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 the growth charts.

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 to a new food (bloating or gas, vomiting or diarrhea, fussiness, rash). Breast milk and formula still provide most of your infant’s nutrition.

Peeing and pooping. You may notice a change in your baby’s poopy diapers once you introduce solids. The color and consistency may vary depending on what your baby eats. Let your doctor know if stools become hard, dry, or difficult to pass or if your baby has diarrhea.

Sleeping. At 6 months, infants average about 14 hours of sleep per day, including two or three daytime naps. Most babies this age usually “sleep through the night” for a stretch of at least 6 hours.

Developing. By 6 months, it’s common for many babies to:

• blow raspberries
• say “ba,” “da,” and “ga” and start to babble (“babababa”)
• reach for and grasp objects
• use a raking grasp (using the fingers to rake and pick up objects)
• pass an object from one hand to the other
• roll over both ways (back to front, front to back)
• sit with support

There’s a wide range of normal, and children develop at different rates. Talk to your doctor if you’re concerned about your child’s development.

3. Perform a physical exam with your baby undressed while you are 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.

Looking Ahead

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

Feeding

1. If you are breastfeeding, continue for 12 months or for as long as is mutually beneficial. 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 there’s a history of food allergies in your family, talk to your doctor before introducing foods.
   • Begin with a small amount of iron-fortified single-grain cereal mixed with breast milk or formula. You can also offer pureed meat, another iron-rich food.
   • Use an infant spoon — do not put cereal in your baby’s bottle.
   • Wait until your baby successfully eats cereal or meat from the spoon before trying other single-ingredient new foods (pureed or soft fruits, vegetables, or other meats).
   • Introduce one new food at a time and wait a few days to a week to watch for any allergic reactions before introducing another.
3. 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. If you give your baby juice, limit it to 2–4 ounces (60–120 ml) a day. Always give juice in a cup, which is safe to introduce at 6 months.
6. Talk to your doctor about giving your baby fluoride supplements.
7. 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, which can be frozen for 30 minutes first.
2. Wipe your baby’s gums with a wet washcloth to clear away bacteria. Once teeth come in, use a soft infant toothbrush with a tiny bit of toothpaste (about the size of a grain of rice) to clean your baby’s teeth.
3. Between 6 and 9 months, babies who previously slept 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. Read to your baby every day.
5. Create a childproof space for your baby to move around, play, and explore.
6. TV viewing (or other screen time, including computers) can interfere with the brain development of young children. Therefore, TV is not recommended for those under 2 years old.

Safety

1. Place your baby to sleep on the back, but it’s OK if he or she rolls over.
2. Don’t use a 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. Brush any baby teeth without toothpaste twice a day. Schedule a dentist visit soon after the first tooth appears or by 1 year of age.
5. Keep small objects and harmful substances out of reach.
6. Always put your baby in a rear-facing car seat in the back seat.
7. 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.
8. 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.
9. Limit your child’s exposure to secondhand smoke, which increases the risk of heart and lung disease.

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