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The American Academy of Pediatrics recommends developmental surveillance at every health supervision visit and general developmental screening using evidence-based tools. Social-emotional screening is recommended at regular intervals, surveillance for risk factors related to social determinants of health during all patient encounters is recommended these include questions about basic needs such as food, housing and heat. Also eliciting parental strengths and needs is an important assessment tool which gives guidance for all preventative care screenings and well-child visits.

For a nine-month-old female with weight in the 5th percentile, questions about consumption of juice, sugar sweetened or soft drink usage, nonnutritive finger and snack foods, high carbohydrate baked goods, or salty snacks, or use of honey or corn syrups would be asked (Green, 2018). The baby should eat solids 3 times each day and have breast milk or formula 4 to 5 times per day. Start giving water in a sippy cup, don’t give cow’s milk but other dairy is okay such as yogurt and cheese (full-fat). Questions about dental exams, and fluoride varnish application should be addressed. Hepatitis B, Polio, and Influenza should be administered at the nine-month-old visit.

Milestones would be discussed with the parent and include understanding “no” making different sounds such as “dadada” or “mamama” sitting up without support, standing, holding on, feeding herself, moving items from one hand to the other, looking around for a toy after dropping it, crawling, waving and clapping her hands, starting to move around while holding on to the couch or other furniture, getting upset when separated from a parent.

Sleeping should be assessed; the child should be awake for most of the day. She may likely nap once or twice a day for a total of about 1 to 3 hours and sleep about 8 to 10 hours at night. Tips on sleeping should be discussed such as routines, avoiding bottles or sippy cups at bedtime, and letting the baby cry for herself to sleep and how long you should let the baby cry.

Safety should be discussed, childproofing the house, choking hazards, avoiding leaving the baby on high surfaces, car seat safety, and poison control number.