ALL patients are seen at our Portsmouth office on Saturday and Sunday for sick visits from 9-12 am

Offices:

Hampton

603.929.3838

55 High Street
Hampton, NH 03842

Portsmouth

603.436.7171

330 Borthwick Avenue Portsmouth, NH 03801

Well Child Visits

The 1 Year Visit

Development:
This is the beginning of the runabout age of childhood. It is the age of exploration1 If your child is not already walking, he probably soon will be. An important thing to remember is that in his explorations, your toddler should be building his self-confidence. He should be allowed to play and exp lo re freely without a lot o f hand slapping and a Stream o f “no - no’ s”. This means now is the time to make SURE your house is child-proof Make a systematic and slow trip through your entire house (try it on hands and knees to see things at his level) to remove any poisons and other objects that could harm him. Reserve the “no-no’s” for things like hot stoves- the real hazards that cannot be removed from the environment. Otherwise, one of the best ways to handle or discipline your toddler when he is into something is the method of distraction or physically moving him to another room. Be consistent. The key to discipline is not punishment, but reward. Smile and praise your baby when he does something right.

Temper tantrums are common at this age. They come from your child trying to have some independence and control and losing both. Some parents find ignoring the tantrum works best; others remove the Child from the situation and place them alone in their room or in corner for a short time (no longer than 1 minute per year of age). Yelling, spanking and throwing a tantrum yourself is not helpful.

Many one year olds “cruise” about by walking and holding onto furniture. Most with release objects to you on request. Their language usually consists of two or three words, including mama and dada. When in the mood, they will shift their weight to help or hinder your efforts to dress them. They may begin to enjoy simple ball games.

Children this age fall a lot and climb whenever given the chance. They have definite “moods” and can be quite negative. Your child may wave bye-bye and follow a few simple commands.
 
You can help expand your child’s vocabulary at this age by playing “labeling” games. Point to objects and name them for him while you are dressing, feeding and playing with him. Also, continue to introduce your toddler to books — the cloth and heavy cardboard variety that have pictures along with single words. Play blowing games- bubbles and horns. Continue to provide noisy push/pull toys. Bathtub toys, such as boats, various sized containers and colored spongers, are fun. Provide changes o f environment: trips to the store, out in the car point out in the car-point out distant objects such as birds, planes, clouds. Use a wading pool and sandbox (with spoons, cups, cars) with supervision

Feeding/Elimination:
Feeding a one year old is an exercise in patience As much as possible; the child should be allowed to feed himself. It’s messy, but he has to learn sometime. Most one year olds have a definite appetite drop and become more choosy and finicky about their food. Since he is growing at a much slower rate, this is normal. DON’T FORCE FOOD! Offer mainly table foods: whole milk, cereal, vegetables, meat and eggs, and let him eat what he will. Make servings small. Beware and avoid nuts, popcorn, hot dogs, grapes and other coarse foods he might choke on. Encourage him to use a cup. Children should be weaned from the bottle by 12-15 months of age. He may take less milk for a few weeks or months when he is first weaned. This is to be expected and is no cause for concern. An average total intake of milk is 16 ounces.

During the next several months, your baby may start to develop an awareness of soiling, but it is too early for him to control his bowels. At this age your baby can transition from formula to whole milk (cow’s milk). This may cause constipation which you can prevent by diet. Offer large amounts of water, whole-grain cereals and dried fruits. Ask for help if problems continue.

Sleep:

Your baby is now probably sleeping 10- 12 hours each night. He usually falls asleep more quickly, and there is improvement in sleeping all night. He may still need a long afternoon nap, but the morning nap may shorten or cease.

Special concerns:
Anemia. By this age, your baby has lost the iron stores he had at birth and is dependent upon dietary intake of iron to produce the red blood cells he needs. Good dietary sources of iron include: liver, pinto and kidney beans, baby cereal and cream of wheat. Other sources are beef, veal, dried prunes, apricots, raisins, spinach and other leafy dark green vegetables, egg yolks and iron fortified cereal. If whole milk intake is excessive decrease the total to 24 ounces/day.
 
Shoes. Shoes are primarily for protection of the feet and have little, if any, influence on the growth of the foot. Unless we instruct you otherwise, a good pair of sneakers is more than sufficient for your child. Shoes hinder the Iearning4o-walk process, and should be worn routinely only after your child is walking well and for protection when outdoors.

Safety:
Remember, the age period 9 months to about 3 years of age is an especially hazardous one. The principal fatal accidents in this age period are auto accidents, poisoning, choking, falls, drowning and burns. You cannot watch your child every minute, but you can make a careful check of his surroundings thereby anticipating and preventing most home accidents. Wall plugs should be covered. Stair doors should be closed or gates put up. Kitchen supplies should be out of reach and all medication locked up. You should also check the garage (fertilizers, insecticides) and the basement (paint and cleaners). Never underestimate a toddler. Everything is exciting and a new challenge and nothing is impossible if they are determined. Children learn to go up the stairs before they can go down. If you have stairs, a gate put up on the second stair allows them to go up a short distance without the risk of a long fall down.

When traveling in the car, BE SURE YOUR CHILD IS SECURE IN AN APPROPRIATE SAFETY SEAT.

Immunization:
Today your child will receive immunizations as recommended by the American Academy of Pediatrics and the Center for Disease Control. Please ask any questions you may have about immunizations. We will also arrange for your child to have a blood test to check for anemia and lead poisoning.

                                                                                                 adapted from John Chamberlain
                                                                                                                  Rose Boynton, et.al.
                                                                                                                              Barton Schmidt