Your Child's Checkup: 6 Months

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on a growth chart.

2. Ask questions, address concerns, and offer advice about how your baby is:

Feeding. If you haven't already, it's time to introduce solids, starting with iron-fortified single-grain cereal or puréed meat. Let your doctor know if your baby has had any reactions (such as throwing up, diarrhea, or a rash) to a new food. Breast milk and formula still provide most of your baby's nutrition.

Peeing and pooping. You may notice a change in your baby's poop after you introduce solids. The color and consistency may vary depending on what your baby eats. Let your doctor know if the poop gets hard, dry, or difficult to pass, or if your baby has diarrhea.

Sleeping. At 6 months, infants sleep about 12–16 hours per day, including naps. Most babies sleep for a stretch of at least 6 hours at night.

Developing. By 6 months, most babies:

• take turns making sounds with you
• blow “raspberries” and laugh
• know familiar people
• like to look at themselves in the mirror
• put things in their mouth to explore
• reach for a toy they want
• roll from their tummy to their back
• push up with straight arms when ontheir tummy
• lean on their hands for support when sitting

Talk to your doctor if your baby is not meeting one or more milestones, or you notice that your baby had skills but has lost them.

3. Do an exam with your baby undressed while you're present. This includes an eye exam, listening to your baby's heart and feeling pulses, checking hips, and paying attention to your baby's movements.

4. Update immunizations.Immunizations can protect babies from serious childhood illnesses, so it's important that your child receive them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

5. Because postpartum depression is common, your baby’s doctor may ask you to fill out a depression screening questionnaire.

Looking Ahead

Here are some things to keep in mind until your next routine visit at 9 months:

Feeding

1. If you're breastfeeding, continue for 12 months or for as long as you and your baby desire. Breastfed babies weaned before 12 months should be given iron-fortified formula. Wait until 12 months to switch from formula to cow's milk.
2. Start giving your baby solid foods:
   • If your baby has eczema or a food allergy, or there's a history of food allergies in your family, talk to your doctor before introducing new foods.
   • Begin with a small amount of iron-fortified single-grain cereal mixed with breast milk or formula. You can also offer puréed meat, another iron-rich food.
   • Use an infant spoon — do not put food in your baby's bottle.
   • Wait until your baby successfully eats cereal or puréed meat from the spoon before trying other single-ingredient new foods (puréed or soft fruits, vegetables, or other cereals or meats).
   • Introduce one new food at a time and wait a few days to watch for any allergic reactions before introducing another.
3. In the coming months, gradually offer foods with different textures: puréed, mashed, and soft lumps. When introducing finger foods, usually around 9 months, choose small pieces of soft foods and avoid those that can cause choking (such as whole grapes, raw veggies, raisins, popcorn, hot dogs, hard cheese, or chunks of meat).
4. Pay attention to signs your baby is hungry or full.
5. Do not give juice until your child is 12 months old.
6. Talk to your doctor about giving your baby fluoride supplements.
7. If breastfeeding, continue to give vitamin D supplements. Breastfed babies may need iron supplements until they get enough iron from the foods they eat.
8. Do not put your baby to bed with a bottle.

Routine Care

1. Babies' first teeth often appear around 6 months. To ease teething discomfort, rub your baby's gums with a clean finger. Or offer a teething toy or a clean, wet washcloth.
2. When your baby's teeth come in, wipe them with a wet washcloth or a soft infant toothbrush. Use a tiny bit of toothpaste (about the size of a grain of rice) to clean your baby's teeth twice a day. To help prevent cavities, the doctor may brush fluoride varnish on your baby’s teeth 2–4 times a year.
3. When they're 6–9 months old, babies who had been sleeping through the night may start waking up. Allow some time for your baby to settle back down. If fussiness continues, offer reassurance that you're there, but try not to pick up, play with, or feed your baby.
4. Sing, talk, play, and read to your baby every day. Babies learn best this way.
5. TV, videos, and other media are not recommended for babies this young. Video chatting is OK.
6. Create a safe space for your baby to move around, play, and explore.
7. It's common for new moms to feel tired or overwhelmed at times. If these feelings are strong, or if you feel sad or anxious, call your doctor.
8. Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your baby? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

Safety

1. Place your baby to sleep on the back, but it's OK if they roll over.
2. Don't use an infant walker. They're dangerous and can cause serious injuries. Walkers do not encourage walking and may actually hinder it.
3. While your baby is awake, don't leave your little one unattended, especially on high surfaces or in the bath.
4. Keep small objects and harmful substances out of reach.
5. Always put your baby in a rear-facingcar seat in the back seat.
6. Avoid sun exposure by keeping your baby covered and in the shade when possible. You may use sunscreen (SPF 30) if shade and clothing don't offer enough protection.
7. Childproof your home. Get down on your hands and knees to look for potential dangers. Keep doors closed and put up gates, especially on stairways.
8. Limit your child's exposure to secondhand smoke, which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.