NINE MONTHS
Get the Nine Month Handout Here
BLOOD TESTS (done by finger prick)
- Hemoglobin. This test will determine if your child is anemic. We will have the result immediately and let you know if any treatment is needed.
- Lead Test. This test determines how much lead is in your baby’s blood stream. We send this test out to a laboratory and receive results in about two weeks. We will contact you if your child’s level is elevated.
DEVELOPMENT
Your baby is usually sitting alone quite well by now, creeping and crawling about, and will soon begin to pull up to stand against objects and furniture. There is no medical reason to buy expensive shoes for a baby. Shoes do nothing to form a child’s arch or ankle. Shoes are only needed for protection when walking outside.
During your routine daily activities, describe what you are doing, even though the baby does not fully understand. Read to your child every day.
Separation anxiety often becomes apparent at this time. The baby might display anxiety and fear at being separated from parents. The frequency and intensity varies depending on the child. When leaving the baby with a babysitter, demonstrate good feelings toward the babysitter and do not delay leaving. At the time of the separation, simply kiss the baby goodbye and reassure him that you will be back, then leave. Usually the baby will be uncomfortable with the separation for only a few minutes or so. A new babysitter can come early and spend some time playing with you and your baby together. Also, playing “peek-a-boo” or similar games may help your child to learn about separation and return.
Over the next months the baby’s desire to be in charge will become apparent. This is a normal stage of development and not a deliberate attempt on the baby’s part to be in conflict with you. In unsafe situations, it is important to begin limit-setting through a firm verbal “No” and redirection to a different behavior, even though the baby will often repeat the unsafe behavior and doesn’t seem to remember what you have said from one time to the next. Over time, this type of limit-setting will help to mold your child’s behavior.
FEEDING
Your baby should continue on breastmilk or formula until one year of age. If most of her milk is breastmilk, she should also continue on a daily vitamin supplement with iron (Tri-Vi-Sol with iron or Poly-Vi-Sol with iron). Start to encourage your baby to drink from a cup at times. If you wish to give your baby juice, limit it to no more than one cup a day, as some children will become “juice addicts” if given too much juice and will not eat well or drink enough breastmilk or formula. Never put your child to bed with a bottle of juice or formula. This will put him at high risk for developing cavities. If you must give a drink at nap or bedtime, make it plain water, preferably from a cup.
Your baby is probably bored with pureed baby foods now and wants to feed herself mostly finger foods (such as Cheerios, small pieces of banana, and cooked peas) as much as possible. To avoid choking, make sure any foods you give your baby are soft, easy to swallow, and cut into small pieces. Avoid high-risk choking foods such as nuts, popcorn, raw vegetables, whole grapes, hard candies, and hot dogs. Avoid honey until after one year old.
SLEEP
Your child should now have the ability to sleep through the night. He no longer needs to be fed during the night—if your baby wakes for a bottle at night, it is probably because of habit, not true hunger. The baby can be taught to go back to sleep by himself. When he wakes at night, allow him to fuss for five minutes or so to see if he can settle himself down. If he cannot, go into the room quietly to check on him, assure him that you’re there for him, and assure yourself that he’s not ill. Comfort him briefly in the crib, but try your best not to take him out of the crib. If he doesn’t settle down, leave the room again for five minutes and see if he can settle himself, and if not, go back in briefly to check on him. Repeating this pattern a few times helps teach most babies to comfort themselves and sleep better through the night. If you need more tips on helping your child sleep well, read Solve Your Child’s Sleep Problems by Richard Ferber or Healthy Sleep Habits, Happy Child by Marc Weissbluth.
SAFETY
Home Safety (see the home safety handout given at the four-month visit and available on our website for more detail)
Infant walkers with wheels are NOT recommended because they can be dangerous.
Poisonings are an important health hazard for children. Keep all medications, cleaning products, and other potentially poisonous substances high up out of reach. Post this phone number for the poison control center near your phone: 1-800-222-1222.
As your child begins to move around, it will be very important to make your home safe. Put a hook outside the bathroom door or install toilet locks. Use caution with all hot liquids and hot surfaces. Place a barrier in front of hot radiators. Place gates at the top and bottom of all stairways. Keep plastic bags, wrappers, and latex balloons out of reach. Move dangling electric cords. Use safety plugs in outlets. Remove house plants from reach, as many are poisonous. Install safety guards on windows (screens are NOT strong enough to prevent a child from falling through).
Car Safety
Your child should be in a rear-facing car seat in the back seat of the car for all car trips, even very short ones! When your child outgrows the weight limit on his infant seat, you should buy a “convertible seat” and face it backwards for now. If you would like further information on child car safety or would like to find a certified car seat inspector who can check the installation of your car seat, please consult the National Highway Traffic Administration website at www.nhtsa.dot.gov.
Sun safety
Avoid the midday sun between 10 am and 3 pm as much as possible. Use a hat or canopy and light clothing that covers as much skin as possible. Sunscreen (SPF 15 or higher) should be used if needed on exposed areas of skin.
NEXT VISIT
The next routine visit should be scheduled when you baby is twelve months.It is important to make sure this appointment is scheduled ON or AFTER your child’s first birthday.