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|Quick reference medical handouts used
by Pediatric offices
Growth Milestones - NINE MONTHS
The 9-month-old child
continues making major gains in development and
begins displaying a little independence. The
youngster of this age is always on the move and will
begin to get opinionated about such things as what
foods to eat and when to go to sleep. Occasionally,
these opinions turn into protests, so now is the
time to begin setting some limits and saying "no."
The following comments are designed to help you and
your partner enjoy your 9-month-old while continuing
to gain confidence in yourselves as parents. The
information is not intended as a substitute for
well-baby visits by your newborn's pediatrician.
Never hesitate to ask your child's physician for
guidance concerning specific problems. This is the
reason for regular well-baby checkups.
- Keep up a constant
chatter with your 9-month-old child. Talking to
your child while dressing, bathing, feeding,
playing, walking and driving encourages speech
- Encourage play
with age-appropriate toys. Babies like to
bounce, swing, reach for you, pick up and drop
objects, and bang things together. Unbreakable
household objects such as plastic measuring
cups, large wooden spoons, pots, pans and
plastic containers make great toys. A foam
rubber ball helps the child develop his or her
small motor skills.
opportunities for safe exploration.
- Begin to set
limits by using verbal "no's," distraction,
removing the object from the baby's sight or
removing the baby from the object. Never use
spanking as a form of discipline, even a
"little" tap on the hand. If you become angry
with your baby, put the child in his or her crib
or playpen for one or two minutes. This will
allow you to calm down and allows your baby to
realize he or she has done something wrong.
Consistence of discipline is very important -
adhering to the limits you set keeps your child
- Shoes are not
necessary at this age (except for "show"). They
should be used only to protect the feet from
sharp objects and the cold.
- Stranger anxiety
may limit some parent's ability to leave their
9-month-old with grandparents or a baby sitter.
It is important for parents to get out from time
to time without their little one. You get a
breather, and your son or daughter learns that
sometimes you do go away, but you always come
- During this period your baby will
probably learn to creep, crawl and otherwise get
around the room. He or she may even pull up in
the bed or on furniture and begin "cruising"
around the room.
- Responds to his or her own name.
- Understands a few words such as
"no-no" and "bye-bye."
- Begins developing certain concepts -
for example, your child will retrieve a toy
after he or she watched you put it under a
- May say "dada" or "mama" but not
- Sits well independently.
- Bangs two toys together.
- Plays interactive games well such as
peek-a-boo and pat-a-cake.
- Perhaps the most striking
developmental achievement is the use of fingers
and thumb to poke, pry, probe and pick up
smaller and smaller objects.
- Sleeps through the night except for
an occasional night wakening.
- The 9-month-old has now learned to be
"cool" or even a little afraid of certain
strangers - even family members he or she does
not see very often. The baby of this age also
begins to take a dim view of being examined by
- Often has one or both bottom front
- Nine months is the age when a child
becomes increasing susceptible to infections,
probably due to loss of maternal antibodies the
youngster received during pregnancy. In
addition, everything goes into his or her mouth,
- Do not be discouraged if your child
has a cold or two between now and his or her
- Give your baby soft table foods if
approved by your doctor to increase the texture
and variety of foods in his or her diet. Give
your child the opportunity to use his or her
newly developed skill of plucking things by
offering small bits of soft table foods. (You
may need to give your child a bath after every
meal!) The 9-month-old is a great imitator. The
food on your plate is much more appetizing to
him or her, so take advantage of this to
introduce new table foods.
- Never give a 9-month-old food that
may cause choking and aspiration, such as
peanuts, popcorn, hot dogs or sausages, carrot
or celery sticks, whole grapes, raisins, corn,
whole beans, hard candy, large pieces of raw
vegetables or fruit, or tough meat.
- Always supervise your child while he
or she is eating.
- Continue teaching the infant how to
drink from a cup so he or she is off any bottles
by 1 year.
- Continue using breast milk or
iron-fortified formula for the first year of
your infant's life.
- Continue giving extra Vitamin D to
the breast-feeding infant and supplemental
fluoride to all children who are not exposed to
At this Checkup
- An important part of each
well-child visit is the evaluation of the baby's
growth. In the vast majority of children, growth
falls within normal ranges on the standard
growth curves for weight,
height or head size.
The smooth curves of a growth
chart might create the impression that a baby
grows in a continuous, smooth manner. Instead,
growth usually occurs in spurts. Therefore,
single growth (height,
weight, head size) measurement at any particular
month in a child's life is of limited value -
more important is the child's rate of
growth over time.
- The 9-month-old
will also be checked thoroughly both physically
- Encourage your baby to console
himself or herself by putting your child to bed
- Due to the emergence of stranger
anxiety, the 9-month-old baby may show
resistance to going to sleep for naps and at
- Some 9-month-old babies begin night
awakenings for short periods of time. Should
this happen, check your baby, but keep the visit
brief, avoid stimulating your infant, and leave
the room quickly once you feel everything is OK.
Do not give extra bottles, take the infant into
bed with you or rock him or her back to sleep.
This will only reinforce the night awakenings
and it will become a habit.
- Sleep is also occasionally disturbed
when the infant pulls up in his or her crib and
can not get back down.
- Never put the baby to bed with a
- Remember, there is no
such thing as a "child proof" cap.
- Your adorable newborn
is now "mobile" so child-proofing, if not done
at 6 months, is a priority. Get down on the
floor at your baby's eye level and see what the
infant can get in to.
- Continue to use a rear
facing infant car seat in the back seat.
- Do not leave your
child alone in a tub of water or on high places
such as changing tables, beds, sofas or chairs.
Always keep one hand on your baby.
- Avoid using baby
walkers. There is considerable risk of major and
minor injury and even death from the use of
walkers. There is no clear benefit from the
- If your home uses gas
appliances, install and maintain carbon monoxide
- Always empty buckets,
tubs or small pools immediately after use.
Ensure that swimming pools have a four-sided
fence with a self-closing, self-latching gate.
Swimming pools are deadly to children at this
- Continue to keep the
baby's environment free of smoke. Keep the home
and car nonsmoking zones.
- Avoid overexposure to
the sun. A waterproof sun screen with an SPF
more than 15 is OK. Even with sun screen, avoid
the hours between 10 a.m. and 3 p.m., when the
sun is most dangerous.
- Do not leave heavy
objects or containers of hot liquids on tables
with tablecloths that the baby may pull down.
- Place plastic plugs in
- Keep all poisonous
substances, medicines, cleaning agents, health
and beauty aids, and paints and paint solvents
locked in a safe place out of the baby's sight
and reach. Never store poisonous substances in
empty jars or soda bottles.
- Install gates at the
top and bottom of stairs, and place safety
devices on windows.
- Lower the crib
- Learn child
cardiopulmonary resuscitation (CPR)
Since immunization schedules vary from
doctor to doctor, and new vaccines may have been
introduced. It is always best to seek the
advice of your child's health care provider
concerning your child's vaccine schedule.
- Many physicians apply a painless skin
test for tuberculosis which needs checking by
the parents in three days. A positive reaction
does not mean the child has tuberculosis - only
that he or she has been exposed to the disease.
- Ask your baby's doctor about possible
side effects (fever, irritability, tenderness
over the injection site).
- Some physicians at 9 months, others
at 12 months, perform a hemoglobin or hematocrit
determination to check for anemia ("low blood").
This requires a small poke on the finger to
obtain a drop of blood.
More Vaccine Information, see:
Vaccines and the Diseases they Prevent;
Immunizations should my child have had by nine
a record of your child's immunizations.
(Click to download an immunization record)
When to call the Doctor
- Anything that bothers you!
- Your baby shows little interest in
social interaction, avoids eye contact and
- Your baby seems stiff or floppy.
- Will not bear weight on legs.
- No babbling, infant squealing or
- Does not turn when name is called.
- Eyes are always crossed.
- You have not seen any developmental
changes since the last checkup.
presented in Growth
Milestones was obtained
with the help of our
pediatric experts and
with material from The
American Academy of
for Health Supervision
and Bright Futures'
Guidelines for Health
Supervision of Infants,
Futures is supported by
the Maternal and Child
Health Bureau, U.S.
Department of Health and
Human Services. Revised
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
Please read our full disclaimer.