12-Month Checkup: Healthy Kids Series

This parenting information is part of the "Healthy Kids, Healthy Futures" series. These fact sheets may be given out by Group Health at routine checkups.

Feeding

  • Continue breastfeeding as long as it is good for the two of you.
  • Give your child whole cow's milk or full fat soy milk to drink. Don't give your child low fat or nonfat milk until 2 years old, unless your child's doctor advises you to do so.
  • Include your child at family meals.
  • Offer a variety of nutritious table foods, such as fruits, well-cooked vegetables, low-sugar cereal, yogurt, whole grain breads and crackers, lean meat, fish, and tofu.
  • Watch out for choking. Do not feed nuts, hard candies, whole hot dogs, popcorn, grapes, raw vegetables, raisins, gum, or seeds.
  • Encourage your child to drink liquids from a cup.
  • Limit juice to no more than 4 to 6 ounces each day. Avoid sodas, chips, fast foods, and sweets.
  • Make sure your baby is taking a vitamin D supplement every day.

For children 1 to 3 years old:

  • Give water and juice in a cup, not a bottle.
  • Your child's eating skills will improve between 12 and 18 months, including biting through food, chewing, and swallowing. Help by cutting food into small bites and giving soft, cooked vegetables.
  • It is normal to eat less at this age. Your child's growth slows down. Look at what your child eats over a week instead of a day. Often parents can relax once they know how little food children need to be healthy.

Here's a guide for how much to offer your child:

  • Milk: Serve your child whole cow's milk or full fat soy milk. (Don't give your child rice milk.) Two to 3 cups per day is enough; over 3 cups takes the place of other foods. You can start to give your child low fat cow's milk or low fat soy milk at 2 years of age.
  • Fruits and vegetables: 5 servings per day. One serving is 1 tablespoon for every year of age. For example, a 2-year-old will eat 2 tablespoons of fruit or vegetable at every meal, plus 2 tablespoons as a snack.
  • Grains: 6 or more servings per day. Bread, cereal, rice, noodles. Choose whole grains whenever possible. One serving is about 3 tablespoons, 1 slice of bread, or 3 crackers.
  • Protein: 2 servings per day of meat, fish, poultry, beans, or eggs. One serving is 1/2 ounce or about 1 to 2 tablespoons. Your child might have an easier time chewing ground meat than solid meat.

Healthy Habits

  • Smoking around your child increases your child's risk of ear infections, asthma, and pneumonia.
  • Don't allow smoking in your home or car. Resources to Quit Tobacco.
  • Do not put your baby to bed with a bottle or breastfeed at night. Babies at this age do not need to be fed at night. Night feeding can lead to tooth decay.
  • Brush your child's teeth after meals and at bedtime every day. It is OK to use a tiny pea-size amount of toothpaste when your child is able to spit it out.
  • Make sure your child's doctor or dentist checks your child's mouth at each visit. Ask about fluoride.
  • If your drinking water is not fluoridated, your doctor may recommend fluoride drops to prevent tooth decay.
  • Take your child for walks.
  • Limit TV and video viewing to 1 hour or less each day.
  • Protect your baby's skin from sun exposure with protective clothing and sunscreen at SPF 15 or higher.

Safety

  • Car seat: Use for every ride. Experts recommend keeping your child in a rear-facing car seat for as long as possible. Be sure that it is properly installed in the back seat. For information on choosing the safest seat for your child, see The Safety Restraint Coalition or call toll-free 1-800-BUCK-L-UP 9282-5587).
  • If you think your child has been poisoned, call the National Poison Center Hotline toll-free at 1-800-222-1222 (voice and TDD). Keep the number near your phone.
  • Prevent drowning: Watch baby at all times around water (pool, hot tub, buckets, bathtub). Swimming pools should be fenced on all sides and have a self-latching gate. Make sure your baby is wearing a life jacket at all times when near water.
  • Avoid choking: Learn the Heimlich maneuver. Hang drapery and electrical cords out of reach.

Parenting

  • Talk, read stories, and play games with your child every day. Show affection by hugging and holding your baby often.
  • Fear of strangers is normal at this age.
  • Discipline: Say "No," then physically move your baby from a dangerous situation. Do not yell or spank. Be a good role model.
  • To distract your child from behavior you do not like, try offering a toy or engaging your child in another activity.

If Your Child Is Choking

These steps are for children aged 1 and older.

If your child is coughing but is also crying or speaking, call your health care provider. After hours, call the Consulting Nurse Service.

If your child is choking and cannot breathe, start rescue efforts and call 911.

The Heimlich Maneuver

  1. Place thumbside of your fist against middle of abdomen just above the belly button. Grasp your fist with other hand.
  2. Give up to 5 quick upward thrusts.
  3. Repeat steps 1 and 2 until object is coughed up or until child starts to breathe.

If child becomes unconscious, make sure someone has called 911 and start CPR.

Take a CPR training class for more information. Contact a local Red Cross Office or the American Heart Association.

To prevent choking, do not let your child have:

  • Toys that can be swallowed, such as buttons, marbles, coins, balloons, or other small objects.
  • Foods that can block airways, such as nuts, hard candies, hot dogs, popcorn, grapes, raw vegetables, gum, raisins, or seeds.

Suggested Resources

Websites

Suggested reading

  • Guide to Your Child's Nutrition, by William H. Dietz and Loraine M. Stern
  • Mommy Made and Daddy Too: Home Cooking for a Healthy Baby & Toddler, by Martha Kimmel, David Kimmel, and Suzanne Goldenson
  • Baby & Toddler Food, by Konemann (publisher)
  • Baby & Child Emergency First-Aid Handbook, by Mitchell J. Einzig

Next well-child visit: 15 to 18 months

Adapted with permission from Kaiser Permanente.

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Clinical review by Emily Chao, DO
Group Health
Reviewed 04/01/2013
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