Six Month Visit

General

• It is normal to sometimes feel stressed and overwhelmed.  If you do not have a good support system, please let your pediatrician know so recommendations can be made to help you.

• It is important to have a child care provider whom you trust.  If you are staying at home, be sure to have some outside social interaction through a parenting or play group.

• Keep your baby in a healthy and predictable routine.

• Your baby’s vision gradually improves during the first year of life.  By six months he should be able to follow you around the room with his eyes.  Put your baby in his high chair or an upright seat during awake times to help him watch and verbally interact with you and other family members.

• Your baby is acquiring his own personality and you will be learning how he relates to the world.  Pay attention to cues that help you respond to his needs and fussy behaviors.

• Help your baby develop communication skills by looking at books with the baby and pointing to pictures.  Play music and sing.  Imitate the vocalizations your baby is making. Read to your baby. Play pat-a-cake, peek-a-boo, and so-big.

• Continue to put your baby to sleep on his back with no soft bedding.

• Your baby may still have fussy periods.  Regular daily naps and a variety of short play activities will help babies with overtiredness and boredom.  Your baby will be developing his own strategies for calming himself by grasping familiar objects and oral and visual exploration.

Nutrition

• Over the next six months your baby’s growth will slow down a little.

• If you are breastfeeding, continue to do so.  Whether your baby is breastfeeding or on iron fortified formula, now is the time to begin to introduce solid foods.  Your baby should be sitting up to eat, facing you.  Her arms should be free.  You will learn to read each others cues.  How do you know your baby is ready for solid food? Your baby has a reflex that causes them to push things out of his mouth.  This reflex begins to fade around this age. A baby at this age will begin to open her mouth as a spoon approaches in anticipation.  She may lean forward toward the food.  Babies will lean back and turn away when they feel full.

• Introduce single ingredient new foods, one at a time and watch for adverse reactions over several days.

• Good sources of iron are iron fortified infant cereals.  One ounce of infant cereal provides the daily iron requirement.  Vitamin C rich foods such as baby fruits, help with iron absorption.

• Gradually introduce soft fruits and vegetables and then meats after your baby has accepted cereal.  Ask your pediatrician if you have any questions about introduction of solid foods.

• Offer solid foods 2-3 times per day and let her decide how much to eat.  Don’t force the baby to finish foods.  Repeated exposures to foods enhances acceptance.  It may take a dozen or more encounters before your baby accepts a new food.

• We do not recommend giving your child fruit juice.  It is better to get those vitamins from the fruit.  If you feel you must give juice, give no more than 2-4 ounces per day.

Safety

• Your child should still be in a rear facing car seat in the back seat of your vehicle until they are one year old and weigh at least 20 pounds.

• Do not smoke around your baby.  Keep your house and car smoke free. If you smoke and want to quit, please ask us for resources to help you.

• Avoid walkers.

• As your baby begins to crawl, do a safety check of your home:

1. Test bath water.  Make sure your water heater is set at 120 degrees.

2. Never leave your baby alone in the bath or on elevated surfaces.

3. Keep barriers around space heaters, wood stoves, kerosene heaters and floor fans.

4. If you child is in the kitchen while you are cooking, keep him in a playpen, stationary activity center, or high chair.

5. Babies explore with their mouths.  Keep small objects and latex balloons outside of your baby’s reach.

6. Limit finger foods to soft bits not much larger than a Cheerio.  Never give children under four years of age hard foods like nuts or popcorn.

7. Keep all cleaners, chemicals and medications locked up and out of reach and sight.  If your child eats something that could be poisonous, call the Poison Control center at 1-800-222-1222

immediately.  Do not make your child vomit.  Put this number by your phone for emergencies.

Oral Health

• Talk to your pediatrician if your water supply is not fluoridated.  He may recommend fluoride supplements.

• Early dental care, with the eruption of the first tooth, means using a soft toothbrush or cloth to clean your baby’s teeth with water only, no toothpaste.

• Never prop a bottle.