The Nine Month Old

dearborn-peds-first-year-visits

Robert Levy, MD    Joel Moses, MD

Houda Dagher-Rodger, MD       Melissa Hoisington, MD

Tiffany A. Harris, CPNP   Kerri Bernard, CPNP

2845 Monroe    Dearborn MI  48124    Telephone:  313-730-0070

 

Nine Month Visit

 

Today’s Measurements:  Height: __________ Weight: __________    Head:  __________

 

Feeding:

  •     Your child is likely on a schedule by now, eating three to four meals a day.  At this point he/she is taking less breast milk/formula.  The average intake at this age ranges anywhere from 16-24 ounces.
  •     Provide regular meal times and begin to offer more finger foods.  Babies at this age are mastering the “pincer grasp” (using their thumb and index finger) and can pick up finger foods.
  •     Introduce a sippy cup and encourage baby to drink water as well as breast milk or formula. Infants should start to be weaned from the bottle by 12-15 months.  By 12 months, a baby’s consumption of formula should not be greater than 24 ounces per day.  This is because your baby will be transitioning to whole milk at 12 months, which is not iron-fortified.
  •     Consumption of greater than 24 ounces of whole milk per day increases the risk for iron deficiency (anemia). Your baby will be tested today to rule out any possible anemia issues.
  •     Breast fed infants can continue to nurse and need not be transitioned to whole milk at 12 months.  Whole milk should not be initiated prior to 12 months of age.
  •     You can continue to offer all fruits, vegetables, meats, eggs, fish and nut containing foods (waffles, pieces of toast, peanut butter).  Continue to be cautious with baby choking on foods. Cut up finger foods into manageable bites. Continue to avoid honey.

Elimination:

  •     Stool patterns will vary based on diet.  Let us know if your child consistently has  hard stools.  Applesauce and bananas tend to constipate.
  •     Prunes, plums and apricots tend to act as laxatives.  Increasing water intake or using diluted pasteurized apple juice may also relieve constipation.

Sleep:

  •     Most infants are sleeping through the night at this age and taking one to two naps per day.  Due to development of separation anxiety at this age, some infants may begin to wake up during the night.
  •     It is important to establish a bedtime routine that teaches your baby to self soothe and learn to fall asleep on his/her own.
  •     Avoid feeding or playing with your infant during any nighttime awakenings.  Instead, if you feel the need to go into the room, do so quietly and for brief periods, helping baby to go back to sleep on his/her own.
  •     Some infants may need to cry for five to ten minutes in order to go back to sleep.  It is fine to use a stuffed animal, doll, blanket or other security object to help baby self soothe.
  •     Avoid pacifiers and never give a bottle in bed.

Development:  The following are some milestones at this age:

  • Gross Motor:  Sits well, crawls or scoots, creeps on hands; may begin cruising along furniture.
  • Fine Motor:  Picks up small objects using thumb and index finger (pincer grasp); brings hands to mouth, feeds self, bangs objects together such as blocks.
  • Cognitive Skills:  Responds to own name; participates in verbal requests such as “wave bye-bye” or “where is mama or dada”; understands a few words such as “no” or “bye-bye”.  Imitates vocalizations, babbles, using several syllables.
  • Social Skills:  Enjoys games such as “peek-a-boo” and “patty cake”.  May react to unfamiliar adults with anxiety or fear; may cry or protest if caregiver leaves the room.

Safety:  Accidents are the leading cause of death in children.

  •     Infants should continue to face the rear in either an infant or child car seat until at least two years of age.  It is OK if the knees are bent while rear facing.
  •     Your home should be sufficiently child-proofed by now, paying attention to things such as  gates on stairs, cabinet locks, plugging electrical outlets, keeping cords out of reach, covering sharp corners, and keeping medications and vitamins out of reach.
  •     The leading cause of death from poisoning in the United States is iron, usually in the form of accidental ingestion’s of vitamins.
  •     Avoid foods that can be easily aspirated such as peanuts, hot dogs, popcorn, frozen peas, candy corn, raw celery, or raw carrots sticks.  Infants should be seated in a high chair and observed by an adult at all times while eating.
  •     Guns should be locked and stored separately from ammunition.
  •     Walkers are not recommended.  Non mobile saucers are fine.
  •     Do not store toxic substances such as cleaning fluids, drain cleaners, etc. in empty soda bottles, glasses or jars.  Such items should be in a locked cabinet at all times.
  •     Syrup of ipecac is no longer recommended for any use unless instructed by Poison Control.  Their number is 1-800-POISON or 1-800-764-7661.