From Twelve to Eighteen Months

Congratulations! You and your baby are celebrating one year togetherand beginning a second year. A lot of growth and changes have taken place

this past year. Your baby’s weight has at least tripled and she’s eating many ofthe same foods you are. She is learning many new skills during this time. She may

be about to walk or is walking and is still very curious about her expanding world. Safetycontinues to be an important concern. Now is the time to enjoy books and talk to each other.Your baby is developing at her own pace and doesn’t need to be pressured into such things astoilet training. Enjoy your baby and look forward to another great year.

Your DevelopingBaby

The 12 to 18-month-old baby is an excitingperson to be around. She is interested ineverything. She wants to practice everynew skill she learns over and over again.Once you have created a safe environmentfor your baby, enjoy re-exploring yourhouse and yard with her. To her, it’s allnew every day and it’s all wonderful.

GENERAL DEVELOPMENTBy her first birthday, your baby willprobably have tripled her birth weight.She will also continue to gain in length,but the rate she is growing will be slowerfrom now on. You will also see that herbody proportions are continuing tochange. She is getting longer in her trunkand extremities (taller) while her headgrows more slowly. She should besleeping 12-14 hours at night and maystart refusing one of her two daily naps.

DEVELOPMENT OFLARGE MUSCLES By 12 months of age your baby willprobably be doing some type of walking.It may be that she is pulling up tofurniture, then cruising along it. She maybe trying just a step or two on her own orshe may be actually walking by now. Allof these are normal for her age. She willwalk with a wide straddle-legged stepholding her arms up and out at shoulderlevel to help her balance.

Congratulations...she’s a toddler.

DEVELOPMENT OFSMALL MUSCLES The toddler is an imitator. Your baby willtry to do whatever she sees you do,whether it’s folding the laundry orsweeping the floors. She continues topractice new skills and will cover manysheets of paper with scribbles. She willenjoy stacking blocks, nesting objects anddumping games. Her attention span isshort (1-2 minutes), so keeping her busywhile you get something done can be achallenge.

DEVELOPMENT OFSELF-HELP SKILLS Babies are learning many new skillsduring this period. In dressing, your babywill anticipate what happens next byholding out her foot for a shoe or puttingout her arms when she sees her coat. Shewill be able to take off at least her owncoat and shoes soon. She may begin to letyou know when she has wet diapers orwhen she has had a bowel movement. Sheis also learning new feeding skills

DEVELOPMENT OFSOCIAL SKILLS The 12 to 18-month-old understandssimple commands. She can give yousomething she has, or get you somethingyou both can see. She may not rememberlong enough to be able to get somethingfrom another room. She understands “no”but may test you by doing what she wantsanyway. An immediate and consistentreaction from you (such as removing herfrom the object) will teach her that youmean what you say.

You can record your baby’s importantdevelopmental milestones in the BabyYour Baby Health Keepsake.

NutritionAt this age you may notice day-to-daychanges in your baby’s appetite. One dayshe might want to eat everything. The nextday, she may refuse almost anything youput in front of her. This is entirely normaland may continue for a year or two. Youshouldn’t worry if your baby seems to beeating less, because her growth is slowernow. Many babies are continuing tobreastfeed; this is normal.

Changes in eating habits also indicateyour baby’s increasing independence. Shemay now show definite likes and dislikes.This is a good time to begin offering avariety of healthy foods and letting herchoose.

Offer the foods more than once in a varietyof forms. Your baby will likely not like itthe first time it is offered. Feed yourgrowing family according to the

Schedule visits forwell child care andimmunizations at

12 months, 15 months, and

18 months of age

MyPyramid guidelines. The groups in theMyPyramid are:• breads, cereals and rice• fruits• vegetables• meats, poultry, fish, dry beans, eggs• milk, yogurt and cheese. It is important to offer small portions offoods from each group every day.

By her first birthday, your baby willprobably be taking milk from a cup atmealtimes rather than from a bottle. Shewill also have been finger feeding forseveral months. Now is the time to let herexperiment with a spoon. Be prepared fora lot of messy fun. You’ll probably have touse two spoons at first – your babypractices with one, while you use the otherto slip a few bites in!

The following suggestions may help youavoid or deal with feeding problems:• Serve snacks that are nutritious and

planned as part of baby’s daily diet.• Don’t serve junk foods that are high in

fats or sugar and low in certainvitamins. These can reduce baby’sappetite.

• To increase baby’s interest in food, planregularly scheduled meals and snacks;start meals by serving smaller portions;let baby get plenty of fresh air, exerciseand sleep.

• Don’t bribe baby to get her to eat.• Baby is easily distracted during

mealtime by television programs or byother children running and playing.Such excitement and distractions cancause baby to waste time. Enough timeshould be allowed for baby’s lack ofskill in eating. But, if mealtime stretchesbeyond reason, the food should beremoved in a matter of fact way withoutcomment or argument.

• Babies learn the most about food bywatching their parents and siblings.Improving food and nutrition habits forall family members is the best way topass on good habits to the younger ones.

• If your baby doesn’t like a particularfood, don’t force her to eat. Let her eatas much or as little as she wants ratherthan as much as you think she needs.

• It’s normal for babies to spit out foodseven if they like them. Continue to offerthese foods, and eventually, your effortswill pay off.

• Let her feed herself as much as she isable. Sometimes she will refuse beingfed because she wants to do it herself!

• Offer water between meals instead ofjuice and milk which can decrease yourbaby’s appetite for meal times.

• Meals and snacks should be given at thetable. Don’t allow baby to wander withfood and cup.

Hearing andSpeech

Since language is something that everybaby learns naturally, a baby doesn’t needtalking lessons. But you can encourageyour baby to talk.

When you are busy with an activity andyour baby is in the same room, talk to her.Tell her what you are doing and why.Talking to your baby may come naturally,but some parents will feel silly – as if theywere talking out loud to themselves. It istempting to go about your business quietly.But don’t miss these excellentopportunities to begin stimulating,meaningful speech. Talking to your babycan be enjoyable. Your baby’s speech willgrow if you remember to give herencouragement rather than correction.

Here are some other speech activities:• Start talking to your baby in simple

sentences and phrases. Begin bydescribing what you are doing, seeingand thinking. For example, if you arebaking a cake you could say, “Here is abowl. Put in the cake mix. Pour in water,one egg, two eggs. Stir the cake. Stir itsome more.”

• When you are playing with your baby,use words to describe what she isseeing, doing, and hearing. This willgive her words to think with and willhelp her understand that words havemeaning. For example, she needs toknow that cats are cats, puppies arepuppies and dolls are dolls. When sheunderstands what these objects are, shewill eventually be able to say the words.

• Throughout the day give your babyopportunities to use often-repeatedwords. For example, at snack time, holdup some juice and say “Juice, wantjuice?” Encourage your baby to say

juice, but do not withhold the juice if shedoes not attempt to say the word.Continue to give her choices, askingquestions and providing a good speechmodel.

• Your baby will enjoy imitating yourvoice pattern. Use “uh-oh” whenappropriate and listen to what happens.Your baby also enjoys you imitating herbabbling. The ease with which yourbaby babbles now is closely related tothe ease and speed with which she willlearn to use real language.

• Be sure to listen and respond to yourbaby. Try to answer her in words whenshe makes noise at you. Remember sheis talking to you.

• Your baby will enjoy listening to rhymesand songs, and watching you playfinger games. She may even try themotions with you.

• Make sounds around the room; watchyour baby go find them. Once she hasfound the sound, talk to her about whatshe has accomplished.

• Looking in the mirror is an excellentway to make conversation with yourbaby. Point out facial and body parts onyourself and your baby. Ask, “where isyour nose?” Help her find it.

• Show your baby picture books. Talkabout the pictures and point to andname things in the picture.

• Talk about and play with toy animals.Your baby can say what the animals say:“Bow-wow,” “Meow,” Moo-oo.”

The following checklist is a guide tonormal hearing and speech developmentfor a 12 to 18-month-old baby. As timegoes by, check to see if your baby can domost of the things listed below:� Hears when called from another room� Follows simple spoken directions, like

“Come here” or “Do you want more?”� Turns directly to interesting sounds or

when her name is called� By 12 months of age, uses about 2 to 3

words� By 15 months of age, uses 6 to 8 words� By 18 months of age, uses 10 to 20

words.

Healthy TeethBetween 12 and 18 months of age, a babyusually has four front top teeth, four frontbottom teeth, and four back teeth. Brushthese teeth with a small, soft-bristledtoothbrush, using little or no toothpaste.Often, the flavor and foaming action of thetoothpaste is irritating to the baby.However, if she likes toothpaste, use lessthan a pea-sized amount on the toothbrush.As you wean your baby, the naptime and

nighttime bottles are often the last to go.Putting your baby to bed with the bottlecan cause baby bottle tooth decay, a seriousdental disease. Sucking on a thumb orfinger is relaxing to babies and will notcause damage to the teeth at this age.

Take your child to a dentist by the time sheis one year old or within six months of thefirst tooth coming in. If your child’s teethare healthy at this visit, the dentist willusually not be doing a full examination, x-rays or fillings, but rather discussing yourchild’s oral health needs. Your dentist maytalk about baby bottle tooth decay, how toclean the teeth and gums, tips on how toease the discomfort of teething and theright amount of fluoride drops. The dentistmay apply a fluoride varnish to prevent orreverse any early cavities. Not all dentistssee children this young, so you may needto be persistent in finding a general orpediatric dentist to see her.

Remember to give a daily fluoridesupplement, as prescribed by your healthcare provider or dentist, until your child is16 years of age.

SafetyDid you know that every month nearly400 children under 4 years of age die inthe United States because of unintentionalinjuries? Most of these injuries can beprevented.

Often, injuries happen because parents arenot aware of what their babies can do.Between 12 and 18 months of age, yourbaby will gain skills in walking and willbegin to run, climb, jump and exploreeverything. This stage begins the mostaccident-prone time of her life. It is yourresponsibility to know that your baby’snext move might result in injury if she isnot protected.

POISONINGYour baby will continue to explore herworld by putting everything in her mouth,even if it doesn’t taste good. She opensdoors and drawers and loves to takethings apart. She can open bottles easilynow, so you must use safety caps on allmedicines. Medicines, alcohol and illegaldrugs should be kept in locked cabinets.

Your baby is now able to get into and ontop of everything. She doesn’t understanddanger or remember “No” when she isexploring. Be sure to keep all householdproducts and medicines up and away,completely out of her sight and reach.

If she does put something poisonous intoher mouth, call the Poison Control Centerat 1-800-222-1222. It’s a good idea to havethis phone number taped to yourtelephone to save time in an emergency.

FALLSEven though your baby is improving herwalking skills, she will still fall. She is nowbeginning to climb and jump and run aswell. A chair left next to a kitchen counteror table allows her to climb to dangerouslyhigh places.

Lock the doors to any dangerous area. Usegates on stairways and window guardsabove the first floor. Remove sharp-edgedfurniture from the room she is in.

BURNSThe kitchen is a dangerous place for yourbaby during meal preparation. Hotliquids, grease, and hot foods spilled onher can cause serious burns. A safe placefor your baby while you are cooking,eating, or distracted is her playpen or highchair. While your baby is learning to walk,she will grab anything to steady herself,including things like hot oven doors, tablecloths or wall heaters. Keep her away fromthese dangers.

If your baby does get burned, put coldwater on the burned area immediately.Then cover the burn loosely with abandage or clean cloth. Call your baby’shealth care provider or local emergencyfacility for all burns.

DROWNING At this age your baby loves to play inwater. Never leave her alone in or near abathtub, pail of water, wading orswimming pool or any other water, evenfor a moment. She can drown in less thanone inch of water.

CAR SAFETY Car crashes are the biggest danger to yourbaby’s life and health. The crushing forcesto your baby in a crash or sudden stop,even at low speeds, can cause severeinjury. The only way you can prevent thistype of injury is to use a car safety seatevery time your baby is in the car.

By now, you should have changed over toa toddler car seat. Ask your health careprovider or local health department whichseats are safe.

Books for BabiesReading and looking at books can be one ofthe most satisfying activities you can sharewith your baby. Many parents find that“story time” is a great part of their baby’sbedtime routine.

At first, your baby seems to have more funjust turning the pages. You don’t have toread every word. Instead, involve yourbaby by asking questions and pointing tothe pictures.

Don’t get upset if your active little toddlerwon’t sit still for the entire story. Forcingher to sit and listen may give her a dislikefor books. If she is more interested inclimbing or chasing a ball, that’s all right.

Most babies will eventually become eagerlisteners when there are interesting booksaround the house and someone willing toread aloud.

ImmunizationsKEEPING TRACKThere are more immunizations today thanever before. It can be hard keeping track ofyour child’s immunizations, especially ifyou switch doctors or use a different clinic.It can get even harder the more childrenyou have.

Now there’s a way to help you keep trackof immunizations, even if you have lost ormisplaced your records. The UtahStatewide Immunization InformationSystem (USIIS) keeps complete, up-to-daterecords of your child’s immunizations.USIIS is a confidential, computerizedinformation system that keeps your child’srecords even if you change health careproviders.

Ask your health care provider’s office if ittakes part in the USIIS system. Your child’s

Reading and lookingat books can be one of

the most satisfyingactivities you can

share with your baby.

records will be entered into USIIS when shegets immunizations at a participating clinicor public health program.

Call the Baby Your Baby hotline or go tothe USIIS website, www.usiis.org forinformation. USIIS can help you keep yourchild healthy.

First Steps,First Shoes

Although some babies begin to walk at 9 to 10 months of age, and some wait until 17 to 18 months of age, most babies are“cruising” by 11 to 12 months. Some aretaking a few steps all by themselves. Thebeginning cruiser pulls from kneeling tostanding, then steps sideways while sheholds on to your hands or the furniture forsupport. Soon, only one hand support isneeded, and finally come those few bravesteps with “no hands.”

Unless your baby has some specificproblem, there is no need to teach her howto walk, nor should you use a “walker” fora healthy, normal baby. You can help makeearly walking easier and safer, however. Besure that floors aren’t slippery. Removescatter rugs, and pad sharp corners ofcoffee tables and other furniture. If a pieceof furniture tips over easily, keep it out ofyour baby’s way. Be sure that as your babyreaches for a hand hold, she won’t pulldown or grab anything fragile ordangerous (tablecloths, electrical cords, hotcoffee, TV on furniture, etc.)

Babies really don’t need shoes until theybegin walking outdoors. Indoors, bare feetgive the best grip – socks and booties aretoo slippery. When you shop for shoes,rubber soled sneakers are your best bet –they give feet flexibility, and they don’t slip.Stiff, high-top shoes don’t allow feet tobend or toes to grip. If you do buy leathersoled shoes, always roughen the sole withsandpaper.

A 1-year-old’s feet grow very fast, so shoesshould be checked for fit every four to sixweeks, especially if you have to push

harder than usual to get baby’s shoes on.To check for fit, stand with full weight onher feet, and check both feet. There shouldbe 1/2-inch of space between the end ofher longest toe and the end of the shoe.The widest part of the foot (the ball of thefoot) should be in the widest part of theshoe, fitting snugly but not tightly at theinstep. The shoe’s heel should not slip upand down during walking. If shoes don’tseem to fit properly, try other sizes andstyles.

Do your baby’s feet turn out when shestands or walks? Some turning out isnormal. It seems to be nature’s way ofgiving beginning walkers better balance.For the same reason, many normal babieshave bowed legs during the early walkingstage. With time, leges and feet graduallystraighten and point forward. If turn-out orbowing seems excessive, call your healthcare provider.

Postpartum Healthfor Mom

Your baby is growing and changing fast,and you may be feeling upset that yourbody is not what it used to be. Workingyour muscles on a regular basis will helpyou burn more calories and help yourbody get back to a healthy weight.

PHYSICAL ACTIVITYStrength training can be done many waysand doesn’t require an expensivemembership at a gym. Pushups, sit-ups orcrunches, squats and other exercises can

be done without any special tools at all.These exercises work the large musclesthat you use every day like your chest,back, stomach, legs and arms, helping youto burn more calories, faster. Theseexercises will also help you in everydayactivities, like lifting your baby, taking outthe garbage and cleaning the house. Youcan get many different exercises to doright in your living room by calling theCheck Your Health hotline or visitingwww.checkyourhealth.org

NUTRITIONAs you get back into a regular routine,you may be eating out more often. Eatingin restaurants can be counter productive ifyou are trying to lose your baby weight.Most restaurant meals are oversized andfull of saturated fat. But your meals outdon’t have to be bad for your health if youfollow some basic rules.

When the server brings your food, ask fora take-out box or bag. Place one half ofyour meal in the box and eat the rest. Thatway you won’t be tempted to overeat andyou will have lunch already prepared forthe next day! Look for foods that arebaked, grilled, dry-sautéed, broiled,poached, or steamed. These cookingmethods use less fat and are generallylower in calories. Always ask for a bakedpotato or steamed vegetables rather thanFrench fries. And, don’t hesitate to split ameal with your dinner partner. You willboth benefit from eating less!

Tip: Try cooking your favorite restaurantmeals at home. It is less expensive thaneating out and you will improve yourcooking skills.

Resources:Baby Your Babywww.babyyourbaby.org1-800-826-9662

Utah Women, Infants, Children Programwww.health.utah.gov/wic1-877-942-5437

Check Your Healthwww.checkyourhealth.org1-888-222-2542

The information contained in this newsletter is not a substitute for personal medical, psychiatric, or psychological advice, and readers are urged to consult their health care providers concerning specific questions or problems.