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One Year Well Visit

Your baby should be rolling, sitting, crawling, and pulling up to stand. They may be walking alone now but the range of normal is 8 to 16 months.  They do not need high top shoes. Just make sure it is a proper size. They should be saying two words like Mama and Dada or uh-oh. The main  thing you should be working with them this year is to develop their language. You should be talking to them all the time saying words and telling them everything you are doing with them. They should be saying up to 10 or more words by 18 months but understand everything you say to them. It is 18 to 24 months that they really start talking and by 2 years they talk your ear off saying 50+ words and putting two words together. Also correct them if they mispronounce the words, and you should not talk baby talk to them. Girls talk more at every age so do not compare boys and girls.  Also it is OK to speak 2 languages and they will learn both fluidly by 18 months old.  Do not combine different language words in the same sentence.  They will out put only one language and if they will stay in the United States, then it needs to be English.  If they speak a second language until school, then they will be at a great disadvantage.  They will learn both languages and when put in the country of the second language, then they will speak that language quickly. 

Get the potty chair out this month and let them sit on the potty while you are sitting on yours. Teach them the words for it like pee pee or poo poo, but I have only seen 3 babies potty trained before 18 months old. Most babies are two years old or more. But go ahead and introduce the potty chair to them but do not expect them to go on the potty until later.  Let them watch you (no more privacy!) and learn by example.  It is OK for the girls to watch Dad but he needs to sit.  Too confusing for little girls who might try to copy Dad or brother.

They are throwing temper tantrums by now and it gets worse by 2 years old. They are pretty well behaved by 4 years old but terrible twos starts at 9 months. You should punish no-nos, but do not punish temper tantrums. Walk away and laugh at them. Video tape them and play them back to them when they are teenagers, or send them into Funniest Home Videos and win 10 thousand dollars. But punishing them for not understanding why they can’t do something is not going to help. Get used to making your child upset with you because you will do it every day for 20 years. I am not against a small swat on their hand for touching the electric outlet or on their bottom for some other important action. You can use time out by 15 to 18 months old. If they hit you, grab their arm and firmly say no. They also frequently start biting this year.  It did not make sense to me to hit them for hitting or bite them for biting. Be consistent with routines. It does not matter  how you raise your child - - - just do or don’t.  Do not frustrate them by doing something one day and not the next. Do not give in to the  temper tantrums. Do not punish them, but do not give in. Once you say it, do it. Think before you speak but once it’s said, do it. The husband  and wife should discipline the same rules and support each other. If one spouse does not discipline what the other thinks is important, then they won't support what you think is important. You both must do the same and  support each other. You won't always agree, but support each other. The differences in the two of you is not the problems of the marriage. If both of you like to spend a lot of money, you will be broke. So one likes to spend more than the other and neither one of you is correct.  Find the middle ground and compromise. This is the checks and balances of the marriage, and is good. Neither one of you are correct! Find the middle between you.  Same with going out to party.  One will want to go out more than the other. Compromise and find the middle ground. Same with discipline. One of you will be harder that the other. Neither one will be correct. Find the middle of the two of your philosophies of rearing children and compromise!!! That is the good part of being married …. to average out our ideas.  Don't look on this as the problems of  marriage. Both male and female adults bring different philosophies to the table on raising children. By the way, do get out with out your children on a "date"!!  It is important to have time alone, time for your children, time for the whole family, and time for the couple. That keeps the "friendship" with the couple. If all you do is sleep and eat together, there will be a divorce 7 years down the road and that's bad for the child. When you have a child you should be handcuffed together for 20 years because a divorce is devastating to children. Better in an unhappy home than divorced. So keep the family happy and don't sweat the small stuff.

You may now switch them to whole milk and the daily intake is 16 to 24 ounces. You need to give them vitamins but the liquid ones are bitter and do not have all the ingredients. Get chewable vitamins with iron and  zinc (Flintstone Complete tastes good) and give half of a vitamin a day  (or a whole one 3 times a week) and crush it up into their food. They can chew it up at 18 months or older. If you are breast feeding, keep it up as long as you wish.  Do not let others shame you into stopping sooner than you or the baby wish. Many countries nurse until 2 or 3 years old. It should be limited to 2 or 3 times a day. Because there are less calories in the breast milk, nursing too many times a day will satisfy their hunger but not supply the calories. Same as too much straight juice will slow down their growth by cutting their appetite. Gradually dilute the  juice each day to end up giving 1/4th to 1/8th strength juice and it will give them fluoride from the tap water and save on the cost of juice. Give them a balanced diet and it is usually more table food and less (or no)jar food. Cut up the food into little pieces that are smaller than raisins so they do not choke on them. They can have honey now but no peanuts or raw carrots or food that stays dry and crumbly in your mouth. You can continue to give the bottle and do not have to take it away.  However do not put them in bed with a bottle or let them walk around the house with it in their mouth; it will rot out their teeth. Actually the sippy cup with the lid and spout is a "bottle" in that it is a container with a spout you suck on!!! So you can continue the bottle till 2 or 3  years old. Just do not miss-use it. We control many of the things in our  kids lives, like how much salt to put on their food, how much sunlight  to get in, and when to come in from a date when they are 16 years old. We control many things in our kids lives until they can. When the child is walking around with the bottle dangling out of their teeth or they have the pacifier in their mouth all day, then the child is running the house. Give them only two or three bottles a day, especially they like one in the morning when they wake up and while you rock them in the evenings.  Clean their teeth several times a day with a washcloth on your finger or a teeth-cleaner from the store to put on your finger to clean baby’s teeth. Put just a tiny amount of tooth paste (any kind but non fluoride paste.) on the brush, or finger so they do not swallow a lot of it. They do not have to see the dentist till 3 but watch the teeth for problems. Don’t put them to bed with the bottle. You can keep the pacifier going till 3 years old but do not let them carry it around all day in their mouth. They can have the pacifier for naps, church, bedtime, car or doctor’s office, but not all day.

We’ll talk about potty training at 18 months. It is more important to work on their language and discipline.

Dr. Knapp