Breast milk is still the best food for a 6 month old. Your baby’s milk, if you are not nursing, should be one of the iron-fortified formulas until she is 1 year old. Formula intake should not exceed 32 ounces per day.
It is a good idea to introduce a cup once your baby can sit up (although it will be messy at first), aiming to be off the bottle by 12 months of age. Never put your baby to bed with a bottle. Once started, this is an extremely difficult habit to break, and can contribute to ear infections and tooth decay. Fruit juices should be given only in a cup and only in very small amounts. If cereal has not been introduced, it’s time to start. Cereal is necessary for its iron content. Do not mix it with sugar or fruit, only formula or breast milk.
If cereal, fruits and vegetables have already been introduced, meats may be added to the diet over the next several months. You may begin to experiment with junior foods and soft table foods. Table foods include such things as bread, peas, soft fruits, mashed potatoes, etc. Continue giving iron-fortified baby cereal. Your baby will let you know by trial and error what she is able to handle.
If a food seems to disagree with your infant, causing such problems as a skin rash, vomiting or diarrhea, leave it out of the diet for several weeks, then retry it. If a food causes an immediate swelling of the face and lips, notify the office and do not give it again until you have discussed it with your doctor. Do not give eggs, peanut butter, nuts, fish or shellfish. Hard, small or slick foods (like nuts, grapes raw carrots, hot dogs), salt and sugar should be avoided for now. Some babies are on all table foods by 9 months of age, and some are still on strained foods beyond their first birthday. By gradually experimenting with foods of different textures, you will find what works best for your child.
At this age, babies are usually rolling over, beginning to scoot and to sit by themselves. They put anything they can grasp into their mouths, so review your childproofing. Your baby is not highly mobile now, but will be before you know it. Babies squeal, babble, laugh and often cry very loudly.
Most 6 month olds are interested in engaging anybody willing to smile at them, although some have a more shy temperament. Even the outgoing ones, however, will normally develop some stranger anxiety, usually at 8-9 months (they may be afraid of people they do not know). Separation anxiety may be quite intense. It is important to realize that this is normal.
6 month olds may not want to be put in bed. A favorite blanket or stuffed animal may make bedtime easier. Develop a bedtime routine like playing a game, singing a lullaby, turning the lights out, and giving a goodnight kiss. Make the routine the same every night. Be calm and consistent with your baby at bedtime. If your baby is not sleeping through the night, ask your doctor for advice.
Fluoride drops should be given if you do not have fluoride in your water supply. Fluoride is important for normal tooth development. If you do not use water supplied by the city or county (e.g. well water), you should have your water tested for fluoride. The health department carries the kits. This will determine the how much, if any, fluoride supplementation your baby needs. Vitamin D supplementation is recommended if your baby is exclusively breastfed.
Vomiting and Diarrhea
At times, babies will develop vomiting and /or diarrhea. These are usually due to an intestinal virus, but sometimes due to a different type of infection (respiratory or ear), or intolerance of some type of food.
The treatment for vomiting is a very light intake so as to “rest” the stomach and intestines. After vomiting occurs, withhold all intake for about an hour. After several episodes of vomiting, it is best to discontinue solid foods and formula temporarily. Offer small amounts at frequent intervals of Pedialyte.
Breastfed babies can continue to nurse with small, frequent feedings. If your baby can take fluids for 12 hours with no vomiting, bland solids can be reintroduced (applesauce, bananas, rice cereal, crackers). If this goes well, formula can be reintroduced. As long as the baby has periods of liveliness and playfulness and has urinated at least every 12 hours, there is no reason to suspect dehydration. If the vomiting continues for more than 1 day, the baby is l
istless or has no urine output in 12 hours, you should call your doctor. Diarrhea can continue for several days or longer, but as long as the baby is active, taking fluids, and urinating, this can be managed at home by pushing fluids and sticking with a bland diet.
Never leave your child alone, except in a crib.
Avoid Suffocation and Choking
- Keep cords, ropes, strings away from your baby, especially near the crib
- Keep plastic bags, balloons, and baby powder out of reach
- Us e only unbreakable toys with no sharp edges or small parts that could come loose
- Keep all small, hard objects out of reach
- Avoid foods on which a child might choke (such as candy, hot dogs, peanuts, popcorn)
Prevent Fires, Burns, Scalds
- Never eat, drink, or carry anything hot near the baby. Keep hot foods and drinks out or reach
- Turn the pot handles on the stove away from the edge
- Turn your wate.r heater down to 120 degrees F
- Install smoke detectors
- Keep a fire extinguisher in or near the kitchen
- Don’t smoke inside the house or near your baby
- Never leave a child alone in a car, even for a minute
- Use an approved infant car seat. Go to safekidscharmeck.org and click on “Calendar” to find out about local car seat checks
- Never step away when the baby is on a high place, even the changing table
- Never place your baby’s car seat unattended on a counter or tabletop
- Keep the crib sides up
- Keep all medications, vitamins, cleaning fluids and gardening chemicals locked away or disposed of safely
- Install safety latches on cabinets
- Keep the poison center number on all phones: 1-800-222-1222
At this visit your baby should receive the following vaccines:
- DPT (diphtheria, pertussis, tetanus)
- HiB (Haemophilus influenza type B)
- Hepatitis B
- Prevnar (pneumococcus)
- Oral Rotavirus
Some of these may be combined to minimize the number of shots. Your baby may run a fever and be irritable for about 1 day after getting shots. Your baby may also have some soreness, redness, and swelling where the shots were given. Tylenol drops (3/4 dropperful or 0.6 ml) every 4-6 hours may prevent fever and irritability. For swelling or soreness, try a cool, wet washcloth on the area.
Call Your Child’s Physician If:
- Your child has a rash or any reaction other than those described above after vaccination
- You are concerned about a fever or if your child is listless
- Your child does not want to eat or vomits multiple times in a day
- Your baby has no wet diapers for 8 hours
- Your child exhibits difficulty breathing
Your baby’s next doctor visit should be at 9 months of age. Your baby will not need shots unless some were not done at previous visits. Please bring your baby’s “shot card” to each well visit.