9 Month Well-Child Visit

Your baby is now very mobile – crawling and sometimes even walking at this point! Babies this age are curious, exploring their environment and testing their skills. Fear or anxiety of strangers is also beginning to develop. What can you expect at this visit with the Pediatrician?

Vitals – Heart rate and respiratory rate will be counted, temperature is taken.

Growth measurements – Length, weight, and head circumference are updated at the nine month visit. These are plotted on a growth chart that is specific to your baby’s gender and will be compared to the previous measurements to make sure growth occurs appropriately and proportionally. Remember, the goal is for your baby to grow consistently on the curve. Growth curves are measured in “percentiles” where 50th percentile is the average measurement for age and gender. Infants who fall above the 50th percentile are “above average” for that measurement, while infants who fall below the 50th percentile are “below average.” Keep in mind that many factors affect where your baby falls on the curve – genetics, feeding patterns, prematurity.

Development –

• Social: They look consistently when their name is called. Play games like peek-a-boo and wave bye-bye when prompted. Social and separation anxiety start to develop. 
• Speech & Language: They say “dada” or “mama” non-specifically. They mimic sounds from parents. 
• Gross (large) motor: They sit well without support, crawl on hands and knees, and pull up to a standing position.  
• Fine motor: They pick up objects with the thumb and 2-3 fingers, will feed self. They bang toys or other objects together

Questions from the Pediatrician – your baby’s doctor will ask questions about feeding, sleeping, voiding (urination) and stooling (bowel movements), and development.

Nutrition – Continue breastfeeding or formula bottles. Average intake for a 9 month old is about 24 ounces per day. Avoid juices and cow’s milk. Continue to give a variety of pureed foods and infant cereals. Your baby may be ready for more chunky foods and small pieces of table foods. Remember that even though they have teeth they will not usually chew food well, so make sure pieces are small enough to be swallowed whole easily. Offer your infant high-allergen foods such as peanut butter and eggs, unless there is a history of severe allergic reaction in another family member. Continue to avoid raw honey. 

Exam – your infant will have a head-to-toe exam at every well-child visit. 

Testing – a small sample of blood will be collected to check your baby’s hemoglobin level, which looks for anemia. This is usually collected from a finger or a toe. 

Vaccinations – If you have followed the CDC recommended schedule, there are no vaccinations due today. The exception to this would be the flu vaccine at appropriate times of year.

Questions from you – as your child interacts more with the environment and people around them, you will likely have more questions about proper developmental milestones, nutrition, sleep habits, and more. Bring your questions to the visit so you don’t forget them!

Safety information – part of every well-child visit is discussion of safety that is appropriate for age. For infants, this includes:

• sleep practices – infants should still be placed to sleep on their back in their own basinet or crib, though at this age they are likely rolling around. There should be no extra blankets, pillows, crib bumpers, stuffed animals, or sleep positioners in the crib. Infants should never sleep in parents’ bed, in swings, or in reclined sleepers. 
• car seat instructions – infants should continue to be in their car seats, in the back seat, facing backwards. Never leave the baby in the car alone. 
• water safety – infants should never be left alone in the water, even if it is only a few inches or only for a short amount of time. Drowning occurs quickly. 
• fall risks – nine month old infants are very mobile, which puts them at a higher risk for falls.  They should not be left alone on couches, changing tables, beds, or any other elevated surface. Use baby gates to block stairs. 
• choking – nine month old infants put lots of different objects in their mouths and are exploring a variety of new foods. Avoid contact with small objects and plastic bags. Make sure foods are cut into tiny pieces. 
• baby proofing – make sure all cleaning supplies, medications, and chemicals are up high or locked away. Check your floors and lower cabinets/shelves for small objects. Use outlet covers and hide electrical cords. Place barriers around space heaters and fireplaces. 
• sun exposure – avoid direct exposure during the middle of the day as much as possible. Use hats and long sleeves. Use sunscreen with a high SPF. 

Next visit: 12 months

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