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Northside Pediatrics

6 Month Check Up

FEEDING:  Although breastmilk or formula still should be your baby’s primary source of nutrition, many babies by 6 months are having 2-3 meals a day of solids, including cereal, fruit, and vegetables.  It is important, though, to continue giving your baby breastmilk or formula until 12 months of age.  After 6 months it is ok to give dilute baby juice or water from a sippy cup once a day, although this is not necessary.  Many parents start introducing some finger foods to babies around 8-9 months, but be very careful to avoid foods that babies could choke on, and never leave baby alone during feeding.   Avoid honey, egg whites, and peanut butter until after 1 year.

SLEEPING:   Many babies by this time are sleeping 8 hours at night, although some may still wake up once at night for a feeding.  Usually, babies stop waking up for a nighttime feeding sometime between 6 and 12 months.  Most babies of this age take a morning and an afternoon nap.

FEVER/ILLNESS:  After 2 months of age, fever is defined as a rectal temperature greater than 101.  If your baby is going to be in daycare or around large groups of children, we expect that he or she will get as many as 1-2 colds or viral illnesses each month.  Cold viruses usually cause nasal congestion, runny nose, cough, decreased appetite, and often fever.  Most cold viruses last up to 10 days, but the fever should not last more than 5 days.  If your baby has cold symptoms that last longer than 10 days, fever that lasts longer than 5 days, or high fever associated with not drinking or sleeping or extreme fussiness, it is a good idea to call the office.  Good handwashing is still the best way to prevent the spread of germs. Common illnesses that young babies may get include gastroenteritis (vomiting and diarrhea), colds, and ear infections.  If your baby develops diarrhea, try to continue feeding with breastmilk or formula.  If your baby is also vomiting and cannot keep anything down, it’s a good idea to call the office to make sure she is not getting dehydrated.  Signs of ear infections include fever, irritability, difficulty sleeping, vomiting, and (once they are older) pulling at an ear.  If you are concerned about a possible ear infection, call the office.

TEETHINGSometime between 4 and 7 months most babies will start getting their first teeth.  Usually one of the bottom or top front teeth appears first.  Sometimes teething will cause mild fussiness, crying, excessive drooling, lowgrade fever (never more than 101 degrees), and the desire to chew on something.  You may gently massage your baby’s swollen gums with your finger or give her a teething ring made of hard rubber or a cold teether.  If your baby seems overly irritable or has a fever more than 101 degrees, it is probably not due to teething alone and you should call the office.  Once teeth have arrived, it is good to gently clean them with a wet washcloth before bed at night.  Toothpaste is not necessary at this age.

DEVELOPMENT Babies at 6 months can usually push up high onto their arms when lying on their tummies, and most can roll over from front to back and from back to front.  Babies can usually sit up when they are supported and sometimes can even sit up alone at this age.  Sometime in the next 2-4 months many babies will start to scoot or crawl and also to pull themselves up to a stand with a chair or sofa or table.  At this age, babies are very social and should be interactive and smiling with others in their environment.  They should be laughing out loud and cooing and babbling.

SAFETYBabies that are 6 months and older often reach for things and put them in their mouths, so it is very important to childproof your home.   Keep small items off the floor that babies can put in their mouths and keep baby away from plastic bags, blind or drapery cords, electrical cords, etc.   Cover all electrical outlets.  Watch out for furniture that might fall over onto your baby when he tries to pull up or items on tables or shelves that could fall onto baby’s head.  Babies still need to be facing backwards in their car seats when riding in a car until they are 20 lbs. and 12 months old.  Check smoke detectors in your home regularly to assure they are working properly.  Avoid baby walkers, as they are associated each year with thousands of injuries when they tip over and they actually delay a baby’s learning to walk. A better choice is a stationary “Exersaucer” or a push toy.