The Year Ahead: Age 1

"Physical development consists of both gross motor (GM) and fine motor (FM) development," says Cheryl Wu, M.D., of LaGuardia Place Pediatrics in New York City. "And while every child develops at his own pace, there are certain milestones I expect most of my patients (90 to 95 percent) to achieve by the first birthday."

By 12 months, children are either very proficient crawlers and/or are cruising easily around using furniture as support, says Dr. Wu. They may also be walking or "toddling" quite well. You can encourage cruising and walking by letting your child move around without help, so be sure to childproof your house sooner rather than later. Try not to pick him up and carry him too often. Although it might take you a little longer to get from room to room, you want to give him as much opportunity to move freely in a safe environment as you can. You might also want to arrange furniture so that it's easier for him to grab hold and move from place to place while cruising.

By 12 months, a child also has the "mature" pincer grasp and can hold objects as small as a raisin between forefinger and thumb. Most children will walk by 16 to 17 months, and by 18 months, he can throw a ball overhead and try to catch it. He can kick a ball, climb into an adult chair or couch, and walk and run fairly well. He can build a tower of two to three blocks, or can try to screw on a water bottle cap or pen cap. He may start to scribble with a pen, and attempt to feed himself with a spoon and fork.

Worried your child isn't hitting his milestones quickly enough? "The best thing parents can do to make the most of their visits with their child's pediatrician -- if they are interested in development -- is to ask the doctor directly what their child should be able to do, or anything they can work on," says Dr. Wu. "Child development is a magical thing. There is quite a large variation, but throughout the world, children from different cultures follow roughly the same pattern in development as they age."

Separation anxiety is typical at this age and may start between 8 and 14 months old. "The timing and intensity of the separation anxiety may be different for different children," says Jessica Mercer Young, Ph.D., a research scientist at Education Development Center in Newton, MA. "A little anxiety about Mom leaving is totally normal. Parents can help their child during separations, such as drop-off to child care, by having a goodbye routine. Create this routine and stick to it, and try not to drag out the separation, as this can intensify the child's anxiety. "

A big mistake is trying to leave when the child is not looking, or sneaking away when the child is engaged in activity, without saying goodbye. "The child may suddenly become anxious or upset that she didn't get a chance to say goodbye or give a kiss goodbye," explains Dr. Young. "Even if the child becomes upset and cries, he should stop crying soon after the parent leaves. I've often stood outside the door of the preschool to wait for my child to stop crying. He always does and pretty quickly too! Having a regular caregiver is also important so that children can develop a sense of trust."

Other notable behaviors include your little one's obsession with throwing anything and everything in his path. Don't worry -- he's not doing it just to annoy you or to be destructive. One-year-olds are just naturally curious, so he's probably thinking more along the lines of "I wonder what will happen when I drop this cup off the high chair" than "Let me see if I can really drive Mom crazy!"

Because your child has also come to realize that he's a separate entity from you, don't be surprised if he tries to exert some independence now and again. This could mean struggles with getting in the car seat or stroller, taking a bath and changing his diaper. "Parents needs to let their children go through this process of trying to be more independent," says Carl Sheperis, Ph.D., the director of doctoral programs for Walden University's School of Counseling and Social Service. "You just need to catch them when they're exerting that independence in a positive way and compliment them on it." At times when you need them to comply and it's nonnegotiable (like getting into the car seat), remain firm and try to head off any meltdowns with distraction, such as letting him hold a favorite toy or singing some songs while you're strapping him in.

As you can guess, a 1-year-old has a pretty limited vocabulary. There are probably a few words here and there -- mama, dada, baba, for example -- but most of it is simply your child vocalizing. "It's more about babbling than talking at this point," says Lauren Krause, Chief of Speech-Language Pathology at La Rabida Children's Hospital in Chicago, IL. In fact, what's most important now is that your child respond to other's speaking. Does she recognize her mom's and dad's voices? Does she respond to her name? Does she raise her arms when you say "up?" Is there reaction to noises, such as the vacuum being turned on, or a car horn? Does she laugh when others laugh or react when people smile at her? If not, then you should consult your pediatrician.

Over the course of this year, you will notice your child start to say single words on her own. She will also start to be able to follow simple directions (e.g., "Where's your nose?") "The most important way to develop your child's language is through talking to her," says Krause. "In fact, 90 percent of kids learn words through repeating and imitating their parents and others around them." Read to your child, but also participate in some "conversations" with them. "It can be as simple as 'What's that? A dog! What is the dog doing? He's running,'" explains Krause. "You want to engage with them as much as possible and expose them to a variety of words."

During your child's 1-year well-visit, you will discuss several issues with the pediatrician. One of the big ones: Is your child walking yet? "Most babies walk somewhere between 12 and 17 months," explains Nora Carrillo, a specialist for the medical model of child development at Phoenix Children's Hospital in Phoenix, AZ. "But at the very least, a doctor will want to know if your child is crawling, standing up, and starting to cruise on his own."

Your doctor will weigh and measure your child to make sure he's growing at a healthy rate, as well as talk to you about (and possibly administer) the next round of vaccinations. Depending on what kind of schedule you and your doctor have agreed upon, some common vaccinations due at this time include varicella (chicken pox), Hib, pneumococcal, polio (the third dose), MMR, and Hepatitis A.

Other issues your doctor will want to know about include:

• Your child's sleeping habits: How much is he sleeping at night and during naps?
• What kinds of solid food is your child eating? Is he starting to feed himself (using his hands, not utensils)? You'll talk to your doctor about making the switch from breast milk or formula to cow's milk (there's more about that in the Nutrition section).
• Is he making eye contact, responding to his name and pointing at objects?
• Vision: Have you noticed frequent squinting or eye rubbing, or a tendency to hold toys and books close to his face?
• Hearing: Does your child turn toward sounds?
• Speech: Does your child imitate sounds, babble, or say any words?

One more appointment to make: your child's first visit to the dentist. The American Academy of Pediatric Dentistry (AAPD), American Dental Association (ADA) and the American Academy of Pediatrics (AAP) all recommend a dental visit by age one. Why? Baby teeth are vulnerable to tooth decay from their very first appearance.
"We were astounded that only one-third of moms considered oral health a concern for their infants," says AAPD President William C. Berlocher, D.D.S. "Parents will be surprised to know that taking children to visit a pediatric dentist by their first birthday actually saves money. Studies show that dental costs for children who have their first dental visit before age one are 40 percent lower in the first five years than for those who do not see a dentist prior to their first birthday."

The big change for baby at age one: the introduction of whole milk into her diet. "If you're worried about your child making the transition, you can start off by mixing the whole milk with formula/breast milk so that you can ease her into the taste," recommends Amy Marlow, a New York-based registered dietician and certified nutritionist serving as an advisor for Hapy Family, the nation's leading premium organic baby and toddler food maker. She suggests offering only milk in a sippy cup, as you're about to wean baby off the bottle anyway, and you don't want to mix the two transitions together.

Your baby should be getting about 16 to 24 ounces of milk per day -- more than that can interfere with iron absorption and affect her ability to eat other foods, as she'll be filling up on milk, says Marlow. And although cheese and yogurt are good sources of Vitamin D and calcium, they don't pack as much of a nutritional punch as whole milk does.

This is also an important time to shape your child's healthy food preferences, introducing lots of fresh fruits and vegetables, along with other nutritious foods in a variety of different textures (to avoid choking, make sure they are soft, bite-size pieces). Don't be put off if your little one refuses to try a new food -- just keep putting it in front of her and eventually she will relent. "It's also a good time to make your baby a part of family meal time," says Marlow. "It's important for her to see her mom and dad eating healthy foods and trying new things, and it's smart to have established meal and snack times to avoid overfeeding."

Be sure to limit sweets, including juices. "A one-year-old should be consuming only a half cup of juice per day," says Marlow. "You can space it out if you dilute it."

Finally, not sure what foods you should buy organic? Marlow recommends choosing organic dairy and meat products, along with the "dirty dozen," which is updated annually (you can find the list online).

Your baby's sleep patterns will change a bit during the course of the coming year. He'll still need an average of 11 1/4 hours of uninterrupted sleep during the night, but somewhere between 15 to 18 months is when baby will typically drop the morning nap and take one long siesta in the middle of the day (for about 2 1/4 hours). "This a tricky stage because there is usually a point when one nap is not enough and two naps are too many," says Kim West, LCSW-C, aka The Sleep Lady. "The result is an overtired child who doesn't sleep well at night."

West says you'll know your child is ready for this milestone when he consistently gets 10 to 11 hours of uninterrupted sleep at night, takes longer and longer to fall asleep for his morning nap, and takes increasingly shorter morning naps or sleeps for too long in the morning and then refuses an afternoon nap. Once you see the pattern emerging for about two weeks, you can make the transition to one nap per day. But stay open to an occasional two-nap day. "If, during the transition, your child seems too tired, it's okay to let her nap twice -- just limit the morning snooze to 45 minutes," explains West.

Night terrors

Night terrors -- which is different from having a nightmare -- occur in 5 percent of all children and are usually revealed around 15 months (of course, it can happen earlier or later). This can be a scary experience for parent and child, says West. "When a child is experiencing a night terror, he may scream and appear anxious. The child is often inconsolable, and may not recognize you. He may even push you away and seem frightened of you."

What should you do if your child experiences a night terror? According to West, monitor the child but avoid interfering, as this can worsen the episode. "Make sure your child is physically safe during the event," says West. "You can also try putting the child to sleep earlier -- even if by only 30 minutes."
If your child is having a sleep terror two to three times a week at set times during the night (e.g., two hours after going to sleep), West suggests doing the following to change his sleep pattern:

• Keep a sleep log to recognize the pattern -- that helps break the pattern.
• Wake your child 15 minutes prior to the time he usually has an episode.
• Don't get him up completely, but you want him to be at that point of awakeness where he mumbles, moves, or rolls over.
• Do this every night for 7 to 10 nights in a row even if he goes a few nights without a terror.

In the first year, social interactions are largely connected with the primary caregiver, says Jason Gold, Ph.D. a consultant at the Pacella Parent Child Center in New York City. "It is this relationship that is most important in the first year. There are, or course, significant interactions with peers and other adults in the first year, but they are relegated to secondary status in the first year."

At age one, babies will point and vocalize to communicate. "Learning to communicate your wants, needs, and intentions is incredibly important for social development," says Dr. Young. "Pointing in particular is an important milestone as it allows the parent to engage in the baby's attention."

Dr. Young says that when both the baby and the parent are focused on the same object or activity, it is called "joint attention." This usually occurs when a parent follows the baby's gaze or pointing gesture. This is very significant, as it is an important context for language development, social development and cognitive development. Reading to your child and pointing at pictures in books, labeling objects and talking about them, as well as expanding on your child's interests, is a great way to interact at this age.

Your child has mastered a lot over the past year, and he'll learn even more -- walking, talking, jumping -- as this year progresses. "At age one, some self-help skills are expected, such as holding a bottle and a sippy cup," says Susan Cooper, M.Ed., early child development expert at www.appliedscholastics.org. "It's not expected that the child be potty trained at this age, but there should be words for having a bowel movement that are understood by the child and his or her caregivers. If there is one word used, then potty training is so much easier later on. More important than any academic learning is mimicry. Having the 1-year-old do what you do is important to further learning."

Of course, reading to your child will help him learn new words, colors, and letters, so continue to make that a part of your daily and nightly routine. Studies show that children who were read to have a larger vocabulary, as well as more advanced mathematical skills, compared with kids their age.

Choose picture books with big, bright, clear images, and ask questions as you read: Can you find the dog? What does the dog say? A 1-year-old should respond to his name and start pointing and identifying his nose, eyes, mouth, etc. He might not be able to say these words yet, but you can work with him on pointing to them on his face and yours.

"Our daughter, Claire, just turned one and we are trying to get her off the bottle and using a sippy cup," explains Laura Monaco of Syosset, NY. "It hasn't been easy, especially since she prefers to drink her milk out of a bottle. She usually just throws the cup on the floor."

The Solution: Take a gradual approach

Toddlers get attached to things between 15 and 18 months, so it's best to ditch the bottles and make the switch to sippy cups before that time, says West. Not only will prolonging it make it harder for your little one to give up her beloved bottle, but staying on it too long can ruin her teeth and her appetite. The best way to make the switch is to:

1. Introduce a cup, if you haven't already. Ideally, you'll have been giving your baby sips of milk from a cup by 6 to 9 months, but if not, start giving him different cup options until you find one he likes.

2. Eliminate the bottle, starting with lunch, the meal at which the bottle is probably least important to him. Instead, serve his milk in his now-favorite cup.

3. Take away the dinner bottle once he's used to having a cup at lunch, after around four to seven days (follow his cues).

4. Next, tackle the morning bottle. Instead of handing your toddler a bottle as soon as he gets up, go right to the table for breakfast.

5. Finally, let the bedtime bottle go. As long as your child has had a good dinner, he doesn't need extra milk to make it through the night. You may even be able to skip the bottle at this point, because he's gotten used to doing without it during the day, but if he puts up a fuss, take a graduated approach.

Parents often get wrapped up in whether their child is hitting her milestones on time. And while that is definitely a concern, keep in mind this is also a magical time in your child's life. "The best advice I can give is to have fun with your child," says Dr. Wu. "Children rouse our imagination, make our lives more unpredictable (just see it as a good thing, and it will be), and make us do things we never in a million years think we would do. So we might as well enjoy it, because most of the time we can't control it... and cross our fingers and hope for the best!"

Copyright &copy 2011 Meredith Corporation.