Six Month Visit

Development

Six months old are beginning to balance in a sitting position. They are starting to roll both ways and scoot. In the coming months they will be crawling and getting into mischief!

Your child will be more interactive, babbling and vocalizing more. They may become upset when parents leave as they begin to differentiate familiar from unfamiliar and separation anxiety may occur.

Babies will be able to transfer toys from one hand to another and play with toys more intently.

Activities

- Babies love noise and are beginning to understand cause and effect. Give them measuring cups, pots, pans and wooden spoons to bang.
- Play peek-a-boo and "so big" and other word motion games.
- Talk, talk, talk; narrate your day to your baby.
- Read, read, read; make reading an important part of your family's day.
- TV and video are not recommended. Early screen time is not beneficial to development.

Sleep

Continuing a bedtime routine will provide security at this age.

Your baby should be able to sleep 8-10 hours at night now.

If your baby is having sleep problems, you can get ideas from one of the several references listed below or from the "Sleep Issues" article on our website under the Medical Information / Parenting tab.

Safety

Begin to childproof the home. Crawl around on your hands and knees. See what is available to a curious person exploring your home at ground level.

Make at least one area of your home safe for exploring; free of sharp objects, coffee tables, glass, breakable objects, dangling cords or small choking objects.

Install gates. Secure stairways, doors, windows and screens.

Check out the crib. Move the mattress to the lowest level and remove cushions, stuffed animals and anything that could assist your baby in climbing out. Be sure the crib is not next to the window or drapery/lighting cords. Remove dangling mobiles.

Always supervise closely in the tub. Never leave the room, even for a brief moment to answer the door or phone.

Use a properly fitting rear facing car seat until your child is at least one year of age. If they outgrow the infant seat, transition to a larger rear-facing seat. The center rear seat is the safest position.

Never hold a baby while drinking a hot beverage or smoking.

Check your smoke detectors and fire extinguishers on a regular basis. Have a family fire exit plan with ladders in upstairs bedrooms.

Avoid direct sunlight; sunburns happen easily. Use light cotton clothing. If direct sunlight is unavoidable use a baby sunscreen.

Check toys carefully for breakage, sharp or small parts as everything goes in the mouth!

Do not use walkers with wheels. They are associated with serious injury. Stationary devices such as Exersaucers or Johnny Jump Up exercisers are good.

Poisonings are common events. Lock up medicines, cleaners, detergents, & antifreeze. Syrup of Ipecac is no longer recommended for home treatment of poisoning by the American Academy of Pediatrics, although some experts continue to recommend its use in certain situations. In case of ingestion of poisons, call the Poison Control Center (1-800-222-1222) immediately prior to giving Ipecac.

Parenting

Separation and stranger anxiety are common during the next several months. Your child may feel like two separate babies. One is outgoing and affectionate; the other is anxious, clingy and frightened by unfamiliar people and objects. Your child can now differentiate familiar from unfamiliar.

During the day respond to separation fears with reassuring words and behaviors. At night and naptime your child may find a "transitional object" helpful. This is often a soft toy or blanket that babies use to provide reassurance when you are not physically present.

Take time for yourself and to be alone with other family members. Try to get back to an exercise program for your own mental and physical health.

Nutrition

Solid foods should be introduced now. Offer 1-3 solid meals a day and 24-32 oz of breast milk or formula. Introduce foods one at a time. If no reaction is seen a new food can be tried every 3-5 days.

Wait until your child is one year of age to introduce foods that are more likely to cause allergies: dairy products, egg whites, peanuts, tree nuts (almond, cashew), fish and shellfish. We recommend waiting until 3 years of age to introduce peanut-containing products if there is a strong family history of allergy, asthma or eczema.

To prevent iron deficiency and vitamin D deficiency, breastfed infants should take 1 ml daily of Tri-Vi-Sol WITH IRON (available over the counter) unless they are taking at least 24 oz. of iron-fortified formula or 2 servings of ΒΌ cup iron-fortified rice cereal daily.

Introduce water in a cup. Children do not need juice. If you decide to give juice put it in a cup, not a bottle, and limit it to less than 4 oz 100% fruit juice a day.

Remember to not put your baby to bed with a bottle.

Looking ahead: by 9 months infants will be eating solid meals 3 times a day, drinking roughly 24 oz of formula with iron or nursing 4-5 times in a 24 hour period.

Ask for a fluoride vitamin if your baby does not receive water containing fluoride.

Immunizations

Please let us know if your child had any reactions to the four-month vaccines.

Next Visit

Please make an appointment for when your child is nine months old as you leave today.

Books/Resources

- Child of Mine: Feeding with Love and Good Sense by Ellyn Sater
- Healthy Sleep Habits, Happy Child by Marc Weissbluth MD
- Solve Your Child's Sleep Problems by Richard Ferber, MD
- Sleeping Through the Night, Revised Edition: How Infants, Toddlers and Their Parents Can Get a Good Night's Sleep by Jodi A. Mindell PhD
- The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night by Elizabeth Pantley