Well-Baby Checkup: 6 Months

Baby being fed in high chair.At the 6-month checkup, the healthcare provider will examine your baby and ask how things are going at home. This sheet describes some of what you can expect.

Development and milestones

The healthcare provider will ask questions about your baby. And he or she will observe the baby to get an idea of the infant’s development. By this visit, your baby is likely doing some of the following:

  • Grabbing his or her feet and sucking on toes

  • Putting some weight on his or her legs (for example, “standing” on your lap while you hold him or her)

  • Rolling over

  • Sitting up for a few seconds at a time, when placed in a sitting position

  • Babbling and laughing in response to words or noises made by others

Also, at 6 months some babies start to get teeth. If you have questions about teething, ask the healthcare provider. 

Feeding tips

By 6 months, begin to add solid foods (“solids”) to your baby’s diet. At first, solids will not replace your baby’s regular breast milk or formula feedings:

  • In general, it does not matter what the first solid foods are. There is no current research stating that introducing solid foods in any distinct order is better for your baby. Traditionally, single-grain cereals are offered first, but single-ingredient strained or mashed vegetables or fruits are fine choices, too.

  • When first offering solids, mix a small amount of breast milk or formula with it in a bowl. When mixed, it should have a soupy texture. Feed this to the baby with a spoon once a day for the first 1 to 2 weeks.

  • When offering single-ingredient foods such as homemade or store-bought baby food, introduce one new flavor of food every 3 to 5 days before trying a new or different flavor. Following each new food, be aware of possible allergic reactions such as diarrhea, rash, or vomiting. If your baby experiences any of these, stop offering the food and consult with your child’s healthcare provider.

  • By 6 months of age, most breastfed babies will need additional sources of iron and zinc. Your baby may benefit from baby food made with meat, which has more readily absorbed sources of iron and zinc.

  • Feed solids once a day for the first 3 to 4 weeks. Then, increase feedings of solids to twice a day. During this time, also keep feeding your baby as much breast milk or formula as you did before starting solids.

  • For foods that are typically considered highly allergic, such as peanut butter and eggs, experts suggest that introducing these foods by 4 to 6 months of age may actually reduce the risk of food allergy in infants and children. After other common foods (cereal, fruit, and vegetables) have been introduced and tolerated, you may begin to offer allergenic foods, one every 3 to 5 days. This helps isolate any allergic reaction that may occur. 

  • Ask the healthcare provider if your baby needs fluoride supplements.

Hygiene tips

  • Your baby’s poop (bowel movement) will change after he or she begins eating solids. It may be thicker, darker, and smellier. This is normal. If you have questions, ask during the checkup.

  • Ask the healthcare provider when your baby should have his or her first dental visit.

Sleeping tips

At 6 months of age, a baby is able to sleep 8 to 10 hours at night without waking. But many babies this age still do wake up once or twice a night. If your baby isn’t yet sleeping through the night, starting a bedtime routine may help (see below). To help your baby sleep safely and soundly:

  • Put your baby on his or her back for all sleeping until the child is 1 year old. This can decrease the risk for sudden infant death syndrome (SIDS) and choking. Never place the baby on his or her side or stomach for sleep or naps. If the baby is awake, allow the child time on his or her tummy as long as there is supervision. This helps the child build strong tummy and neck muscles. This will also help minimize flattening of the head that can happen when babies spend too much time on their backs.

  • Do not put a crib bumper, pillow, loose blankets, or stuffed animals in the crib. These could suffocate the baby.

  • Avoid placing infants on a couch or armchair for sleep. Sleeping on a couch or armchair puts the infant at a much higher risk of death, including SIDS.

  • Avoid using infant seats, car seats, strollers, infant carriers, and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant’s airways or suffocation.

  • Don’t share a bed (co-sleep) with your baby. Bed-sharing has been shown to increase the risk of SIDS. The American Academy of Pediatrics recommends that infants sleep in the same room as their parents, close to their parents’ bed, but in a separate bed or crib appropriate for infants. This sleeping arrangement is recommended ideally for the baby’s first year. But should at least be maintained for the first 6 months.

  • Always place cribs, bassinets, and play yards in hazard-free areas—those with no dangling cords, wires, or window coverings—to reduce the risk for strangulation.

  • Do not put your child in the crib with a bottle.

  • At this age, some parents let their babies cry themselves to sleep. This is a personal choice. You may want to discuss this with the healthcare provider.

Safety tips

  • Don’t let your baby get hold of anything small enough to choke on. This includes toys, solid foods, and items on the floor that the baby may find while crawling. As a rule, an item small enough to fit inside a toilet paper tube can cause a child to choke.

  • It’s still best to keep your baby out of the sun most of the time. Apply sunscreen to your baby as directed on the packaging.

  • In the car, always put your baby in a rear-facing car seat. This should be secured in the back seat according to the car seat’s directions. Never leave the baby alone in the car at any time.

  • Don’t leave the baby on a high surface such as a table, bed, or couch. Your baby could fall off and get hurt. This is even more likely once the baby knows how to roll.

  • Always strap your baby in when using a high chair.

  • Soon your baby may be crawling, so it’s a good time to make sure your home is child-proofed. For example, put baby latches on cabinet doors and covers over all electrical outlets. Babies can get hurt by grabbing and pulling on items. For example, your baby could pull on a tablecloth or a cord, pulling something on top of him or her. To prevent this sort of accident, do a safety check of any area where your baby spends time.

  • Older siblings can hold and play with the baby as long as an adult supervises.

  • Walkers with wheels are not recommended. Stationary (not moving) activity stations are safer. Talk to the healthcare provider if you have questions about which toys and equipment are safe for your baby.

Vaccinations

Based on recommendations from the CDC, at this visit your baby may receive the following vaccinations. Depending on which combination vaccines are used by your healthcare provider, the number of vaccines in a series can vary based on the manufacturer.

  • Diphtheria, tetanus, and pertussis

  • Haemophilus influenzae type b

  • Hepatitis B

  • Influenza (flu)

  • Pneumococcus

  • Polio

  • Rotavirus

Having your baby fully vaccinated will also help lower your baby’s risk for SIDS.

Setting a bedtime routine

Your baby is now old enough to sleep through the night. Like anything else, sleeping through the night is a skill that needs to be learned. A bedtime routine can help. By doing the same things each night, you teach the baby when it’s time for bed. You may not notice results right away, but stick with it. Over time, your baby will learn that bedtime is sleep time. These tips can help:

  • Make preparing for bed a special time with your baby. Keep the routine the same each night. Choose a bedtime and try to stick to it each night.

  • Do relaxing activities before bed, such as a quiet bath followed by a bottle.

  • Sing to the baby or tell a bedtime story. Even if your child is too young to understand, your voice will be soothing. Speak in calm, quiet tones.

  • Don’t wait until the baby falls asleep to put him or her in the crib. Put the baby down awake as part of the routine.

  • Keep the bedroom dark, quiet, and not too hot or too cold. Soothing music or recordings of relaxing sounds (such as ocean waves) may help your baby sleep.

 

Next checkup at: _______________________________

 

PARENT NOTES:



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