• walk holding on to furniture
• look for dropped or hidden objects
• play pat-a-cake or peekaboo
• say one to three words and imitate sounds
• point with fingers and feed him/herself Feeding
• The advantages of breastfeeding continue for you and your baby as long as you nurse. Continue breastfeeding as long as it is good for the two of you.
• Give your child whole cow’s milk or full fat soy milk to drink. Nonfat or low-fat milk can be introduced when your child is 2 years old.
• Offer a variety of healthy foods each day (fruits, well-cooked vegetables, low sugar cereal, yogurt, cheese, whole grain breads, crackers, lean meat, fish, tofu, etc.).
• Avoid foods that may cause choking (whole hot dogs, nuts, chunks of meat, cheese, peanut butter, whole grapes, hard or sticky candy, popcorn, bagels, or raw vegetables).
• Let your child decide how much to eat.
• Encourage your child to drink from a cup.
• Juice is not recommended. If you do give your child juice, limit it to no more than 4-6 ounces in a day, served in a cup, not a bottle. Make sure the label says “100% whole fruit juice.” Do not give your child soda or other sweet drinks.
• Limit chips, fast foods, and sweets. Healthy habits
• Don’t smoke! Talk with your doctor or contact your Kaiser Permanente Health Education Department if you would like to quit smoking.
• Protect your child’s teeth. This is the time to schedule your child’s first visit to the dentist.
• Do not put your child to bed with a bottle. It can cause tooth decay.
• Brush your child’s teeth every day with water only. Don’t use toothpaste until your child is 2 years old.
• Take time to walk with your child.
• Children under age 2 should not watch TV or videos. Too much TV may negatively affect early brain development.
• To protect your child from the sun, try to stay in the shade, especially between 10 am and 4 pm. Use a broad spectrum (UVA and UVB protection) sunscreen with an SPF of at least 15. Cover him or her up with a broad brimmed hat, long sleeves and pants, and sunglasses with UV protection. Safety
• Protect against drowning. Watch your child at all times when he/she is near water (pool, hot tub, bucket, bathtub, toilets, lake, etc.). Swimming pools should be fenced with a self-latching gate.
• Use the car seat for every ride. Your child should always ride in a rear-facing car seat in the back seat. Keep your child in a rear-facing car seat until 2 years of age or until he or she reaches the highest height or weight allowed by your car seat’s manufacturer. If you have questions or need help installing your car seat call 1-866-SEATCHECK or visit www.seatcheck.org. For more information, review the car seat information on your child’s doctor’s home page.
• Avoid choking. Learn the Heimlich Maneuver (first aid for choking, see other side). Keep drapery cords and electrical cords out of your child’s reach.
• Make a note of the Poison Control Center phone number. 1-800-876-4766
• Avoid lead poisoning. Tell your doctor if your child spends a lot of time in a house built before 1978.
• Pet safety. Never leave your child unattended with any animal, even family pets. Learn to recognize signs of aggression in your pets.
Parenting
• Read stories, talk, and play games with your child every day. Show affection.
• Fear of strangers is normal at this age.
• Discipline your child. Say “no,” then physically move your child from the dangerous situation. Do not yell or spank. Be a good role model.
• To distract your child from misbehaving, try offering a toy or simply give the child a hug. Feeding children: 1–3 years old It is important to teach your child good eating habits early on. Offer a variety of healthy foods. If your child doesn’t want to eat them it’s okay. There is no need to offer less-healthy food choices. In the long run, your child will get enough to eat. Starting at 12 months, your child can begin to drink whole cow’s milk or full fat soy milk, instead of formula. Whole milk provides fat calories that your child needs. Nonfat or low-fat milk can be introduced when your child is 2 years old. Give milk and water in a cup, not a bottle. Limit juice to no more than 4-6 ounces each day. By 18 months, stop giving bottles to your child. Your child will get better and better at feeding him/herself between 12 and 18 months of age, including biting through food, chewing and swallowing. Help your child by cutting or grinding food into small pieces and giving soft, well-cooked vegetables. Ground meat is more easily chewed than solid meat. Introduce soft combination foods, such as casseroles, macaroni and cheese, spaghetti, yogurt, cheese, rice, and beans. Avoid battles over food. As a parent, you are responsible for what you offer your child to eat—but your child decides what and how much is eaten. During this time your child needs to assert him/herself to know that he/she is a separate person from you. It is normal for your child to eat less at this age because your child’s growth slows down. Look at what your child eats over a week instead of a day. Parents can often relax once they know how little food children need to be healthy. Serving sizes Dairy: 2 to 3 cups per day (such as whole milk or full fat soy milk, yogurt, and cheese). Giving your child 2 cups of milk a day is enough, but more than 3 cups replaces other foods. Do not feed your child rice milk. Fruits and vegetables: 5-9 servings per day (fruits like peaches, pears, plums, bananas, and apples; vegetables such as peas, corn, green beans, squash, mixed vegetables, and sweet potatoes). One serving is about 1 tablespoon for each year of age. Grains: 6 or more servings per day (such as bread, cereal, rice, noodles, crackers). One serving is about 3 tablespoons or 1/3 a slice of bread, or 3 crackers. Protein foods: 2 servings per day at 1/2 oz. per serving (such as meats, fish, poultry, tofu, beans, eggs). One serving is about 1 to 2 tablespoons.
How to determine if your child is choking
• If your child is able to cough or cry, it’s a good sign that he/she is getting enough air. Call the Advice Nurse if you are concerned.
• If your child cannot breathe or cry, he/she is probably choking. Call 911 immediately, then do the following: Step #1: Hold your child in front of you on your lap (facing away with his/her back towards you). Place the thumbside of your fist against the middle of your child’s abdomen just above the belly button. Step #2: Give up to five quick upward thrusts. Repeat steps 1 and 2 until the object is coughed up, or until your child starts to breathe. If your child becomes unconscious, make sure someone has called 911. Then start CPR right away. Take CPR training for more information. To prevent choking, do not let your child have:
• Toys with buttons, marbles, coins, balloons, or small removable parts.
• Foods such as whole hot dogs, nuts, chunks of meat, cheese, peanut butter, whole grapes, hard or sticky candy, popcorn, or raw vegetables. Other Resources Web sites American Academy of Pediatrics healthychildren.org Kaiser Permanente kp.org National Highway Traffic Safety Administration nhtsa.org. Bright Futures brightfutures.org Preventive Ounce preventiveoz.org Books Guide to Your Child’s Nutrition – American Academy of Pediatrics Mommy Made and Daddy Too: Home Cooking for a Healthy Baby & Toddler – Martha Kimmel, et al. Baby & Toddler Food – Konemann Staff Baby & Child Emergency First-Aid Handbook – Mitchell, MD, Einzig Contact your local Health Education Department or Center, for health information, Healthy Living Programs, and other resources.