As your baby becomes more independent and mobile, your questions
for your child's doctor may have more to do with bumps,
bruises, and behavior than with anything else.
You can't protect your baby from every knee-bump suffered
while learning to walk. But you can make sure poisons and medicines
are kept where kids can't possibly get to them and provide a
safe environment for exploration.
Your baby is probably hearing "no" a lot these days
while exploring boundaries; soon, you'll hear that word
back from your little one! Be consistent but loving while
teaching the difference between acceptable and unacceptable
behavior.
When Will We See the Doctor?
Doctors often have their own schedules for well-baby visits, but
most will generally see a baby twice during this stage, once at 9
months and again at 12 months. If you have missed any
immunizations, or if a problem has been detected that needs special
attention, additional visits may be scheduled.
What Will Happen During the Office Visit?
The well-baby visits at 9 and 12 months are pretty similar to
the exams that have taken place so far, although your discussions
with your doctor about behavior and habits may become more
frequent.
Expect these common procedures and questions:
- Measurement of your baby's length, weight, and head
circumference.
Growth
will be plotted on the growth chart and you will be advised of
your little one's progress.
- A physical examination checking for normal function of the
eyes, ears, heart, abdomen, hands and feet, reflexes, etc. The
doctor may check your baby's soft spot (the fontanel), which
may be closed or much smaller (the size of a fingertip). The
doctor will check your baby's mouth for new teeth and signs
of others to come.
- A review of your baby's physical and emotional
development through both observation and your report: Can your
baby sit up alone? Pull up on things to stand? Recognize his
or her own name and the names of family members? Enjoy games like
"peekaboo"? Your doctor may ask you these questions and
others.
- You may be asked how you're doing with your baby and how
the rest of the family is functioning. Your doctor may review
safety with you: Have you
babyproofed
your home? Is your baby in an appropriate
car seat
while riding in the car?
- A discussion of
eating habits
: Is your baby eating more table foods? Interested in finger
foods on the tray of the highchair? Able to use a cup? Being
weaned from the breast or bottle? Most doctors advise a switch
from bottle to cup by the first birthday to be sure the bottle
doesn't interfere with normal tooth development and to avoid
struggles with a determined toddler later. By age 1 year, most
babies can be given foods that were off-limits before, such as
cow's milk, citrus fruits, and eggs. Your doctor can discuss
these dietary additions with you.
- Advice on what to expect in the coming months.
- Your baby will receive
immunizations
during some visits (see below).
Depending on where they live and the potential risk of
tuberculosis
, sometimes babies at about 1 year of age undergo a tuberculin skin
test. You'll be given instructions on how to monitor the test
and asked to return to the office for the nurse or doctor to check
the results of the test. Discuss possible vaccine reactions with
your doctor and when to call with unusual problems.
During appointments, raise any questions or concerns you
have and jot down any instructions the doctor gives you about
special baby care. Keep updating your child's permanent
medical record
, listing information on growth and any problems or illnesses.
What Immunizations Will My Baby Receive?
If your baby missed immunizations at previous visits because of
illness or scheduling problems, he or she will probably be brought
up-to-date now. Because your baby is becoming more and more mobile
and is in contact with other kids more often, you'll want to
make sure immunizations are given as close to the recommended times
as possible. This is especially true if your baby goes out of your
home for childcare.
Because more immunizations than ever are given to kids by 2
years of age, doctors are spacing vaccinations so that they
won't need more than three to four shots per well-baby
visit.
From the Recommended Childhood Immunization Schedule of the
American Academy of Pediatrics (AAP):
- At the 12-month visit, your baby may receive the first
measles, mumps, and rubella (MMR) vaccine (it's given between
12-15 months of age).
- The chickenpox (varicella) vaccine is given as a single
injection between 12-18 months of age.
- The fourth pneumococcal conjugate vaccine (PCV) is given
between 12-15 months of age.
- The fourth Haemophilus influenzae type B (Hib) vaccine is
given between 12-15 months of age.
Your baby also may receive:
- the third hepatitis B vaccine (Hep B), which can be given at
any time during 6-18 months of age
- the third polio vaccine (IPV), which can be given at any time
during 6-18 months of age
This immunization schedule can vary depending on what combined
vaccines your doctor uses.
When to Call the Doctor
You should feel comfortable enough with your doctor to call with
questions and concerns that can't wait until the next scheduled
visit. If your questions can wait, write them down so you don't
forget. Of course, call the doctor immediately if your child has an
injury or illness that needs attention.
Call the doctor right away if your baby seems especially
sluggish, is refusing food or drink, is vomiting or has diarrhea,
or has a temperature of 102º Fahrenheit or higher.
At this age, developmental delays may cause concern, so contact
your doctor if you suspect your child is not developing within the
range of normal. Kids have their own timetable for crawling,
talking, and walking, so keep that in mind when checking for these
signs of developmental progress by the first birthday. Make sure
your child:
- has said a first single word (mama, dada)
- uses gestures (waves bye-bye, shakes head no)
- responds to familiar pictures or toys
- stands when supported and pulls up on things to stand
Again, the absence of any of these signs may or may not be cause
for concern. Share them with your doctor, though, because problems
caught early can be treated more successfully.
Reviewed by:
Steven Dowshen, MD
Date reviewed: October 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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