12 month well baby visit ontario

The Hub – Family Medicine

Well child visit.

Conduct an age-appropriate well child visit that includes physical exam, assessment of growth, nutrition, development, and education regarding injury prevention and safety risks.
Address parental concerns, social context, and safety, and provide relevant anticipatory guidance (e.g. dental caries, family adjustment and sleeping position).
Know the current childhood immunization schedule, be able to assess vaccination status of a child, and counsel parents on the risks and benefits of vaccinations.
Use an evidence-based tool to help guide a well child visit, e.g. Rourke Baby Record, Greig Health Record.
Identify common presenting concerns in newborns and children (e.g. jaundice, murmurs, autism), identify patients who require further assessment and perform the initial steps in management of these common presenting conditions.

Core Resources

Rourke baby record: evidence-based infant/child health maintenance.

Rourke L, Leduc D, Rourke J. Rourke Baby Record. Revised January 22, 2020.

18 Month Clinical Card

Rourke L, Leduc D, Li, P, Riverin B, Rourke J, Englert S, Power L. 18 Month Enhanced Visit. Canadian Family Medicine Clinical Card. 2016. Available at: https://sites.google.com/site/sharcfm/

Feeding your baby in the first year

Feeding your baby in the first year. Caring for your kids website. https://www.caringforkids.cps.ca/handouts/feeding_your_baby_in_the_first_year. Updated January 2020.

Greig Health Record 2016 Guidelines page 1

Greig A. Greig Health Record 2016: Selected Guidelines and Resources – Page 1. Canadian Paediatric Society. 2016. Available at http://www.cps.ca/

Greig Health Record 2016 Guidelines page 3

Greig A. Greig Health Record 2016: Selected Guidelines and Resources – Page 3. Canadian Paediatric Society. 2016. Available at http://www.cps.ca/

Greig Health Record 2016 Guidelines page 5

Greig A. Greig Health Record 2016: Selected Guidelines and Resources – Page 5. Canadian Paediatric Society. 2016. Available at http://www.cps.ca/

Newborn and Early Child Assessment E-Module

Law M, Mardimae A, Moaveni A et al. Newborn and Early Child Assessment: Family and Community Medicine Clerkship Core Curriculum Module. University of Toronto.

Publicly Funded Immunization Schedules for Ontario

Ontario Ministry of Health and Long-Term Care. Publicly Funded Immunization Schedules for Ontario. June 2022.

Supplemental Resources

Greig executive summary.

Greig AA, Constantin E, LeBlanc CM, et al. An update to the Greig Health Record: Executive summary. Paediatr Child Health. 2016;21(5):265-272.

Greig Health Record 2016 Guidelines page 2

Greig A. Greig Health Record 2016: Selected Guidelines and Resources – Page 2. Canadian Paediatric Society. 2016. Available at http://www.cps.ca/

Greig Health Record 2016 Guidelines page 4

Greig A. Greig Health Record 2016: Selected Guidelines and Resources – Page 4. Canadian Paediatric Society. 2016. Available at http://www.cps.ca/

Nutrition Healthy Term Infants 6 to 24 Months

Critch JN, Canadian Paediatric Society, Nutrition and Gastroenterology Committee. Nutrition for healthy term infants, six to 24 months: An overview. Paediatr Child Health 2014;19(10):547-49. For a wealth of information on child and youth health and well-being, visit www.cps.ca

Jaundice Clinical Practice Guideline

Canadian Paediatric Society The Hospital for Sick Children (‘SickKids’). Guidelines for detection, management and prevention of hyperbilirubinemia in term and late preterm newborn infants. Paediatr Child Health 2007;12(Suppl B):1B-12B. Available at https://cps.ca/en/

Child Obesity Recommendation

18-Month Pathway

The 18-month enhanced well-baby visit (OHIP: A002, A268) provides healthcare providers an opportunity to identify growth and development concerns by using the Looksee Checklist ® (formerly Nipissing District Developmental Screen ® ) and Rourke Baby Record. Based on your findings, refer your patients to specialized services for early intervention.

To speak to a Public Health Nurse, or to refer to the Healthy Growth and Development home visiting program, call 613-PARENTS (613-727-3687) or visit OttawaPublicHealth.ca/PHNReferral .

Parenting in Ottawa Drop-ins Prenatal to 6 Years available daily! Parents can speak, in person, with a Public Health Nurse about all areas of parenting, including but not limited to infant feeding support, safe sleep, growth and development and perinatal mental health. For more information call 613-PARENTS (613-727-3687) or visit ParentinginOttawa.ca/dropins .

Do you have more questions?

Speak with a Public Health Nurse. Call the Ottawa Public Health Info Centre at 613-PARENTS [613-727-3687] (TTY: 613-580-9656) or email Ottawa Public Health at [email protected]
Connect with a Public Health Nurse and other parents on the Parenting in Ottawa Facebook page
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Ages & Stages

Checkup checklist: first birthday (12 months old).

Happy first birthday to your baby! That little bundle you first held is now a budding toddler, soon to take their first steps (if they haven't already). Be sure to share all your proud-parent moments with your pediatrician. Here's what you can expect at the 12-month checkup:

✅ Immunizations

At the 12-month visit, your baby may receive vaccines for measles, mumps and rubella (MMR), Hepatitis A , and Varicella (chickenpox). They may also be due for a booster shot for earlier vaccines. If it's flu season, your doctor will also recommend an influenza (flu) vaccine.

✅ Screenings

The doctor will check your child for anemia at this visit. Based on your child's risk, they may also test blood lead level, hearing, vision, and blood pressure. If your child may have been exposed to tuberculosis , they can do a skin test.

✅Feeding & development

Your pediatrician will measure and weigh your baby to make sure their growth is on track. They will also observe their development and behavior, and perform a physical exam.

Questions your pediatrician may ask

Has your baby tried to stand or take their first steps without support?

How is your baby doing with feeding themselves during meals and snacks?

If your baby is formula fed, have you started to switch to whole milk ?

Questions you may have

Why is the best way to react to a tantrum ? Are time-outs OK when my child isn't following directions?

How can I help my child fall asleep at bedtime?

How can I encourage my child to try new foods?

Is it normal for my baby's appetite to change a lot from meal to meal?

Do you have stair guards and window guards ? Where is the mattress positioned in the crib?

Do you apply sunscreen and put a hat on your child when they play outside?

Are there swimming pools or other potential water dangers near or in your home? Are you thinking about starting your child in a swimming program ?

How long do I need to keep pillows and other soft objects out of the crib?

Should I use a baby walker ?

Can I put the car safety seat in the front seat of my car?

✅ Communication tips

Never hesitate to call your pediatrician's office with any questions or concerns—even if you know the office is closed. If your pediatrician is unable to see you but believes your baby should be examined, they will advise you on the most appropriate place for your baby to receive care and how quickly your baby should be seen.

More information

AAP Schedule of Well-Child Care Visits

The 12-Month Well-Baby Visit

Medical review policy, latest update:, the physical checkup, developmental milestones, read this next, 12-month vaccines, questions to ask your doctor, recognizing the signs of a delay.

And before you leave, don't forget to get the next appointment scheduled, which will be the 15-month checkup .

What to Expect the First Year , 3rd edition, Heidi Murkoff. WhatToExpect.com, Your Guide to Well-Baby Visits , March 2020. WhatToExpect.com, What Order and When Do Baby Teeth Appear? This Baby Teething Chart Can Help , February 2021. WhatToExpect.com, Your Baby's Vaccine Schedule: What Shots Should Your Child Get When? , January 2021. American Academy of Pediatrics, AAP Schedule of Well-Child Care Visits , September 2021. American Academy of Pediatrics, Assessing Developmental Delays , February 2019. American Academy of Pediatrics, Language Delays in Toddlers: Information for Parents , April 2021. Centers for Disease Control and Prevention, Recommended Vaccines by Age , November 2016. Centers for Disease Control and Prevention, Important Milestones: Your Child by One Year , August 2021. KidsHealth From Nemours, Your Child’s Checkup: 1 Year (12 Months) , April 2021. Mayo Clinic, Language Development: Speech Milestones for Babies , March 2021.

Go to Your Baby's Age

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Babies and Toddlers, 0 to 3

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18-Month Well-Baby Visit

Breadcrumbs, page summary.

The enhanced 18-month visit is intended to support healthy development for all children in Ontario.

Why is 18 months an important time?

Key developmental skills, such as speech and language, are starting to emerge at 18 months. Your baby’s 18-month well-baby visit is a chance for:

the healthcare provider to assess your child’s development
you to discuss any concerns you may have

What can I expect?

The 18-month visit will be longer and more in depth than previous visits
You will be able to have a more detailed discussion about your child with the healthcare provider

How should I prepare for the visit?

Complete the 18-month LookSee Checklist (formerly NDDS) screen before your visit
Make note of any 'NO' boxes you have checked on the LookSee Checklist so that you can discuss these with the healthcare provider
Make a list of any other questions or concerns that you would like to discuss with the healthcare provider
Use the online 18-Month Well-Baby Visit Planner (external link) to help you think about specific areas of your child's development to discuss with the healthcare provider at this visit

Ontario and the enhanced 18-month well-baby visit: Trying new approaches

Affiliation.

1 Niagara Region Public Health, Thorold, Ontario.
PMID: 19436551
PMCID: PMC2603505
DOI: 10.1093/pch/13.10.850

Abstract in English, French

In Ontario, the 18-month well-baby visit is the last scheduled primary care visit before school entry. Recognizing the importance of this visit and the role that primary care plays in developmental surveillance, an Ontario expert panel recommended enhancing the 18-month visit. Their recommendations are based on evidence from multiple disciplines, which underscore the reality that the quality of the early years experience establishes trajectories of health and well-being for children. An underlying premise of the recommendations is that when there are collaborations among parents, primary care, community health and child development services, the outcomes for children will be improved. The present article focuses on two Ontario pilot projects that were funded to discover how, in real life primary care settings, the recommendations could be implemented and outcomes measured. Findings and insights were significant, and future directions are clear, as the strategy for an enhanced 18-month well-baby visit is implemented in the future for Ontario.

En Ontario, la visite de 18 mois de l’enfant bien portant est la dernière visite de première ligne prévue avant la rentrée scolaire. Conscient de l’importance de cette visite et du rôle des soins de première ligne sur la surveillance du développement, un groupe d’experts de l’Ontario a recommandé de l’améliorer. Leurs recommandations se fondent sur des données multidisciplinaires probantes selon lesquelles la qualité de l’expérience des premières années établit des trajectoires de santé et de bien-être pour les enfants. Selon une prémisse sous-jacente des recommandations, grâce à une collaboration entre les parents ainsi que les services de soins de première ligne, de santé communautaire et de développement des enfants, le devenir des enfants s’améliore. Le présent article porte sur deux projets pilotes ontariens mis sur pied pour découvrir comment, en soins de première ligne réels, il serait possible d’implanter les recommandations et de mesurer les issues. Ces projets ont suscité des observations et des constatations importantes et de futures orientations tellement claires que la stratégie en vue d’offrir une visite de 18 mois améliorée pour le bébé bien portant sera mise en oeuvre en Ontario.

Well Baby Visit: 1 month baby check up

Your baby's first health check-up will be about one month after you bring him home from the hospital. Your provider will check his weight and height, andoffer you advice on how to handle minor illnesses or concerns at home and when to call the doctor.

You're still getting used to life with your baby, so give yourself as much time for this check-up as you can. Bring along whatever you need to keep yourbaby warm, fed, and contented, and make sure to bring a copy of your newborn's hospital record, if you have it.

What your healthcare provider will check

Weigh and measure your baby to make sure he's growing at a healthy rate. Click here to see our growth chart .

Check that his umbilical cord stump has fallen off and the belly button is healing well. If your baby son was circumcised, your provider will check that this is healing as well.

Give your baby a hepatitis shot if he didn't get one at the hospital or at a previous doctor's visit.

Address any health concerns that he or she notices, such as cradle cap or diaper rash .

Ask you about your baby's sleeping, eating and elimination patterns.

What your healthcare provider will want to know

Has your baby seen another healthcare provider since the last visit? If so, why? What was the outcome of that visit, and were any medications or treatments prescribed?

Does your baby hold his head up when you put him on his tummy?

Does he quiet down, at least briefly, when he hears you or when you pick him up?

Does he sleep a little longer during some part of the day or night?

Does he have longer periods when he's alert?

Does he follow you with his eyes, and study your eyes and face when you're close?

Does he respond to your voice or other sounds?

Is he put to sleep on his back? Are his bedding and room appropriate?

Does he watch a mobile above him?

Is he a little fussier at the end of the day? All of these behaviors are expected at this time.

If you are breastfeeding, are you taking any medication or supplements?

Are there any special stresses or changes at home?

Talk it over

You no doubt have many other concerns. Now's the time to discuss them with your provider. Here are a few common issues:

How is your baby eating and sleeping? Let your provider know how often your baby eats.

Talk about how siblings and other family members are adjusting.

Ask about crying management and comforting techniques. Your baby should respond to being held. Discuss pacifier use as well.

New parents always have questions. Your healthcare provider is there to help, so don't be shy. For example, you should speak up if the following situationsapply to you:

People are giving you advice that confuses you or is contradictory.

Your baby doesn't respond to sounds, especially your voice.

Your baby isn't moving both hands and feet equally.

Your baby has a puffy or runny eye.

Your baby doesn't focus on your face when he is alert.

You're having a hard time comforting your baby.

You're feeling blue, or having a hard time sleeping or eating.

You're going back to work soon, and you're not sure how you're going to manage it.

Your baby doesn't stay awake for more than 30 minutes at a time.

Although every baby is different and reaches developmental milestones at unique times, it's always reassuring to mention any issues or concerns about yourbaby's development with your provider.

How many diapers has your baby used?

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Blind-Low Vision Early Intervention Program

Learn about support and services for children who have been diagnosed with blindness or a visual impairment.

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About the blind-low vision early intervention program.

The Blind-Low Vision Early Intervention program (Blind-Low Vision program) is available for families with children who have a visual impairment from birth until school entry.

The program provides support in your home and in your community.

If your child has been diagnosed with blindness or low vision, you can get support through the Blind-Low Vision program.

The Blind–Low Vision program offers:

family support
intervention services
consultation services

For a child with visual impairment, touch, hearing and the use of remaining or residual vision are important for learning and development.

Trained and knowledgeable professionals in the area of child development and visual impairment can help your child develop these senses.

Get an eye exam

All children should have their first eye exam from an eye doctor at 6 months old . Children should have an eye exam again at 2 or 3 years old and every year after that .

Find out how to get an eye exam .

What services you can get

The Blind-Low Vision program provides support in your home and in your community.

Identify problems early

If you notice that your child has any of the following symptoms, talk to you doctor immediately:

swollen or encrusted eyelids
bumps, sores or styes on or around the eyelids
drooping eyelids
does not make eye contact with you by three months of age
does not watch or follow an object with the eyes by three months
haziness or whitish appearance inside the pupil
frequent "wiggling", "drifting", or "jerky" eye movements
misalignment between the eyes (eye turns or crossing of eyes)
lack of coordinated eye movements
drifting of one eye when looking at objects
turning or tilting of the head when looking at objects
squinting, closing or covering of one eye when looking at objects
excessive tearing when not crying
excessive blinking or squinting
excessive rubbing or touching of the eyes
avoidance of or sensitivity to bright lights

Early identification of a problem can sometimes eliminate or decrease the risk of long-term impacts.

A child who is blind or has low vision is at a significant risk for difficulties in all areas of development, including:

communication and language
fine and gross motor skills
understanding and thought processes
social skills
emotional development

Family support

Social workers provide many family support services. They can help your family understand and cope with the implications of the diagnosis to make informed decisions about support services.

Intervention services

Specially trained early childhood vision consultants provide intervention services in your home. The consultant can work with you to support your child's development in:

development of motor skills (for example, rolling, reaching, crawling, walking, and use of hands to manipulate and explore objects)
daily living skills (for example, eating, dressing, toileting)
concept development (for example, object identification, function, and characteristics)
social and emotional development
language and communication development
how to make the most of residual vision
how to use all the senses to promote development

Consultation services

Early childhood vision consultants will work with early childhood educators in child care settings to learn how to best work with and teach your child. They will also work in collaboration with other community partners (such as, speech pathologists, occupational therapists, infant and child development consultants) to coordinate services and goals for you and your child.

You do not need a referral from your doctor.

To register, contact a blind-low vision program location near you.

Blind - Low Vision Early Intervention Program locations

Hamilton, niagara, brant and haldimand-norfolk.

Affiliated Services for Children and Youth
Tel : 905-385-7927
Toll-free: 1-866-826-4327

Dufferin, Halton, Peel, Waterloo and Wellington

ErinoakKids Centre for Treatment and Development
Tel : 905-855-2690
Toll-free: 1-877-374-6625
TTY : 905-855-4925

Manitoulin-Sudbury, Algoma, Cochrane, and Nipissing-Timiskaming

North Bay Regional Health Centre
Toll-free: 1-877-522-6655

Kenora and Rainy River District

Northwestern Health Unit
Toll-free: 1-877-553-7122

Ottawa, Renfrew County and Eastern counties of Prescott-Russell & Stormont, Dundas and Glengarry

Pinecrest Queensway Community Health Centre
Tel : 613-688-3979
Toll-free: 1-866-432-7447
TTY : 613-820-7427

Simcoe County and Muskoka-Parry Sound

Royal Victoria Regional Health Centre
Tel : 705-739-5696
Toll-free: 1-800-675-1979

Kingston and counties of Frontenac, Lennox & Addington, Leeds, Grenville, Lanark, Hastings and Prince Edward

KidsInclusive
613-544-3400 ext. 3175
Toll-free: 1-855-544-3400 ext. 3175
Fax: 613-548-6017

Middlesex, London, Oxford, Elgin- St. Thomas, Sarnia-Lambton, Huron- Perth and Grey Bruce Owen Sound

Thames Valley Children's Centre
Tel : 519-663-0273
Toll-free: 1-877-818-8255

Thunder Bay

Children's Centre Thunder Bay
Tel : 807-343-5000
Toll-free: 1-866-343-5020

City of Toronto

Surrey Place
416-925-5141
Toll-free: 1-833-575-5437

York, Durham, Peterborough, Northumberland, Haliburton & Kawartha Lakes

Oak Valley Health
Toll-free: 1-888-703-5437
TTY : 905-773-7282

Windsor-Essex and Chatham-Kent

Connections Early Years Family Centre
Local: 519-252-0636

Get more information

For more information, contact:

ServiceOntario
Toll-free: 1-866-821-7770
TTY : 1-800-387-5559

Monitor your child's vision milestones

Babies learn to see over a period of time, much like they learn to walk and talk. They are not born with all the visual abilities they need in life. It is important to detect any problems early to ensure your child can develop the visual abilities he or she needs to grow and learn.

Consult your child's doctor if you think that your child is not seeing correctly or is having other problems with their vision.

Most children can:

stare at surroundings when awake
briefly look at bright lights and objects
blink in response to light
move eyes and head together

By 3 months

glance from one object to another with their eyes
follow a moving object or person with their eyes
stare at caregiver's face
begin to look at hands and food

By 6 months