Well-Child Checkup: 12 Months

Development and milestones

At this age, your baby may take his or her first steps. Although some babies take their first steps when they are younger and some when they are older.

The healthcare provider will ask questions about your child. They will observe your toddler to get an idea of the child’s development. By this visit, most children are doing these:

• Pulling up to a standing position

• Moving around while holding on to the couch or other furniture (known as “cruising”)

• Putting objects into a container

• Waves "bye-bye"

• Using the first or pointer finger and thumb to grasp small objects

• Understands "no"

• Saying “Mama” and “Dada”

• Playing games with you, such as pat-a-cake

Feeding tips

At 12 months of age, it’s normal for a child to eat 3 meals and a few snacks each day. If your child doesn’t want to eat, that’s OK. Provide food at mealtime, and your child will eat if and when they are hungry. Don't force the child to eat. To help your child eat well:

• Gradually give the child whole milk instead of feeding breastmilk or formula. If you’re breastfeeding, continue or wean as you and your child are ready. But also start giving your child whole milk. Your child needs the dietary fat in whole milk for correct brain development. Give whole milk to toddlers from ages 1 to 2 years.

• Make solids your child’s main source of nutrients. Think of milk as a beverage, not a full meal.

• Begin to replace a bottle with a sippy cup for all liquids. Plan to wean your child off the bottle by 15 months of age.

• Don't give your child foods they might choke on. This is common with foods about the size and shape of the child’s throat. They include sections of hot dogs and sausages, hard candies, nuts, whole grapes, and raw vegetables. Ask the healthcare provider about other foods to stay away from.

• At 12 months of age it’s OK to give your child honey.

• Ask the healthcare provider if your baby needs fluoride supplements.

Hygiene tips

• If your child has teeth, gently brush them at least twice a day such as after breakfast and before bed. Use a small amount of fluoride toothpaste no larger than a grain of rice. Use a baby's toothbrush with soft bristles. 

• Ask the healthcare provider when your child should have their first dental visit. Most pediatric dentists recommend that the first dental visit should happen within 6 months after the first tooth appears above the gums, but no later than the child's first birthday. 

Sleeping tips

At this age, your child will likely nap around 1 to 3 hours each day, and sleep 10 to 12 hours at night. If your child sleeps more or less than this but seems healthy, it's not a concern. To help your child sleep:

• Get the child used to doing the same things each night before bed. Having a bedtime routine helps your child learn when it’s time to go to sleep. Try to stick to the same bedtime and routine each night.

• Don't put your child to bed with anything to drink.

• Put the crib mattress on the lowest crib setting. This helps keep your child from pulling up and climbing or falling out of the crib. Ask your healthcare provider for tips on baby proofing your child's sleeping area. 

• If getting the child to sleep through the night is a problem, ask the healthcare provider for tips.

Safety tips

As your child becomes more mobile, it's important to keep a close eye on them. Always be aware of what your child is doing. An accident can happen in a split second. To keep your baby safe: 

• Childproof your house. If your toddler is pulling up on furniture or cruising (moving around while holding on to objects), check that big pieces such as cabinets and TVs are tied down or secured to the wall. Otherwise they may be pulled down on top of the child. Move any items that might hurt the child out of their reach. Be aware of items like tablecloths or cords that your baby might pull on. Plug all unused electrical outlets. Make sure medicines and cleaning products are stored in locked cabinets that are out of reach to your child. Do a safety check of any area your baby spends time in.

• Protect your toddler from falls. Use sturdy screens on windows. Put gates at the tops and bottoms of staircases. Supervise your child on the stairs.

• Don’t let your baby get hold of anything small enough to choke on. This includes toys, solid foods, and items on the floor that the child may find while crawling or cruising. As a rule, an item small enough to fit inside a toilet paper tube can cause a child to choke.

• In the car, always put your child in a car seat in the back seat. Babies and toddlers should ride in a rear-facing car safety seat for as long as possible. That means until they reach the top weight or height allowed by their seat. Check your safety seat instructions. Most convertible safety seats have height and weight limits that will allow children to ride rear-facing for 2 years or more.

• Teach animal safety. At this age many children become curious around dogs, cats, and other animals. Teach your child to be gentle and cautious with animals. Always supervise the child around animals, even familiar family pets. Never let your child approach a strange dog or cat.

• Never leave your child unattended near any water. If you have a pool make sure it's enclosed with a fence that is closed at all times.

• Keep your child out of rooms where there are hot objects that may be touched or put a barrier around them.

• If you own a firearm, keep it unloaded and locked up at all times.

• Keep this Poison Control phone number in an easy-to-see place, such as on the refrigerator: 800-222-1222.

Also limit screen time. Screen time (TV, tablets, phones) is not recommended for children younger than 2 years. Limit screen time to video calls with loved ones.

Vaccines

Based on recommendations from the CDC, at this visit your child may get the following vaccines:

• Haemophilus influenzae type b

• Hepatitis A

• Hepatitis B

• Influenza (flu)

• Measles, mumps, and rubella

• Pneumococcus

• Polio

• Chickenpox (varicella)

• COVID-19

Choosing shoes

Your 1-year-old may be walking. Now is the time to buy a good pair of shoes. Here are some tips:

• Get the right size. Ask a clerk for help measuring your child’s feet. Don’t buy shoes that are too big, for your child to “grow into.” Walking is harder when shoes don't fit.

• Look for shoes with soft, flexible soles.

• Don't buy shoes with high ankles and stiff leather. These can be uncomfortable. They can make it harder for your child to walk.

• Choose shoes that are easy to get on and off, but won’t slide off your child’s feet by accident. Moccasins or sneakers with Velcro closures are good choices.