Well Check-Up / 6 Months
FEEDING
Although breastmilk or formula still should be your baby’s primary source of nutrition until 12 months of age, many babies by 6 months are eating soft or pureed solid food, including cereal and pureed fruits and vegetables. After 6 months it is ok to give baby small amounts of water from a sippy cup, although it often takes babies several months to learn to use the cup by themselves. Babies under 1 year of age do not need fruit juice. Many parents start introducing some finger foods to babies around 8 months, but be very careful to avoid foods that babies could choke on and always supervise feeding time. Avoid honey until after 1 year. Breastfed babies should continue to receive Vitamin D drops as well.
SLEEPING
Many babies by this time are sleeping 8-12 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. A consistent, quiet bedtime routine is important to help babies learn to put themselves to sleep. It is safest to put babies to sleep on their backs, but if they can roll themselves over, parents do not need to flip them back to their backs during the night.
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 3-5 days. If your baby has cold symptoms that last longer than 10 days, fever that lasts longer than 3 days, or high fever associated with not drinking or not 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, call the office to make sure she is not getting dehydrated. Signs of ear infections include fever, irritability, difficulty sleeping, and pulling at an ear. If you are concerned about a possible ear infection, call the office.
TEETHING
Sometime between 4 and 7 months most babies will start getting their first teeth. All babies will begin drooling and chewing on things by 4 months, even if teeth do not come in right away. Usually one of the bottom or top front teeth appears first. Sometimes teething will cause mild fussiness, crying, excessive drooling, low grade fever (never more than 101 degrees), and increased 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. Teething tablets and gels are not considered safe for babies and should not be used. Also, amber teething necklaces are dangerous and create a choking and strangulation risk. 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 at bath time or before bed at night.
DEVELOPMENT
Babies at 6 months can usually roll over from front to back and from back to front. Babies can usually sit up with some support, and some can even sit alone at this age. Sometime in the next 2-4 months many babies will start to scoot or crawl and 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. Around 6 months most babies will start babbling with consonant sounds, making sounds like “da-da” and “ba-ba.”
SAFETY
Babies 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. This includes locking up all medicines, chemicals, and cleaning supplies; covering electrical outlets; keeping small items off the floor; and using cabinet locks. Be very careful with small tables that baby might pull up on and use caution with hot cups of liquid where baby might reach. Babies should face backwards in their car seats until they are 2 years 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 which may delay baby’s learning to walk. A better choice is a stationary “Exersaucer” or a push toy.