliminate the bottle, realizing that his intake will drop.  For infants who are not breast feeding, at one year we switch from formula to whole milk.  A pint of milk a day (16 oz) is adequate.  Most toddlers make this transition without difficulty.  Although infants and children often like to drink juice, it offers few nutritional benefits and many empty calories.  Don’t give your child more than four ounces of juice a day.  It is best to dilute it 1:1 with water.  Do not give them a bottle in bed.

Many babies have six teeth by now; some are just beginning to erupt their first one.  Initial dental consultation is recommended by the AAP between 12 and 18 months of age.

The AAP recommends vitamin D supplementation for all infants, children, and adolescents.  After reviewing the literature, it certainly looks like many children may benefit from vitamin D, although not everyone necessarily needs it.   Some children are more at risk for vitamin D deficiency than others.  Risk factors for vitamin D deficiency include dark skin (African-americans, Indians, Hispanics), time spent indoors and not out in the sunlight (particularly in the winter months), low amount of milk consumption (less than 16 oz a day), and exclusively breastfed infants.   The recommended dose is 400 IU (international units) once daily.  This can be bought over the counter in either a single drop form, or with a larger dropper.  Read the label carefully when dosing this to your child.  Too much vitamin D can be harmful.

SAFETY

  • Never underestimate a toddler!
  • Wall plugs should be covered
  • Cleaning supplies should be out of reach and all medication locked up.  You should also check the garage (fertilizers and insecticides) and basement (paint and cleaners).  Call poison control at 1-800-222-1222 immediately for any possible ingestion.
  • Cover sump pump holes
  • Hot beverages should not be in reach of your child
  • Stairs should be gated and a lock placed high on the basement door
  • Never leave your child unattended near water
  • Keep the bathroom door closed
  • Keep your baby rear facing until their second birthday or until they reach the maximum weight allowed by your car seat manufacturer.  The longer you can keep them rear facing the better.

IMMUNIZATIONS

A Hepatitis A vaccine is given at this visit, a second dose of this vaccine is given at 18 months.

HEALTH SCREENING

We will be seeing your child at 15 months for their next visit.  We would like to focus on behavioral concerns you may have and to talk to you about discipline, injury prevention, development, and nutrition.