Mt. Ascutney Hospital and Health Center

6 Month Well Child Visit

Your Baby
 

PROFILE:  Babies show more and more personality as they get older.  Most 6 month old babies have already learned to tell strangers from Mom and Dad.  They are sociable and should be included in family activities, outings, etc.  They explore more; they reach into their world with hands and mouth, transferring toys and other things from hand to hand and from hand to mouth.  By copying your sounds they are learning about language.  Before long they will be creeping or crawling.
 

FEEDING:  Breast milk or formula with iron is still best at this age.  Now is a good time to introduce the cup.  Reminder:  putting the baby down at bed or nap time with a bottle of formula can cause ear infections, early tooth decay, and is a very hard habit to break.  Babies at this age do not need juice.

Many babies are just starting “solid foods” – boxed baby cereal, plain vegetables and fruit (“stage 1” commercial baby foods).  Many baby food items include ingredients your baby does not need (such as starches, sugars, salt).  Read labels and stick to simpler foods.  Soft, mashed, unsalted table foods are fine, too.  Your baby will enjoy chewing on hard teething biscuits, but do NOT start other finger foods until she can feed herself Cheerios one at a time (about 9 months old).  Never leave a baby alone while she is eating.  Avoid milk, egg whites, peanut butter and fish until at least one year of age, due to concerns about food allergies.  Infants should not have honey before one year of age due to the risk of botulism.
 

FLUORIDE FOR HEALTHY TEETH:  If your water supply does not contain fluoride, begin fluoride drops now (prescription).  We recommend this daily at least until age 11 or 12 years.  Wells need to be tested as some contain natural fluoride (ask us for testing kit for NH or the request form for VT).
 

BEHAVIOR:  It is normal for a baby this age to begin to play well by himself for a short while, sometimes ignoring the parents completely.  You should encourage independent play in the crib or a safe playpen – just don’t leave him for long times as he still needs a lot of your attention.  At this age babies learn to repeat behaviors that get attention.  Do not neglect your own needs or other family members because of his demands.  Guide him into new routines by being consistent in the way you handle him.  If you generally do things the same way each time, he learns to trust you and feel secure.  If your baby keeps waking at night you can change this by your actions.  At naps and night time, put him in his own bed when he is still a little bit awake; let him fuss and settle himself.  This teaches him how to fall asleep by himself without you or a feeding.  When he wakes at night, comfort him briefly but do not pick him up or feed him; keep lights low; leave the room before he falls back to sleep, so he learns to fall asleep without your help.

Your baby may cry if you leave the room (separation anxiety) or leave him with others (stranger anxiety).  It is a normal stage that begins around 6 to 9 months of age.  It helps to use familiar sitter and to act cheerful when you must leave him.  He will learn in time that you always do return.
 

SAFETY:    Childproof your home.  Before the next checkup your baby will be able to move very quickly from place to place – and he’s much too young to understand the word “no”  - so he is more likely to fall, find something to choke on, spill hot liquids, get electrical burns, etc.  It takes a lot of effort to childproof your home and even more to childproof other homes where he might visit, but please do these things. 

*Get down on the floor yourself, at baby’s eye level, to look for small objects, plastic bags, open drawers, electrical cords, etc.  Check every room!  Review a home safety video or complete a home safety checklist.  Go over this with family members and sitters.

*Post the Poison Control Center number near your phone  1 (800) 222-1222.  Ipecac syrup is no longer recommended for treatment of pediatric poisonings!

* Place guard gates across the top of all stairways and around floor furnaces, doorways, and other unsafe areas.  Walkers have caused serious injuries and even death and are not recommended.  Safe alternative to consider are the stationary based ones such as the “exersaucer”.

*Your baby may outgrow his car seat before his next checkup.  Check the label to see if it’s time for a larger seat.  Remember that your baby must be 20 pounds AND 1 year of age before he can “face forward”.
 

ACTIVITY/TOYS:  A baby this age enjoys motion and change of scenery.  He’s more interested in toys and will work to get to things he can’t reach.  He’ll learn to sit alone soon – so sit him up in a baby swing or your lap to practice.  Talk, sing, and read to him.  Call him by name and tell him the names of body parts and toys.  Play interactive games like peek-a-boo, patty-cake, mirror games and finger and toe games.  Gently bounce him on your lap, and hear him squeal and laugh!

Some good toys for this age are “touchy” books, simple cardboard or cloth books, stacking rings, mirrors, balls, pull toys, activity panels, bells, rattles and musical toys.  Avoid toys that are small enough to fit completely into the baby’s mouth, and toys with small pieces, including beads and buttons, that could come off and choke the baby.  Anything that can fit through a toilet paper roll is too small!

Babies at this age should not watch television or video – even “educational” channels and videos specially marketed for infants!
 

IMMUNIZATIONS:  The third Pentacel (Dtap/IPV/Hib), HepB, and pneumococcal conjugate vaccines are usually given at this visit.  We recommend acetaminophen (Tylenol or other brands) every 4 hours for the next 24 hours to help prevent pain and fever.  Use a cold compress at the injection sites for pain and swelling if necessary.
 

FOLLOW-UP:  Your baby’s next visit is at 9 months of age.