115 – 9 Months Old

Dr. Carole Keim MD introduces everything to know about babies at 9 months of age in this episode. She details developmental milestones and safety considerations for the 9 to 12 month age range and lets you know what to look for.

Dr. Keim encourages parents to have date nights at this stage, to leave your baby with a trusted sitter, and also to start really talking out any parenting differences that may have appeared. She talks about all the ways in which your baby will have developed, from object permanence to repetitive sounds, and covers sleep, nutrition, and teeth as well. This is the age to really start baby proofing your home with outlet covers and stairway gates, and Dr. Keim also shares advice on skincare and the 9 month check up.

This episode will cover: 

• Parents
• Development
• Sleep
• Nutrition
• Teeth
• Elimination
• Skin Care
• Safety
• 9 Month check-up

Parents: 00:26

• Typically have routines down
• Engage with child often by speaking with/to them, waiting for them to respond
• Infant should be able to separate or move away from parent for moments, but will check back to look at them
• Have a “yes” space
• Have regular date nights with a babysitter watching baby
• Make time for yourself
• Hang out with friends 
• Use consistent positive discipline (notice/comment on good behavior, avoid using the word “no” and instead tell them what they CAN do, use distraction, be a role model) 

Development: 03:00

• Stranger anxiety / apprehension
• Seeks out parent
• Uses repetitive consonant and vowel sounds while babbling
• Says mama or dada (not specific)
• Points out objects
• Has object permanence
• Interactive games (responds to peek-a-boo, cause-and-effect toys)
• Explores environment with eyes, body, and mouth
• Some movement across floor
• Can start weaning pacifier 

Sleep: 05:20

• 10-12h at night, 2 naps per day
• Bedtime routine established: quiet time, reading, singing
• In crib in parents room; consider moving to own room when 1 year old
• Still no blankets until 1 year old
• No bottles in bed

Nutrition: 06:21

• 3 meals and 2-3 snacks per day at the same time as the family
• Offer a variety of foods and textures 
• Should be consuming 24-30oz of breast milk or formula daily
• Can have water; can start using a cup
• No cow’s milk or honey until 1 year of age
• Should be eating greens daily; ok to have meat; supplement with iron if not eating greens daily or red meat 3x per week
• Lots of oral exploration at this age; they might get into dog food/water, eat crumbs off the floor, eat rocks/sticks/dirt outside 

Teeth: 09:59

• Brush teeth BID with fluoride-free toothpaste; if there is no fluoride in water source can use a grain-of-rice sized amount of fluoride toothpaste 
• If no teeth yet, brush gums BID with plain water and toothbrush
• First dentist visit will be at 1 year of age

Elimination: 11:10

• Can start potty training by putting baby on potty after eating and upon waking
• Typically voiding at least 6x per day, stooling 1-2x per day
• If baby is constipated: first increase water intake, increase fiber (fruit and veggies), then consider prune juice or pear juice 2oz 1-2x per day.  If not enough, talk to your doctor about miralax.

Skin care: 13:29

• Bathe as often as they get dirty (2-3x per week)
• Can use lotion 
• Use sunblock if spending more than 30 mins outside 
• Insect repellant for babies (citronella based is best)

Safety: 14:54

• Baby proof the house – outlet covers, stairway gates, barriers around space heaters, cleaning products locked away, electrical cords out of reach 
• Keep baby in arms or a high chair or playpen in the kitchen and bathroom; never allow baby to be alone in those rooms
• Set water temp to 120’F 
• Avoid secondhand smoke
• Rear facing car seat until age 2
• Don’t leave heavy objects or hot liquids on tablecloths or coffee table 
• Save poison control number in your phone 

9mo Checkup: 18:40

• Expect them to tear up and try to eat the exam room paper
• They try to eat my stethoscope and badge 
• Full head-to-toe exam
• Postpartum depression screening
• No vaccines this visit, other than flu and covid
• Next checkup is at 1 year of age (after first birthday); will do vaccines at that visit 
• Reminder that after 1 year of age should have their first dentist visit and eye exam at ophthalmologist 

All of the information in this episode is also in The Baby Manual book, which is available for purchase. Remember it is always okay to call your doctor or emergency services if you have concerns about your baby’s health.  

Resources discussed in this episode:

• The Baby Manual (https://www.amazon.com/Baby-Manual-Ultimate-Guide-Parents/dp/1977608698/ref=sr_1_2?crid=37H1GELHZW5FJ&keywords=The+Baby+manual&qid=1643324113&sprefix=the+baby+manual%2Caps%2C118…