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 to Expect 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.
Immunizations Your Baby Will 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 first dose of chickenpox (varicella) vaccine is given as a single injection between 12-15 months of age.
- The fourth pneumococcal conjugate vaccine (PCV) is given between 12-15 months of age.
- The third or fourth Haemophilus influenzae type B (Hib) vaccine is given between 12-15 months of age, depending on the type of vaccine used.
- The first dose of hepatitis A vaccine may be given at 12 months of age or older.
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
- a flu shot
- the meningococcal vaccine, which can be given from 2 months. This is given to children at higher risk of developing meningococcal disease, which can lead to bacterial meningitis and other serious conditions.
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 102.2ºF (39ºC) 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: Steve Dowshen, MD
Date reviewed: September 2011