DIET
Please use whole milk (3% fat), because your child needs a high fat diet (50% of calories from fat compared to 30% for an adult) until 2 years of age. If your child just won't take whole milk, then use 2% or skim or even none if milk allergic, but add a lot of extra fat in the diet by giving a lot of cheese, peanut butter, butter on all foods, etc. There is good evidence that feeding oranges, peanuts, oatmeal and shellfish may cause allergies in a child who has a strong family history of allergies, therefore avoid them until 1 to 2 years in that case. Continue to give your child foods that are thicker so that he or she may be on table foods at 12 to 15 months. Most dentists agree that the bottle should be removed by 12 to 15 months, but so long as your child is not sleeping with the bottle in the mouth, then a little extra time can be taken to remove the bottle. Pacifiers should be taken away by 2 to 3 years or sooner if the front teeth appear to be molding to the shape of the pacifier. Vitamins are only necessary if your child does not get a balanced diet. Many children, who don’t seem to get a balanced diet, actually do get one if you average what they eat over a few days. In other words, they eat meats well one day, and fruits and vegetables well the next. You may still give a vitamin if you wish. Only give liquid vitamins until you are sure your child will not choke on a chewable. Vidalyn and Polyvisol are two liquid brands. Make sure to get the one with iron, and follow the directions on the box for the dose. If you have well water, please let the doctor know.
COMMON ILLNESSES & PROBLEMS
If your child is not already walking, then he or she soon will be. Your child will be able to reach over 2 feet tall and may soon be climbing. Thousands of children each year are injured or die from electrical outlets, choking on small objects, falling down stairs, pulling things like cords, table cloths and pot handles onto themselves, etc. Accidents are now the most common potential cause of death for your child, therefore, go over every inch of your house, and always watch your child closely.
Temper tantrums and behavior problems are a common concern at this age. There are probably more opinions on this subject than there are grandparents in the world. I will give you some basic pointers, but ultimately, you should listen to all those opinions (mine included) and as parents decide how you want to proceed with child rearing. The pointers:
- Never hit a child. 70% of pediatricians advocate corporal punishment only as a last resort or when safety is a concern.
- Be as consistent as possible. This is the absolute key to raising a good child. If you cannot be consistent in how you react to your child’s behavior problems, then you are going to have problems. This is probably more important than what you actually decide to do.
- Try redirecting the child’s attention. A child’s attention span is very limited, and they are easily moved to another area of interest when they are getting into something that you don’t want them into.
- Don’t expect more than your child is capable of. You can’t expect a 9 month old to be potty trained anymore than you can expect a 3 year old to stop something they are doing, and take out the trash.
- Don’t let your anger guide your decisions. It is very easy to turn a spanking into abuse, even by the best of parents.
- You can reason with a child, just don’t try to over-reason with them. As the child’s speech improves, you can bargain with them about expected behavior and punishments. Expect the child to live up to his or her expectations, and apply the punishment you both decided on. Don’t expect perfection.
- Try to ignore what you can. Just as a child learning how to speak will say something again if you respond, they will misbehave again if they think you like it. Children often misinterpret “no” or anger for attention, and will still misbehave.
- Praise them when they are good. Children obviously need much love and attention. Children are like clay that is easily molded by a parent’s love. While children are often born with a certain temperament, they can definitely be shaped by your love. Also, ignoring will not be effective unless the child knows the difference between this and attention.
- Pick your battles. When you ignore a child, they throw a bigger fit, and then you give in, you are only teaching that child that bigger fits gets them what they want. I have patient’s that can vomit at will to get what they want. It’s very difficult to be consistent when you know the item you are fighting about is not important. The child innately knows this, and will simply push you. If it’s not important, then give it to them. If it is important, then you had better send them a consistent message.
SAFETY
Most children can now eat thicker and bigger bites of foods. Children are still very prone to choking on food. The most likely things for a child to choke on are; hot dogs, bologna chunks, grapes, nuts, and pieces of meat. Make especially sure to crush hot dogs and bologna.
NEXT VISIT
We schedule check ups at 18, 24, 30 months and then every year starting at 3 years of age. There are vaccines at 18 months. Make sure the 18 month check up is 6 months or more from the 12 month vaccines. One of the shots given at 18 months is give 6 months from the first one at 12 months.
