My Six-Month-Old and Me
By far, my favorite infant office visit is the 6 month well check. At this stage babies are quite happy to please their parents and are so enthralled by every new experience. This is an age of huge smiles and leaps in development in all areas (motor, speech and social skills).
Baby is half-a-year old now and has many new skills:
- Sitting — Baby will sit alone for a few seconds with a straight back before falling over. Do not leave him on a bed or high surface for even a moment because he has no fear and will take a dangerous leap! Bumbo seats should only be used on the ground (not table)!
- Exploration — Baby continues to have improved vision and hearing and will take more notice of herself in a mirror. As one parent told me, "If she sees her reflection smile, she keeps smiling. If her reflection is crying, she keeps crying.” You may notice baby turns more directly to sounds than previously. She will find body parts that she did not notice before: toes, fingers, hands, and ears. Baby may even find private parts during diaper changes! Ear pulling at this point is likely to be purely out of exploration or sometimes a sign of teething. If your baby is running a fever, ear pulling could be related to an ear infection, but it is not specifically a sign of ear infection.
- Rolling over — Use the belt on the changing table for diaper changes because he will roll over very well by this age. This can happen in a split second, so take care to never leave baby on a high surface, not even a bed. Baby will also begin to scoot backward and creep a bit over the next few months. Time to get on your hands and knees and crawl at his level to be sure the house is baby-proofed!
- Babbling — Baby will begin to make some sounds with consonants now. Generally, syllables such as "da," "ba," and "ga" will be spoken before "ma." It doesn't mean that Baby loves "mama" any less than "dada." Baby will probably call almost everything "dada" at this age. If you do not hear hard consonants by 7 months of age, please talk to your pediatrician about having your baby’s hearing tested again.
- Transferring toys — This is a big milestone for Baby. You may notice soon that Baby can move a toy from one hand to the other. He is becoming much more skilled with his hands. He will become particularly interested in putting his fingers in your mouth, face, and ears and gripping your hair when you hold him.
- Stranger Anxiety - Babies typically develop an awareness of strangers at this age. If a person is not a routine caregiver (friends, grandparents or relatives who come to visit but do not live in the home), your baby may see them as a stranger even though you know the person very well. Encourage visitors and relatives to talk to you for a little while first before trying to transfer your baby to their arms or before making strong direct eye contact. If Baby has some time to adjust to the visitor, they will react calmly.
Ideas for Play:
- Look at board books with Baby. Don't be concerned about reading all the words on every page. Allow Baby to explore the book by hitting it, patting it and putting it in his mouth. Point to pictures in the book and say the names of the objects. Read longer stories to your baby while nursing him or her.
- Let baby explore food in her highchair. Undress Baby except for her diaper and put some food (mashed or pureed) directly on the table surface of her high-chair. While she explores the food with her fingers, she will let you feed her with a spoon. This is a good technique for introducing new foods because it allows her to explore the food on her own a bit before it is placed into her mouth. Be prepared for a mess!
- Let baby have a little time to himself to play with teething rings, rattles or other baby safe toys in his pack-n-play or crib. Baby may be content to play alone for a while. This is good and normal. You should not feel as if you need to entertain him constantly. Please do not let your baby have any screen time during the first year of life. It can create problems with attention and problems with sleep.
- Peek-A-Boo — Still an excellent game at this age for teaching that objects and people are present even when not seen! She may start to look over the side of her high-chair when an object is dropped. This is called object permanence.
- Go for a walk once a day! This is an excellent habit for the whole family to develop. You are teaching Baby at a young age that it is fun to be outside and exercise- even if it is mommy and daddy doing all the exercise while Baby reclines in the stroller or backpack!
- Most infants are teething or have cut a tooth by this age. Start to brush your baby’s teeth once per day with children’s fluoride containing toothpaste by putting a tiny dab (size of a single grain of rice) on a child’s toothbrush and rub along the teeth, especially after the last feeding before bedtime. No need to rinse. This tiny amount of fluoride will help protect your baby’s teeth overnight.
- Do not use teething tablets or other over the counter teething drops/gels even if they say they are “all natural.” Many contain substances (belladonna, lidocaine) that are dangerous to your baby. For teething pain, give a cool teething ring instead.
- Baby will probably still need 2 naps at this age. Keep the start of the afternoon nap early (at least by 1pm) so it does not hinder the bed-time routine. One nap will be longer than the other but whether it is the morning or afternoon nap varies.
- Baby will be more alert and ready to learn during the day if she receives about 10-12 hours of consolidated sleep at night. Remember to keep a consistent bedtime routine and actual bedtime. You determine wake-up (get up out of crib) time, not baby.
- Baby may wake-up between her sleep cycles at night time (about every 3 hours). Allow her some time to go back into deep sleep before "rescuing her." If she begins to cry strongly, give her a pacifier or gently pat her a moment. Avoid strong eye contact as this is very stimulating and will pull her completely out of sleep. Parents who pick up Baby, rock her back to sleep or feed her back to sleep are setting themselves up to be part of her sleep pattern for a long time to come. Remember she is developing object permanence and will expect you to be there each awakening if you start that routine. If you need help with sleep training, please review the sleep interval techniques found in “My Two Month Old Baby and Me.”
- Avoid feeding Baby during the night as this will teach her to rely on feedings at night as part of her sleep routine, setting her up for excessive weight gain, interrupted sleep and dental cavities. Yes, she will have teeth soon!
Baby is ready to learn a new skill: eating from a spoon! This means that she will learn to chew and swallow rather than just sucking and swallowing. This skill is just as challenging to her now as riding a bike will be when she is older. Be patient.
Teach this new skill by feeding Baby cereal from a spoon:
- Mix a few spoonfuls of infant cereal (recommend oatmeal) with breast milk or formula to the consistency of applesauce and spoon-feed Baby. This is a vital source of iron and vitamins. You may start with a vegetable such as sweet potato if your prefer.
- She will put her fingers in her mouth to have something to suck on. This is good!
- She may spit it out. It doesn't mean she doesn't like it. It's just brand new to her and she must learn how to use her tongue for solids.
- Don't get frustrated when she puts it on her face and in her hair. You may want to feed her in just a diaper at first and place a towel around the high chair.
- Start with once a day and then move to 2-3 times per day as she progresses.
- Feed her the solid food before her bottle or breast feed so she will be hungry for it.
- Give her fresh water (filtered tap water is fine) from an open cup between spoonfuls. She may have as much water as she would like now. Sippy cups of water are good also.
- Gradually thicken the cereal over the next two weeks.
Start some other foods if Baby has done well on the cereal.
Remember to introduce only one new food every 3 days at this age, so you can identify any foods that cause an allergy (rash, diarrhea, hives, blood in stools). Call your pediatrician if you notice any signs of allergies.
- Homemade food is better than bottled, but Stage 1 bottled foods are appropriate now.
- Sweet potato is a good starter food because it becomes a smooth base for adding in other vegetables and meats that may be difficult to blend on their own.
- Other good vegetable starters are green peas, carrots, green beans, broccoli, mashed potatoes and corn. These are all very good for preventing constipation.
- Remember that everything must be cooked well and pureed.
- If she eats a lot of orange vegetables, her skin will turn a little pumpkin color. It’s ok!
- After she learns to like vegetables, try some fruits (apple, pear, prune, banana, avocado).
- Hold off on honey, juices, eggs, shellfish. These may cause allergies or illness at this age.
- Some babies find oranges, strawberries, tomatoes and other acidic foods difficult to digest (spitting up and reflux symptoms) and they may cause a temporary rash around the mouth due to acidity. If that is the case for your baby, just wait and try them later on.
- Peanut butter introduction has been hotly debated recently. It seems that introduction even as early as 4 months of age may be beneficial to prevent allergies in families prone to nut allergy. It is preferred to wait on all solid foods until 6 months of age unless your pediatrician recommends you start them sooner.
- Begin meats (ground chicken, ground beef or fish) once baby has adjusted to some vegetables. Avoid fish high in mercury. Tilapia is a good fish choice.
- Initially you will give one solid food feeding per day and work your way to a 3 meal per day and 1-2 snack time program as your baby seems interested.
- Solid pieces of food (finger foods) are not introduced until 9 months of age when Baby has a nice pincer grasp. They can be a choking hazard at this age.
- Baby needs no juice unless it is advised by your pediatrician for treatment of constipation for your baby (2 ounces undiluted one time a day). Do not put even a splash of juice in your baby’s water as drinking this all day may cause cavities once the teeth erupt. Cavities of the front teeth are avoidable by limiting juice to no more than once per day (and only if needed for constipation relief), eliminating night-time feedings at this young age and brushing the teeth with a “rice grain sized” amount of children’s fluoride toothpaste after the last breast or bottle feed before bedtime.
- Continue to give Baby cereal by spoon once or twice per day even as she increases her intake of other solid foods. Cereal is vitamin fortified and iron rich for good brain development.
Typical Schedule for a 6 month old infant (just an example, actual times will vary):
|7am Wake up Time||(breast or bottle feed 6-8 oz)|
|8 am Play and exercise time|
|9 am Breakfast feeding||(1-2 oz cereal and water) followed by breast or bottle feed (4-6oz)|
|10 am Nap time||(allow her to awaken on her own from nap)|
|11 am Play and Exercise Time|
|12 pm Lunch||(1-2 oz vegetable, 1-2 oz fruit, 1-2 oz protein such as beans, meat or nut butter)|
|1 pm Feed and Nap Time||(4-60z) then Nap time (allow to awaken on own)|
|3pm Play and exercise time|
|4pm Stroll or play outside||( at least 15 minutes)|
|5pm Dinner time||(1-2 oz vegetable, 1-2 oz cereal, 1-2 oz protein) and water.|
|6pm Bath, Massage, Feed Time||(6-8oz) and brush teeth|
Baby should routinely sleep 10-12 hours overnight without any feedings by this age.
Babyproof your home. Use the following checklist:
- Safety lock cabinet doors.
- Prevent access to stairs with baby gates.
- Put plastic plugs in electricity outlets.
- Put safety lock on toilet seat cover.
- Never leave a mop bucket or container of water around for even a short time.
- Put self-locking gate around swimming pool.
- Do not leave "kiddy pools" filled.
- Remove coins and toys with small parts from the floor.
- Lower Crib Mattress (if not already lowered).
- Post the Poison Control # 1-800-222-1222 on the refrigerator and phone contacts.
- Secure television screens and bookshelves to walls.
- Use an app on your smart phone to remind you to remove Baby from the car. Waze has this feature. https://www.waze.com/
- Do not text while driving.
- Do not leave button batteries or any magnets around the home.
- Do not leave Baby in bath tub alone.
"If you want your children to be intelligent, read them fairy tales. If you want them to be more intelligent, read them more fairy tales."
— Albert Einstein, theoretical physicist
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