12-Month Checkup and Vaccines: What Parents Should Know

Your child’s first birthday marks a big transition—from infant to toddler—and the 12 month checkup helps you and your clinician make that leap with confidence. This milestone visit covers vaccines, growth, nutrition, safety, sleep, and development. If you’re wondering what to expect at a 12 month check up, what the 12 month vaccines are, or how to prepare, you’re in the right place.

Key takeaway: The 12 month well visit is about prevention—protecting your child with vaccines, screening early for issues, and setting healthy routines that support the toddler years.

Quick navigation

Vaccines at 12 months
Screenings and measurements
Developmental milestones
Nutrition at one year
Safety check
Sleep and routines
How to prepare
After-visit care and follow-up
Common questions
Helpful resources

1) Why the 12‑Month Visit Matters

The American Academy of Pediatrics (AAP) recommends regular well-child visits as children grow, and the 12-month appointment is a cornerstone as your baby enters toddlerhood. It helps ensure your child is:

Protected against serious infections with on-time immunizations
Growing well (weight, length/height, head circumference) and meeting milestones
Getting adequate iron and screened for lead exposure when needed
Safe at home, in the car, and around water as mobility increases
Supported with nutrition and sleep routines that fit toddler development

This visit also gives you space to bring questions about behavior, feeding, sleep, and family transitions (AAP/HealthyChildren).

2) Vaccines at 12 Months: What’s Given and Why

Most children receive these routine 12 month vaccines:

MMR (Measles, Mumps, Rubella): First dose at 12–15 months protects against three highly contagious illnesses that can cause serious complications like pneumonia, encephalitis, and hearing loss. The second dose is given at 4–6 years (CDC).
Varicella (Chickenpox): First dose at 12–15 months helps prevent severe disease, complications, and outbreaks; second dose at 4–6 years (CDC).
Hepatitis A: First dose at 12–23 months with a second dose 6–18 months later. Prevents liver infection that can spread through contaminated food/water or person-to-person contact (CDC).
Influenza (flu) vaccine: Recommended yearly for everyone 6 months and older. If it’s your child’s first flu season receiving flu shots between 6 months and 8 years, they’ll need two doses at least 4 weeks apart (CDC).
COVID‑19 vaccine: CDC recommends updated COVID‑19 vaccination for everyone 6 months and older; it can be given at the same visit as other vaccines (CDC).

Some children may also receive catch-up doses of Hib or pneumococcal (PCV) vaccines, depending on their individual schedule (CDC).

How effective and safe are these vaccines?

MMR and Varicella vaccines are highly effective after the first dose, with even greater protection after the second dose. Widespread use has dramatically reduced measles and chickenpox in the U.S. (CDC).
Hepatitis A vaccination leads to strong, long-lasting immunity and has sharply decreased infection rates (CDC).

Side effects to expect

Most side effects are mild and temporary:

Soreness or redness where the shot was given
Low-grade fever, fussiness, or sleepiness
Mild rash (especially after MMR or Varicella) 1–2 weeks later

Rarely, fever can lead to a febrile seizure in young children. The risk is small, and febrile seizures are generally brief with excellent outcomes (CDC). For the first dose at 12–47 months, some clinicians prefer separate MMR and Varicella shots instead of the combined MMRV to slightly reduce febrile seizure risk; your pediatrician can help you choose (CDC).

Can vaccines be given together?

Yes. Most routine vaccines—including MMR, Varicella, Hepatitis A, influenza, and COVID-19—can be safely given at the same visit. If live vaccines (like MMR and Varicella) are not given on the same day, they should be spaced by at least 4 weeks (CDC).

Key takeaway: On-time 12 month vaccines offer strong protection as your child becomes more mobile, social, and exposed to new environments.

3) Screening Tests and Measurements

At the 12 month well visit, your clinician will typically:

Measure growth: weight, length/height, and head circumference, then plot on growth charts.
Check development: ask about language, movement, play, and social behavior; observe how your child moves and interacts (AAP Bright Futures).
Screen for anemia (hemoglobin): Universal screening around 12 months helps detect iron deficiency early, which can affect development if untreated (AAP/HealthyChildren).
Assess risk for lead exposure and perform a blood lead test if indicated by local policy or risk assessment (e.g., older housing with peeling paint, certain water sources, recent renovations). Some states require universal testing at 12 and 24 months, and all children on Medicaid are tested at 12 and 24 months (AAP/CDC).
Vision and ear checks: Behavioral/observational screens for vision, review of hearing history, and attention to any parental concerns.
Oral health: Fluoride varnish may be applied in the clinic if your child is at risk for cavities, and your clinician will encourage establishing a dental home around the first birthday (AAP).

Ask your pediatrician how your region handles lead screening at 12 months so you know what to expect.

4) Developmental Milestones: 9–12 Months

Your clinician will ask what your child does at home and observe skills during the visit. Every child develops on their own timeline, but common skills around 9–12 months include:

Social/Emotional: Shows a variety of facial expressions, has favorite people, may be shy with strangers, waves “bye-bye” (CDC).
Language/Communication: Babbles with different sounds, responds to name, may say “mama” or “dada” specifically and a few other words by 12 months (Mayo Clinic).
Cognitive: Looks for hidden objects (object permanence), imitates gestures, understands simple requests (Mayo Clinic).
Motor/Physical: Sits well, pulls to stand, cruises along furniture, may take first steps; uses thumb and finger to pick up small items and bangs two objects together (CDC/Mayo Clinic).

When to check in sooner:

Not babbling, not making eye contact, or not responding to sounds
Not bearing weight on legs or not sitting independently by late infancy
Loss of skills your child once had

If you notice any of these, reach out—early support matters (CDC/Mayo Clinic).

5) Nutrition at One Year

Turning one brings feeding changes—and lots of new foods to enjoy.

Milk: After the first birthday, most children can transition to whole cow’s milk (about 16–24 oz/day). If you’re avoiding dairy, talk with your clinician—fortified, unsweetened soy milk is usually the most nutritionally similar alternative. Avoid low-fat milk until age 2 unless advised by your clinician (AAP/HealthyChildren).
Breastfeeding: Continue as long as parent and child desire. Breast milk remains a valuable source of nutrition and comfort (AAP).
Iron-rich foods: Offer meats, beans/lentils, tofu, nut butters thinned and spread thinly, eggs, iron-fortified cereals, and leafy greens. Pair plant sources with vitamin C–rich foods (berries, citrus, tomatoes) to boost iron absorption.
Cup skills: Practice open or straw cups; aim to move away from bottles between 12–18 months to protect teeth and support oral-motor development.
Sugary drinks: Avoid soda, sports drinks, sweet tea, and flavored milks. If offering 100% fruit juice, limit to 4 oz/day at most—and water or milk should be the go-to beverages (AAP).
Allergens: Continue offering common allergens (peanut, egg, dairy, wheat) regularly if already introduced and tolerated. Consult your clinician if there’s a strong family history of allergies.
Choking prevention: Avoid whole grapes (cut into quarters lengthwise), hot dogs (cut lengthwise then into small pieces), popcorn, whole nuts, hard candies, chunks of raw apple or hard veggies. Always supervise while eating and have your child seated for meals.

Tip: Keep meals relaxed and responsive. Offer a variety of nutritious options, and let your child decide how much to eat—appetite naturally varies day to day (AAP/HealthyChildren).

6) Safety Check: Home, Car, and Water

As mobility surges, so does curiosity—and risk. A quick safety review at the 12 month checkup can prevent injuries (AAP Bright Futures).

Falls: Install safety gates at the top and bottom of stairs; secure windows and keep furniture away from window ledges. Anchor heavy furniture and TVs to the wall.
Poisoning: Keep medicines, cleaning products, and cannabis/alcohol locked and out of reach. Save Poison Help: 1‑800‑222‑1222 (U.S.).
Drowning prevention: Always stay within arm’s reach around water—even bathtubs and buckets. Empty water from tubs/buckets immediately after use and fence pools on all sides.
Burns: Set water heater to 120°F (49°C), keep hot beverages out of reach, and use back burners with pot handles turned in.
Firearm safety: If firearms are in the home, store them unloaded, locked, and separate from ammunition.
Car seat: Keep children rear-facing as long as possible within the height/weight limits of their seat, in the back seat every ride (AAP).
Sleep safety: Continue a clear sleep space (firm mattress, fitted sheet, no loose bedding or pillows). Many families keep the crib free of soft items well beyond the first birthday.

7) Sleep and Daily Routines

Most 1‑year‑olds sleep about 12–16 hours in 24 hours, including naps (CDC/AAP).

Expect 1–2 naps; some children begin transitioning toward one longer midday nap between 12–18 months.
Keep a consistent bedtime routine (bath, books, cuddles) and a regular sleep schedule.
Separation anxiety is common. Offer brief, predictable goodbyes, reassure with words, and keep routines steady.
Avoid screen time for children under 18 months (except video chat) and keep screens out of sleep spaces (AAP).

8) How to Prepare for the Appointment

Make the most of your 12 month well visit:

Bring:

- Your child’s vaccine card/records - A list of questions or concerns (feeding, sleep, behavior, development) - Notes on diet, bowel habits, and sleep if you’re tracking - Any forms for childcare or programs

Comfort strategies for shots:

- Breastfeed before/during/after if you wish - Hold your child upright, offer a pacifier, or use skin-to-skin contact - Distract with songs, bubbles, or a favorite toy - Ask about topical numbing options in advance

Discuss openly: Bring up anything on your mind—tantrums, biting, walking late, weaning, co-sleeping, sibling transitions. Your clinician is there to help, not judge.

9) After‑Visit Care and Follow‑Up

Managing common vaccine reactions: For soreness or low fever, cool compresses and cuddles help. If needed, your clinician can advise on acetaminophen or ibuprofen dosing by weight. Avoid pre-medicating before shots unless your clinician recommends it (CDC/AAP).
When to call: High fever, severe or persistent crying, unusual sleepiness, widespread rash, or any reaction that worries you warrants a call. Emergency symptoms (trouble breathing, facial swelling) are rare—seek urgent care if they occur.
Update records: Send vaccine updates to childcare/school and keep your personal records current.
What’s next: The next routine visit is usually at 15 months, focusing on language growth, behavior, safety, and any additional vaccines per schedule (AAP/CDC).

10) Common Questions, Answered

What if we’re late or missed a vaccine?

- Don’t worry—there’s a CDC catch‑up schedule to get back on track. You don’t need to restart a vaccine series (CDC).

Can my child get shots with a mild cold or low fever?

- Usually yes. Mild illness (runny nose, low-grade fever) isn’t a reason to delay vaccines. Your clinician will assess (CDC).

My child has an egg allergy—what about MMR or flu shots?

- MMR is safe for children with egg allergy. Flu vaccines are recommended for people with egg allergy of any severity; extra precautions are no longer required (CDC).

We’re traveling internationally—can we get MMR early?

- Yes. Babies 6–11 months can receive one early MMR dose before international travel. They’ll still need the routine two-dose series at 12–15 months and 4–6 years because the early dose doesn’t count toward the series (CDC).

Can multiple vaccines be given at once?

- Yes. Co‑administration is common and safe. If live vaccines (MMR, Varicella) aren’t given the same day, they should be separated by 4 weeks (CDC).

I’m unsure about a vaccine—what should I do?

- Bring your questions. Ask about the disease it prevents, how common it is, vaccine safety data, and side effects. Your pediatrician can share evidence-based guidance and help you decide.

11) Helpful Resources and References

AAP HealthyChildren: Checkup Checklist—First Birthday (12 Months)

- https://www.healthychildren.org/English/ages-stages/Your-Childs-Checkups/Pages/Your-Checkup-Checklist-12-Months-Old.aspx

CDC: Immunization Schedule (Birth–18 Years)

- https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

CDC: Milestones by 9 Months (and links to later ages)

- https://www.cdc.gov/act-early/milestones/9-months.html

Mayo Clinic: Infant development—Milestones from 10 to 12 months

- https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/infant-development/art-20047380

AAP Bright Futures (Parent information and safety guidance)

- https://www.aap.org/en/practice-management/bright-futures/bright-futures-family-centered-care/

CDC: Travel and Vaccines (MMR for infants 6–11 months)

- https://www.cdc.gov/vaccines/vpd/mmr/public/index.html

CDC: Flu and Egg Allergy Guidance

- https://www.cdc.gov/flu/prevent/egg-allergies.htm

Evidence note: Guidance above reflects recommendations from the AAP and CDC current at time of writing. Local policies (e.g., lead screening) can vary—ask your clinician how your region applies these recommendations.

Final Thoughts

Your 12 month well visit is a chance to celebrate how far your child has come and to set up the months ahead for safety, growth, and joy. With on-time vaccines, smart screenings (including lead screening at 12 months when indicated), and simple routines for sleep and nutrition, you’ll help your toddler thrive.

If you have questions about the 12 month checkup or vaccines, add them to your list and bring them to your appointment—your care team is ready to support you. And if your child’s first birthday is around the corner, happy birthday to your growing explorer!