9-Month-Old Well-Child Checkup

What Happens at the Visit?

Your doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on a growth chart.

2. Do a screening test that helps with the early identification of developmental delays.

3. Ask questions, address concerns, and offer advice about how your baby is:

Eating. Your baby should be eating a variety of baby foods, in addition to regular feedings of breast milk or formula. Your baby can probably drink from a cup and may try to eat with their fingers.

Peeing and pooping. You may notice a change in the look of your baby's poop (and how often they go) as you introduce new foods. Tell your doctor if your baby has diarrhea or poop that is hard, dry, or difficult to pass.

Sleeping. The average amount of daily sleep is about 12–16 hours. Your baby might still take 2 naps a day — one in the morning and another sometime after lunch — but every baby is different. Waking at night is common at this age.

4. Do an exam with your baby undressed while you are present. This will include an eye exam, listening to your baby's heart and feeling pulses, checking hips, and paying attention to your baby's movements.

5. Update vaccines.Vaccines can protect babies from serious childhood illnesses, so it's important that your child get them on time. Vaccine schedules can vary from office to office, so talk to your doctor about what to expect.

6. Order a blood test. Your doctor may check for lead exposure or anemia, if needed.

How Is My Child Developing at 9 Months?

By 9 months, most babies:

• make different sounds like “ma-ma-ma” and “ba-ba-ba”
• look when you call their name
• show facial expressions like happy, sad, angry, and surprised
  
• are shy, clingy, or fearful around strangers
• smile or laugh when playing peek-a-boo
• use their fingers to rake food toward them
• pass things from one hand to the other
• look for objects when dropped out of sight
• can get into a sitting position by themselves
• sit without support

Talk to your doctor if your baby is not meeting any of these 9-month-old milestones, or you notice that your baby had skills but has lost them.

How Can My 9-Month-Old Stay Healthy?

Here are some things to keep in mind until your baby's next checkup at 12 months:

Feeding

• If you're breastfeeding, continue for 12 months or for as long as you and your baby desire. Breastfed babies weaned before 12 months should be given iron-fortified formula. Wait until 12 months to switch from formula to cow's milk.
• Don't give juiceuntil 12 months. Avoid sugary drinks like sodas.
• Continue to offer new foods. It can take 10 or more tries before your baby accepts a new food..
• Pay attention to signs your baby is hungry or full.
• Pull the highchair up to the table during meals. Your baby will start to show interest in table foods. Give your baby a variety of tastes and textures, including foods that are pureed, mashed, and in soft lumps.
• Give your child soft finger foods.
• Avoid foods that can cause choking, such as whole grapes, raisins, popcorn, pretzels, nuts, hot dogs, sausages, chunks of meat, hard cheese, raw veggies, or hard fruits.

Routine Care & Safety

• If your baby wakes up at night, wait a few minutes to give them some time to settle down. If fussiness continues, offer reassurance that you're there, but try not to pick up, play with, or feed your baby.
• Separation anxiety often starts around 9 months. Keep good-byes short but loving. Your baby may be upset at first, but will calm down soon after you're gone.
• Continue to keep your baby in a rear-facingcar seat until your child reaches the weight or height limit set by the car-seat manufacturer.
• Avoid sun exposure by keeping your baby covered and in the shade when possible. You may use sunscreen (SPF 30) if shade and clothing don't offer enough protection.
• Brush your child's teeth with a soft toothbrush and a tiny bit of toothpaste (about the size of a grain of rice) twice a day. Schedule a dentist visit soon after the first tooth appears or by 1 year of age. To help prevent cavities, the doctor or dentist may brush fluoride varnish on your baby’s teeth 2–4 times a year.
• Keep up with childproofing:
  • Install safety gates and tie up drapes, blinds, and cords.
  • Keep locked up/out of reach: choking hazards; medicines; toxic substances; items that are hot, sharp, or breakable.
  • Keep emergency numbers handy, including the Poison Control toll-free number: 800-222-1222.
  • To prevent drowning, close bathroom doors, keep toilet seats down, and always supervise around water (including baths).

How Else Can I Help My Child?

• Sing, talk, play, and read to your baby. Babies learn best this way.
• TV viewing (or other screen time, including computers) is not recommended for babies this young. Video chatting is OK.
• Protect your child fromsecondhand smoke, which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.
• Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Lock up ammunition separately. Make sure kids can't get to the keys.
• Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your baby? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.