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Parents often wonder about their child’s health, leading to the frequently asked question: “Is my baby healthy and growing normally?”

These information sheets outline normal and healthy growth and developmental milestones, and common health topics for your baby.

Due to space constraints, some messages are repeated at several ages while others appear once only. Read the complete set of sheets to obtain the entire information.

The Rourke Baby Record (RBR) is a guide that many Canadian doctors and other healthcare professionals utilize for well baby and child visits for babies and children from 1 week to 5 years of age.

photo of a baby smiling

12 Months

Preventing Injuries

  • Car seat safety: Your baby should be in the back middle seat of the car in a rear-facing infant car seat that is manufacturer approved for use until at least 2 years of age. Follow the instructions that come with your car seat to install it properly and keep your baby in each stage as long as possible.
  • Childproof your home. Lock away all medications and cleaning products. Cover electrical outlets and tape down cords. Secure TVs, computers and furniture to prevent them from tipping over. Use window guards and stair gates. Be vigilant about hot liquids on countertops. Find the hazards before your baby does. Have Emergency numbers handy. Use safe toys for your baby`s age.

Vaccinations

  • Discomfort when the vaccine needles are given is less when your baby is breastfeeding or given a sweet liquid, or if a local anaesthetic cream is applied before the needles are given.
  • After vaccinations, your baby may have no reaction, or may be fussy or sleep more or less than usual. He may have a mild fever or a little redness or swelling where the needle was given. If needed, you can give him ibuprofen or acetaminophen. Call your doctor if his fever reaches 40oC (104oF), if he is crying/fussy for more than 24 hours, is unusually sleepy or unresponsive, or has swelling at the needle site that is worsening.
  • Vaccines do not cause autism.

Feeding & Growth

  • Your baby likely weighs about 3 times his birth weight.
  • You can continue to breastfeed your baby oncue until 2 years and beyond.
  • You can change from formula to homogenized milk at 9-12 months. At this age, offer 500 mL (16 oz) milk per day in an open cup.
  • Avoid sweetened liquids or fruit juices as they can cause tooth decay, problems with weight gain or diarrhea, and can take the place of healthy foods. Encourage water.
  • Wash all fruits and vegetables that cannot be peeled.
  • Avoid processed food high in sugar and salt.
  • Convert her from a bottle to an open cup.
  • Do not give bottles in bed to reduce the risk of dental caries and ear infections.
  • You can give your baby honey after 1 year old.
  • If your child is following a vegetarian diet, get advice to be sure that it is nutritionally complete.
  • To prevent choking, avoid small, round, hard, smooth and sticky foods until 4 years of age. Have your child sit when eating or drinking.
  • You may notice that your baby`s appetite is smaller at this age. It is normal for him to gain weight more slowly now. Remember to let him eat as little or as much as he is hungry for. Never force your child to eat.
  • Aim to offer 3 meals and 2 to 3 snacks at regular times during the day. Offer her a variety of foods from all 4 food groups from Canada’s Food Guide.
  • Be a good role model for healthy eating. Eat together as a family away from the TV or other distractions.

Development

  • At 12 months, your baby should:
    • Respond to her name.
    • Understand simple requests. E.g. Where is the ball?
    • Say 3 or more words, although they may not be clear.
    • Crawl or `bum` shuffle.
    • Pull to stand and walk holding on.
    • Pick up small objects with her thumb and index finger and uses both hands equally.
    • Be upset when she is separated from you.
    • Follow your gaze when you are both looking at something.
  • Continue reading to your baby and let him hold the book and turn the pages. Avoid TV, video and computer time to allow more time for reading and for physical activity with you.
  • Play games with singing, rhyming, clapping. Use actions when giving instructions.
  • Report any concerns about your baby’s development, including her hearing and vision, to her physician or other healthcare professional.

Other Advice

  • Do not use over the counter cough/cold medications.
  • Within 6 months of your baby’s first tooth, or at one year of age, take her to her first dental appointment.
  • It’s normal if your baby cries or fusses when you leave him in his crib for the night. Keep your bedtime routine consistent and predictable and allow him to find ways of comforting himself to fall asleep on his own.
  • Having a healthy lifestyle yourself with healthy eating and physical activity will provide a good role model for your child.
  • Warm, consistent, and responsive discipline techniques are associated with positive behavior outcomes. Praise good behavior.

Resources

For more information on your baby’s health, the top 5 websites cited by the RBR Parent Resources are:

  1. Canadian Pediatrics Society – Caring for Kids (www.caringforkids.cps.ca)
  2. Hospital for Sick Children – About Kids Health (www.aboutkidshealth.ca)
  3. Parachute - formerly Safe Kids Canada (www.parachutecanada.org)
  4. Dietitians of Canada (www.dietitians.ca)
  5. Health Canada (www.hc-sc.gc.ca)

Support and Acknowledgements

The RBR Parent Resources website and this series of information sheets were created by then Memorial University of Newfoundland (MUN) medical student, Dr. Laura Butler, and the RBR authors (Drs. L. Rourke, D. Leduc and J. Rourke). Two MUN Summer Undergraduate Research Awards and MUN Faculty of Medicine Office of Professional Development supported these projects. Evaluation project by Dr Aimee Holla, MUN FM Resident. 2020 brochure revisions by Dr. Anne Rowan-Legg.

Support for the RBR includes the Government of Ontario and MUN's Dr. W. Ingram Award. Licensing contributions for RBR electronic medical record use go to the MUN RBR Development Fund.

As evidence-based information is constantly changing, the Rourke Baby Record and these recommendations should be used as a guide only.

May 2020