Well Child Visit 3 Handout - 9 Months

NINE MONTHS
 
Date of Visit:  ___________
Weight:           ___________
Height:            ___________
HC:                 ___________
 
 
NORMAL DEVELOPMENT:  Your baby may . . .  
 
•  Be very curious and explore everything.
•  Begin to crawl and crawl upstairs.
•  Pull up to a standing position.
•  Walk along furniture (“cruising”).
•  Pick up small objects using his/her thumb and finger (pincer grasp).
•  Be sleeping through the night; however, night waking is common.
•  Imitate behavior of others.
•  Enjoy approval of other people.
•  Wave bye-bye.
•  Uncover a hidden toy and attempt to retrieve a dropped object.
•  Show anxiety toward strangers and from separation from parents.
•  Begin to say “Dada,” (easiest word to say), “Mama,” and “bye-bye.”
•  Listen intently to words.
•  Respond to sound of his/her name.
 
DIET:
•  Continue breast milk or formula.
•  Whole milk may be started at 12 months or when indicated by your healthcare provider.
•  No iron drops are necessary unless breast milk is the only food your baby gets.  No fluoride drops are needed if you use filtered water or bottled water with fluoride.     
•  The cup can be introduced now (two handled cups are usually easier).  A good way to start is to put milk in the cup.  Avoid giving more than 4 ounces of juice per day.
•  Your child is probably eating three meals plus snacks each day.
•  AVOID foods that are easily choked on: hot dog rounds, raw carrots, popcorn, peanuts, and hard candies.
•  Children love finger foods like cheerios, crackers, banana slices, cheese, soft cooked vegetables and fruits.
•  AVOID egg whites and fish until your baby is twelve-months-old as these have high potential for food allergy.
 
HYGIENE:
•  Teeth may be cleaned with a soft washcloth or soft child’s toothbrush.
•  Do not allow your baby to go to bed with a bottle.  Tooth decay may result from milk or juice pooling around the teeth during the night.
•  Your baby is too young to toilet train.  The necessary muscle control is lacking.
 
SAFETY:  See Childproofing Handout
•  Always be sure your baby is properly restrained in a car safety seat in the backseat.  Switch to a toddler car restraint when your baby is 20 lbs and can sit up well.
•  Install smoke alarms on every floor and change batteries twice a year.
•  Place safety gates at top and bottom of stairs.  Be sure all windows have screens.
•  Place all heavy or sharp objects out of your baby’s reach.
•  Check electrical cords so your baby cannot pull appliances or lamps over onto him-/herself.
•  Keep cigarettes and hot beverages out of his/her reach.
•  Cover electrical outlets.
•  Keep your baby away from the stove and turn pot handles away from the edge of the stove.
•  Set the hot water heater thermostat to less than 120 degrees Fahrenheit.  Fence a space heater so your child cannot get to it.
•  Keep the Poison Control Center phone number handy (1-800-222-1222).
•  Lock up all medicines (including vitamins and iron), cleaning products, cosmetics, paint products, gasoline, and oil.  Watch your baby carefully while visiting, as accidents frequently occur at the homes of friends and relatives.  Keep visitors’ purses out of reach.
•  Do not leave your baby alone in the bathtub or near a pool or bucket of water even for a minute.  Children drown even in shallow water.  Even with swimming lessons, your child is never drownproof.
•  Toys should be carefully inspected for small loose parts that might be swallowed or inhaled.  Children under age 4 years should not be given toys with parts smaller than a ping pong ball.
•  Keep household plants out of your baby’s reach—many are poisonous.
 
STIMULATION:
•  Talk and sing to your baby as much as possible.  This enables your baby to begin to imitate your speech sounds.
•  Board books with colorful pictures are good choices to read with your baby—it is never too early to read to your child.  
•  Babies at this age love to play “Patty-Cake” and “Peek-a-Boo.”
•  Supply your baby with pots, pans, and wooden spoons for a “kitchen orchestra.”  You baby will love creating and manipulating sounds.
 •  Brightly colored balls of all sizes are fun for your baby to chase, clutch, and roll around.
•  Stacking blocks, rings, and push-pull toys are also fun at this age.
•  Age appropriate busy boxes encourage various kinds of manipulation and help with dexterity.
•  Your baby will continue to love huggable dolls/stuffed animals and may sleep with one.
•  Colorful, sturdy cars and trucks are also fun.
 
HEALTH MAINTENANCE:
•  IMMUNIZATIONS:  Not usually given at this visit.
 
ANTICIPATORY GUIDIANCE:  (Information credited to Brazelton’s Touchpoints)
 •  Separation:  Separations between you and your child are likely to become increasingly difficult over the next few months.      
 •  Feeding:  The baby’s demands for control will increase.  Finger feeding should be a mode of feeding with soft foods offered in between.
 •  Safety:  By now your baby is probably very mobile and childproofing is becoming very important.