Well-Child Checkup: 9 Months
I can sit up and may have begun crawling. I will soon be able to pull myself up to a standing position. Once I am secure in this upright position, I may start cruising around on objects that I can hold on to, like the couch or coffee table. I am curious about everything. I like to open drawers and cabinets and examine everything within my reach.
My vocal abilities also are improving, and I may start making word-like sounds and imitating what you say. I am also beginning to hear the word “no” now. Although I don’t know what it means, I know I have done something wrong. I might test you a little. I am more aware of other people and may be scared of new faces. I am able to feed myself with my fingers, and this helps me learn to use my hands. I like to play Peek-a-Boo. Soon I will learn to wave bye-bye.
Please remember to:
Use my rear-facing car seat, even if I protest. Child-proof the house with locks, latches, gates and socket covers when appropriate. Know the phone number to the local poison control center (1-800-222-1222). Keep all small objects out of my reach, such as peanuts, hot dogs, grapes and small toy parts. Make sure I can't get my hands on plastic bags, because I can suffocate. Start introducing me to a sippy cup so that you can take my bottle away soon. Make sure to put sunscreen and a hat on whenever I go outside. Please brush my teeth twice a day, but don't use fluoride toothpaste, I'm not ready for it yet.
Water Safety
The key to successful water safety is recognizing that a child’s capabilities are always changing. Since drowning kills more toddlers in California than any other cause, the following guidelines should be followed.
Never leave a child less than five years old unattended in a bathtub or wading pool. Toddlers can drown in two inches of water.
Never leave a toddler unattended near a bucket, large can, toilet or even a dog’s bowl, with water inside. If children peer inside, they may fall in and drown because they are unable to hold their breath or lift their head out of the container.
Never leave children who can’t swim well unattended near a swimming pool. More children drown in backyard swimming pools than at beaches or public pools. Make sure that all home and neighborhood pools are fenced off and that the gates around them are kept locked. Identify the adult in charge of watching the child. Drowning happens more when parents assume their spouse is watching the child(ren).
An infant or toddler can be acquainted with water fun; however, submersion of the head should be avoided. A child can inhale enough water in the first ten seconds under water to cause symptoms of near drowning.
A child under four years of age is not able to understand the basic elements of water safety. Try to arrange swimming lessons for your child after the age of four and before the age of eight. Remember, while children can be taught to swim, they cannot be taught to save themselves. Adult supervision is essential whenever your child is around water.
Caution children of all ages to check the depth of the water before diving into a pool and not to dive into the shallow end. Caution the accomplished swimmer to always swim with a buddy, never alone.
Caution children not to over-breathe (take repeated deep breaths) before diving into a pool as a way to stay under water longer. This practice can lead to passing out while under the water, causing drowning.
Anyone over 14 years old can and should learn CPR and update their skills annually.
All children must wear life jackets when boating or sailing. A child who can swim in a warm, calm pool may not be able to swim to shore in a cold river or ocean after falling overboard. Falling overboard can also lead to head injuries, and life jackets can prevent drowning in this situation as well. Set a good example and wear your life jacket as well.
Car Safety Seats
The major killer and crippler of children in the United States is motor vehicle crashes. Improper use of child safety seats causes death or injury in thousands of children each year. Seven out of ten children in child safety seats are not properly buckled in.
Important safety rules
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Always use a car safety seat, starting with your baby's first ride home from the hospital.
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Never place a child in a rear-facing car safety seat in the front seat of a vehicle that has an airbag.
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The safest place for all small children to ride is in the back seat.
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Set a good example: always wear your seat belt. Help your child form a lifelong habit of buckling up.
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Remember that each car safety seat is different. Read and keep the instructions that came with your seat.
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Read the owner's manual that came with your car on how to correctly install car safety seats.
Choosing a Car Seat
Choose a car safety seat that is right for your child’s age and size.
| AGE GROUP |
TYPE OF SEAT |
GENERAL GUIDELINES |
| Infants/Toddlers |
Rear-facing only seats and rear-facing convertible seats |
All infants and toddlers should ride in a Rear-Facing Car Seat until they are 2 years of age or until they reach the highest weight or height allowed by their car safety seat's manufacturer. |
| Toddlers/Preschoolers |
Convertible seats and forward-facing seats with harness |
All children 2 years or older, or those younger than 2 years who have outgrown the rear-facing weight or height limit for their car seat, should use a Forward- Facing Car Seat with a harness for as long as possible, up to the highest weight or height allowed by their car seat's manufacturer. |
| School-Aged Children |
Booster seats |
All children whose weight or height is above the forward-facing limit for their car seat should use a Belt-Positioning Booster Seat until the vehicle seat belt fits properly across their shoulder, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age. |
| Older Children |
Seat belts |
When children are old enough and large enough to use the vehicle seat belt alone, they should always use Lap and Shoulder Seat Belts for optimal protection. All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection. |
Infant-Only Seats
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These are small and portable (sometimes come as part of a stroller system).
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These have a 3-point or 5-point harness.
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They can only be used for infants up to 20 - 35 pounds, depending on the model.
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Many come with detachable base, which can be left in the car. The seat clicks in and out of the base, which means you don’t have to install it each time you use it.
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Most have carrying handles.
Convertible Seats
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These are bigger than infant-only seats.
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These can also be used forward-facing for older and larger children; therefore, these seats can be used longer.
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Many have higher rear-facing weight limits than infant-only seats. These are ideal for bigger babies.
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They may have the following types of harnesses.
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5-Point Harness
5 Straps:
2 at the shoulders
2 at the hips
1 at the crotch
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T-Shield
A padded T-shaped
or triangle-shaped
shield attached to the
shoulder straps.
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Overhed Shield
A padded tray-like shield that swings.
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Booster Seats
Your child should stay in a car seat with a harness as long as possible (i.e. as long as they fit the weight and height limits of the car seat) and then ride in a belt-positioning booster seat. You can tell when your child is ready for a booster seat when one of the following is true:
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He reaches the top weight or height allowed for the seat.
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His shoulders are above the harness slots.
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His ears have reached the top of the seat.
Booster seats are designed to raise your child so that the lap/shoulder belt fits properly. This means the lap belt is across your child’s pelvis and the shoulder belt crosses the middle of your child’s chest and shoulder. Correct belt fit helps protect the stomach, spine, and head from injury. Both high-backed and backless models are available. Booster seats should be used until your child can correctly fit in a lap/shoulder belt, which is typically when a child is at least 4’9” and 8-12 years old.
Government safety standards
Since January 1981, all manufacturers of child safety seats have been required to meet stringent government safety standards, including crash-testing. Choose a seat that has met Federal Motor Vehicle Safety Standard 213, with 1981 or later as the year of manufacture. When in doubt or if you have questions about installing your car safety seat, Child Passenger Safety (CPS) Technicians can help you. A list of inspection stations is available at www.seatcheck.org. You can also get this information by calling the National Highway Traffic Safety Administration (NHTSA) Auto Safety Hot Line at 888-327-4236. The American Academy of Pediatrics also publishes a list of infant/child safety seats that is updated yearly. To obtain this list, go to http://www.healthychildren.org/English/safety-prevention/on-the-go/pages/ Car-Safety-Seats-Product-Listing.aspx. California Law
California law (as of 1/1/2012) states that each child must be properly restrained in a child safety seat or booster seat in the back seat of the car until the child is 8 years old or at least 4’9” in height. The law specifically states that:
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Children under the age of 8 must be secured in a car seat or booster seat in the back seat.
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Children under the age of 8 who are 4’9” or taller may be secured by a safety belt in the back seat.
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Children who are 8 years and over shall be properly secured in an appropriate child passenger restraint system or safety belt.
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Passengers who are 16 years of age and over are subject to California’s Mandatory Seat Belt law.
Exceptions to the law are:
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There is no rear seat.
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The rear seats are side-facing jump seats.
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The Child Passenger Restraint System cannot be installed properly in the rear seat.
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All rear seats are already occupied by children under the age of 7 years.
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Medical reasons necessitate that the child or ward not ride in the rear seat. The court may require satisfactory proof of the child's medical condition.
A child may NOT ride in the front seat with an active passenger airbag if:
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The child is under one year of age,
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The child weighs less than 20 pounds, or
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The child is riding in a rear-facing Child Passenger Restraint System.
Poison Control
If a Poisoning Occurs
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First, remain calm.
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Call the California Poison Control System at 1-800-222-1222. If, for some reason, you are unable to contact the poison center, call 911 or your physician. Be prepared to answer these questions:
Who was poisoned?
What is the age of the person?
What is the name of the suspected poison?
How much of the poison was involved?
When did it happen?
Is the person having any symptoms?
Your name and telephone number.
3. Follow the instructions given to you exactly. If you don’t understand something, ask.
4. DO NOT follow the first aid instructions on product labels; many are wrong. DO NOT make the person vomit unless instructed.
Prevent Poisoning
You can prevent poisonings by “poison-proofing” your home: choosing products carefully, storing products safely, using products safely, and knowing what to do if a poisoning occurs. Follow these guidelines to prevent poisonings in your home.
Choose Safe Products
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Read the label and compare products, paying close attention to warnings, cautions and hazards. Choose the least dangerous one to use.
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Select products with childproof caps or containers, and close tightly after each use.
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Buy the smallest amount needed so you won’t have dangerous leftovers.
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Know the names of all your house plants and remove any (for example, dieffenbachia) that could cause sickness other than vomiting or diarrhea. Teach your child never to put leaves, stems, seeds, or berries from any plant into his/her mouth.
Use Products Safely
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Read the directions each time you give a medicine. Don’t call medicine “candy.”
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Turn on a light _ never give medications in the dark.
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Don’t leave your child or pet alone with poisons, even for a moment to answer the door or telephone. Don’t leave medicines in a purse because children often search purses for candy or gum. When you have guests, keep purses out of reach of children.
Store Products Safely
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Lock cabinets containing medicines and chemicals. Use child-safety latches.
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Use original containers for chemicals. NEVER store them in soda bottles, jars, etc.
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Keep chemicals out of sight and out of reach. Keep them away from food items and never under the sink.
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Keep alcoholic beverages out of reach. As little as three ounces of hard liquor can kill a two-year-old child. Remember that most mouthwashes contain 15 percent to 25 percent alcohol.
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Clean out storage areas regularly. Check expiration dates, and get rid of outdated products, especially medicines.
Poisonous Substances
Listed below are some common items found in and around homes that are poisonous.
Keep these items out of the reach of children and pets.
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Acrylic Nail Removers Antifreeze
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Alcoholic Beverages
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Charcoal Lighter Fluid
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Dishwasher Detergents
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Drain Cleaners
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Furniture Polish
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Gasoline
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Gun Cleaners
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Hair Permanent Solutions
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Insecticides
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Oven Cleaners
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Paint Thinner
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Plants and Wild Mushrooms
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Rubbing Alcohol
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Swimming Pool Chemicals
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Toilet Bowl Cleaners
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All medications, especially:
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Anti-depressant Medications
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Blood Pressure Medications
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Camphophenique®
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Cough and Cold Products
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Diarrhea Medicines
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Fever Reducers
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Heart Medicines
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Iron Tablets
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Pain Relievers
Be Prepared
Keep the telephone number of the Poison Control Center programmed into or written on every phone. If you don’t have a sticker, cut out the above box and tape it to your phone RIGHT NOW.
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