Well Child Care at 6 Months

Feeding

Your baby should keep having breast milk or infant formula until 1 year of age. Your baby may soon be ready for a cup but it will be messy at first. Try giving a cup sometimes to see if your baby likes it.

Make cereal with formula or breast milk only. Use a spoon to give your baby cereal, not a bottle or an infant feeder. Sitting up while eating helps your baby learn good eating habits.

If you haven't started giving your baby other baby foods, you can start now. Start each meal by breast-feeding or giving formula before solid food. Start with pureed fruits, vegetables, and meats. Wait at least 2 days before you start each new food or juice so you have time to make sure your baby is not allergic to the new food. Diarrhea, rash, or vomiting are signs of a possible food allergy.

If your child has an allergic reaction to a food, have your child checked by his healthcare provider. There is no evidence that restricting foods after 6 months of age helps to prevent food allergy. If your child does not have allergies, asthma, eczema or hives, or has mild allergies, some studies suggest that eating small amounts of foods such as peanuts may help prevent severe allergies. Talk with your child’s healthcare provider if you have questions about foods or food allergies.

Do not give foods that require chewing. Don't start eggs, shellfish and food containing peanuts or tree nuts at this age. Avoid foods that can choke your child, such as candy, hot dogs, and popcorn. Make sure your child’s food is not too hot, especially if foods have been heated in a microwave oven.

Don't give your baby a bottle just to quiet him when it’s unlikely that he is hungry and don’t put your baby to bed with a bottle. Babies who spend too much time with a bottle in their mouth start to use the bottle as a security object. This makes it harder for them to give up the bottle and start eating solid food. Babies who spend too much time with a bottle in their mouth are also more likely to have ear infections and tooth decay problems. Find another security object like a stuffed animal or a blanket.

Development

At this age babies are usually rolling over and starting to sit by themselves and later scooting and crawling. Babies squeal, babble, laugh, and often cry very loudly. They may be afraid of people they don’t know. Meet your baby's needs quickly and be patient with your baby.

Six-month-olds may not want to be put in bed. A favorite blanket or stuffed animal may make bedtime easier. Don't put your baby to bed with a bottle. Your baby will use the bottle as a security object and this will make it hard to wean your child from the bottle.

Develop a bedtime routine like playing a game or reading a book, singing a lullaby, turning the lights out, and giving a goodnight kiss. Make the routine the same every night. Be calm and consistent with your baby at bedtime. If your baby wakes up a lot at night, ask your healthcare provider for advice.

Reading and Technology

Books help you and your child grow closer. Make reading fun for your child by making sound effects for animals, cars, or trains, and by looking like you enjoy the story. Pick books with bright colors and large simple pictures. Reading the same books over and over will help your baby recognize and name familiar objects.

Limit how much time your child spends with technology. Play games, read, or watch TV with your child and communicate with your child while you do. Children this age need to be active because it helps their brains and bodies to develop. Play and interact with your child, and be a role model by limiting your own use of technology.

Dental Care

While getting teeth, your baby may drool and chew a lot. It may help to massage your baby's swollen gums with your finger. A teething ring may be useful. As your baby’s teeth start coming in, you can clean them by wiping them with a damp washcloth.

It’s important to take care of your child’s baby teeth because they help your child chew food and speak clearly. They also help save space for the permanent teeth that will come in later.

The best time for children to start seeing a dentist is by 1 year of age. Your child may need to see a dentist at a younger age if he has:

• Special healthcare needs
• Stains on his teeth or white spots in his mouth
• A habit of sleeping with a bottle or drinking a lot of sweet drinks, which can cause tooth decay
• Any other dental problem

Safety Tips

If you find yourself getting annoyed or angry with your baby, or if your baby is crying too much and you cannot cope with it, call a friend or relative for help. NEVER shake a baby.

Child-Proofing Your Home

• Install safety gates to guard stairways.
• Lock doors that lead to dangerous areas like the basement or garage.
• Check drawers, tall furniture, and lamps to make sure they cannot fall over easily.
• Cover unused electrical outlets with outlet covers to keep your child from sticking things into the outlet.
• Throw away cracked or frayed electrical cords.

Choking and Suffocation

• Keep soft objects, toys, and loose bedding out of your baby's crib. Also keep plastic bags, balloons, baby powder, and small hard objects out of reach.
• Keep cords, ropes, or strings away from your baby, especially near the crib. Remove hanging mobiles or toys before your baby can reach them. Ropes and strings around your baby's neck can choke him.
• Use only unbreakable toys that don’t have any sharp edges or small parts that can come loose.
• Don’t let your baby sleep in a bed or on a couch, and don’t sleep with your baby.

Falls

• Never leave your baby on a high place, like a changing table, bed, or couch. Your baby should never be left alone except in a playpen or crib with the sides up.
• Do not use a baby walker.
• Always buckle the safety belts or straps when your baby is in an infant carrier or shopping cart.

Car Safety

• Car seats are the safest way for babies to travel in cars and are required by law. Place infant car seats in the back seat with your baby facing toward the back of the car. If you are not sure how to install the seat in your car, contact your local fire department.
• Never leave children alone in a parked car, even for a few minutes. Children are at risk for heat illness and injury when left alone. Always check to make sure your child is not still in the car when you leave your car.

Water Safety

• NEVER leave your baby or toddler in a bathtub or sink alone.
• Stay within arm’s reach of your child around any water, including toilets and buckets. Keep toilet lids down, never leave water in an unattended bucket, and store buckets upside down. Infants and toddlers who have completed swimming programs are still not safe from drowning.

Fires and Burns

• Keep hot foods and liquids out of your child’s reach.
• Turn down your water heater to 120°F (49°C) or lower.
• Install smoke detectors. Check your smoke detectors as often as recommended by the manufacturer or at least once a month to make sure they work. For all detectors that use batteries, replace batteries at least once a year or when they are low.
• Keep a fire extinguisher in or near the kitchen.

Smoking

• Children who live in a house where someone smokes have more respiratory infections, like colds, flu, and throat infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.
• If you smoke, set a quit date and stop. Ask your healthcare provider for help in quitting. If you cannot quit, do NOT smoke in the house or car or near children. It helps keep your child healthy and sets a good example.

Immunizations

Immunizations protect your child against several serious, life-threatening diseases. At the 6-month visit, your baby should have a:

• Diphtheria, tetanus, and pertussis (DTaP) shot
• Hepatitis B (hep B) shot
• Polio shot
• Pneumococcal (PCV13) shot
• Rotavirus (RV) oral vaccine
• Influenza (flu) shot

Some children also get a Haemophilus influenza type B (Hib) shot.

Some vaccines may be combined to reduce the total number of shots for your baby.

Your baby may have a fever and be irritable for a few days after getting shots. Your baby may also have some soreness, redness, and swelling where the shots were given. Ask your healthcare provider what symptoms or problems you should watch for and what to do if your child has them.

Bring your child's shot record to all visits with your child’s healthcare provider.

Next Visit

Your baby's next routine visit should be at the age of 9 months.