Maybe you don’t have a degree in child development, but when it comes to your child’s
development, even the experts agree that you’re something of an expert. Unlike a pediatrician, who usually sees your baby only once a month or less—and who sees hundreds of other
babies in between—you see your baby every single day. You spend more time interacting with your baby than anyone else. You probably notice nuances in your baby’s development that others might miss.
Whenever you have a concern about your child’s development—whether it’s because some areas are lagging, or because a skill that was mastered seems to have been forgotten, or just because you’ve got a nagging feeling that something’s not quite right—don’t keep it to
yourself. Child development experts believe that parents are not only their children’s best advocates but can be key in the early diagnosis of developmental disorders, such as autism.
Early diagnosis can lead to the kind of early intervention that can make an enormous difference in the long-term developmental future of a child with autism or another developmental disorder.
To help parents help their children better, doctors have pinpointed a number of developmental red flags to look out for as early as twelve months. Hopefully your baby’s pediatrician will screen for these red flags as well during well-baby checkups. But if you notice your one-year-old doesn’t exchange back-and-forth sounds with you, doesn’t smile or gesture with you, fails to establish and maintain eye contact with you, doesn’t point or use other gestures to get needs met, doesn’t enjoy playing social games such as peekaboo or patty- cake, fails to respond when you call his or her name, or doesn’t look when you point at
something, let the doctor know. It could be that nothing at all is wrong. But further assessment, and perhaps referral to a specialist, can help determine whether there is reason for concern.
use a few gestures to get needs met
… will probably be able to:
play patty-cake (clap hands) or wave bye-bye (most children accomplish these feats by 13 months) drink from a cup independently
pick up a tiny object neatly with tips of thumb and forefinger (many babies do not accomplish this until nearly 15 months; continue to keep all dangerous objects out of baby’s reach)
stand alone momentarily (many don’t accomplish this until 13 months)
say “dada” or “mama” discriminately (most will say at least one of these by 14 months)
say one word other than “mama” or “dada” (many won’t say their first word until 14 months or later)
… may possibly be able to:
“play ball” (roll a ball back to you; many don’t accomplish this feat until 16 months) stand alone well (many don’t reach this point until 14 months)
use immature jargoning (gibberish that sounds like a foreign language; half of all babies don’t start jargoning until after their first birthday, and many not until they are 15 months old)
walk well (three out of four babies don’t walk well until 13ẵ months, and many not until
considerably later. Good crawlers may be slower to walk; when other development is normal, late walking is rarely a cause for concern)
… may even be able to:
say three words or more other than “mama” or “dada” (a good half of all babies won’t reach this stage until 13 months, and many not until 16 months)
respond to a one-step command without gestures (“Give that to me”—without hand out; most children won’t reach this stage until after their first birthday, many not until after 16 months)
What You Can Expect at This Month’s Checkup
Each practitioner will have a personal approach to well-baby checkups. The overall organization of the physical exam, as well as the number and type of assessment techniques used and procedures performed, will also vary with the individual needs of the child. But in general, you can expect the following at a checkup when your baby is about twelve months old:
Questions about how you and baby and the rest of the family are doing at home, and about baby’s eating, sleeping, and general progress.
Measurement of baby’s weight, length, and head circumference, and plotting of progress since birth.
Physical exam, including a recheck of any previous problems. Now that baby can pull up, feet and legs will be checked when standing supported or unsupported, and walking if baby walks.
A test to check for anemia, if not performed earlier.
Developmental assessment. The examiner may actually put baby through a series of “tests” to evaluate baby’s ability to: sit independently, pull up and cruise (or even walk), reach for and grasp objects, pick up tiny objects with a neat pincer grasp, look for dropped or hidden objects, respond to his or her name, cooperate in dressing, recognize and possibly say such words as Mama, Dada, byebye, and no, and enjoy social games such as patty-cake and peekaboo; or he or she may simply rely on observation plus your reports on what baby is doing.
Immunizations, if not given before and if baby is in good health and there are no contraindications.
Be sure to discuss previous reactions, if any, beforehand. (A test for tuberculosis will be
performed only if your child is at high risk of having come into contact with an infected person. It may be given before, or at the same time as, the MMR vaccine.)
Guidance about what to expect in the next months in relation to such topics as feeding, sleeping, development, and child safety.
Recommendations about supplemental fluoride, if needed.
You may want to ask these questions if the doctor hasn’t already answered them:
What new foods can be introduced to baby now? When can wheat, citrus fruits, fish, meats, tomatoes, strawberries, and egg whites be introduced, if they haven’t been already?
When should you consider weaning from the bottle, if your baby is bottle-fed, or from the breast, if you haven’t weaned yet? When can whole milk be introduced?
Should you take your baby to the dentist? The AAP recommends that children have their first dental visit sometime between their first and second birthdays (sooner if they’re at high risk for tooth decay).
Also raise concerns that have arisen over the past month. Jot down information and instructions from the doctor. Record all pertinent information (baby’s weight, length, head circumference, immunizations, test results, illnesses, medications given, and so on) in a permanent health record.
Feeding Your Baby: WEANING FROM THE BREAST
Weaning may be just around the corner, or months (or even years) down the line. Either way, it’s a big step on that long road to independence—a step that means your child will never again be quite so dependent on you for a meal (though you can almost certainly look forward to many years of “Mom, I’m hungry! What’s for dinner?”). It’s also a step that’s almost as big for you as it is for your child, and one you’ll want to be prepared for physically and emotionally. For support and strategy dealing with this major milestone, whenever it comes, read on.
WEANING FROM THE BREAST
As the task of weaning your baby looms as large as any childcare challenge you’ve faced so far, it may be comforting to know that you’ve probably already begun the process. The first time that you offered your baby a sip from a cup, a nip from a bottle, or a nibble from a spoon, you took a step toward weaning. You’ve been taking baby steps ever since.
Weaning is basically a two-phase process:
Phase One: Getting baby accustomed to taking nourishment from a source other than your breasts. Since it can take a breastfeeding baby a month or more to catch on to drinking from a cup (and some a considerable time before they’re even willing to give such alternative methods of feeding a try), it’s best to introduce them well before you hope to complete weaning.1 That’s why it’s a good idea to begin Phase One of weaning now, even if you’re not planning to wean until age one or later (as recommended by the American Academy of Pediatrics).
The longer you wait to introduce a breast substitute (the cup being the ideal one at this age), the slower and more difficult weaning may prove to be. That’s because the older a baby gets, the more stubbornly opposed to change he or she becomes. If your baby proves particularly inflexible on the cup issue, you may need to break down resistance by: