PEDIATRIC AND ADOLESCENT MEDICINE Health Maintenance Handout 9 To

pediatric and adolescent medicine health maintenance handout: 9 to 12 months date: _____________________________________ -------------

PEDIATRIC AND ADOLESCENT MEDICINE
Health Maintenance Handout: 9 to 12 Months
Date: _____________________________________
-------------------------------------------
KIDS DOC PEDIATRICS

Especially for:
________________________________________________________and his/her
parents.
Your Child’s Current Exam: Height: _________ Weight: _________ Head
Circumference: _________
________ % ________ % ________ %
Services Provided Today:
□ Test for Anemia □ MMR □ Varicella □Hepatitis B □ Proquad (MMR and
Varicella)
□ Lead Screen □ Other ________________________ □ No immunization
A low fever following shots may occur. You may give Tylenol every 4 –
6 hours or Motrin every 6 – 8 hours for fever or irritability. A lump
or bruise at the site of injection is common. It may persist for
several weeks
Tylenol (Acetaminophen) Dose: __________mg =_________infant dropper
=_________ tsp children’s suspension
(every 4-6 hours as needed) (80 mg/ 0.8 ml) (160 mg / 5 ml)
Motrin/Advil (Ibuprofen) Dose: __________mg =_________infant dropper
=_________ tsp children’s suspension
(every 6-8 hours as needed) (50 mg /1.25 ml) (100 mg / 5 ml)
Next Visit: 12 or 15 months
Special Comments:
NUTRITION
*
Breast-feeding or formula should be continued until one year at
which time you may switch to whole milk. At this stage, children
need extra fat to ensure healthy nerve and brain development.
*
Provide regular meals and snacks time; toddlers do well with three
meals and 2-3 healthy snacks daily.
*
Respect your child’s ability to know when he or she is hungry.
*
Expect a drop in appetite as your child enters the toddler years.
This is normal because the rate of growth slows.
*
Encourage the use of cup.
*
Children should be moving from baby food toward all table foods by
one year. Avoid nuts, hard candies, popcorn, hard raw fruits and
vegetables which can cause choking.
*
Encourage healthy eating habits and remember that our children
learn by watching us.
*
Juice is okay in moderation. Realize that although juice contains
vitamins, too much (more than 4 – 8 ounces per day) may cause
loose stools and poor growth since the sugar (sorbitol) is hard to
absorb.
SLEEP
*
Establish a regular bedtime routine. By this age a child should be
able to put self to sleep.
*
Most infants sleep through the night by this age and are taking 1
–2 naps per day.
*
Recognize that each child has different sleep patterns.
BEHAVIOR AND DEVELOPMENT
*
Over the next few months you will witness your infant becoming
more mobile and independent. Encourage this by providing a safe
environment in which to explore and by introducing your child to
new textures, scents, and sounds.
*
Encourage children to use their emerging language. Narrate your
life, point out objects, talk and sing together.
*
Read to your child daily.
*
This is a good time to begin establishing consistent rules and
limits. Infants should be noticed more for their appropriate
behavior than for their undesirable behavior. Praise your child
when he or she does something well. If your child’s behavior is
inappropriate, try redirecting his or her attention. Other
effective disciplinary actions, when necessary include a stern
restatement of the forbidden act (“biting is not allowed”), or a
brief period of non-interaction (“time-out”). It is more realistic
to structure the home environment than to expect a toddler not to
injure himself or break things.
*
Cuddle! Let your child know that he or she is special.
*
Try to wean from the bottle between 12 and 14 months. Babies at
that age are so involved in learning to walk, talk, and explore
they won’t miss it. Weaning is important to prevent excessive milk
intake (more than 24 oz).
*
Your child at this age should try to sing along with radio/TV,
laughs, and imitates a cough. At 9 months waves bye-bye and says
ma-ma/da-da. At 1year uses two words and follows one-step command.
At 1 year tries to walk alone.
SHOES
*
Shoes are needed only to protect the feet from sharp objects and
the cold.
*
Shoes should be flexible, with non-skid soles, inexpensive, and
fit well in both length and width.
*
Most infants have feet that turn in or out when they begin to walk
and they may be bowlegged.
HEALTHY HABITS
*
The carseat should remain rear-facing until he or she has reached
both 20 pounds and a year of age. At that time it may be turned to
face forward. The safest place is in the center of the rear seat.
*
Make sure that the poison control number (1-800-222-1222) is
available. You may have ipecac syrup available in your home and
call the poison control center to obtain advice about the need to
administer ipecac syrup prior to giving.
*
Make sure your child’s environment is baby/toddler friendly:
*
Electrical outlets and cords covered
*
Poisonous plants, household cleaners, medications and other
potential poisons in a safe place
*
Stairs and open windows should be guarded
*
Hot water temperature below 120 – 130 degrees.
*
Swimming pools, hot tubs, bathtubs, and open containers with water
should be off limits.
*
Garage door openers should have safety devices.
*
Smoke detectors and fire extinguishers.
*
Avoid small, round, or hard foods that your child can choke on. Be
familiar with the first-aid steps for choking. Consider taking a
pediatric CPR course.
*
Keep environment smoke free that can increase the risk of lung
infections, ear infections, and asthma.
*
Keep children out of the sun at peak times (10:00 – 3:00) and
always protect with a PABA-free sunscreen (SBF of 15 or above).
Insect repellent should contain less than 10% DEET.
*
If a gun is kept at home make sure it is securely locked and
stored separately from the ammunition. Terrible accidents can
happen quickly. Every 2 seconds in the U.S., a gun kills someone’s
child.
SUGGESTED READING
What to Expect the First year and What to Expect the Toddler years, A.
Eisenberg
Touchpoints: Your Child’s Emotional and Behavioral Development, T.B
Brazelton
Solve your child’s sleep problems, Richard Ferber
Guide to You Child’s Symptoms, American Academy of Pediatrics
Caring for Your Baby and Young Child: Birth to Age 5, American Academy
of Pediatrics
S
Remember that you are your child’s first and most important teacher.
This stage will pass quickly. Make the most of it and enjoy.
leeping Through the Night, Jodie Mindell, PhD