Educational Materials for 9 Month Well-Visit

The topics listed below are based on American Academy of Pediatrics national recommendations about the kinds of things that are important to discuss or get more information about for children your child's age.

Click on the info to get education and tips from pediatric health care experts about each topic.

How you and your family are doing:

Ways to guide and discipline your child More Info
Ways to guide and discipline your child
What is this and why is it important?

Your baby’s desire to explore is almost impossible to satisfy at this age. As a result, he wants to touch, taste and manipulate almost everything he can get into his hands. As part of that process, he’s bound to find his way into places and situations that are off limits.  Keep in mind that the way you handle these early incidents will lay the foundation for future discipline. Learning not to do something that he wants to do is a major first step towards self-control. The better he learns the lesson now, the less you have to intervene in years to come.

What are some strategies that you can use?

  1. Distraction: Distraction usually can deal effectively with undesirable behavior. Your baby’s memory is still short and thus you can shift his focus with minimal resistance. If he is headed for something he shouldn’t get into, you don’t necessarily have to say “no”. Overusing that word will blunt its effect in the long run. Instead, pick him up and direct him toward something he can play with. Look for a compromise that will keep him interested and active without squelching his natural curiosity. That said, he may seem to always be getting himself into awkward or even dangerous situations. When you see your child approaching an unsafe situation, physically remove him from the situation, say "NO" firmly, and redirect him to another activity. A child at this age is not yet developmentally able to "mind" his parents and will likely repeat the action. This is not an act of disobedience but just natural curiosity and exploration. Punishing your child by spanking or slapping his hand for this behavior is never appropriate and only confuses him .
  2. Consistency: To improve the effectiveness of your discipline, consistency is critical. Make sure that everyone responsible for caring for him understands what your child is and is not allowed to do. Keep the rules to a minimum and preferably limited to situations that are potentially dangerous to your child.  Then, make sure he hears “no” every time he strays.  React as soon as he is heading into trouble, not five minutes later. If you lay your reprimand, he won’t understand.
  3. Respond in a positive way to his good behavior! This kind of reaction is equally important in helping him learn self-control. If he hesitates before reaching for the stove, notice his resistance and tell him how pleased you are. As he grows older, his good behavior will depend, in large part, on his desire to please you. If you make him aware now of how much you appreciate the good things he does, he’ll be less likely to misbehave just to get your attention.  Messages like, ‘Be nice to the kitty, pat gently,” work better than “NO, don’t touch kitty.” It also helps to model how to be nice to the kitty. Helping him know what you do want, rather than what you don’t, begins building desirable behavior.  For example; “let’s sit down,” or “let’s not throw the toys-we can put them into the basket if you’re done with them.”
  4. Remember, independence and exploration at this age are expected and are to be encouraged. Therefore, it may be helpful to eliminate as many temptations as possible so that your child has the freedom to explore areas that are not filled with a number of “no no’s”.

You can talk to your child’s health care provider about effective ways to guide and discipline your 9-month-old child.

What are common questions I can ask my health care provider?
  • I feel like I spend most of my day keeping child safe from things that could be a danger. Am I worrying too much?
  • We visit family a lot and they all yell when my child touches things at their houses. How can I make the visits less upsetting for my child and me?
  • I was spanked as a child and I turned out okay, why do experts recommend no spanking?
Where can I find more information about this topic?

How Can I Begin Setting Limits for my Child? (AAP)

Family Adaptation: 9 Month Changes for You and Your Baby (AAP)

Ages & Stages: Aggressive Behavior (AAP)

Disciplining Your Child (KidsHealth)

How Can Parents Discipline Without Spanking? (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

Why having consistent guidance and discipline strategies between parents, family members and care providers are important More Info
Why having consistent guidance and discipline strategies between parents, family members and care providers are important
What is this and why is it important?

A key part to successful guidance and discipline strategies is consistency. Since young children are just “learning the rules” of behavior, different messages from different caregivers is confusing.

Parents don’t always agree about how to raise children. Your own experiences growing up often affect the choices you make today. Some of what you do with your child will be the same as what your parents did; some will be much different.  However, having similar limits and strategies for dealing with unwanted behaviors is ideal for helping a child learn and can help reduce problem behaviors.

Talking about the guidance and discipline strategies to use with a child is best done before a situation arises.  It is a good idea to come up with a clear list of what your child is and isn’t allowed to do. At this age, keep the rules to a minimum and preferably limited to situations that are potentially dangerous to your child. Then, make sure that all caregivers agree to convey “no” every time he strays into forbidden territory.

You can talk with your child’s health care provider about why consistent discipline strategies are important and about ways to assert your preferences to family members and other caregivers.

What are common questions I can ask my health care provider?
  • My partner was spanked as a child, but I don’t think that is a good way to discipline. How can we work out our differences?
  • Everybody does things a little bit differently – how much difference is too much for my toddler?
  • Our families have different ideas about caring for the child and we often get caught in the middle. What’s the best way to handle this?
Where can I find more information about this topic?

How Can I Begin Setting Limits for my Child? (AAP)

Family Adaptation: 9 Month Changes for You and Your Baby (AAP)

How Becoming Parents Can Affect Your Relationship (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Why parents should save using the word “NO!” for the most important times More Info
Why parents should save using the word “NO!” for the most important times
What is this and why is it important?

As your child grows more independent and mobile, “No” can become a very useful word, if used appropriately, to warn him of danger.  However, even before your child may be able to say “no”, if he hears it too often, it may lose some of its impact and value as a safety warning.

Save the use of the word “no” for when your child is in physical danger. When you see your child approaching an unsafe situation, remove him , and say "NO Touch" firmly. Using short phrases like “No touch, hot” or “Don’t climb” helps  your child understand what action you want him to do or not do and will have real meaning for him .

For other times when your child is not in danger but is doing an unwanted behavior, consider distracting or redirecting him with another activity or object that is more acceptable to you  – remove the hammer he’s been pounding incessantly and hand him a new toy. Another great distraction is to read to your child as he wants to be near to you and hear your voice.   Also, eliminate as many temptations as possible - he needs freedom to explore in an area that is not filled with a number of “no no’s”. These methods allow you to manage your child’s behavior in a more positive way rather than repeating “NO”. 

You can talk with your child’s health care provider about why it is important to avoid overuse of the word “NO.”

What are common questions I can ask my health care provider?
  • I feel like parenting styles are getting too soft and children are displaying worse and worse behavior, is limiting the use of the word “No” only adding to this shift?
  • Rather than “no”, what are other things I can say to my child if I do not like what they are doing?
  • How do I redirect or distract my child instead of saying “No”?
Where can I find more information about this topic?

How Can I Begin Setting Limits for my Child? (AAP)

Family Adaptation: 9 Month Changes for You and Your Baby (AAP)

Growth Milestones: 9 Months (KidsGrowth)

Just Say YES (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How you balance taking care of yourself while being a parent More Info
How you balance taking care of yourself while being a parent
What is this and why is it important?

Parenting is a 24/7 job—even when you aren’t actually with your child, you are still responsible for his well-being. A key part to a child being happy and healthy is having a parent whose own needs are met.  Where do you and YOUR interests and other responsibilities fit in? Striking a balance between finding a way to meet the needs of your child without ignoring your own needs is important and is often a challenge.

An important part of parenting is finding a balance that ensures that the child’s needs are met, and the parent still feels like they have a life as well. Remind yourself of all the interests and things you did before this child was born! Schedule some time for yourself – whether to take a walk, attend a class, get together with friends – and take it seriously.  Maybe you’d like to develop some new interests and skills? Learn what’s available in your community – check at the library or in the newspaper or through adult education sources.  Also, don’t forget your own health appointments.

You can talk to your child’s health care provider about how to balance taking care of yourself while being a parent. Your child’s health care provider sees many parents and may know about different strategies that other parents use to balance meeting their child’s needs while meeting their own.

What are common questions I can ask my health care provider?
  • I don’t want to upset our childcare provider by asking too much. What are reasonable duties for a childcare worker?
  • My mother has some old-fashioned ideas about child care. How do I ask my mother to respect my childcare wishes?
Where can I find more information about this topic?

Family Adaptation: 9 Month Changes for You and Your Baby (AAP)

Parenting: Being supermom stressing you out? (APA)

Parenting: High expectations, dads and stress (APA)

How Becoming Parents Can Affect Your Relationship (KidsHealth)

Parenting Tip of the Week: Family Overload and How to Manage It! (KidsGrowth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Domestic violence; do you feel safe at home? More Info
Domestic violence; do you feel safe at home?
What is this and why is it important?

Domestic violence is serious—it harms everybody in the family.   If a mother in the family is experiencing abuse, a majority of the time, the children are also being abused.  In families where domestic violence is present, child abuse and neglect is 15 times more likely than in other families and children under 4 years of age are at greatest risk for death from abuse and neglect. In addition, children who are exposed to domestic violence are at increased risk of adverse mental and physical health. If you don’t feel safe in your home, experts recommend that you seek help immediately. It is important to know that it is okay to ask for help if you are experiencing domestic violence issues.  The National Domestic Violence Hotline 1-800-799-SAFE (7233) for help and information.

Not many people know that they can talk to their child’s health care provider about this but they can and the health care provider can help.

What are common questions I can ask my health care provider?
  • My family is one where yelling is the norm. What are some tips for changing this norm?
  • My husband yells, not just at me, but now at the child. What should I do?
  • Sometimes when I’m tired and my child is crying a lot I get so angry I’m afraid I might hurt him . What should I do?
Where can I find more information about this topic?

Family Adaptation: 9 Month Changes for You and Your Baby (AAP)

Domestic Violence: Resources for Victims and Families (MCH Library)

Domestic violence prevention and intervention services (MCH Library)

Childhelp National Child Abuse Hotline

References

Action Alliance for Children (AAC). Children’s Advocate Fact Sheet: Domestic Violence and Young Children. Retrieved 4/1/2010 from http://www.4children.org/issues/1997/july_august/fact_sheet_domestic_violence_and_young_children/

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

U.S. Department of Health and Human Services (HHS). Child Welfare Information Gateway. Retrieved 4/1/2010 from http://www.childwelfare.gov/pubs/factsheets/fatality.cfm

How your child is growing and developing:

Behaviors to expect in the next few months More Info
Behaviors to expect in the next few months
What is this and why is it important?

Thanks to their new memory skills, children at this age know that when you leave, you still exist. This is a very important skill, but also can lead to difficulty when leaving.  This is why children often protest at bedtime and cry out for you in the middle of the night.  You can help your child with this by being positive when you leave him , reassuring him with pats on the back that you are still there at night without picking him up and giving him something that gives him comfort, such as a blankie. Disappearing games such as hide and seek and peek-a-boo will help your child learn to cope with separation and feel secure that you always come back.

Children at this age do things over and over again because that’s the way they figure out how things work, and doing things repeatedly builds their self-confidence.  It also strengthens the connections in their brains.  The ability to move in new ways (crawl, stand, even walk) makes it easier to explore and helps him make new discoveries, such as finding his favorite book under the chair.  Be your child’s learning partner and coach.  Encourage him to put one more block on his tower or try and fit the cube in a different hole.  Follow his lead – the more he directs the play, the more invested he is and the more he will learn.

With his increasing mobility in the next few months, it is important that he have the opportunity to safely explore, which means you need to create a safe environment for him and always stay nearby.

You can talk to your child’s health care provider about the changes you have seen and what to expect in the next few months.

What are common questions I can ask my health care provider?
  • What kind of behaviors can I expect to see for my child around social development? Physical development? etc.
Where can I find more information about this topic?

Cognitive Development: 8 to 12 Months (AAP)

Emotional and Social Development: 8 to 12 Months (AAP)

Infant Independence and the 9 Month Visit (AAP)

Your Baby's Development: 9 to 12 Months (Zero to Three)

Early Learning: Focus on Birth to Five (PBS)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Zero to Three. Healthy Minds: Nurturing Your Child’s Development from 9 to12 Months. Retrieved 4/1/2010 from http://main.zerotothree.org/site/DocServer/9-12months.pdf

Changes to your child’s bed and naptime habits More Info
Changes to your child’s bed and naptime habits
What is this and why is it important?

Your child is probably still taking two naps, one in the morning and one at night. It is very common for children this age to start waking in the night again. Your child may not wake from hunger, but from dreams, teething or just needing to know you are there. Although babies are usually more active at this age, instead of sleeping soundly, they may wake up to see who’s around. They’re on the verge of learning that people and objects they can’t see haven’t disappeared for good.  In addition, as he is learning to stand and walk, he will want to practice that in the middle of the night too!

When he wakes up during the night, check on him and reassure him that you are still there with soothing words and a gentle pat on the back – but then leave him to go back to sleep. Falling back to sleep in your arms makes it more difficult for him to soothe himself back to sleep if he wakes up again at night. If your baby awakens during the night, check on safety and comfort, use a favorite toy or security object, have as little interaction as possible, and put him back to bed as soon as possible. Unless he missed a meal, babies this age do not need to eat during the night. Try to avoid offering a bottle or nursing.

You might also notice that when you put your child to bed that he stands up in the crib as soon as you leave the room. If you put him down, up he comes again- and he will keep doing this many times. At every light sleep phase, his new motor skill is likely to emerge. Researchers have recently suggested that there may be good reason why babies start waking up more often at night between the ages of 9-13 months, which is right when they are learning to stand and to walk. As it turns out, they spend more time in light sleep than at other ages – which in turn causes more night waking and fussing.

Therefore, this is an age when sleep routines that help your child gradually relax and get ready for sleep are especially important. The pre-bedtime hour, before the routine begins, should be especially affectionate and nurturing. The bedtime routine can include a bath, stories and/or singing songs. Disruptions in routine, such as vacations, visitors, or late evenings out do occur, but they can significantly disturb sleep patterns.  While you still want to do and experience new fun things as a family, it is important to keep the routine as consistent as possible on most days.

That being said, night waking and fussing and disruptions to sleep can be extremely difficult for parents.  An important tip to remember is that children at this age are reacting to the anxieties and stresses that are natural at their age. If you stay calm and follow a consistent pattern from one night to the next, your child will soon be putting himself to sleep again. Keep this objective in sight as you struggle through the “training nights”.

You can talk to your child’s health care provider about your child’s sleep habits and bed/naptime routines and ways to deal with night waking.

What are common questions I can ask my health care provider?
  • My child was sleeping so soundly through the night, why is he waking up now?
  • Why shouldn’t I pick my child up and rock him back to sleep when he wakes up?
  • Will he ever go back to sleeping well so we can get enough sleep?
Where can I find more information about this topic?

Getting Your Baby to Sleep (AAP)

Phases of Sleep (AAP)

Infant Sleep Patterns and Locations (AAP)

Growth Milestones: 9 Months (KidsGrowth)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed). New York: Bantam Books, 2004.

How your child may start to become more independent and explore away from you More Info
How your child may start to become more independent and explore away from you
What is this and why is it important?

Your child’s gross motor skills (his ability to control his head and body parts and to move around) will rapidly develop during the next 3 months.  A part of your child’s increased mobility will be growth in independence and a desire to separate from you and from others. He is curious about everything, and will be eager to interact and play with others. Whether he is crawling or beginning to walk, he will need safe places to explore freely and you should expect that he will separate from and explore when opportunities arise. Play areas need to allow for “supervised freedom” where you can keep an eye on him and he can move around at his own pace.  Make sure to be realistic about his abilities at this age and set realist, nonthreatening, enforceable limits.

In the next several months, your child will swing back and forth constantly between fierce independence and clinging to you. Brief separations from you may help your toddler become more independent. He’ll still suffer some separation anxiety and perhaps put up a fuss when you leave him—even if it’s just for a few minutes - but the protest will be brief. Chances are you may be more upset by these separations than he is, but try not to let him know that. If he believes his fussing has a chance of getting you to stay, he’ll learn to continue this behavior.

You can talk to your child’s health care provider about encouraging your child’s exploration while keeping him safe as he grows more independent from you.

What are common questions I can ask my health care provider?
  • One day my child wants to meet everyone and the next he is very clingy and shy, is this normal?
  • My child used to be clingy, but no crawls away without looking back. How do I adjust to this sudden burst of independence?
  • What are some things I can do to help my child grow more independent?
Where can I find more information about this topic?

Infant Independence and the 9 Month Visit (AAP)

Emotional Development: 1 Year Olds (AAP)

How I Grow in your Care: Eight to Eighteen Months (KidsGrowth)

References

American Academy of Pediatrics (AAP). Emotional Development: 1 Year Olds. Retrieved 4/1/2010 from http://www.healthychildren.org/English/ages-stages/toddler/Pages/Emotional-Development-1-Year-Olds.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Ways your child communicates More Info
Ways your child communicates
What is this and why is it important?

Children at this age may begin to use gestures such as pointing, as well as, vocalizations to let you know what they want. While you are waiting for your child’s first words, reinforce some of the ways he lets you know his preferences. If he says Mama or Dada, point to the person and repeat the word. If he shakes his head no when offered a toy or food, say “No, you don’t want that?”  Follow his gestures and even use simple sign language to help him express his need for a drink or more to eat.

Language is built from understanding. Watch for signs that your child understands what you are saying, like when he responds to his own name. Even though you’ve been talking to your baby from birth, he now understands more language, and thus your conversations will take on new significance. Before he can say many, if any, words, he’ll probably be comprehending more than you suspect. Point to and name things, actions, colors and people in pictures, magazines and newspapers. Label simple objects throughout the day, including body parts, and be sure to include music, singing and rhymes in your child’s playtime.

Face your child when you speak so he can see lip movements and your facial expression.  This will help him to learn how to form words and match words with emotions. Tell him what’s happening around him , particularly as you bathe, change, and feed him . Make your language simple and specific: “I’m drying you with the big blue towel. How soft it feels!” Verbally label familiar toys and objects for him , and try to be as consistent as possible— that is, if you call the family pet a cat today, don’t call it a kitty tomorrow.

Reading your child’s cues and responding to him helps you understand him and helps him learn how to communicate.  Whether you’re reading or talking to him , give him plenty of opportunities to join in. Ask questions and wait for a response. Or let him take the lead. If he says “Gaagaagaa,” repeat it back and see what he does. Yes, these exchanges may seem meaningless, but they tell your baby that communication is two-way and that he’s a welcome participant. Paying attention to what he says also will help you identify the words he understands and make it more likely that you’ll recognize his first spoken words.

These first words, incidentally, often aren’t proper English. For your child, a “word” is any sound that consistently refers to the same person, object, or event. So if he says “mog” every time he wants milk, you should treat “mog” with all the respect of a legitimate word. When you speak back to him , however, use “milk,” and eventually he’ll make the correction himself .

There’s a tremendous variance in the age at which children begin to say recognizable words. Some have a vocabulary of two to three words by their first birthday. More likely, your baby’s speech at twelve months will consist of a sort of gibberish that has the tones and variations of intelligible speech. As long as he’s experimenting with sounds that vary in intensity, pitch, and quality, he’s getting ready to talk. The more you respond to him as if he were speaking, the more you’ll stimulate his urge to communicate.

You can talk to your child’s health care provider about how you can help your child’s verbal and non-verbal communication grow.

What are common questions I can ask my health care provider?
  • Sometimes he asks for things but I can’t figure out what he wants and we are both frustrated. What do I do?
  • Should I teach my child baby sign language?
  • Will speaking more than one language at home confuse my child and delay his speech?
Where can I find more information about this topic?

Language Development: 8 to 12 Months (AAP)

Infant Independence and the 9 Month Visit (AAP)

How Babies Communicate (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Separation anxiety More Info
Separation anxiety
What is this and why is it important?

From 9 to 18 months of age, your child may become much more wary of “strangers.” This is a normal stage of development and shows that your child recognizes you as a special person who they feel safe and secure with. Some people may tell you that your child is fearful or shy because you’re “spoiling” him , but don’t believe it. His widely diverse behavior patterns aren’t caused by you or your parenting style; they occur because he’s now, for the first time, able to tell the difference between familiar and unfamiliar situations. If anything, the predictable anxieties of this period are evidence of his healthy relationship with you.

Anxiety around strangers is usually one of the first emotional milestones your baby will reach. Even relatives and frequent babysitters with whom your baby was once comfortable may prompt him to hide or cry now, especially if they approach him hastily.

At about the same time, he’ll become much more “clingy” about leaving you. This is the start of separation anxiety. Just as he’s starting to realize that each object is unique and permanent, he’ll also discover that there’s only one of you. When you’re out of his sight, he’ll know you’re somewhere, but not with him , and this will cause him great distress. He’ll have so little sense of time that he won’t know when—or even whether—you’ll be coming back. Once he gets a little older, his memory of past experiences with you will comfort him when you’re gone, and he’ll be able to anticipate a reunion. But for now he’s only aware of the present, so every time you leave his sight—even to go to the next room—he’ll fuss and cry. When you leave him with someone else, he may scream as though his heart will break. At bedtime, he’ll refuse to leave you to go to sleep, and then he may wake up searching for you in the middle of the night.

How long should you expect this separation anxiety to last? It usually peaks between ten and eighteen months and then fades during the last half of the second year. In some ways, this phase of your child’s emotional development will be especially tender for both of you, while in other ways, it will be painful. After all, his desire to be with you is a sign of his attachment to his first and greatest love—namely you. On the other hand, you may feel suffocated by his constant clinging, while experiencing guilt whenever you leave him crying for you. Fortunately, this emotional roller coaster eventually will subside along with his separation anxiety. In the meantime, try to downplay your leave-taking as much as possible. Here are some suggestions that may help.

  1. Your baby is more susceptible to separation anxiety when he’s tired, hungry, or sick. If you know you’re going to go out, schedule your departure so that it occurs after he’s napped and eaten. And try to stay with him as much as possible when he’s sick.
  2. Don’t make a fuss over your leaving. Instead, have the person staying with him create a distraction (a new toy, a visit to the mirror, a bath). Then say goodbye and slip away quickly.
  3. Remember that his tears will subside within minutes of your departure. His outbursts are for your benefit, to persuade you to stay. With you out of sight, he’ll soon turn his attention to the person staying with him .
  4. Help him learn to cope with separation through short practice sessions at home. Separation will be easier on him when he initiates it, so when he crawls to another room (one that’s baby proofed), don’t follow him right away; wait for one or two minutes. When you have to go to another room for a few seconds, tell him where you’re going and that you’ll return. If he fusses, call to him instead of running back. Gradually he’ll learn that nothing terrible happens when you’re gone and, just as important, that you always come back when you say you will.
  5. If you take your child to a sitter’s home or a child care center, don’t just drop him off and leave. Spend a few extra minutes playing with him in this new environment. When you do leave, reassure him that you’ll be back later.

If your child has a strong, healthy attachment to you, his separation anxiety probably will occur earlier than in other babies, and he’ll pass through it more quickly. Instead of resenting his possessiveness during these months, maintain as much warmth and good humor as you can. Through your actions, you’re showing him how to express and return love. This is the emotional base he’ll rely on in years to come.

You can talk with your child’s health care provider about why your child’s separation anxiety is a sign of healthy development, and ask for strategies to help you and your child can get through this period.

What are common questions I can ask my health care provider?
  • My child used to love everyone he met and now he is afraid of all new people, is this normal?
  • How long will this phase of separation anxiety last and what are some tips for getting through it?
  • My child is very anxious with new people. What is the best way to introduce a new caregiver?
Where can I find more information about this topic?

Stranger Awareness/Stranger Anxiety (AAP)

Soothing Your Child's Separation Anxiety (AAP)

Separation Anxiety (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

Your child’s moods and emotions More Info
Your child’s moods and emotions
What is this and why is it important?

Your child’s temperament and moods are becoming more evident, as well as his ideas about what he wants and needs. While there are some common things that most children “generally do” at certain ages, each child’s own unique personality is now starting to develop.  If your child is very sociable, he will more easily adjust to new people.  If your child seems more shy or hesitant, you can help him adjust to new people or situations by staying close, calmly talking to him about what’s happening and encouraging others to let him take his time becoming acquainted.
 
Your child lets you know his likes and dislikes through his body language and facial expressions. He will vocalize, reach and crawl to let you know when he wants something. Help him to feel understood and loved even when he can’t have what he wants, such as breakable, hot or other unsafe items.  Say things like “I know you want that glass, but that wouldn’t be safe for you. Here is a plastic cup to hold instead.”

You can talk to your child’s health care provider about your child’s personality and moods, and how you can best respond to his changing needs and wants.

What are common questions I can ask my health care provider?
  • My child’s temperament seems just like my husband’s – very intense, is this normal? Will it change over time?
  • Our child can be very insistent when he wants something. How do I deal with this kind of behavior?
Where can I find more information about this topic?

Emotional and Social Development: 8 to 12 Months (AAP)

Infant Independence and the 9 Month Visit (AAP)

Social-Emotional Development: Birth to 12 Months

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Television – why the experts say no TV More Info
Television – why the experts say no TV
What is this and why is it important?

National recommendations discourage TV, DVD and video watching for children under the age of two.  No study has shown benefits to viewing and several have found that early TV viewing is associated with delayed language and shorter attention spans. Do your best to avoid letting your child watch TV or videos. If others in your household are watching, try to move your toddler to another room or distract him with toys or games.  You can also restrict TV time for others to when your toddler is napping or in bed for the evening.

You can talk to your child’s health care provider about why the experts say no TV watching for your child.

What are common questions I can ask my health care provider?
  • Is public television okay? What about videos that are made for toddlers to enhance their learning and development?
  • It’s very hard to keep my child from watching TV when others are watching, what are some tips to avoid this?
  • My toddler really seems to pay attention and become engaged with some of programs, isn’t this good for him ?
  • If a football game is on the TV in the same room, that is ok right?
Where can I find more information about this topic?

Where We Stand: TV Viewing Time (AAP)

How TV Affects Your Child (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Games and toys that help your child learn More Info
Games and toys that help your child learn
What is this and why is it important?

Children learn through play and your 9-month-old is ready to learn. Causality is a new concept for a 9-month old and is just surfacing. How do things work? What makes a toy truck go? Perhaps while kicking his mattress, he’ll notice the crib shaking. Or maybe he’ll realize that his rattle makes a noise when he hits or waves it. Once he understands that he can cause these interesting reactions, he’ll continue to experiment with other ways to make things happen.

Your baby will quickly discover that some things, such as bells and keys, make interesting sounds when moved or shaken. When he bangs certain things on the table or drops them on the floor, he’ll start a chain of responses from his audience, including funny faces, groans, and other reactions that may lead to the reappearance—or disappearance—of the object. Before long, he’ll begin dropping things intentionally to see you pick them up. As annoying as this may be at times, it’s one important way for him to learn about cause and effect and his personal ability to influence his environment.  Like any good scientist, he’s observing the properties of objects, and from his observations, he develops ideas about shapes (some things roll and others don’t), textures (things can be scratchy, soft or smooth) and sizes (some things fit inside each other).

It’s important that you give your child the objects he needs for these experiments and encourage him to test his “theories.” But make sure that everything you give him to play with is unbreakable, lightweight, and large enough that he can’t possibly swallow it. If you run out of the usual toys or he loses interest in them, plastic or wooden spoons, unbreakable cups, and jar or bowl lids and boxes are endlessly entertaining and inexpensive.

Try playing games that he can participate in like putting things into a container and then dumping them out, pat-a-cake or rolling a ball back and forth. Hide an object under a towel or scarf and ask your child “Where is the ‘toy’?” Then let your child uncover the toy. He will enjoy the structured play time with you.

You can talk to your child’s health care provider about other games and activities that you, your child and your other children can all play together.

What are common questions I can ask my health care provider?
  • At first it was cute that my child started dropping things for us to pick up, but now it is driving me crazy. How long should I let him play this game or how can I move him onto something else?
  • What are some good games that help my child learn about cause-and-effect?
Where can I find more information about this topic?

Cognitive Development: 8 to 12 Months (AAP)

Infant Independence and the 9 Month Visit (AAP)

Problem Solving: Activities to Help Your Baby Grow & Learn (ASQ)

Social-Emotional Development: Birth to 12 Months (Zero to Three)

Learning, Play, and Your 8 to 12-Month-Old (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How your child is eating:

Feeding time strategies and self feeding More Info
Feeding time strategies and self feeding
What is this and why is it important?

During the next 3 months, children begin to get better and better at feeding themselves and its part of his growing independence that he wants to do this himself .   Parents must remember that this age, food is not the main issue. Your baby’s need to imitate, to explore, to begin to learn to refuse, takes priority.

Give your child small, bite-size portions of soft fruit, vegetables or cereal that he can easily pick-up. He can also have small amounts of breast milk or formula, water, or unsweetened juice to help develop his ability to drink from a cup. Cups with two handles and a lid with a spout help make this learning a little easier.  Your child will also begin to let you know when he doesn’t want to eat or drink something. Don’t force him , since he is learning to recognize when he is full, and this is important in his development of healthy eating habits.

It takes time and practice to develop neat self-feeding skills. In the meantime, expect and prepare for very big food messes.  Create a space for your child to explore and learn new eating techniques by using bibs with pockets to catch spills and spreading newspapers or towels under the highchair for easier clean-up.  Unbreakable dishes, cups, and glasses are essential, since they may go flying when the child is bored.

You can talk to your child’s health care provider about issues related to feeding your child.

What are common questions I can ask my health care provider?
  • I am trying to let my child feed himself , but he usually plays with the food and I can’t get a rounded diet into him if I let him feed himself . How do I strike this balance?
  • My child makes a huge mess when I let him feed himself pieces. Is it better to wait until he is older for him to feed himself ?
  • I worry about choking even though I give him only very small bits of food. Should I be afraid to give solid foods?
  • Is using a straw in a cup ok? My child likes it better than a sippy cup.
Where can I find more information about this topic?

It’s About Food: Feeding and the 9 Month Health Visit (AAP)

Feeding and Nutrition: 0 to 12 Months (AAP)

Weaning To A Cup (AAP)

References

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Using a cup More Info
Using a cup
What is this and why is it important?

Tooth decay develops when a child's teeth and gums are exposed to any liquids or foods other than water for long periods. The most common way this happens is when parents put their children to bed with a bottle of formula, milk, juice, soft drinks, sugar water, or sugared drinks. It can also occur when children are allowed to drink from a sippy cup, suck on a bottle, or breastfeed for long periods during the day or night.

Bottle weaning ages vary considerably from child to child. However, prolonged bottle use can cause tooth decay and may cause your child to drink more milk than he really needs. Getting your child to give up a bottle may be difficult but he should be weaned by 18 months of age at the very latest. Teaching your child to use a cup now willl help with weaning him from a bottle and sippy cup later. Teach your child to drink from a cup as soon as possible. Drinking from a cup is less likely to cause the liquid to collect around the teeth.

Tips for teaching your child to use a cup and preventing tooth decay:

  • Help your child learn to use a cup by giving him a training cup with a spout or put small amounts of liquid in a regular cup. 
  • When you are drinking from a cup, let him hold the glass for you and then offer him a sip. This kind of play and experimentation that accompany feeding are to be enjoyed and encouraged.
  • Go to the store and buy three or four brightly colored cups. Have the entire family begin drinking their liquids out of the same cup your baby gets. Children this age are great imitators and want what their parents have.
  • Using the cup will be messy at first. Your 9-month-old does not have the coordination to hold the cup on his own and it will take him a while to learn a new task.
  • You may have to let him hold his own cup (empty) while you give him another similar cup containing milk.
  • Only give your child a bottle during meals. Do not use a bottle or sippy cup as a pacifier or let your child walk around with or drink from them for long periods.
  • If your child must have a bottle or sippy cup for long periods, fill it only with water.
  • Never put your child to bed with a bottle or food. Not only does this expose your child's teeth to sugars, it can also put your child at risk for ear infections and choking.
  • Remember to be patient - it will take him some time for him to learn how to use a cup properly.

You can talk to your child's health care provider about learning to use a cup and why it is important.

What are common questions I can ask my health care provider?
  • How can I teach my child to use a cup?
  • Why do I need to start teaching my child to use a cup?
  • A bottle in bed really helps my child go to sleep – what would be a good substitute?
  • Is just the milk/juice in the bottle that’s harmful or is it okay to give my child a bottle in bed that has water in it?
Where can I find more information about this topic?

Preventing Tooth Decay in Children (AAP)

Weaning to a cup (AAP)

How To Discontinue the Bottle (KidsGrowth)

References

American Academy of Pediatrics (AAP). Preventing Tooth Decay. Retrieved 1/1/2010 from http://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/pages/Preventing-Tooth-Decay.aspx

American Academy of Pediatrics (AAP). Weaning to a cup. Retrieved 1/1/2010 from http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/pages/Weaning-to-a-Cup.aspx

KidsGrowth. How to Discontinue the Bottle. Retrieved 1/1/10 from http://www.kidsgrowth.com/resources/articledetail.cfm?id=355

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

How much and what kinds of food your child eats More Info
How much and what kinds of food your child eats
What is this and why is it important?

The nutritional needs of your child haven’t changed very much.  At this age, your baby needs between 750 and 900 calories each day, about 400-500 of which should come from breast milk or formula.  Breastfeeding is recommended for up to a year or more and formula is also given until 12 months. Don’t be surprised if your baby’s appetite is less robust now than it was during the first eight months. This is because his rate of growth is slowing AND because he has so many new and interesting activities to distract him .

While pureed foods are fine as starter foods, your child is getting ready to experience more textures and foods. Gradually add solid foods to his diet, offering him small, finely chopped pieces of the same foods you and your family are eating.  Very small pieces of crackers, soft fruit, cooked vegetables and cereal are good finger foods. Offer a variety of textures by gradually introducing them.  This will reduce the chance of feeding problems such as refusing to chew or vomiting. Avoid mixing textures such as broth with vegetables or meat because they are difficult for children to eat at this age.  Also do not offer foods that are hard to chew, such as raw vegetables, as this could cause him to choke.  It is a good idea to sample the foods yourself to check and see how easily your child can gum them.

Foods that are common allergens, such as peanuts, tree nuts, fish and shellfish, shouldn’t be introduced until after 1 year or even later. 

Remember that it might take 10 to 15 tries of introducing a new food before your child will accept it. While you may have 3 meals a day, your child will need those plus several healthy snacks.  Skip the sweet snacks, though, since these just add calories, not nutrition.

You can talk to your child’s health care provider about how much and what kinds of food your child should be eating at this age.

What are common questions I can ask my health care provider?
  • What are good snacks to have on hand? Or for when we’re going out?
  • I’m worried that my child isn’t getting enough food, how do I know how much is enough?
Where can I find more information about this topic?

How Often and How Much Should Your Baby Eat? (AAP)

Growth Charts (KidsHealth)

It’s About Food: Feeding and the 9 Month Health Visit (AAP)

Growth and Your 8 to 12-Month-Old (KidsHealth)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Importance of mealtime routines More Info
Importance of mealtime routines
What is this and why is it important?

Most 9-month-old children can be on the same eating schedule as the family (breakfast, lunch and dinner), plus a mid-morning, afternoon, and bedtime snack.  Your child’s appetite will vary from meal to meal and day to day, but feeding him 3 meals plus snacks will help to ensure that he is getting the nutrition he needs. 

Eating when the family does helps your child enjoy the social part of mealtimes. Even if he eats only small amounts with you, it’s the beginning of more grown-up patterns.  Feeding your child at the table helps him learn, and he can be great company and even entertainment for the whole family.  Make sure you turn off the television during meal times, as can be a distraction for your child.

Eating some of the same foods you do also helps your child become used to the meals you make. You may still have to do some spoon-feeding before or after the meal, but shared regular mealtimes can be pleasant and enjoyable times for the whole family.

You can talk with your child’s health care provider about ways to make your child’s mealtime routine enjoyable for the entire family.

What are common questions I can ask my health care provider?
  • When will my child be able to eat the meals I cook for the rest of my family?
  • How do I incorporate breastfeeding into my child’s meal schedule?
  • ow do I incorporate breastfeeding into my child’s meal schedule?
  • I feel like I spend the whole meal cleaning up after my child and not enjoying my food, how can I make mealtimes enjoyable for BOTH of us?
Where can I find more information about this topic?

It’s About Food: Feeding and the 9 Month Health Visit (AAP)

Family Meals (KidsHealth)

Making Mealtime a Family Time (USDA)

Follow a Meal and Snack Schedule (USDA)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your child's safety:

Indoor and outdoor childproofing More Info
Indoor and outdoor childproofing
What is this and why is it important?

Your 9-month-old child is now or will soon be pulling himself to stand and beginning to ‘cruise’ while holding on to things.  New muscle strength and coordination now means he can explore more freely on his own and is getting ready to walk.  He’ll need sturdy and securely attached furniture with no sharp edges.  Stairs will tempt him , but he should not be allowed to play on them alone.  Your child also wants to taste everything he touches, so keep choking hazards such as small toys and latex balloons out of his reach.

Keep a close eye on your child, and plan ahead to minimize potential dangers.  A 9-month-old who is able to move around under his own power can get into, onto, and around things that might not be safe.  Parents and caregivers have to keep an eye on these infants, but also can try to make the home and other play areas, inside and outside, as safe as possible.  This also includes grandparents’ homes or anywhere your child visits. Try getting down on your child’s level to see if there are dangers you may have missed.

There are great tips and checklists for childproofing in the resources below.  That being said, no matter how safe your home is or what childproofing you do, children this age need constant watching, unless they are in a playpen or crib.

You can talk to your child’s health care provider about ways to keep your home safe indoors and outdoors for your active child.

What are common questions I can ask my health care provider?
  • What are some childproofing tips for inside or outside my home?
  • What types of furniture should be secured to the wall?
Where can I find more information about this topic?

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

Home Safety: Here's How (AAP)

A Parent's Guide to Toy Safety (AAP)

Safety Guide (Home Safety Council)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Installing the car seat correctly/when it can be faced forward More Info
Installing the car seat correctly/when it can be faced forward
What is this and why is it important?

Car seats, when correctly installed and used, are extremely effective in saving children’s lives, reducing the risk of death by as much as 71 percent for infants. However, they are complicated to install and use, making mistakes extremely common. In fact, studies have found that as many as four out of five car seats are installed or used incorrectly.

A correctly installed, rear-facing safety seat in the backseat of the car is the safest place for your child. It’s best to keep the car seat rear-facing until your child reaches the highest weight and height specified by the manufacturer. At the earliest, do not switch your child to a forward-facing safety seat before he is at least one year and weighs at least 20 pounds.  New recommendations are emerging, however, and some experts are saying that children should not face forward until 2 years old.  This is an important topic to discuss with your child’s health care provider.

This is also a good time to double check the manufacturer’s instructions. Or perhaps even better, contact the Child Safety Seat Inspection Station locator to find the nearest certified inspector who can check the installation and make any corrections needed.   You can find this information at www.seatcheck.org or by calling 1-866-SEAT-CHECK.

You can talk to your child’s health care provider about how to install your car seat correctly, in what position the car seat should face, and where you can go to have someone check the installation of your car seat.

What are common questions I can ask my health care provider?
  • My child really does not like being in a car seat, I think facing him forward will really help this, is it okay since he is so close to being 1?
  • When can I switch the child to a more grown up seat?
  • Can I use a car seat from my nephew who is 8 now?
  • My child is over 20 pounds, but he is not 1 yet. Can I still turn his seat around?
Where can I find more information about this topic?

Car Safety Seats: Information for Families for 2012 (AAP)

Home Safety: Here's How (AAP)

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

Child Safety Seat Inspection Station Locator

References

Center for Disease Control and Prevention (CDC). Injury Prevention & Control: Motor Vehicle Safety. Retrieved 4/1/2010 from http://www.cdc.gov/motorvehiclesafety/child_passenger_safety/childseat-spot.html

Henary, B., Sherwood, C.P., Crandall, J.R., et al. (2007). Car safety seats for children: rear facing for best protection. Injury Prevention. 13: 398-402. Downloaded 4/1/2010 from http://injuryprevention.bmj.com/content/13/6/398.full.pdf?sid=2f12453d-7f87-477d-8be6-3e5debde2e5a

Safe Kids USA. Preventing injuries at home, at play, and on the way. http://www.usa.safekids.org/tier3_cd.cfm?content_item_id=2530&folder_id=680. Accessed 4/1/2010.

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Preventing your child from getting burned and how to use barriers to stoves/space heaters More Info
Preventing your child from getting burned and how to use barriers to stoves/space heaters
What is this and why is it important?

Children under the age of 4 are at the greatest risk of burn injuries. Your child is moving around more now and can reach dangerous things that could cause burns. As your child gains the ability to crawl and reach things on his own, parents need to think ahead and plan how to prevent painful burn injuries from happening. If you use space heaters, place sturdy protective screens around them, and keep heaters away from curtains, paper and other materials that can catch fire.  

The majority of scald burns for kids under age 2 are caused by hot liquids or food being spilled.  Prevent burns from hot pots or dishes by turning handles away from edge of stove or table and by placing pans or dishes out of reach and not on tables with tablecloths so he can’t pull contents onto himself .   Keep all electric cords attached to hot appliances out of reach.  When in the kitchen rushing to prepare meals, it is a good idea to restrain your child in a highchair or playpen.

Most burn-related hospitalizations and deaths are as a result of hot tap water. Prevent hot water burns by keeping the hot water temperature in your home turned down to 120°F. Always check the temperature of your child’s bath water before putting him into the tub. Be extra careful when travelling to hotels or other homes in which the hot water temperature may not have been turned down.

Also, protect your child from getting sunburned outside by using sunscreen and protective clothing, even on cloudy days.

You can talk with your child’s health care provider about how to keep your child from getting burned.

What are common questions I can ask my health care provider?
  • I don’t like to restrain my child too much, but maybe that’s a good idea when we’re making dinner. How should I do this?
  • Our house is so cold, we need to use heaters. I’m afraid he’ll climb over anything we put up. What’s a good barrier to use?
Where can I find more information about this topic?

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

Burn Injuries Common, But Preventable in Young Children (AAP)

Fire Prevention Tips (Home Safety Council)

Scald Prevention (Home Safety Council)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Safe Kids USA. Burn and Scald Prevention Fact Sheet. Retrieved 4/1/2010 fromhttp://www.safekids.org/our-work/research/fact-sheets/burn-and-scald-prevention-fact-sheet.html

Preventing falls from stairs, windows and other dangerous places More Info
Preventing falls from stairs, windows and other dangerous places
What is this and why is it important?

Children belong at low levels or in safe play areas to prevent accidents from falls, including falls from windows. Don’t leave your child on any surface high enough to fall from, especially near windows. Children love to look out of windows, but the weight of a child who leans against a screen is enough to push the screen out and cause the child to fall.  Open windows from the top if possible. Install operable window guards that only an adult or older child can open from the inside. Never put chairs, sofas, low tables, or anything else a child might climb on in front of a window. Doing so gives him access to the window and creates an opportunity for a serious fall.

Stairs are another ready-made—but potentially dangerous—obstacle course. Although your child needs to learn how to go up and down stairs, you should not allow him to play on them alone during this time. Use safety gates with latches to prevent your child from climbing up or falling down stairs.

Falls from the diaper changing table are common at this age due to your child’s increased ability to move and roll over. Even when you are with your child such as when changing his diaper, keep a hand on him at all times. 9-month-olds move quickly and even if parents are nearby, there often isn’t time to prevent a fall.

You can talk to your child’s health care provider about keeping your child safe from falls.

What are common questions I can ask my health care provider?
  • Should my landlord provide window guards or help me install some?
  • Do I need window guards if I live in a one story home?
  • How do I prevent falls from the diaper changing station?
Where can I find more information about this topic?

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

Changing Table Safety (AAP)

Safe Kids USA - How to Install a Window Guard

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Bathtub, water, and pool safety More Info
Bathtub, water, and pool safety
What is this and why is it important?

Drowning is a leading cause of injury-related death in children and is a risk even for your 9-month-old.  Keeping your child safe in the bath and around water takes extra attention.  Always stay within an arm’s length of your child around water.

Children love water whether it is in toilets, pails, or in the tub. But they can drown in only an inch or two of water.  To reduce risks of drowning, put safety locks on toilets, bathroom doors and hot tubs. Use “touch supervision” and never be more than a few inches from your child in the tub, ready and able to grab him . Be aware of hazards like kiddie pools that aren’t empty, post holes, open ice chests or fish ponds that a child could fall into, and don’t ask an older child to supervise your little one around water.

Other water safety tips include:

  • Empty all buckets, pails, and bathtubs completely after each use — do not leave them filled and unattended.
  • Teach others in the home to keep the bathroom door closed. Install a hook-and-eye latch or doorknob cover on the outside of the door.
  • Never leave a child alone in a bathtub or in the care of another child, even for a moment.
  • Use a rigid, lockable cover on a hot tub, spa, or whirlpool, or fence in all 4 sides as you would for a swimming pool.
  • Throw away or tightly cover water or chemical mixtures after use.
  • Fill in empty holes or have fences installed to protect your child.

Think ahead. Learn infant CPR and know how to get emergency help.  Remember that even though your child may not be able to reach the toilet or tub now, climbing to stand and walking are just around the corner. This kind of care can prevent a tragedy.

You can talk to your child’s health care provider about keeping your child safe around water.

What are common questions I can ask my health care provider?
  • Child locks on the toilet make it hard for adults to use them. Are they really necessary?
  • Are swimming lessons for 9-month-olds good protection?
Where can I find more information about this topic?

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

Water Safety And Young Children (AAP)

References

American Academy of Pediatrics (AAP) Committee on Injury, Violence and Poison Prevention. Policy Statement: Prevention of Drowning in Infants, Children, and Adolescents. Pediatrics. Vol. 112 No. 2 August 2003, pp. 437-439. Retrieved 4/1/2010 from http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;112/2/437?maxtoshow=&HITS=&hits=&RESULTFORMAT=&fulltext=drowning&searchid=1194229372884_2954

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

What to do if your baby swallows poison and when to call the poison control center More Info
What to do if your baby swallows poison and when to call the poison control center
What is this and why is it important?

Many substances that seem safe can be dangerous for children, including soaps, shampoos, pet products and medicines. A safe home means one where your child can’t reach foods or cleaning agents that could be dangerous for him . You can lock or block cabinets where you keep unsafe products or move them to high cabinets instead of keeping them under the counters. Be aware that many of these items come in colorful containers that may attract your child.

If you suspect that your child has swallowed something poisonous, FIRST call the National Poison Control Center at 1-800-222-1222 and follow their instructions.  (The Poison Control Center should be called before your child’s doctor’s office when you are concerned about what poisoning). Syrup of Ipecac is no longer recommended nor is anything else to induce vomiting.

Some plants are poisonous, so avoid them or make sure they’re out of reach.  If you are unsure about any of the plants in your house or yard, call your local Poison Help Line (1–800–222–1222) and request a list of poisonous plants common to your area. If you have any poisonous plants, either replace them or securely fence and lock that area of the yard away from your child.

You can talk to your child’s health care provider about what you should do if your child swallows poison.

What are common questions I can ask my health care provider?
  • If I think my child has eaten or drunk something I am not sure is safe should I call you or the poison control center?
  • Should I make my child vomit if he drinks something dangerous?
Where can I find more information about this topic?

Tips for Poison Prevention and Treatment (AAP)

Keep Your Home Safe From Poisons (AAP)

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

Tips to Prevent Poisonings (CDC)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Gun safety in your home and places where your child visits More Info
Gun safety in your home and places where your child visits
What is this and why is it important?

Approximately one-third of families with children keep at least one gun in the home. You may not have thought about guns in relation to a child this age, but other children in your home or children visiting your home could be at risk of finding a gun. Unfortunately, gun accidents are not uncommon occurrences. A safe home needs to have safe places for any guns you or family members own.

Kids will be curious and may try a gun if they find one. Children as young as 3-years-old have the finger strength to pull a trigger. Make sure that if you have a gun in the house it is not loaded and is carefully locked up.  Ammunition should be locked and stored separately from the gun.  Before your child spends time in someone else’s home, you should ask whether there are firearms in the house and how they are stored.

You can talk to your child’s health care provider about gun safety and your child.

What are common questions I can ask my health care provider?
  • In my family everyone hunts and has guns around but my child couldn’t get to them at this age, so why make a fuss about locking them up?
  • Why should we be worried about gun safety when my child is only 9-months-old?
Where can I find more information about this topic?

Where We Stand: Gun Safety (AAP)

Handguns in the Home (AAP)

Home Safety: Here's How (AAP)

Safety and Your 9 Month Old: Topics for the Health Visit (AAP)

References

Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.

National SAFE KIDS Campaign (NSKC). Unintentional Firearm Injury Fact Sheet. Washington (DC): NSKC, 2004. Retrieved 4/1/2010 from http://www.preventinjury.org/PDFs/UNINTENTIONAL_FIREARM_INJURY.pdf