9 month Well Child Check

9 month old Well Child Check

NUTRITION

•FEEDINGS
Milk - Breast milk and/or commercially prepared formula is still required. Although your infant may be less interested in the breast or bottle as solids are introduced, they should be drinking around 24 ounces per day. Try to introduce a cup before the age of one. It is best if your infant is weaned off the bottle by 12 to 15 months.
Solids - By nine months your infant should be eating a variety of pureed foods including cereals, fruits, vegetables, and meats. These should be given as three meals a day and on a regular schedule.
Finger Foods - Finger foods will be of interest to your baby as hand-eye coordination develops. These finger foods should be small and soft to avoid choking. Do not give your baby foods that could cause choking, such as nuts, popcorn, carrot sticks, whole grapes, raisins, whole beans, hard candy, tough meat, hot dogs or chunks of peanut butter

•VITAMINS
Exclusively breast fed infants should receive vitamins supplements such as poly-vi-sol - one dropper a day according to the AAP guidelines. Breast feeding mothers should continue their prenatal vitamins. Formula fed infants receive adequate vitamin supplements from commercially prepared formula.

•FLOURIDE
Fluoride is very important for the development of your child's teeth and it is recommended to begin fluoride supplements at 6 months of life. Fluoride is not in formula or breast milk and must come through water or supplements. Although most municipal water supplies add fluoride, some do not. Let us know if your child needs fluoride. If you are uncertain or moved recently, then ask us or call your utility company.

DEVELOPMENT

At this age most infants:
•Look for hidden toy
•Throws toys or objects
•Feeds self finger foods such as cereal
•Imitates sounds like "ooh" and "ahh".
•Pull themselves to a standing position and may begin to cruise around furniture
•Go from a sitting to lying position
•Be happy or sad just like Mom and Dad
•Understand a simple direction and sometimes do it (and sometimes pay no attention to it)
•Wave bye-bye; crawl or scoot around well
•Repeat sounds you make.
Indicators for concern:
•Unable to sit by self
•Difficulty picking up objects
•Not imitating or babbling

VACCINATIONS

At this visit, your child is scheduled to receive the IPV immunization. Please review the immunization your child will receive.

COMMON ISSUES AND CONCERNS

MEDICATIONS - to see information on Acetaminophen (Infant Tylenol) dosage, click here. Remember to always dose based on the weight of your child.

SLEEP (Helpful hints for preventing problems)
•Infants should be sleeping through the night. If not, please review previous recommendations.
•Development of a predictable bedtime ritual is important.
•Once in bed, your child should stay there. Try to ignore protests and leave the room.
•Limit naps to 2 hours or less.

WALKING
•Legs, feet and shoes - See this handout on "What Parents Should Know".

DENTAL CARE
•Brush your baby's teeth with a soft brush each day . Pleae see handout on Tooth Decay, Prevention.

DISCIPLINE
•Distraction and redirection works well as a discipline for a young child. Be patient.

SAFETY - Your infant is becoming more mobile and constant supervision and safety precautions are critical. Please review the safety and TIPPS handouts.

RECOMMENDATIONS
•Use your car seat at all times.
•Know and be prepared to use CPR.
•Never leave your baby unattended.
•Do not use a baby walker.
•Your baby is learning so many things every day; he is beginning to stack blocks and loves putting things in containers, or inside of other things and taking them out
•Install safety devices on drawers, low cabinets, gates at the top and bottom of stairs, and safety devices on windows
•Latex balloons are a dangerous choking hazard - do not let your infant play with balloons
•Keep small objects out of reach.
•Check the thermostat on your hot water heater and set at 120 degrees or lower.
•Lower your baby's mattress as he pulls to stand.
•Keep recently used curling irons, dangling electrical cords and drapery cords out of reach.

TESTS TODAY

Hematocrit - a blood test to check for anemia usually caused by low amounts of iron in the body.

NEXT VISIT

The next routine physical examination is at 12 months of life. Please schedule the appointment today. Please review the 12 month physical examination information on our website prior to your visit as well as the immunization information on the vaccines your child will receive.