12 Months

Immunizations:

Safety:

Nutrition:

• At the one-year visit, children receive vaccinations for MMR, Varivax, Hepatitis A, and PPD. The MMR vaccine immunizes children for measles, mumps, and rubella (also known as German measles), while Varivax protects against chickenpox. The PPD, given in the right-side arm, tests to see if your child has been exposed to tuberculosis.
• After your child receives the PPD, you MUST check your child's right arm in three days to see if the area displays a red or bumpy reaction. If you see signs of redness or bumps, you must call our office. Don't forget to check!
• Few children have any reaction to either the MMR or Varivax vaccines. About five percent of children may experience a delayed reaction within one to two weeks of receiving the shots. When a reaction occurs, children may get a fever or be cranky; a very small percentage of children will develop a blotchy red rash from head to toe. These are normal reactions, and the child is not contagious. You can give Tylenol® to reduce the fever.
• About five percent of children will get a delayed reaction to the Varivax vaccine about three to four weeks after receiving the shot. These children may develop ten to twenty chicken pox spots, which usually start at the site of the injection. If you see chicken pox spots within three to four weeks, your child could be contagious. This is especially important to note if there are people who are immunocompromised in your home, such as family members who may be receiving chemotherapy for cancer or high dose steroids for autoimmune diseases, or people who have HIV or may be pregnant, or who have never had the Varivax vaccine or chicken pox. Please discuss any signs of a reaction with your doctor.
• Most reactions to the Hepatitis A vaccine are mild. Some children may experience soreness at the injection site or a headache.

• Place gates at the top and bottom of your stairs. Always supervise your child.
• Never leave your child unattended in or near any water, even for a second – this includes buckets, toilets, tubs, swimming and wading pools, lakes, and the ocean.
• Always use an approved car seat in the back seat of your car. Continue to have your child rear facing as long as possible.
• Keep a smoke-free home.
• Keep the water temperature in your home at 120°F.
• Install smoke detectors and carbon monoxide detectors on every level of your home; check smoke detectors twice a year and replace batteries as needed.
• Move the crib mattress to its lowest level.
• Keep all chemicals, cleaning products, and medications out of your child's reach. The telephone number for the Poison Control Center is 1-800-222-1222; keep it near all phones.

• Your baby will eat between two to five little meals a day.
• Toddlers like to feed themselves. Let them get messy!
• At this age, children are picky eaters and may often like to eat only the same five or six foods; however, continue to offer a variety of foods. Don't worry if children don't eat all food groups at every meal.
• Toddlers will likely eat one good meal each day, and all the food groups several times per week.
• You may introduce eggs at this age. The first few times your child tries eggs, offer egg whites and egg yolks separately.
• Avoid fruit juice. Offer your toddler whole milk and water.
• Now is the time to switch from formula to whole milk. As you make this change, you may notice that your child's stools will become harder or softer – this is normal and will typically adjust in one to two weeks.
• Start to wean your child from the bottle by introducing milk in a "sippy" cup. Don't let your child walk around with food, cups, or bottles. Eating and drinking should be done sitting down.
• Introduce regular family meal times.
• Start to brush your child's teeth. Use a small toothbrush with a very small dab of fluoride free tooth paste.
• Philadelphia water is fluoridated. If you live outside the city in an area without fluoridated water, you will need to give your baby a prescription fluoride. Your child's dose is 0.25 mg of fluoride a day. Do not give fluoride with milk or formula.

Next visit: when your child is fifteen months old.