Nine months is the age of exploration. Your infant is, for good or bad, mobile. Your baby is discovering that he or she can finally get to things of interest and is trying to reach everything. Your baby is learning to communicate and interact with the environment.

Safety

1. Car: The car seat should be in the back of the vehicle and rear-facing (I like the five-point harness style that allows you to pull the straps tight against the baby’s chest). Most babies transition out of the infant to the bigger convertible car seat at this age. The convertible car seat stays in the car (you don’t lift it out like an infant seat) and can convert to forward facing when your child is old enough/big enough (2+ years old). You will know your child is too big for the infant seat if his or her head comes within an inch or two of the top of the car seat (or surpasses the weight recommendation of the seat).
   1. For help securing the seat make an appointment with a Nationally Certified Child Passenger Safety Technician (to find a location nearest you visit https://highwaysafety.utah.gov/seat-belts-and-car-seats/car-seat-safety/)
2. Sleep:
   1. The crib is the safest place; slats less than 2 3/8 inches apart; place the mattress at the lowest setting of the crib.
   2. Your baby can sleep in whatever position he or she finds most comfortable (the risk of SIDS has dropped significantly).
   3. You may put mesh/breathable bumpers back into the crib if your baby is a wild sleeper and arms and legs are getting stuck outside of the slats.
3. Childproofing: Get down on floor level and look for hazards.
   1. Outlet covers
   2. Safety gates in front of stairs (starting to crawl up the stairs but are high risk for falling down).
   3. Consider what a mobile child can pull down on him/herself (anything with a dangling cord).
   4. Chemicals/medications/cleaners out of reach or locked.
   5. Toys with small parts and sharp objects out of reach (high choking risk at this age).
   6. Keep guns with ammunition separate and in a gun safe.
   7. Do NOT use walkers (they delay walking skills and are high risk for falling down the stairs).
4. Water: Don’t leave unattended in bathtub and keep water heater less than 120 degree F (to prevent scalding).
5. Smoking: Do not smoke in the home or in your car.
6. Sun: Limit sun exposure, use sunscreen when outside.
7. Choking: Risk of choking is highest at this age (foods, toys, essentially anything that goes in that mouth). Make sure you know how to do “back blows” should that happen.

Nutrition

1. Continue to breastfeed or use formula. You will not transition to whole milk until 12 months. (total volume is 24-36 oz/day).
2. Continue offering solid foods. Your infant should be eating 3 “meals” (sitting in the high chair) and 3 snacks a day. Most of the foods will be table style (bites of whatever you are eating), but may also include stage 2 and stage 3 baby foods, depending on your preference.
3. Offer a cup (typically a sippy style) with eat meal.
4. Give water throughout the day.
5. Do not give your child honey (because of botulism risks), there are no other food limitations. You can do milk products (like yogurt or cheese), but not straight milk as your infant needs the extra nutrients found in breast milk or formula.
6. Nuts. The newest recommendations (as of 3/2019) say you can also introduce nuts/nut products (like peanut butter). You only need to be cautious if there is an immediate family member with a nut allergy (in that case, let me know due to the increased risk of allergies). If giving peanut butter makes you nervous, consider giving it for the first time in the waiting room of your child’s next well visit (that way you are already at the doctor if there is a problem).

Sleep

1. Should be sleeping through the night and in a crib still.
2. Typically taking 2 naps a day (a shorter morning and a longer afternoon nap).
3. Total sleep should be 12-16 hours per 24 hours (including naps).

Milestones

1. Crawling
2. Has a pincer grasp
3. Making consonant sounds (lots of babbling)
4. Steady sitting and maneuvering without falling over
5. Waving
6. Stranger danger is common at this age
7. Pulling to a standing position

ORAL HEALTH

1. Do not put your baby to bed with a bottle. It establishes bad habits, causes bottle rot (have you seen the children with rotten teeth or capped teeth?), and is a choking hazard.
2. Discuss with your pediatrician whether your infant needs supplemental fluoride (this depends on your city’s water supply).
3. Teething typically happens between 6-9 months. Start brushing teeth (with a non-fluoridated toothpaste) when teeth erupt.

Illness

At this age you may treat fever and minor illnesses at home as long as your baby looks and acts ok swiss replica rolex watches. Bring your baby to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your infant isn’t eating well, your infant is particularly fussy, or you are concerned.

YOUR NEXT VISIT

Your baby’s next well child check is at 12 months of age. Vaccines at that visit can be split and given half at 12 months, half at 15 months, or given all at once. They include: DtaP (diphtheria, tetanus, pertussis), Hib (Haemophilus influenza type b), PCV-13 (pneumococcal disease), MMR (measles, mumps, and rubella), Varicella (chickenpox), and Hepatitis A. Depending on the time of year, your infant may qualify for a flu shot (remember, the first time your infant gets a flu shot, he or she will need a booster/2nd dose in 30+ days). Your baby will also get his/her hemoglobin checked at 12 months (typically done with a finger poke) to ensure he or she is not anemic.