6 month old Well Child Check
NUTRITION
•FEEDINGS
At this age, feeding time will be messy as your child is learning to eat. Breast milk and/or commercially prepared formula is still required. Cow's milk is not recommended until after one year of age. Thirty-two ounces per day is usually the maximum amount recommended, and your infant will likely consume less as solids are introduced. Continue to advance baby cereal and strained fruits and vegetables. You may introduce juice but limit to 4-6 ounces a day. Please see our feedings handout.
Solids - Solids should be introduced as per the feeding handout, if not already started. Start with single foods given once a day. Feed with a spoon and do not put solids in a bottle or infant feeder.•VITAMINS
Exclusively breast fed infants should receive vitamins supplements such as poly-vi-sol - one dropper a day according to the AAP guidelines. Breast feeding mothers should continue their prenatal vitamins. Formula fed infants receive adequate vitamin supplements from commercially prepared formula.•FLOURIDE
Fluoride is very important for the development of your child's teeth and it is recommended to begin fluoride supplements at 6 months of life. Fluoride is not in formula or breast milk and must come through water or supplements. Although most municipal water supplies add fluoride, some do not. Let us know if your child needs fluoride. If you are uncertain, then ask us at the 6 month visit or call your utility company.
DEVELOPMENT
At this age most babies:
•Sit without support
•Support weight on their legs for a short time
•Rock on their hands and knees
•Babble more than two sounds
•Roll over, scoot around, bounce
•Move object from hand to hand
•Reach for objects and hold them; bring feet to mouth
•Turn to a voice when called; recognize strangers
•Cry when left alone in a room.Indications for concern:
•Unable to roll over
•Difficulty lifting head
•Does not turn head to direction of sound
VACCINATIONS
At this visit, your child is scheduled to receive DTaP, Prevnar, and Rotavirus immunizations. Please review the immunizations your child will receive.
COMMON ISSUES AND CONCERNS
MEDICATIONS - to see information on Acetaminophen (Infant Tylenol) dosage, click here. Remember to always dose based on the weight of your child.
SLEEP (Helpful hints for preventing problems)
•Six months is when separation anxiety usually begins. Provide a friendly, soft toy as a crib companion or transitional object.
•Remember the four month instructions and make middle-of-the-night contacts brief and boring. Do not offer feedings.
•For fearful babies, make middle-of-the-night contacts prompt and reassuring. For mild night-time fears, check on your child promptly and be reassuring, but keep the interaction as brief as possible. In severe cases in which your child panics when you leave or vomits with crying, stay in your child's room until he is either calm or goes to sleep.
•Short of lifting your child out of his crib, provide whatever is needed for comfort.
•Do not turn on the light, and limit talking to a minimum.COLDS - As your infant grows and is exposed to other children (particularly if in daycare), upper respiratory infections may be frequent. Treatment is discussed in our hand-out on Colds and Congestion.
DENTAL CARE - Clean your infant's teeth with a soft brush or washcloth when the first tooth pushes through the gum. See Tooth Decay, Prevention
DISCIPLINE - Distraction works well for discipline of a young child - if they are doing something you feel they should not, move them away from that place or object, and help them get interested in something else.
SAFETY - Your infant is becoming more mobile and constant supervision and safety precautions are critical. Please review the safety and TIPPS handouts.
RECOMMENDATIONS
•Make sure you are using your car seat correctly and at all times.
•Take a course in safety and infant CPR.
•Keep crib rails at the highest setting so your baby will not fall when he learns to pull up
•Do not use a baby walker. Walkers can cause injury, and delay learning and development.
•Childproof your home. Keep small and sharp objects, plastic bags, hot liquids, poisons, medications, outlets, cords and guns out of reach
•Install gates at the top and bottom of the stairs.
•Do not leave your baby unattended.
NEXT VISIT
The next routine physical examination is at 9 months of life. Please schedule the appointment today. Please review the 9 month physical examination information on our website prior to your visit as well as the immunization information on the vaccines your child will receive. In addition, your child will have their hematocrit measured at the nine month visit.