Your Child's Checkup: 1 Year (12 Months)

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your toddler's weight, length, and head circumference and plot the measurements on the growth charts.

2. Ask questions, address concerns, and offer advice about how your child is:

Eating. By 12 months, toddlers are ready to switch from formula to cow's milk. Children may be breastfed beyond 1 year of age, if desired. Your child might move away from baby foods and be more interested in table foods. Offer a variety of soft table foods and avoid choking hazards.

Pooping. As you introduce more foods and whole milk, the appearance and frequency of your child's poopy diapers may change. Let your doctor know if your child has diarrhea, is constipated, or has poop that's hard to pass.

Sleeping. One-year-olds need about 11 to 14 hours of sleep a day, including one or two daytime naps.

Developing. By 1 year, it's common for many children to:

• say "mama" and "dada" and one or two other words
• follow a one-step command with gestures (such as pointing as you ask for a ball)
• imitate gestures
• stand alone
• walk with one hand held and possibly take a few steps
• precisely pick up object with thumb and forefinger
• feed self with hands
• enjoy peek-a-boo, pat-a-cake, and other social games

3. Do a physical exam with your child undressed while you are present.

4. Update immunizations. Immunizations can protect kids from serious childhood illnesses, so it's important that your child receive them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

5. Order tests. Your doctor may check for lead exposure, anemia, or tuberculosis if your child is at risk.

Looking Ahead

Here are some things to keep in mind until your child's next checkup at 15 months:

Feeding

1. Give your child whole milk (not low-fat or skim milk, unless the doctor says to) until 2 years of age.
2. Limit your child's intake of cow's milk to about 16–24 ounces (480–720 ml) a day. Move from a bottle to a cup. If you're nursing, begin offering pumped breast milk in a cup.
3. Serve juice in a cup and limit it to no more than 4 ounces (120 ml) a day. Avoid sugary drinks like soda.
4. Serve iron-fortified cereal and iron-rich foods (such as meat, tofu, sweet potatoes, and beans) in your child's diet.
5. Encourage self-feeding. Let your child practice with a spoon and a cup.
6. Have your child seated in a high chair or booster seat at the table when drinking and eating.
7. Serve three meals and two or three nutritious snacks a day. Don't be alarmed if your child seems to eat less than before. Growth slows during the second year and appetites tend to decrease. Talk to your doctor if you're concerned.
8. Avoid foods that can cause choking, such as whole grapes, raisins, popcorn, pretzels, nuts, hot dogs, sausages, chunks of meat, hard cheese, raw veggies, or hard fruits.
9. Avoid foods that are high in sugar and fat and low in nutrition.

Learning

1. Babies learn best by interacting with people. Make time to talk, sing, read, and play with your child every day.
2. TV viewing (or other screen time, including computers) is not recommended for those under 18 months old.
3. Have a safe play area and allow plenty of time for exploring.

Routine Care & Safety

1. Brush your child's teeth with a soft toothbrush and a tiny bit of toothpaste (about the size of a grain of rice) twice a day. Schedule a dentist visit soon after the first tooth appears or by 1 year of age.
2. Continue to keep your baby in a rear-facing car seat in the back seat until age 2, or whenever your child reaches the weight or height limit set by the car-seat manufacturer.
3. Avoid sun exposure by keeping your baby covered and in the shade when possible. You may use sunscreen (SPF 30) if shade and clothing are not protecting your baby from direct sun exposure.
4. Keep up with childproofing:
   • Install safety gates and tie up drapes, blinds, and cords.
   • Keep locked up/out of reach: choking hazards; medicines; toxic substances; items that are hot, sharp, or breakable.
5. Keep emergency numbers, including the Poison Control Help Line number at 1-800-222-1222, near the phone.
6. To prevent drowning, close bathroom doors, keep toilet seats down, and always supervise your child around water (including baths).
7. Protect your child from secondhand smoke, which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.
8. Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids cannot access the keys.
9. Talk to your doctor if you are concerned about your living situation. Do you have the things that you need to take care of your child? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.