Growth Milestones – TWELVE MONTHS

“Happy Birthday”

A year ago, did you wonder if you would ever make it to this day? Well, you have! And along the way you have taken a tiny helpless newborn and watched him or her become a constantly moving and exploring person. Get ready! Your baby is about to enter the toddler stage of child development. Some 1-year-old children are cruising around furniture while others are walking. All 1-year-olds get into everything and become more vocal . . . and more assertive! Your child’s world is enlarging, bringing new excitement and new challenges to you as a parent. The following comments are designed to help you and your partner enjoy your 12-month-old son or daughter while continuing to gain confidence in yourselves as parents. They are not intended as a substitute for well-baby visits by your newborn’s pediatrician. Never hesitate to ask your child’s physician for guidance concerning specific problems. This is the reason for regular well-baby checkups.

Parenting and Behavioral
  • Because your one-year-old is mobile, whether crawling, cruising, or walking, it is important to begin putting limits on their behavior. They learn by exploration but need safe limits.
  • Praise the one year old for good behavior.
  • It is important to teach the child the word “no.” Saying “no” in a stern voice with good eye contact is almost always effective in this age group. Some parents have a fear of the word “no.” They do not want their child to feel restricted, so they bend the other way and let their youngster run wild without any limits. A child needs guidance for his or her own protection and to learn that others have rights. “No” at the appropriate time is as important for the child’s development as is nutrition and love.
  • Discipline should be consistent to be effective. To discipline a one year old, use distraction, loving restraint, removal of the object from the toddler or the toddler from the object.
  • Discipline does not mean punishment or spanking. If you become angry with your baby, put your little one in his or her crib or playpen for one or two minutes of “time out.” This will allow you to calm down and it also allows your baby to realize that he or she has done something wrong. During “time out” the child should not be able to see you or any other family member.
  • Encourage play with age-appropriate toys. Children this age love push and pull toys. Develop motor coordination by clapping and dancing to children’s music. Encourage your toddler to play alone as well as with playmates, siblings and parents.
  • Encourage your child to play alone with supervision and with other toddlers.
  • Remember that aggressive behaviors – hitting and biting – are common at this age. How parents respond to this behavior determines if it will continue.
  • Despite your child’s desire to become independent, you will find the 1- year-old often clinging to a parent more than before. In addition, stranger anxiety may cause some parent’s not to be able to leave their child with grandparents or a baby sitter. It is important for parents to get out from time to time without their little one. You get a breather, and your son or daughter learns that sometimes you do go away, but you always come back.
  • A demon explorer who wants to learn all about the size, shape and movability of everything in sight. Opens cabinets, pulls tablecloths, usually examines an object before putting it into mouth
  • Pulls to stand, crawls rapidly, seats self on floor , cruises on furniture or walks alone with an unsteady gait.
  • Plays social games such as pat-a-cake, peek-a-boo and so-big.
  • Bangs two blocks together.
  • Has vocabulary of one to three words in addition to “mama” and “dada.”
  • Drinks from a cup – not bottles.
  • Waves “bye-bye.”
  • Feeds himself or herself
  • Points with a finger and displays a precise pincher grasp when picking up small objects.
  • May say one to three meaningful sounds besides using “mama” and “dada” correctly. Shows definite understanding of a few simple words; Loves music, rhythms, and rhymes
  • Will begin to cooperate a little in getting dressed by holding still.
  • The 12-month-old child will continue to experience upper respiratory infections (colds) and might even have an occasional ear infection. Children who are in day care will experience more infections than those who are at home with a parent or grandparent.
  • Your baby’s appetite is going to take a nose dive in the next six months. Your child has been experiencing very rapid growth for a while – doubling their birth weight at 5-6 months and tripling it at a year. Now their rate of growth is slower than in the first year and their appetite cuts back. Do not misinterpret this normal decrease in eating as a sign of illness or disease. Never, under any circumstances, force a child to eat. Develop a “take it or leave it” attitude and do not get into the habit of substituting, bribing or begging your child to eat. Your child will determine the amount of food he or she needs. Therefore, never overload the plate. If your son or daughter wants more, he or she may have it. One of our problems as adults is over eating, and many of us learned this in childhood.
  • Most babies at this age are eating mostly table foods but it is okay if your youngster still prefers “baby food.”
  • Milk intake decreases considerably and your child will either want to feed himself or herself or will still want you to do it.
  • Give your 12 month old child a spoon to hold and get used to, although most cannot master utensils until 18 months. As much as possible, let your toddler feed himself or herself (most will want to anyway).
  • Feed your youngster three meals a day eaten with the family, and a midmorning and mid- afternoon snack.
  • Discuss milk feedings with your doctor. If you are formula feeding, your doctor might suggest weaning to whole milk ( note: some babies have harder bowel movements at first with whole milk) and limit the amount of milk to 24 ounces or less. It is important to eliminate all bottles by one year of age. After one year, the bottle is more of a comfort item and can cause damage to the teeth. If you are breast feeding, discuss with your child’s pediatrician your feelings aboutweaning to a cup.
  • Avoid foods that can cause choking, such as peanuts, popcorn, hot dogs or sausages, carrot sticks, celery sticks, whole grapes, raisins, corn, whole beans, hard candy, large pieces of raw vegetables or fruit, or tough meat.
  • Always supervise your child when he or she is eating.
Oral Health
  • Begin brushing your child’s teeth with a tiny, pea-size amount of toothpaste.
  • To protect the toddler’s teeth, do not put him or her to bed with a bottle or prop it in his or her mouth.
  • Give your child fluoride supplements as recommended by the pediatrician based on the level of fluoride on the level of fluoride in the toddler’s drinking water.
  • Ask your pediatrician when your child should see the dentist for the first time.
  • Encourage your baby to console himself or herself by putting your child to bed awake.
  • Children this age frequently resist going to sleep because they do not want to be separated from people and their new activities.
  • Your child may start to give up one of his or her naps, although most 1-year-olds still take two naps.
  • Some 1-year-old children continue to experience night awakenings for short periods of time. Should this happen, check your baby, but keep the visit brief, avoid stimulating your infant, and leave the room quickly once you feel everything is okay. Do not give extra bottles, take the infant into bed with you, or rock him or her back to sleep. This will only reinforce the night awakenings it will become a habit.
  • Never put your baby to bed with a bottle.
Immunizations and Medical Tests Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to seek the advice of your child’s health care provider concerning your child’s vaccine schedule. It is recommended that the one-year old child receive:
  • Measles, Mumps, and Rubella (MMR) Vaccine #1 (Can be administered at either 12 or 15 months)
  • Varicella (chicken pox) vaccine (Can be administered at either 12 or 15 months)
  • Hepatitis B (HepB) #3 may be given at this time if not previously administered.
  • Prevnar (Pneumococcal) Vaccine #4 (this may also be given at 15 months instead)
  • 3rd Inactivated Polio Vaccine
  • 4th HIB vaccine (can be administered at 15 months instead)
  • Lead screening is done at 12 months of age for children at risk.
  • Hematocrit or hemoglobin (for anemia) screening if not done at nine months or if needed for WIC (Women-Infants-Children).
  • You must take safety to the “next level!” Your adorable newborn is now more “mobile” than ever, so child-proofing, if not done previously, is a priority. Accidents kill more children than all other diseases combined. Get down on the floor at your baby’s eye level and see what your toddler can get in to.
  • Remember, there is no such thing as a “child proof” cap.
  • Keep the number of the poison control center near the telephone.
  • One year is the minimum age for riding in a forward-facing car seat.
  • If guns are in the house, safety precautions are crucial.
  • Do not leave your 1-year-old alone in a tub of water or on high places such as changing tables, beds, sofas or chairs.
  • Always empty buckets, tubs or small pools immediately after use. Ensure swimming pools have a four-sided fence with a self-closing, self-latching gate. Swimming pools are deadly to children this age.
  • The cupboard under the kitchen sink is very attractive to a baby of this age, so have a lock put on all doors that have cleansers, detergents, bleaches, furniture polish and insecticides behind them.
  • As soon as you use medicine of any kind, replace the cap and put the bottle out of reach, preferably locked up. Be particularly vigilant when you have visiting grandparents who are not used to watching the medicines that closely.
  • Continue to keep the baby’s environment free of smoke. Keep the home and car nonsmoking zones.
  • Avoid using baby walkers. There is considerable risk of major and minor injury and even death from the use of walkers and there is no clear benefit from their use.
  • Prevent fires and burns by: Turning your water heater down to 120 degrees F (50 degrees C), use the back burners on the stove with the pan handles out of reach, do not cook with your child at your feet, keep all electrical appliances out of the bathroom, keep hot appliances and cords out of reach, place plastic plugs in electrical sockets.check your smoke detectors and replace batters if necessary, and practice a fire escape plan.
  • If your home uses gas appliances, install and maintain carbon monoxide detectors.
  • Avoid overexposure to the sun and use sunscreen.
  • Do not leave heavy objects or containers of hot liquids on tables with tablecloths that the baby may pull down.
  • Keep all poisonous substances, medicines, cleaning agents, health and beauty aids, and paints and paint solvents locked in a safe place out of your baby’s sight and reach. Never store poisonous substances in empty jars or soda bottles.
  • Install gates at the top and bottom of stairs, and place safety devices on windows. Lower the crib mattress.
  • Learn child cardiopulmonary resuscitation (CPR).
The information presented in Growth Milestones was obtained with the help of our pediatric experts and with material from The American Academy of Pediatrics’ Guidelines for Health Supervision and Bright Futures’ Guidelines for Health Supervision of Infants, Children, and Adolescents. Bright Futures is supported by the Maternal and Child Health Bureau, U.S. Department of Health and Human Services. Revised 05-08-07