6 Month Well Child Visit

Immunizations Today:

  __    DTaP  (diphtheria, tetanus, and pertussis  vaccine)

  ___  Prevnar (pneumococcal vaccine)

  ___  Hib  (Haemophilus Influenza type B vaccine)

  ___  HepB (Hepatitis B Vaccine) or Influenza Vaccine

  ___  Rotavirus vaccine

Next Visit:    

   __ at 9 months of age

NUTRITION

¨       Continue breast or formula feeding (24-36 oz.), usually 4-6 times a day.

¨       Work towards three meals per day.

¨       Finger food (food that can be gummed and swallowed, swallowed whole, or will melt in a mouth) may be started at about 7-8 months. By one year most children should be on finger food.

¨       Avoid meat sticks, hot dogs and grapes, as they fit neatly, and too often tragically, into the infant’s airway.  Cut foods into non-round pieces.  Do not give raw vegetables, raw apples, popcorn, nuts, hard candy or chips to children under 4-5 years.  Prevention is best, of course, but ask for information about what to do if your infant is choking.

¨       Juice is okay in moderation.  Realize that although juice contains vitamins, too much (more than 4-8 ounces per day) may cause loose stools and poor growth since the sugar (sorbitol) is hard to absorb.

¨       Avoid the temptation to make your child finish every bit of food on the plate or every last drop in the bottle.  Encouraging babies to eat after they are full may establish a habit of overeating.

¨       Offer a variety of foods to the older baby; encourage, but don’t force the baby to sample them.  There is nothing wrong with a little sugar in the diet of the older baby, but children should not think all food must be made sweet.

¨       Establish certain eating places so your child doesn’t get in the habit of eating and drinking all over the house.  Most babies can sit up well in a highchair by six months.  Use a restraining or safety belt, and supervise meals for safety.  Make a habit of eating together as a family when possible.  Turn the TV off so that you can talk to each other.

¨       If child is thirsty, encourage him/her to drink water.

FLUORIDE

¨       Ready-to-feed formulas do not contain fluoride.  In areas with a fluoridated water supply, a concentrated or powdered formula mixed with tap water, rather than ready-to-feed, can be used to protect the infant’s developing teeth against dental cavities.  If your water does not contain fluoride, please let us know.

HEALTHY HABITS

¨       The poison center phone number should be posted on your phone and wherever your child spends much time.

¨       Poison control can be reached at 275-3232 locally and 1-800-222-1222 nationally.

¨       Infant CPR courses are offered through The American Red Cross.  Call Bill Peck at 241-4434 to schedule an appointment.

¨       Car seat should still be in the backseat, rear-facing, until one year old.

¨       Make sure your house is baby proofed with appropriate gates, outlet covers, safety guards and latches to prevent injury. Try not to leave small objects, sharp objects, hot or caustic liquids, poisons, balloons or plastic bags around. Your child will become increasingly interested in exploring.  Let him/her do so in a safe environment with supervision.

¨       Make sure smoke detectors work and fire extinguishers are available.

¨       Keep environment smoke-free.

¨       Crib mattress should be lowered if the child sits alone and lowered completely when he/she pulls to stand.

¨       Be aware of safety risks posed by pets and well-meaning older siblings.

¨       Keep children out of the sun at peak times (10:00 – 3:00) and always protect with a PABA-free sunscreen. (SPF of 15 or above).  Insect repellent should contain less than 10% DEET.

¨       Shoes are needed only to protect the feet from sharp objects and the cold.  They should be flexible, inexpensive, and fit well in both length and width.  Avoid rigid shoes.

SLEEP

¨       By now many children are able to sleep through the night without parental help.  A transitional object, such as a blanket or soft cuddly toy, may provide an easy transition back to sleep when the child reaches a period of light sleep.  Do not use a bottle as a transitional object.

¨       Putting babies down with a bottle at nap or bedtime allows milk, or other sugar containing liquids, to pool in their mouths as they go to sleep.  This can cause tooth decay, contribute to ear infections and lead to poor sleep habits.

¨      Provide a consistent bedtime routine.

SUGGESTED READING

The First Three Years of Life, by Burton White

The Magic Years, by Selma Fraiberg

Caring For Your Baby and Young Child, by AAP

Infants and Mothers, by T. Berry Brazelton

Your Baby and Child, From Birth to Age Five, by P. Leach

Baby and Child Care, by B. Spock

Solve Your Child’s Sleep Problems, by Richard Ferber

Guide to Your Child’s Symptoms, by American Academy of Pediatrics

Sleeping Through the Night, by Jodi Mindell, Ph.D.