First pillar
Medical prevention
At the visit: measure growth, examine the child, watch development, complete screening, review oral health, and give vaccines that are due.
Academy · Prevention · Pediatrics
12months
Preventive visit
Know what happens at the visit—and how daily life changes at one year.
Use this guide to understand today’s checkup, screening and vaccines, development, the move toward family foods, first teeth, a newly mobile child, and when to ask for help.
Jump to sectionStart here
Start here · Five useful questions
One year brings a new kind of visit.
Second pillar
Lifestyle prevention
Every day: build family meals, support movement and language, protect sleep and relationships, care for first teeth, and prepare the home for exploration.
What the doctor does
The visit follows one simple arc: listen, check, protect, plan.
The exact order can change. These are the main parts a family can expect.
01
Listen
Health changes, feeding, sleep, behavior, childcare, family life, safety, and your concerns.
02
Check
Weight, length, head size, a complete examination, vision, hearing, teeth, movement, and interaction.
03
Protect
Emotional and behavioral screening, blood tests when due, fluoride varnish after teeth appear, and routine vaccines.
04
Plan
Family foods, milk and cups, active play, language, sleep, childproofing, dental care, and the next visit.
The one-year transition
The visit connects medical care with a changing daily life.
Your child may be pulling up, cruising, using gestures and first words, eating more table food, and exploring everything within reach. The clinician looks at how growth, development, nutrition, teeth, behavior, and the home fit together.
Prepare for the visit
A small list you can actually use.
0 of 5 ready
Tests and vaccines
What happens depends partly on your child’s history.
Some screening belongs at this visit. Other testing depends on feeding, insurance requirements, location, exposure, or a specific concern.
Usually part of the visit
Development, behavior, eyes, and teeth
The clinician watches development and completes a parent questionnaire about emotional and behavioral health. The eyes, alignment, hearing responses, mouth, and teeth are also assessed.
Depends on your child
Iron, lead, tuberculosis, and hearing tests
Nutrition, birth history, insurance, local rules, housing or other exposure, travel, family history, and concerns about hearing determine which tests are needed.
Timing follows nutrition and risk
Iron and anemia
Children mainly fed human milk are generally screened at 9–12 months. Children mainly fed formula are generally screened at 15–18 months after changing to cow’s milk. Prematurity, low birth weight, limited iron-rich foods, or too much cow’s milk can change the timing.
What the test may involve
The test may use a finger-stick or a blood draw. If the first result is low, additional blood testing can confirm whether iron deficiency is the cause and guide treatment.
Coverage, location, and exposure matter
Lead
Testing is required at 12 and 24 months for children enrolled in Medicaid or CHIP. For other children, state and local rules and risks such as older housing or a known lead hazard determine the plan.
What the test may involve
Screening commonly begins with a finger-stick. An elevated result needs a blood draw from a vein for confirmation, followed by exposure assessment and repeat testing as needed.
Vaccines due at or around 12 months
MMR
Protects against measles, mumps, and rubella.
First dose · 12–15 months
Varicella
Protects against chickenpox.
First dose · 12–15 months
Hepatitis A
Protects against a liver infection spread through contaminated food or stool.
First dose · begins at 12 months
Pneumococcal
Protects against serious pneumococcal infections, including pneumonia and meningitis.
Booster · 12–15 months
Hib
Protects against serious bacterial infections, including meningitis.
Final booster · 12–15 months
Giving vaccines together
The routine vaccines can share one visit.
These vaccines can be given at separate injection sites during the same visit without reducing how well they work or increasing serious reactions. If MMR and varicella are not given on the same day, they must be separated by at least 28 days.
Usually mild and short-lived
What is common
Pain, redness, or swelling where a shot was given and an early fever may occur during the first day or two.
MMR and varicella
Some reactions arrive later
A mild fever or faint rash can appear about 5–12 days after MMR. Varicella vaccine can cause a small number of mild chickenpox-like spots.
After vaccination
When to get help
Call for a high or persistent fever, a spreading rash, or a child who seems unusually unwell. Hives, swelling, difficulty breathing, collapse, or a seizure requires urgent or emergency care.
A choice for the first dose
Separate MMR and varicella shots are generally preferred over the combined MMRV shot.
The combined shot means one fewer injection, but it causes about one additional febrile seizure for every 2,300–2,600 children vaccinated. This small increase occurs mainly 5–12 days later. Personal or family seizure history may also affect the decision.
Vaccines that depend on season or the earlier record
Influenza is seasonal. Polio and hepatitis B doses may already be complete or may still be due. DTaP is ordinarily given later but can sometimes be given at 12 months when enough time has passed. COVID-19 recommendations differ, and RSV protection is only relevant to some children. The complete record and current schedule determine the plan.
Growth and development
The clinician is watching the pattern—not testing performance.
Growth is compared with earlier visits. Development is watched through movement, communication, play, and your experience of your child.
Around 12 months
Connection
Waves bye-bye and plays simple games such as pat-a-cake.
Around 12 months
Communication
Uses a special name such as mama or dada and briefly pauses when told no.
Around 12 months
Thinking
Puts an object into a container and looks for a hidden object.
Around 12 months
Movement
Pulls to stand, moves while holding furniture, and picks up small items with thumb and finger.
Speak up promptly
Do not wait when a skill disappears.
No babbling or gestures such as pointing or waving
No response to name
Loss of a skill your child previously had
Not pulling to stand
No eye contact or social engagement
Concern about hearing or vision
Food, milk, and first teeth
A family table begins to take shape.
At one year, feeding becomes more social, more varied, and more independent—but the adult still prepares the environment.
Eating and drinking
Move toward family foods, a cup, and self-feeding.
- Continue breastfeeding when desired. Otherwise, whole cow’s milk can begin at 12 months.
- Offer varied textures and iron-rich foods, and work toward leaving the bottle behind by 12–15 months.
- Choose what, when, and where food is offered; let your child decide how much to eat.
- Avoid added sugar before age 2. Keep juice to no more than 4 ounces a day after age 1 and serve it in a cup.
Milk and iron
Too much cow’s milk can replace iron-rich foods. A limit of 24 ounces per day is commonly used, while some recommendations suggest approximately 16–17 ounces. Growth, appetite, diet, and family health can change the milk plan.
First teeth
Brush, protect, and establish a dental home.
- Brush twice a day with a smear—about a grain of rice—of fluoride toothpaste after the first tooth appears.
- Fluoride varnish may be applied after teeth appear. Fluoride supplements depend on the household water supply.
- Establish a dental home by age 1 and avoid bedtime bottles and sugared drinks.
Prevent choking by supervising meals and modifying or avoiding hard, round, or large foods such as whole grapes, hot dogs, nuts, popcorn, hard candy, raw carrots, and large pieces of meat.
Life at home · Contrada second pillar
A moving child changes the room.
At 12 months, prevention lives in the daily environment: meals, movement, language, sleep, relationships, and the spaces your child explores.
Daily practice 01
Make room for movement
Encourage floor play, crawling, cruising, standing, and walking practice. Limit unnecessary time in confining equipment when not traveling.
Daily practice 02
Talk, read, sing, and play
Use ordinary moments for language and connection. Predictable routines and responsive caregiving support emotional regulation too.
Daily practice 03
Protect sleep
Keep a consistent bedtime routine. Through 12 months, begin every sleep on the back on a firm, flat surface without soft bedding, pillows, or toys.
Daily practice 04
Stay close around water
Remain within reach, empty tubs and buckets, and use secure pool barriers. Swim lessons may be considered after age 1.
Daily practice 05
Secure the surroundings
Use stair gates and window guards. Lock medicines, cleaners, and toxins. Keep hot liquids out of reach and store firearms locked and unloaded, with ammunition separate.
Daily practice 06
Reduce harmful exposure
Avoid tobacco smoke, nicotine, e-cigarette aerosol, and impaired caregiving. Avoid screen media before 18 months except interactive video chatting.
Car safety: keep the car seat rear-facing while your child remains within the manufacturer’s rear-facing limits.
Poisoning: keep the U.S. Poison Control number available: 1-800-222-1222.
When to get help
Know what can wait—and what should not.
This is a focused guide, not a complete emergency manual. Contact your child’s clinician whenever something feels seriously wrong.
Discuss with the clinician
Less interest in food, fewer wet diapers, mild diarrhea or occasional vomiting, concerns about development, or any loss of a skill.
Seek prompt assessment
Poor feeding, unusual sleepiness or reduced activity, fast breathing, persistent vomiting, very few wet diapers, dry mouth, no tears, or fever with a child who looks unwell.
Emergency care
Bluish lips or face, serious breathing difficulty, grunting or the chest pulling inward, difficulty waking or responding, a seizure, signs of shock, or a severe injury.
Looking ahead
Next routine visit: 15 months.
Growth, development, feeding, safety, teeth, and the vaccine record are reviewed again.
The immediate next step
The 15-month visit
Continue the move toward family foods and cup use, childproof for new movement, build daily language and play, and bring the vaccine record forward.
After that
The 18-month visit
Routine developmental and autism-specific screening are scheduled at 18 months.
References & review
This family guide was last reviewed September 12, 2026. It is educational and does not replace individualized clinical care.
Evidence reviewed includes guidance from national pediatric preventive-care recommendations and evidence reviews. Where recommendations differ, those differences are identified explicitly.