INFANT CARE from 9 Months to 12 Months

Have you noticed how quickly your baby is developing at this stage?  Every day, it seems as if something new is being learned.  He is crawling everywhere and may begin pulling up or even "cruising" around furniture.  You may notice how much your baby is using his hands to accomplish tasks.  For example, he uses the finger and thumb in a "pincer" grasp to pick up small objects instead of "raking" them.  He may show a preference for a dominant hand when reaching for something.  Your child may respond to simple verbal commands such as "Say bye-bye" and can comprehend "no-no."  When separated from care givers and family, especially Mom, the fear of strangers is even stronger now and is intensified.

Feeding

Because of the increased fine motor (hand) coordination, your baby is able to eat more finger foods.  Some examples of these include:  cheese cubes, small chunks of hot dog or infant chicken franks (with the skin removed), small chunks of fruit (fresh or canned), cooked vegetables such as broccoli, beans, peas or carrots.  Dry cereals without sugar coatings such as Cheerios or Chex are good snacks as are crackers and fruit chunks.  You must carefully watch your child to see that he can handle (without choking) each food tried until it is finished.  He is able to hold a spoon but may spill much of its contents but let him continue to try, even though this will be messier for you!  An old shower curtain or plastic table cloth placed under the high chair makes clean-up easier.

Your baby may also hold his own cup (infant-type) without assistance.  Your baby is still on breast milk, or formula or whole milk if it has been recommended, along with solid food.  However, he should not be taking more than 32 ounces in a 24 hour period.  Since your baby is on table or infant foods, it is a good time to begin weaning, if you so desire.  You may want to ask your doctor about a weaning schedule, as well as about vitamin and mineral supplements (and fluoride if it has not been previously discussed).

Sleeping

This age can be difficult!  Your baby may show fears of going to bed and fight it every night.  He may also fuss some after being put to bed.  A regular bedtime routine is helpful and provides extra reassurance to your child.  You can check on the baby every five minutes, pat and reassure, but do not pick him up or put him in your room.  You don't want to reinforce this behavior.  In a calm voice, take a minute to remind your baby that he needs sleep and that everything is OK.  Your child will understand your calm reassurance.

You may also notice that your baby, who previously had undisturbed night-time sleep, is now awakening abruptly and crying.  This may even be accompanied by nightmares.  You should check your baby immediately, however, keep the time spent brief and do not give extra bottles, take him to your bed, or rock him.  These positive reinforcements encourage night-time awakening and could set you up for problems later if awakening becomes a habit.

Elimination

Bowel patterns remain mostly regular for your baby.  He may even begin to let you know when he has a soiled diaper, although toilet training should not begin until at least 18-24 months of age and when readiness signs are noted.

Safety

The more mobile your baby is, the more curious.  He is into everything!  Accidents, burns, and poisonings are among the injuries your baby could incur.  Child-proofing your house means examining every room, including the garage, basement, shed, and yard! (see references below which have a good section* on accident prevention and safety or which are devoted to this subject**) Purchase a bottle of Syrup of Ipecac (at your pharmacy) in case your baby ingests medication or poison and the treatment recommended is to induce vomiting.  Tape the poison control number by the phone(s) along with your other important numbers.  Having the emergency numbers and the Ipecac handy to use, if instructed can save your child's life.  Never give Ipecac unless your physician or poison control says to.

If you take your baby bicycle riding, be sure he has a helmet, is securely strapped in the bicycle infant safety seat, and his feet cannot reach the spokes.  In the car make sure your baby remains buckled up.  Always supervise your baby when outdoors and never leave him alone to "just run inside for a minute."  Swimming pools should be surrounded by a fence with a padlock on the gate.  THEY'RE DEADLY!!!  Also, beware of wading pools and even buckets of water or open toilets.

Development/Play

Talk with and listen to your baby!  At this age he loves to interact with you.  He may begin to repeat simple words such as "Da-Da," "Mama," or even his name.  He may also begin to name parts of his body and point to them or name his favorite foods.  He likes to play peek-a-boo, pat-a-cake, or games such as "Where's Baby?"  He is a great imitator -- of people, animals, or sounds.  Read to your baby!  A portion of his vocabulary develops from seeing and verbally hearing objects identified.  Purchase infant books made of cloth, plastic, or hard cardboard.  Let your baby read.  Hold him on your lap and point to an object on the page, say and repeat the word.  Soon your baby will be saying this word.  You are sending a message about the importance of reading that will last a lifetime.

Containers which permit baby to "put objects in and take them out" are great at this age.  These toys are called "nesting" toys and include colored boxes or cups.  They are relatively inexpensive.  Toys or books with different textures (for example, squares of different fabrics in a box) allow him to experience soft, rough, smooth, etc.  Remember, your baby is learning about in and out, up and down, on and off, so say these words when performing the task.

Although baby walkers are appealing at this age, they are no longer recommended at any age.  They encourage lower leg muscle development when babies need upper leg muscle exercise to prepare for walking.  In addition, walkers are a safety hazard because they tip over easily and children can slip through and be seriously injured or strangled.

A word about Discipline

Try to use the word "no" only when necessary.  Babies do not need to be spanked.  If you become angry with your baby, place him in his crib or playpen for a time-out for 1-2 minutes.  This will allow you to calm down and the baby to realize that he has done something wrong.  Parents and other care givers should discuss this subject together before the baby gets much older.  Your consistency in manner of interaction helps your child develop a foundation for relating to you and others.  Your consistency in the use of the word "no" and in adhering to reasonable limits helps to keep your child safe.  You can not accident-proof their world forever.

Suggested Handouts, Readings and Videos

For this visit if not previously given:

• Immunizations - 5 (generally and or specific to those to be given next visit)
• Selecting a Day Care or Sitter - 4
• **Safety for Children
• **Preventing Accidental Ingestions and Poisonings
• **Preventing Injuries and Choking
• **Preventing Burns
• **When Choking Occurs.
  
  

For this visit consider:

• Introducing Solid Foods - 1
• Fever in Children Six Months and Older
• Teething (if needed)
• Care of Teeth
• Weaning
• Sleep Problems in Infant (if needed)
  
  

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Anticipatory Guidance Sheets for Parents by M. Cohen, D. Hansen, and K. Skilling, ©1994 has been reviewed favorably by the American Academy of Family Physicians Foundation.

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Additional Resources for Parents

General Child Care

• *Babyhood
  by P. Leach
  
  
• *The Well Baby Book
  by M. Samuels and N. Samuels
  
  
• *What To Expect the First Year
  by A. Eisenberg, H. Murkoff, and S. Hathaway
  
  
• *Caring For Your Baby and Young Child
  by American Academy of Pediatrics
  
  
• *Taking Care of Your Child
  by R. Pantell, J. Fries, and D. Vickery
  
  
• A Family Doctor's Answer Guide to Your Child's Health
  by M. Cohen (after 1/95)
  
  

Growth and Development

• Infants and Mothers
  by T. Brazelton
  
  
• The First Twelve Months of Life
  by T. Caplan
  
  
• Kid Fitness
  by K. Cooper
  
  
• Arnold's Fitness for Kids, Ages Birth - 5
  by A. Schwarzenegger
  
  

Discipline and Communication

• Your Child's Self-Esteem
  by D. Briggs
  
  
• Parent Effectiveness Training
  or
  P.E.T. in Action
  by T. Gordon
  
  
• When Your Child Drives You Crazy
  by E. LeShan
  
  

Other

• Mothers' Almanac
  by M. Kelly and E. Parsons
  
  
• Working and Caring
  by T. Brazelton
  
  
• Parents Guide to Feeding Your Kids Right
  by C.T.V.
  
  
• Feed Me!  I'm Yours
  by V. Lansky
  
  
• Natural Baby Food Cookbook
  by M. Kenda
  
  
• Child of Mine, Feeding with Love and Good Sense
  by E. Satter
  
  
• Solve Your Child's Sleep Problems
  by R. Ferber
  
  
• **A Sigh of Relief
  by M. Green
  
  
• Helping Your Child Sleep Through the Night
  
  by J. Cuthbertson and S. Schevill
  
  
• Raising a Son
  by D. Elium & J. Elium
  
  
• Raising a Daughter
  by J. Elium & D. Elium
  
  

Copyright ©1994-1997 Sunbelt Medical Publishers.  All rights reserved.