Well Child Care at 9 Months

Feeding

Your baby should keep having breast milk or infant formula until 1 year of age. Encourage your child to drink milk and juice from a cup now. This is a good time to start weaning from the bottle. Do not let your baby keep the bottle between meal times and don’t put your baby to bed with a bottle. Don't give your baby a bottle just to quiet him when it’s unlikely that he is hungry. Babies who spend too much time with a bottle in their mouth start to use the bottle as a security object. This makes it harder for them to give up the bottle and start eating solid food. Babies who spend too much time with a bottle in their mouth are also more likely to have ear infections and tooth decay problems. Find another security object like a stuffed animal or a blanket.

Babies at this age will eat 3 meals and 2 to 3 snacks each day. Cut food into small pieces no bigger than half the width of a pencil. Avoid foods that can choke your child, such as candy, hot dogs, popcorn, and peanuts. Do not give foods that require chewing. Make sure your child’s food is not too hot, especially if foods have been heated in a microwave oven.

If your child has an allergic reaction to a food, have your child checked by his healthcare provider. There is no evidence that restricting foods after 6 months of age helps to prevent food allergy. If your child does not have allergies, asthma, eczema or hives, or has mild allergies, some studies suggest that eating small amounts of foods such as peanuts may help prevent severe allergies. Talk with your child’s healthcare provider if you have questions about foods or food allergies.

Development

Your baby may start to crawl and pull herself up to stand. Shoes protect your child's feet but are not needed when your child is learning to stand and walk indoors. Bare feet help your child balance with her toes. If your child needs shoes to walk outside, choose shoes with a flexible sole.

Babies this age love to bang things together to make sounds. Soon, they may start to say "dada" and "mama." At this age, your baby should learn what "no" means. Say "no" calmly and firmly and either take away something that your child should not be playing with or remove her from the situation. Comfort your baby by using a soothing voice and being gentle with her.

Give your baby a choice of toys. Talk to her about the toy she chooses and what she is doing with the toy. Peek-a-boo is often a favorite game.

Nine-month-olds have a lot of energy and you need a lot of energy to take care of your baby. Make sure you get enough rest. Ask friends and family for help so you can take a break and rest. If you are rested, you will be better able to take care of your child.

A regular bedtime hour and routine are important. You may want to look at a book with your child at bedtime each night. A favorite blanket or stuffed animal may help your baby feel secure. Put your baby to bed awake, but drowsy. If your baby wakes up a lot at night, ask your healthcare provider for advice.

Reading and Technology

Babies enjoy looking at picture books. Your child will enjoy feeling the rough and smooth textures found in "touching" books and listening to the sounds of nonsense verse and nursery rhymes. You'll be surprised at how quickly your child will learn to join in the rhymes and songs.

Limit how much time your child spends with technology. Play games, read, or watch TV with your child and communicate with your child while you do. Children this age need to be active because it helps their brains and bodies to develop. Play and interact with your child, and be a role model by limiting your own use of technology.

Dental Care

By now, most children have 2 or more teeth. It’s important to take care of your child’s baby teeth because they help your child chew food and speak clearly. They also help save space for the permanent teeth that will come in later.

After meals and before bedtime, try to wash off your baby’s teeth with water and a soft baby toothbrush or a clean, damp cloth. Don't worry too much about getting every last bit of food off the teeth. Try to make this a fun time for your baby.

The best time for children to start seeing a dentist is by 1 year of age. Your child may need to see a dentist at a younger age if your child has:

• Special healthcare needs
• Stains on her teeth or white spots in her mouth
• A habit of sleeping with a bottle or drinking a lot of sweet drinks, which can cause tooth decay
• Any other dental problem

Ask your healthcare provider or dentist if your baby is getting the right amount of fluoride. Fluoride is a mineral that is sometimes added to tap water and some brands of toothpaste. Fluoride helps to strengthen teeth and prevent tooth decay.

Safety Tips

Child-Proofing Your Home

• Install safety gates to guard stairways.
• Lock doors that lead to dangerous areas like the basement or garage.
• Check drawers, tall furniture, and lamps to make sure they cannot fall over easily.
• Remove or pad furniture with sharp corners. Keep sharp objects out of reach.
• Put safety latches on cabinets.
• Cover unused electrical outlets with outlet covers to keep your child from sticking things into the outlet.
• Keep cords out of reach, especially for coffee makers, irons, or other hot devices.
• Throw away cracked or frayed electrical cords.
• Keep all electrical devices in the bathroom unplugged and put away.

Choking and Suffocation

• Keep cords, ropes, or strings away from your baby. Ropes and strings around your baby's neck can choke her.
• Keep plastic bags, balloons, and small hard objects out of reach.
• Use only unbreakable toys that don’t have any sharp edges or small parts that can come loose.
• Store toys on shelves or in a chest without a dropping lid. Small children can get trapped inside a toy chest.
• Don’t let your baby sleep in a bed or on a couch, and don’t sleep with your baby.

Falls

• Make sure windows are closed or have screens that cannot be pushed out.
• Do not use a baby walker.
• Install safety gates to guard stairways.
• Check drawers, tall furniture, and lamps to make sure they cannot fall over easily.
• Don’t place furniture near windows or on balconies. Don't underestimate your child's ability to climb.
• Always buckle the safety belts or straps when your baby is in an infant carrier or shopping cart.

Car Safety

• If your child has outgrown his infant seat, you can get a convertible safety seat or a three-in-one safety seat. Both kinds of safety seats can be used facing toward the rear or the front of the car. Three-in-one seats can also be used as booster seats when your child is older. Your child should ride in the backseat facing the rear of the car until he is at least 2 years of age.
• Never leave children alone in a parked car, even for a few minutes. Children are at risk for heat illness and injury when left alone. Always check to make sure your child is not still in the car when you leave your car.

Water Safety

• NEVER leave your baby or toddler in a bathtub alone.
• Stay within arm’s reach of your child around any water, including toilets and buckets. Keep toilet lids down, never leave water in an unattended bucket, and store buckets upside down. Infants and toddlers who have completed swimming programs are still not safe from drowning.

Poisoning

• Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away. Dispose of them safely.
• Keep the poison center number on all phones.

Fires and Burns

• Use the back burners on the stove with the pan handles out of reach. Do not allow children to play on the kitchen floor while you are cooking or baking.
• Turn your water heater down to 120°F (49°C).
• Install smoke detectors. Check your smoke detectors as often as recommended by the manufacturer or at least once a month to make sure they work. For all detectors that use batteries, replace batteries at least once a year or when they are low.
• Keep a fire extinguisher in or near the kitchen.

Smoking

• Children who live in a house where someone smokes have more respiratory infections, like colds, flu, and throat infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.
• If you smoke, set a quit date and stop. Ask your healthcare provider for help in quitting. If you cannot quit, do NOT smoke in the house, car, or near children. It helps keep your child healthy and sets a good example.

Immunizations

Immunizations protect your child against several serious, life-threatening diseases. At the 9-month visit, your child may get a flu shot. Children over 6 months of age should have a flu shot every year.

Bring your child's shot record to all visits with your child’s healthcare provider.

Next Visit

Your baby's next routine visit should be at the age of 12 months.