Well-Child Visit: 1 Year (12 Months)

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your toddler's weight, length, and head circumference and plot the measurements on a growth chart.

2. Ask questions, address concerns, and offer advice about how your child is:

Eating. By 12 months, toddlers are ready to switch from formula to cow's milk. Children may be breastfed beyond 1 year of age, if desired. Your child might move away from baby foods and be more interested in table foods. Offer a variety of soft table foods and avoid choking hazards.

Pooping. As you introduce more foods and whole milk, the look of your child's poop (and how often they go) may change. Let your doctor know if your child has diarrhea, is constipated, or has poop that's hard to pass.

Sleeping. One-year-olds need about 11–14 hours of sleep a day, including 1–2 naps.

Developing. By 12 months, most toddlers:

• call parents "mama" and "dada" or another special name
• understand “no” (pause briefly or stop when you say it)
• wave bye-bye
• enjoy pat-a-cake and other social games
• can put something in a container, like a block in a cup
• look for things that someone hides
• pull to stand
• walk while holding onto furniture ("cruising")
• pick things up with their thumb and pointer finger

Talk to your doctor if your toddler is not meeting one or more milestones, or you notice that your toddler had skills but has lost them.

3. Do an exam with your child undressed while you are present.

4. Update vaccines. Vaccines can protect kids from serious childhood illnesses, so it's important that your child get them on time. Vaccine schedules can vary from office to office, so talk to your doctor about what to expect.

5. Order tests. Your doctor may check for lead, anemia, or tuberculosis, if needed.

Looking Ahead

Here are some things to keep in mind until your child's next checkup at 15 months:

Feeding

• Give whole milk (not low-fat or skim milk, unless the doctor says to) until your child is 2 years old.
• Limit the amount of cow's milk to about 16–24 ounces (480–720 ml) a day. Move from a bottle to a cup. If you're breastfeeding, you can offer pumped breast milk in a cup.
• Serve 100% juice in a cup and limit it to no more than 4 ounces (120 ml) a day. Avoid sugary drinks like soda.
• Include iron-fortified cereal and iron-rich foods (such as meat, tofu, sweet potatoes, and beans) in your child's diet.
• Encourage self-feeding. Let your child practice with a spoon and a cup.
• Have your child seated in a high chair or booster seat at the table when drinking and eating.
• Serve 3 meals and 2–3 scheduled healthy snacks a day. Don't be alarmed if your child seems to eat less than before. Growth slows during the second year and appetites tend to decrease. Let your child decide how much to eat. Talk to your doctor if you're worried.
• Avoid foods that can cause choking, such as whole grapes, raisins, popcorn, pretzels, nuts, hot dogs, sausages, chunks of meat, hard cheese, raw veggies, or hard fruits.
• Avoid foods that are high in sugar, salt, and fat and low in nutrition.

Learning

• Babies learn best by interacting with people. Make time to talk, sing, read, and play with your child every day.
• TV viewing (or other screen time, including computers) is not recommended for kids under 18 months old. Video chatting is OK.
• Have a safe play area and allow plenty of time for exploring.

Routine Care & Safety

• Brush your child's teeth with a soft toothbrush and a tiny bit of toothpaste (about the size of a grain of rice) twice a day. Schedule a dentist visit soon after the first tooth appears or by 1 year of age. To help prevent cavities, the doctor or dentist may brush fluoride varnish on your child’s teeth 2–4 times a year.
• Never spank or hit your child. When unwanted behaviors happen, say “no” and help your child move on to another activity. You can use a brief time-out instead.
• Continue to keep your baby in a rear-facing car seat in the back seat until your child reaches the weight or height limit set by the car-seat manufacturer.
• Avoid sun exposure by keeping your baby covered and in the shade when possible. You may use sunscreen (SPF 30) if shade and clothing are not protecting your baby from direct sun exposure.
• Keep up with childproofing:
  • Install safety gates and tie up drapes, blinds, and cords.
  • Keep locked up/out of reach: choking hazards; medicines; toxic substances; items that are hot, sharp, or breakable.
  • Keep emergency numbers handy, including the Poison Control number: 1-800-222-1222.
    
  • To prevent drowning, close bathroom doors, keep toilet seats down, and always supervise around water (including baths).
• Protect your child from secondhand smoke, which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.
• Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids can't get to the keys.
• Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your child? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.