This will be a messy time as your infant learns to eat!
Nutrition
Feedings
At this age, feeding time will be messy as your child is learning to eat. Human 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, meats, and vegetables. Juice has no nutritional value and is not recommended, but if given, limit to no more than 4 ounces per day.
Solids should be introduced as per the feeding recommendations. Start with single foods, given once a day. Feed with a spoon and do not put solids in a bottle or infant feeder. Ask your provider about introducing peanut protein at the 6-month wellness visit.
Vitamins
The American Academy of Pediatrics recommends supplementing exclusively breastfed babies and those who are formula fed (but get less than 32 oz per day) with vitamin D 400 IU once a day. One such supplement, D-vi-Sol, can be purchased over the counter. Check the package of the product you buy for dosing instructions.
Fluoride
Fluoride is very important for the development of your child's teeth and it is recommended to begin fluoride supplements at six months of life. Fluoride is not in formula or human milk and must come through water or supplements. Although most municipal water supplies add fluoride, some do not. If you are uncertain, you can check with your local utility company.
Development
At this age your baby should:
- 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 objects 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
Indicators 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 the DTaP, Hib, IPV, Pneumococcal Conjugate, and Rotavirus immunizations. The influenza vaccine is also recommended if we are in flu season.
Common Issues And Concerns
Medications
To see information on acetaminophen and ibuprofen dosage for fever associated with immunizations, click here. Remember to always dose based on the weight of your child.
Sleep
(Helpful hints for preventing problems)
- Pillows, quilts, comforters, sheepskins, bumper pads, and stuffed toys can cause your baby to suffocate.
- Remember the four month instructions and make middle-of-the-night contacts brief and boring. Do not offer feedings.
- For babies with mild night-time fear, 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.
- The American Academy of Pediatrics recommends for babies to sleep in parents' room (in their own crib/bassinet) until at least 6 months of age.
Colds
Upper respiratory infections may be frequent as your infant grows and is exposed to other children, particularly if in daycare. Treatment is discussed here, Colds and Congestion.
Dental Care
As soon as your child has a tooth, begin to use a smear (size of a grain of rice) of fluoride toothpaste. Clean the teeth at least twice a day.
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. Do not leave your baby unattended. Click here for safety prevention guidelines from the AAP.
Recommendations
- Make sure you are using your car seat correctly and at all times.
- Take a course in safety and infant CPR. (Click here for a link to a DVD training video)
- 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, guns, batteries, and magnets out of reach
- Install gates at the top and bottom of the stairs.
- Let your baby be curious, this is how she learns.
- Be patient and do not scold.
- Talk to your baby.
Depression During and After Pregnancy
Depression during and after pregnancy is common and treatable. Having a baby is challenging and every woman deserves support. We will screen for caregiver depression at your child's well-child visits through the first year. Talk to your child's healthcare provider or your healthcare provider if you are experiencing symptoms. Please review this information from the CDC regarding postpartum depression. There are also resources available. Contact the Postpartum Support International Warmline and a trained helpline volunteer will call/text you back to identify a local coordinator and resources in your area:
- Call 1-800-944-4773, #1 en Espanol or #2 English
- Text 503-894-9453
Next Well Child Visit
Your child's next well child visit will be at nine months of age. A developmental assessment will be conducted.