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 may be moving away from baby foods and may 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 12 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” (specific to parents), plus one or two other words
• follow a one-step command (such as “Please bring me the ball.”)
• point at objects
• stand alone
• walk with one hand held and possibly even walk alone
• precisely pick up object with thumb and forefinger
• feed self with hands
• enjoy peek-a-boo, pat-a-cake, and other social games

3. Perform 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 next routine visit at 15 months:

Feeding

1. Give your child whole milk (not low-fat or skim milk) 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. Transition 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.
4. Serve iron-fortified cereal and increase iron-rich foods (such as sweet potatoes, strawberries, and beans) in your child’s diet.
5. Encourage self-feeding.
6. Have your child remain seated 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 drinks or foods that are high in sugar.

Learning

1. Babies learn best by interacting with people. Make time to talk, read, and play with your child every day.
2. TV viewing (or other screen time, including computers) can interfere with the brain development of young children. Therefore, TV is not recommended for those under 2 years old.
3. Have a safe play area and allow plenty of time for exploring.

Routine Care & Safety

1. Brush your child’s teeth without toothpaste 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. Be vigilant about 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 poison control, near the phone.
6. To prevent drowning, close bathroom doors, keep toilet seats down, and always supervise your child around water (including baths).
7. Limit your child’s exposure to secondhand smoke, which increases the risk of heart and lung disease.
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.

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