Mt. Ascutney Hospital and Health Center

2 Month Well Child Visit

Your Baby

PROFILE/BEHAVIOR:  A baby 2 months old is already a unique individual.  She has her own personality and her own way of responding to people and events in her world.  Her eating, sleeping and crying patterns may be fairly well established.  She has also learned a lot.  She has learned to look forward to happy times like feedings and play-times with adults.  She can coo and grin and has learned that she gets attention from adults.  If you listen carefully you might find that she has different cries for different problems – one for being bored, one for hunger, one for a messy diaper, etc.

FEEDING:  Continue breast-feeding or, if bottle-fed, formula with iron.  Most babies don’t need solid foods until 4 to 6 months of age.  Unless your doctor tells otherwise, let your baby drink as much breast milk (or formula) as she wants.  Your baby needs a lot of calories because she’s growing a lot – she’ll probably weigh twice as much as her birth weight by 4-6 months of age and three times her birth weight by a year.

It’s best to always hold your baby when you feed her; that way she learns to love you, not just the feeding.  Also bottle propping is a very hard habit to break, and if you continue to do it, it can cause ear infections and early tooth decay.

We encourage waiting until at least 4 months before starting baby foods.  Current thinking suggests that it is probably even better to wait until 6 months.  At that time, rice cereal from a spoon, not a bottle, is a good starting food.  Once taking rice cereal well, you can move on to vegetables, then fruits.  We will discuss this in more detail at your baby’s 4 month visit.

TOYS/ACTIVITIES:  At 2 months a baby can follow objects with her eyes.  Bright colored mobiles, crib toys, and mirrors are good toys.  Rattles and soft snuggly toys will be more important when she begins to play with her hands (about 3 months) and to hold things (a little later).  Select toys that are too large to go in her mouth and too tough to break.   Look carefully for sharp edges and for small parts that might come loose.

Take her with you when you go from room to room.  Being with her parent, touching, holding, playing, and being talked to are all very important to a baby’s learning and her feeling loved and secure.  A blanket on the floor is an ideal place for her (it lets her exercise her muscles, hold up her head and chest, kick, wave her arms and wiggle) but playpens are safer if toddlers or pets are around.  Never leave her alone on a bed or couch; sooner or later she’ll wiggle off the edge and fall and hurt herself!

SAFETY:  Some things are especially important for safety when there’s a baby in the house.  If you haven’t already done these, why not do them now?

*Continue to put baby to sleep on back or side to help prevent SIDS.

*Set the hot water heater in your home to 120-125 degrees F (low setting).

*Have working smoke alarms in your home, and check the batteries regularly.

*Always stay right with the baby when he is in or near water.

*Make sure crib rails are no more than 2 3/8” apart, so the baby’s head can’t slip through.  Make sure the rails are up whenever the baby is in the crib.

*Always use an infant car seat that faces the rear of the car, put the seat belt through the safety seat, and buckle it tightly.  Follow the directions exactly.  Learn what a locking clip is and when to use it.  If your car is equipped with a passenger side airbag, do not place your baby in the front seat.

*Keep plastic bags away from the baby.  This is a tremendous suffocation hazard.

*Prepare an “advanced authorization” letter so your sitter can get medical care for the baby.  Ask your nurse about a form.

*Place emergency phone numbers by the telephone.

FAMILY ISSUES:  Your family should be adjusting to the new baby by now; if things are not going well, please let us know.  Your baby needs parents who take care of themselves and the family’s needs!  Mom should begin to take some time for herself and Mom and Dad should think about going out on a few “dates”, leaving baby with a mature sitter.  Continue to encourage Dad and siblings to be involved in baby’s care.  Is Mom returning to work soon?  If so, share household tasks with others, plan meals in advance, and don’t try to be “super mom” – save your energy for things your children NEED you to do for them and for FUN things.

FEVER/ILLNESS:  Please use a rectal thermometer to confirm a fever in a young infant.  It is more accurate than ear and axillary measurements.  Temperatures vary over the day, being highest in the evenings.  We consider a rectal temperature over 38.0 C or 100.4 F to be a fever.  Very young infants can get ill quickly and may not give you many clues about what is wrong.  Therefore, if your baby acts ill, check for a fever and call us to decide what to do next.

IMMUNIZATIONS:  The first Pentacel (Dtap/IPV/Hib), HepB and pneumococcal conjugate vaccines are usually given at this visit.  Remember to keep a copy of your baby’s shot record in your wallet so it will always be handy when he comes in for a check-up, and especially if he is injured and might need a tetanus booster.

You can give your baby acetaminophen (Tylenol, Tempra, Panadol, or other brands) as needed after the shots to help reduce fever and pain.  We recommend using infant drops, with a dose of 0.4ml (40mg) every four to six hours as needed.  If you have questions regarding dosing, ask your doctor.

You may also use a cold compress on the injection sites to help with pain and swelling if necessary for the first 24 hours after shots.

FOLLOW-UP:   Your baby’s next visit is at 4 MONTHS OF AGE.