The transition between the first and second year of your child’s life can be very confusing to parents. Your baby is now becoming a toddler. Their development is increasing rapidly, milestones are starting to speed up, diet is changing and the safety around the house becomes more demanding. The 12-month visit is where you can better understand all the changes coming and how to nurture your baby’s growth. A quick tip to remember, your baby is becoming more and more aware of their surroundings and forming their own opinions, so there may be more tears and resistance from your little one as the exam happens. That’s OK: Together with your doctor, we can work together to make it a happy experience for all.
Before you attend the visit after your baby’s first birthday, there are three big areas to focus on and help you get prepared.
MILESTONES: What to expect their physical, cognitive, emotional and linguistic developments
A 1-year young toddler starts being more independent, walk or cruise (walking while holding onto objects or people), following simple commands such as “come here”, attempt to feed themselves using the mature pincer grasp, recognize the names of familiar people, and can even have one to five words in their vocabulary. Not all children will hit these by their first year, but this is a good range to look for in their development.
QUESTIONS TO ASK:
Should I be worried if my baby isn’t saying specific words?
My baby is cruising but not walking unassisted yet, is it a problem? What can we do?
How can I help my baby feed themselves?
SAFETY: The 5 areas to be sure to babyproof
As independence of a toddler also increases with walking, the house needs to be at its peak for safety. My safety speech starts at the 6-month visit with many infants starting to crawl between 7-8 months and can get into loads of trouble moving around the house. After one year, though, children are able to wander out of sight quickly and the risks of injury increase and there’s a need for greater supervision. Make sure to safety proof:
- Stairs: Get baby gates to make sure they are not able to go up or down. Do this on the top and bottom of the stairs
- Kitchen: There are a number of dangerous areas in your home, but the kitchen is a big one. Get baby proofing locks for drawers, cabinets, oven doors and dishwasher doors. Babies are stronger than you think!
- Electronics: Plug sockets need to be covered, but also be mindful of the cords. Tuck them as you can so the baby can’t pull on them
- Bathroom: Same as the kitchen, you’ll want to make sure the cabinets are secured and that toilet bowl cover is covered and not able to open.
- Doors: As your baby is walking and growing they will be able to reach things on shelvings, tables and door handles. Make sure closets and rooms that they should not be in are protected with door knob covers.
Pro tip: It may sound silly, but get on the floor and crawl around at your baby’s level. See what they will see and all the dangerous things they can get into. This way you won’t miss anything.
DIET: The food transition from baby to toddler
For most parents, this is the most important part of the visit. Common questions such as “What should I feed my toddler?”, “What is my toddler allowed to eat?”, “Is it time to transition to regular milk?” are asked in almost every 1-year visit. I feel after the milestones it’s the most important part of the visit. If there are allergies in the family, a blood draw for allergies can be taken to help make food choice decisions for safer for the toddler.
If there are no allergies, I give parents the ok to have their toddler try everything, including honey. Exceptions to that rule according to the American Academy of Pediatrics is the list of unsafe foods which include: Hot dogs, Raw cherries with pits, Round hard candies, Gum, Whole grapes, Raw carrots, celery, raw green beans, and popcorn. Again, every child is different and I do tailor the diet according to the child’s capabilities in chewing actual pieces and if they have already started eating some of their parents table foods.
SPICES: Keep spices, such as salt and pepper to a minimum. If you are cooking one meal for the entire family, spices can be added after the meal is prepped and on their plates.
CONSISTENCY VARIATION: After 9 months, Stage 3 foods are introduced, which are six-ounce portions blended meals with small chunks within. Parents could continue with these Stage 3 foods, but I also do recommend starting to increase the amount of chewable solids in order to avoid any texture issues moving forward.
HELP THEM FEED THEMSELVES: Place pieces of food in front of your toddler in order for them to use their mature pincer skills. This encourages more independent but supervised eating.
MILK: Milk should also continue to be a part of a toddlers diet, but to a much lesser degree since solids become the main focus of their diet. Milk drops down to about 16-20 ounces per day. For our breastfed babies, the mother can have a choice to continue breastfeeding if she chooses, but continue to use the vitamin D supplement at 600 I.U. per day. For the parents that want to transition to other types of milk, cow’s milk is recommended since it has the highest fat content needed for brain growth and development. For an overweight child, 2% milk can be given instead. The transition can happen by any means the parent chooses:
- Mix breast milk or formula with cow’s milk at half and half.
- Give 1 bottle of cows milk per day and the rest breast milk/formula for a week and slowly within 3-4 weeks only have cow’s milk.
- Introduction of the new milk can be done in a straw or sippy cup instead of a bottle to show the toddler the difference in this new milk. Milk can be split in two 8-ounce portions or three 6-ounce portions, but all depends on the schedule that you will create for your child.
NEW FOOD INTRODUCTION: This is the time to introduce all types of different foods to enhance the toddlers palate. Unfortunately around 18 months, your toddler will most likely become a picky eater and new foods will most likely not be able to be introduced after that period. Expand your toddlers palate now!
Here is a sample meal plan for your toddler: Three meals and one or two snacks per day, all based on our American Academy of Pediatrics recommendations and based for your average 22-pound, 12-month-old toddler.
Breakfast
A half cup infant cereal mixed with milk with a fruit (half a banana or berries/strawberries)
Or one egg with fruit and six ounces of milk
Snack
One slice toast with cream cheese or peanut butter
Or eight ounces of milk
Lunch
Four ounces of veggies with about three to four ounces of meat (cooked or ground)
Snack
Two ounces of cheese (string cheese)
Or one cup of yogurt with fruit
Dinner
Two to three ounces of meat or fish with four ounces of veggies
Or four ounces of pasta with four ounces of veggies and meat
And six to eight ounces of milk
The combination possibilities are endless and I advise parents to play around with the types of food given, but I do strongly recommend to try and have structured times for meals and at least one of the meals in a day to be given along with the family, which can produce healthy meal choices and family bonding. Also, you can still give milk before bed but you have to make sure to give milk, brush teeth, then bed. Milk contains lots of sugar, which could produce lots of cavities if it stays on the teeth overnight.