Developmental Goals:

• Walking may occur as young as 9 months, but not usually until 13-15 months.
• Use shoes only when walking well.  Babies learn to walk best when barefoot.
• Curiosity is healthy and promotes learning - but be careful!  Make your home as safe as can be so your toddler can roam and learn!
• Let your child put things in and out of boxes and drawers, stack blocks and make noise.
• A one year old should be able to say 1-3 words.  A general rule of thumb is 2 of 4 words should be understood by a stranger at 2 years, 3 of 4 by 3 years and 4 of 4 by 4 years, so don’t expect the words to be clear yet!
• Toddlers understand more than they can say, so watch what is said around them, but talk about everything!
• Teach body parts, names of pictures in books, objects you see on walks, sing the alphabet song, count as you walk stairs, the more talking the better!
• Offer paper and crayons for use while supervised.
• Read to your child 20 minutes daily.
• Turn off the television.  Television is linked to ADHD and other behavior problems in children, as well as poor depth perception with vision if children less than 2 years watch television! 

Discipline:

• Temper tantrums will decrease if ignored.   Many children between 1 and 2 years will hit, kick, bite, and push.  Intervene if you see a situation developing before this happens (one toddler is eyeing the toy of another…).  If a toddler does one of these, separate the child from the other person (often it is MOM!).  Tell the child “No biting (or hitting, etc.).  It hurts.”  A short time away from that person often helps.  If it is mom they are hitting, it is really beneficial for mom to ignore the child for a moment.  Giving any attention, even if you are telling him how “bad” a behavior is, rewards behavior because they have your attention.
• Praise good behavior!!!  Kids want your attention and will then try to be good!  Catch them being good and offer lots of praises!
• Children learn by imitation. Hitting, spanking or biting your child does not teach good behavior.
• Remove child from negative situations.
• Keep explanations short.
• Provide a variety of activities.  Be calm, firm and consistent.  Don’t laugh or give unintended praise for bad behaviors! 
• For sleep information, click here.

Safety: 

• Lock out of reach all cleaning products, medications, vitamins, herbs, beauty products, and plants.  Keep products in their original containers with the label intact.
• Remember that babies can often climb before walking; be sure stairs are off limits and monitor furniture!
• Leave the light on when measuring medicine, so you dose it accurately.  Do not use a spoon from the kitchen… a syringe or dropper are the most accurate way to measure liquid medicines.  Be sure to put the cap back on tightly each time you dispense medicine.
• Clean the medicine cabinet 1-2 times per year.  Do not pour expired medications down the drain or toilet.  Click here for proper disposal of medications information.
• Poison Control: 1-800-222-1222.  Have number readily available beside every phone - or better yet, make it one of your pre-programmed numbers!
• Change smoke alarm and carbon monoxide batteries every time you change your clock.  Change the alarm itself every 5 years.  Write the dates of battery changes and installation of the system on the alarm.
• Drowning danger:  Never leave baby alone in bathtub.  Keep toilet lids down/locked.  Keep the door to the bathroom closed at all times.
• Empty wading pools and buckets immediately after use.
• Swimming pools should have a locked fence on all sides.
• Do not let baby near hot foods.
• Cover all electrical outlets.
• Keep small and sharp objects out of reach.
• Use sunscreen (SPF 30 or above).  Apply 30 minutes before going outside and repeat every 1-2 hours.
• Infant's car seat must remain facing the back until 12 months AND 20 pounds, but this is the BARE MINIMUM, NOT the RECOMMENDATION.  It is recommended to remain backwards until the child outgrows the rear facing seat, which is usually about 30 pounds and 2 years.  See our Car Seat page for more information.
• Lead poisoning risk may exist from cracked/peeling paint if it is from before 1960.  We screen all babies at 9 and 24 months and if at risk based on known exposure.
• Keep toddlers away from dangerous equipment, garage doors and streets.
• Keep the toilet lid down and the bathroom door closed at all times.
• Lead poisoning risk may exist from cracked/peeling paint if it is from before 1960.  We screen all babies at 12 months and if at risk based on known exposure, simply let your provider know if you have concerns.
• All parents should learn CPR and refresh skills every 2 years.  For a list of CPR classes for both non-medical and medical professionals, click here.
• Click here for more safety information, including a car seat safety page. 

Health:

• Continue to wipe or brush child’s teeth daily.
• Do not use fluorinated toothpaste until your child can spit it out.
• For more on dental care, visit our dental pages.
• If your child any vision concerns, such as a lazy eye, please discuss at your visit.  Some of the apparent lazy eye is a normal finding, other times it needs to be addressed by an eye care professional.  If there is a family history of "lazy eye" or other infant eye problems, make an appointment with an eye care specialist.
  
• Smoking in enclosed places allows smoke dust to settle on clothes and hair.  When held, the child inhales the smoke dust and can develop allergies, asthma and ear infections.  Never smoke around your child or in the home or car - even if the child is not present at the time.
• If you choose to stop the pacifier, there are many methods.  Some parents choose the cold turkey method.  Others keep it in the crib only for a few weeks, then stop it.  Some will cut off the tip, so the child loses interest.  See our dental pages for more information.
• For information on penile adhesions (the head of the penis sticking to surrounding skin), click here.
• For fever, use Acetaminophen (Tylenol) or Ibuprofen as directed.  Dosing chart is on our medication page.
• All children are encouraged to have an eye exam by a specialist by the first birthday.  For information on the Infant See program, click here.
• Immunizations:
• Fever is common after shots.  Give Acetaminophen every 4-6 hours as needed for symptoms, but we no longer recommend routine fever prevention with fever reducers.  Research has shown that preventing the fever might decrease the immune response (ie make the vaccine less effective).
• Bring your shot record each visit.
• Review the VIS (Vaccine Information Sheet) before visits.
• Flu (Influenza) shots are recommended each Fall after 6 months of age.

Sleep:

• Continue reading a picture book before bed.
• If your toddler has a hard time falling to sleep, you can let her cry a few minutes longer each night.
• Bringing baby to bed is a hard habit to break - don’t start now! 
• For more information on sleep, click here.

Diet:

• Toddlers can eat most table foods and shouldn’t need pureed baby food.
• Begin whole or 2% milk from a cup or continue formula made for 9-24 month olds.
• All children should receive a vitamin D and iron supplement.  We limit milk to 24 ounces or less per day, and there is not enough vitamin D in this amount of milk per day.  See our Vitamin D page for more information.  There is no iron in milk and many kids do not eat enough iron rich foods.
• Breastfeeding may continue as long as mutually desired.
• Stop the bottle.
• Limit juice to 4 oz. or less and minimize sugary snacks.  Juice offers little nutrition and has a lot of sugar!
• At this age, the appetite commonly decreases.  Don’t force child to eat.  Toddlers may seem to go for days without eating, then want to have seconds for a day, then return to minimal food.  This is normal.  Balance food groups and minimize unhealthy treats.  You can supplement with a liquid multivitamin if desired at this age.
• No small, hard foods such as popcorn, M&M’s or other choking risks.
• Click here for more age-specific feeding recommendations.

Be sure to obtain any required health forms at your well visit!