Advanced Pediatrics

100 East Street SE, Suite 301

Vienna, VA 22180
(P) 703.938.5555

(F) 703.319.8580


12 Months Old

From nine to twelve months of age, your baby will become increasingly mobile, a development that will thrill and challenge parents. Being able to move from place to place will give your child a delicious sense of power and control—his first real taste of physical independence.   


Your child’s feet also may look a little odd to you. When he lies on his back, his toes may turn inward so that he appears pigeon-toed. This common condition usually disappears by eighteen months.   It marks the beginning of being ambulatory and a whole new world for your new toddler.










Vaccinations for this visit

We recommend the following vaccines:


  • Proquad (MMR/Varicella)
  • Hepatitis A

​Recommended Tests

As an infant grows older, she may deplete her reserves of iron, especially those who are breastfed.  To ensure they are not iron deficient and facilitate the timely treatment of this condition at a critical time for development, we recommend the following test:




What to Expect

​Sleep


  • Sleep Routine:  Establish a nightly bedtime routine that begins with quiet time for your child to relax before bed, and ends with your child soothing himself in his own crib. Reading and singing to your child will help him get to sleep. A favorite toy or a nightlight also can help. Make sure to space nap times so that your child is tired at bedtime.
  • Naps:  Toddlers should continue to have at least one nap during the day. It is important to establish a regular nap time routine.
  • Quantity of sleep:  A 1-year-old should be sleeping 12 to 14 hours a day. Bedtime should be at the same time each night and should become a nightly routine.


Feeding

  • Feeding routine:  Meals should be relaxed, safe, and enjoyable family times. Encourage fine-motor skills, such as using a cup or spoon and eating finger foods.  Snacking now plays a role in the 3-meals-a-day schedule.  Make sure that you’re not teaching your child “grazing”—snacking all day without having any real meals.
  • Self-feeding:  Cover your floor and don’t worry about messes—young children learn from experimenting. Your child should be developing toddler eating skills—biting off small pieces of food, feeding herself, and holding and drinking from a cup. Toddlers learn to like foods by touching, smelling, and mouthing them repeatedly.
  • Foods to avoid:  Avoid small, hard foods like peanuts or popcorn, on which your child can choke, and cut any firm, round food (eg, hot dogs, raw carrots, or grapes) into thin slices.
  • Set an example:  Include your toddler in family meals by providing a high chair or booster seat at table height. Make mealtimes pleasant and companionable. Encourage conversation.   Sharing meals is one of the most influential things a parent can do to get a toddler to try new foods and help a child establish a lifetime of healthy, balanced eating.
  • Normal behavior:  Toddlers tend to “graze.” Her appetite will vary; she will eat a lot one time, and not much the next time.
  • Give your toddler some control:  Let your toddler decide what and how much to eat from an assortment of nutritious foods you offer. Trust your child’s ability to know when she is hungry and full. If she asks for more, provide a small, additional portion. If she stops eating, accept her decision.


Development


  • Suddenly, your toddler will start to seem to understand everything you say. This is a developmental leap, and it means you need to change the way you act and speak to and around her.
  • This is the age where your toddler’s really going to start to learn how to walk. Even if she hasn’t mastered the art of walking quite yet, she is still moving around, holding onto everything and propelling herself forward.
  • She may be using her hands for some very important things, such as holding a cup, picking up tiny objects, playing patty cake
  • Some toddlers may be the life of the party, while others may be shy. Both behaviors are normal and nothing to worry about.


Safety


  • Lock away medications and all cleaning, automotive, laundry, and lawn products out of sight and out of reach. Climbing toddlers can reach even high shelves.
  • Keep your toddler out of rooms where there are hot objects that may be touched, including hot oven doors and heaters, or put a barrier around them.
  • Now that your toddler is walking, get down on the floor yourself and check for hazards.
  • Keep plastic bags, latex balloons, or small objects, such as marbles, away from your toddler.
  • Be sure there are no dangling telephones, electrical, blind, or drapery cords in your home.
  • Make sure televisions, furniture, and other heavy items are secure so that your child can’t pull them over. If they seem unsteady, anchor bookcases, dressers, and cabinets to the wall and put floor lamps behind other furniture.
  • Keep sharp objects, such as knives and scissors, out of your toddler’s reach. Keep medications, household cleaners, and poisons locked up.
  • The rear-facing position provides the best protection for your child’s neck and head in the event of a crash. For optimal protection, your child should remain rear facing until she reaches the highest weight or height allowed for use by the manufacturer of a convertible seat or infant-only seat that is approved for use rear facing to higher weights and heights (up to 30 pounds and 32 inches for infant only and up to 35 pounds and at least 36 inches for convertible seats). Do not switch your child to a forward-facing car safety seat before she is at least 1 year old and weighs at least 20 pounds.


Activities


  • Toddlers love games at this age including Pat-a-cake and This Little Piggy Went to Market.  Try different ways of playing the games.  Hide behind furniture or doors for Peekaboo, clap blocks or pan lids for Pat-a-cake.
  • Play the naming game.  Name body parts, common objects, and people.  This lets your baby know that everything has a name and helps him or her begin to learn these names.
  • Tape a large piece of drawing paper to a table.  Show your toddler how to scribble with large nontoxic crayons.  Take turns making marks on the paper.  It is also fun to paint with water.
  • Make an obstacle course with boxes or furniture so your toddler can climb in, on, over, under, and through.  A big box can be a great place to sit and play.
  • Let your toddler help you clean up.  Play “feed the wastebasket” or “give it to Mommy or Daddy.”
  • Most toddlers enjoy music.  Clap and dance to the music.  Encourage your baby to practice “balance by moving forward, around, and back.  Hold his hands for support if needed.
  • Play “pretend” with a stuffed animal or doll.  Show and tell your toddler what the doll is doing (walking, going to bed, eating, dancing across a table).  See if your baby will make the doll move and do things as you request.  Take turns.