115 – 9 Months Old

Introduction to the 9-Month Visit 0:00

Hi, you're listening to the Baby Manual podcast, the podcast that helps you feel confident as a new parent. I'm your host, a pediatrician and mom, and the author of the baby manual, Dr. Carol Keim. Hello and welcome to this week's episode of The Baby manual podcast. This is episode number 15 for when your baby is between nine and 12 months old. So for the nine month visit, when I'm talking with parents, it seems that they usually have their routines down by now. I'd say this is sort of a golden period where you're really feeling on top of things.

Babies are sleeping a little bit better. You're able to watch their cues a bit more easily. And usually you feel a lot more confident as a parent at this time. It's okay if you don't. Parenting is one of the hardest things we ever do. Make sure you engage with your child often by talking to them and waiting for them to respond. A lot of babies at this age will babble back and forth with parents, and they usually start to become mobile at his age, they'll start moving away from you a little bit, but they should be checking back often to look at you and make sure that they connect and that you're watching them.

I like to suggest having a yes space at this age, which is an area where your baby can be totally safe, no matter what they get into in that area.

Development and Social Interaction 1:12

So maybe that's a playpen, maybe it's the room, but somewhere where you know that anything that they're touching, if you needed to step away for a second or look away from them, you now that their going to be safe. You should start having regular date nights at this time, and you can have a babysitter watch your baby. Most parents at nine months of age are feeling more comfortable letting their baby stay with somebody else. And also make sure you're making time for yourself. You can go and do some self-care things, maybe go get a massage, get your nails done, go a haircut, hang out with friends, those types of things.

Have a baby sitter during those times so that you get little bit of a break. Also make sure you're having regular date nights with your partner. This is a good time to reconnect and make you are on the same page about everything. Somewhere around a year is where the parenting differences really start to show up. So if there's anything you need to talk through with you partner, this is great time do that. And with baby, you want to be using consistent and positive discipline, which means things like noticing and commenting on the good behavior that they have.

Like, Oh, You handed me that toy to play with. Oh you put that away. Things like that. You don't need to say good job. That's actually something you know, over praising can actually be harmful to children. So just noticing. And commenting. On it is one great way for them to get that attention and to know what they're supposed to. Be doing. and try not to use the word no as much as possible. Instead, tell them what they can do or use distraction. So, for example, if your baby reaches for a knife, you can say, oh, here, let me give you a spoon instead and just swap it out for them.

You should also be a role model for your baby at this age. So model, for them, what to do when you're feeling angry or frustrated or sad. And they'll be watching you and learning those sorts of cues. For development at nine months of age, a lot of babies will have some stranger anxiety or apprehension, and it starts going away around a year or a little before a They should be looking for you in a room of people, so they'll seek out their parent and the people that they know well. And they will be using repetitive consonant and vowel sounds while babbling.

So most nine months old will say mama, dada, but it's not specific. They might call both parents mama or data, or they might use other types of similar repetitive sounds like that. They'll typically point out objects. So you can ask them in a book, you know, where's the cat? Where's dog? And they'll point to it. Or they might point at things that they find interesting. They have object permanence at this age. At six months, when they were grabbing something and you took it away and hid it behind your back, they wouldn't go looking for it, at nine months they do start looking.

If you take a toy away, and hide it they will go after it and look for where it went.

Sleep, Feeding, and Nutrition 4:00

That's object permanent. They'll also play interactive games at this age. So they'll respond to peek-a-boo when you cover your face and say peekaboo. Whereas at six months with peek a boo, they think you're totally gone when your hide your phase like that. But now with that object permanence, They think it's hilarious. They also respond well to cause and effect toys. so things like where you push a button and something pops up. they like those types of toys at nine months. They're going to be exploring their environment a lot at this age, with their body by crawling or rolling around the floor, their eyes by looking all over, and then also with the mouth.

So they put everything in their mouth at that age and that's pretty typical. And they should be moving across the floors on their own to try to get things that they want. If you wanna start weaning a pacifier, nine months is a good age to start with that. A lot of babies, if you wait until after a year, they get a little bit more attached to it and it's a lot harder to do. So if your thinking you want to get them off the pacifiers sooner than later, then nine month is good time to to with start that, but if they need it, like their one comfort object, than I say don't take that away.

Let them have something to soothe them down. You can try subbing it out for like a stuffed animal instead of a pacifier at this age. Remember ones that don't have any eyes or buttons or anything that could come off. They should have the eyes that are sewn on if it's a stuff animal. For sleep at the age, they're typically sleeping 10 to 12 hours at night and taking two naps during the day that about an hour or two each. Babies at nine months pretty much have their bedtime routines established. So if you have your nice little wind down with some quiet time, maybe some reading and singing to them, brushing teeth, some parents will do a bath before bedtime to help them calm down.

But they really get used to those patterns and start to expect them at this age. They should be sleeping in a crib in your room at this age still, but you can consider moving them into a Crib in their own room when they're a year of age. Remember still no blankets in the bed until one year age and no pillows until two years of Age. And you should not be putting them down with a bottle in there bed. That's a very bad habit that is hard to break and can cause serious tooth decay in babies. If they really need that bottle for bedtime, they're old enough now that they can have water, so it's okay to give them a bottle of water at bedtime at nine months.

For nutrition at this age, this should be doing three meals and two or three snacks per day, typically at the same time as family. So usually they are sitting in a high chair with the family and you're eating all together. Make sure you are offering a variety of foods and textures so that baby can play with food and get used to a lot of different foods. then you should be offering all of the food groups at this age. The only thing they're not allowed to have is anything containing honey because honey has a spore that can cause botulism, which can be deadly for babies.

And you shouldn't be giving them cups of milk because milk is fairly lacking in nutrition and it fills them up a lot. But it is okay to do dairy products. So you can give them yogurt, cheese, whatever sort of dairy product you have at home. Those are okay, just not straight up milk. They should be drinking still about 24 to 30 ounces of breast milk or formula per day and then supplementing with foods on top of that. They're getting about half of their nutrition from the breastmilk or the formula and about a half from foods at this age.

They can start having water on their own in a cup at this age. And I like those little, you know, those solo cups, they make shot glasses and they're one ounce and are the perfect size for babies to hold at his age, their disposable. If they, if they crush them, it's okay. You have plenty of them. Or if throw it on the floor, It's not going to break. But you can also use soft, like silicone cups or plastic cups at the age as well. And really one or two ounces at a time is plenty to be offering. And you should offer water with each meal that they have and each snack that the have.

They should be eating something green every day. So things like broccoli, string beans, peas, kale, any green veggies, they iron in them and that's nice and healthy for them. It's okay for the to have meat. If you're doing red meat, it should about two or three times per week. And having greens every day or red meat two or three times per week is enough to give them the iron that they need. But if your baby's a picky eater and not wanting those things, then you might need to be supplementing with a vitamin that contains iron.

Remember that most gummy vitamins don't have iron in them. And that's because iron is something that babies can overdose on and can be pretty dangerous. So with the gummies being so tasty and looking like candy, they leave the Iron out of those gummys typically. The chewable vitamins are good, or you can do liquid vitamins still at this age. Remember, they're doing lots of oral exploration right now. And if you have a dog at home, most babies will get into the dog food and eat a couple pieces or get in to the water and play with it.

That's okay. A lot of parents get worried about that. But there aren't really any diseases that dogs carry that babies can catch other than intestinal worms.

Teeth, Potty Training, and Digestion 9:00

Most dogs in the US are being treated with some anti-worm medicine. It's something that, you know, if your baby does end up getting a worm infection, we can talk about that a little later during one of the toddler episodes, but it would look like a very itchy bottom where when you take the diaper off, they start itching their butt right away or it might get really red or you might actually even see worms in their poop. So other than worms, though, it's totally safe for kids to eat dog food. It is not dangerous or poisonous for them.

You should also expect them to be eating crumbs off the floor. Anything they find on the floors, they're going to put in their mouth. They're gonna put pieces of fuzz in there mouth, dirt, rocks, dust, anything that they can find. But they love eating everything at this age. So basically, if they swallow it, it's okay. It's gonna pass through them. Yeah, you don't need to too worried about them eating things off of the flour. That they typically don' t get diseases. unless it's like maybe in a hospital or in the bathroom or something.

That's a little gross. But yeah, for the most part, it is okay to just let them get their hands up to whatever they want. For teeth care at this age, most babies will have some teeth at nine months, but some still won't, and that's okay. It's OK for them not to have any teeth even as late as 18 months of age. As soon as they do start having teeth, you should be brushing them twice a day with a toothbrush and plain water or fluoride-free toothpaste. And if you don't have fluoride in your water source, then you can also use fluorid toothpaste, but only the size of a grain of rice on the toothbrush.

So just a tiny bit, just enough that you see that, you've touched the tooth brush to the toothpaste and a little bit stuck to it. And that amount is okay to swallow. So if there's no fluoride in your water source, you can do that to help protect their teeth. And when they swallow that extra fluorite, it goes into their bloodstream and it actually helps the teeth that are still developing inside the gums to get stronger enamel so it can help prevent future cavities. If they don't have any teeth yet at this age, you can be brushing their gums twice a day with a plain water and a toothbrush, or you could use a wet washcloth to just clean off their gum and their tongue after they eat twice the day.

And their first dentist visit is going to be at a year of age. So if you want to plan ahead, schedule that now, but after their 1st birthday. As far as peeing and pooping is going at this age, this is actually a really good age to start potty training. I know in the US, the typical age for potting training is between two and four years. And a lot of parents look at me like I'm crazy when I say you can train your infant, but you really can. Once they're nine months, they are able to sit unsupported, which means that if you have a baby pot, you could put them on the pot every time they were done eating and every they wake up and just let them sit there for 10, 15 minutes or until something comes out.

And they get used to that routine and they will try to hold it until they're able to go on the potty. They won't hold long enough that they would cause any infections. So babies who are less than a year are not able hold their pee long to cause a urinary tract infection. It'll just come out. But yeah, this is a great time to start potting training. And also it's okay to keep using diapers. They're usually peeing at least six times per day at this age and pooping about once or twice per. And the poops are starting to look more like adult poos because they're eating food.

So they should be brown and they kind of stick together. It's okay if they are a little bit mushy. If they really hard like pellets, it means that your baby is going to need some more water and maybe even a bit more fiber because that is constipation. Or if there's straining or crying when they poop at that age, then start with increasing their water intake. Then increase the fiber, so fruits and vegetables. And then you can consider adding in prune juice or pear juice. Two ounces once or twice per day should help.

And if all of those are not enough, then talk to your doctor before you start any other medicines or any treatments. Typically, we'll give Miralax for constipation at this age. If your baby develops diarrhea, which is soft, watery poop at this age, then you want to just replace those losses with extra water, or you can look up a recipe for oral rehydration solution. It's basically water with a little sugar and salt in it. And we do have things like Gatorade and Pedialyte here in the U.S. too that you use, but also it's a lot cheaper to make it yourself and it actually kind of tastes better.

If they don't like the flavor of it, you could put a tiny bit of juice in or even do half apple juice and half water or one quarter apple with three quarters water. Typically, we don't do juice before a year of age, and if they have too much juice, that will cause diarrhea. If you've been giving your baby juice and they're getting diarrhea, then you should cut back on that and just try giving them water or water with a tiny splash of juice in it for flavor. For skincare at this age, they've typically outgrown their baby acne by now.

And there's usually not a whole lot going on except the occasional diaper rash. Remember if a diaper rush lasts longer than two or three days with regular diaper cream, it's probably infected with something like Candida, which is a yeast or a bacterial infection like staph. So talk to your doctor if the diaper rashes lasting more than 2 or 3 days and they can send in a prescription cream for you. You should be bathing them as often as they get dirty, which really varies at this age. Sometimes when they're crawling around a lot, they might get 30 every day and some babies just don't.

Skin Care and Baby-Proofing 14:00

So two or three times a week is about the average on this edge. But yeah, anything from, you know, twice a weak up to every days. OK for this. And you can use lotion in these babies if their skin is dry, but it's typically not necessary. Make sure you're using sunblock if you are going to be outside more than 30 minutes during the day. And a high SPF like 50 or higher is great for babies because they don't have a lot of pigment in their skin yet to protect them from the sunlight. You can use insect repellent but make sure it's one that's safe for baby.

I like the ones that are citronella based rather than the one's that deet based because deets is poisonous and it is a pretty harsh chemical. Citronella works really well. And if their skin is sensitive, you can actually just spray the citronellas spray on their car seat or their stroller or whatever they're going to be in outside and that can help protect them from mosquito bites. For safety, we're gonna start baby-proofing at this age if you haven't already. And so the baby proofing that happens at nine months is outlet covers so that they can't stick anything into an outlet, stairway gates so they're not falling downstairs, put some barriers around the space heaters or radiators if have those because babies can get burned by touching them.

Or if like a wood-burning stove or a barbecue grill outside, make sure there's a barrier around it so baby can crawl too close to those. Make sure your cleaning products are locked away, either high up in a cabinet where they can't get to it, or in the low down cabinet that has a cabin lock on it so that they cant get that. Remember that babies are kind of like little crooks and they will get into anything if they get enough time to. So nothing is ever completely child proof. If you're able to open it they, can too.

It just takes a little bit longer. Putting things where you can reach it and can see it is one really good way to just baby proof stuff. Make sure electrical cords are out of reach. Babies love to pull on stuff at this age. They like to put themselves up to standing. So they'll pull those cords and can pull things down. And also make sure you're not having any hot liquids or heavy objects on tablecloths or the coffee table at his age because they are likely to pulled those over and I've seen some pretty bad burns in babies at the stage because the pulled over a coffee cup.

Make sure you keep your baby in your arms or in a high chair or playpen when they're in the kitchen and also in bathroom. And make sure they are never in these rooms alone because babies can drown in toilet. They can turn on the water in tub and get burned or drown. In that water and in kitchen there are sharp things like knives, there's glass. Make the glass bowls and things are up in high up cabinets where they can't reach them. and expect them to go into the cabinets down below. So I like to keep things like pots and pans down, below or plastic ware like the plastic baby dishes so that in case they do pull them out to play with them, it's still safe.

Also, one piece of advice I like to give is not to take medicines in front of your baby, not even Tylenol, because your babies going to learn that those types of bottles, you're supposed to open it and put those things in your mouth that come out of it. And they're watching everything you do at this age. So if you need to do take medicine with your Baby around, just turn away from them while you open the bottle and the pills in the mouth. You want to set your water temperature to 120 degrees Fahrenheit.

And that is because temperatures higher than that can cause scald burns quicker than baby can pull their hand away. But if it's less than 120 degree, even if the water's on full hot, they should be able to get their hands out if they touch it before they get burned. Make sure you're avoiding secondhand smoke. And remember, if anybody smells like smoke and is then holding your baby, that baby is breathing in thirdhand-smoke particles. So if you do need to smoke, make sure to go outside for that. Change your clothes when you come back in and wash your hands with soap and water before you hold your Baby.

The best is, of course, to stop smoking if your are able to. Make sure that you have a rear-facing car seat until they're two years old or until the outgrow the size of the carseat. It's actually safer to keep them rear facing as long as possible, even as toddlers, but at least until age two or outgrowing the cars seat size. And then make sure you save the poison control number in your phone. So if you just go online and look up poison, control, uh, you can save that phone number. In case of emergencies, in case your baby swallows something or in you find them with an open container of something that could potentially be poisonous.

They know what to do immediately. And a lot of doctors offices won't necessarily know all of the poisons by heart, but the Poison Control Centers will know exactly what sort of monitoring

Checkup, Vaccines, and Closing 18:30

they need and whether or not you're going to have to take them into the emergency room. For the nine months checkup, man, I love this age. So most nine-month-olds, as soon as I get in the room, they've already torn up all the exam room paper and the parents were like, oh, so sorry. And I'm like it's disposable. It's fine. I expect them to tear up that paper. They might try to eat it as well. If they try not to let them eat, and then also they always try and eat my stethoscope and my badge because they're just, you know, if they want to put everything in their mouth, or just exploring like that.

so I always make sure I sanitize my Stethoscoping badge before I go in those rooms. We're going to do a full head to toe exam and make sure that everything looks physically normal. And we'll still screen you for postpartum depression because remember post partum, depression symptoms can show up any time in that first year of life. At the nine month visit, there's typically not any vaccines other than the flu vaccine and the COVID vaccine now, but the other routine vaccines of the primary series should be done at two, four and six months.

Now, the next checkup is going to be at one year of age and we're going go every three months now. So after nine months, we do 12 months 15 months and 18 months And we typically do vaccines at the next three visits. So the 12 month, 15 month and 18 month visit, they will get some shots. It's typically between five and seven vaccines, depending on whether your office does combo vaccines or single vaccines. And that will happen over the Next few. We'll usually do three or four at a year, two or three at 15 months, and then one or two at 18 months.

Remember that after a year of age, they're going to have their first dentist checkup and their 1st eye exam by an ophthalmologist if anyone in the family wears glasses. So you can get those scheduled now if you want to plan ahead, but also you could wait until next visit and I'll tell you that again at the next episode, which will be our 12 month visit. That's all for today. Enjoy your 9 month old baby and feel free to reach out to me on social media. My handle is doctor at your door. I'm on TikTok, Instagram, Facebook, and would love to hear from you if have any feedback for me.

Thank you for listening to the Baby Manual podcast. Please hit that subscribe button below so you don't miss the new episodes when they come out. I would also love it if you could leave me a review. If you'd like to buy a copy of the baby manual, it's on Amazon and Kindle. The author, Dr. Carol Keim, and that's spelled K-E-I-M. You can also follow me on YouTube, TikTok, Instagram, or Facebook to get some quick baby tips that will make you feel like an expert. Thanks for