Six Month Highlights

Introduction: Congratulations, you made it to 6 months! And your reward is a wonderful baby! Somewhere around this time you will notice him/her changing from being an infant to a young child (a “little person”). It will seem as though things are changing almost daily: new skills, new “tricks”, new foods, and new interests.

Sleep issues: In general, 6 month-olds sleep through the night. Unfortunately, over the next few months, many begin waking again. There are a few factors that can contribute to new night waking:

Object permanence is developing, and now the child knows that you are missing and cries for you.
Stress and illness: Changes in the home environment, travel, illness, and very active days can all contribute to night waking.
Sleep cycles are also part of the waking. During the lightest stages of the sleep cycle it is common to become partly awake.

Parents can prepare infants for these sleep changes by teaching them good sleep skills. The first step is to have a child who can go into her crib awake and fall asleep on her own. Second, she needs to learn to fall back asleep by herself when she happens to wake up in the middle of the night. If you have already developed these patterns, that is excellent; but be sure to continue to encourage them. If your child still needs a little work, we have a few suggestions.

Develop a bedtime routine. If a bath makes your baby sleepy, then give it in the evening. Get into pajamas and have story time (even 6 month old babies benefit from having book read to them. Add songs if desired. The importance is to get into a routine that signals to your child it is time to unwind and go to sleep.
Start teaching sleep skills at bedtime first. If she falls asleep in your arms, wake her up just a little and put her in her crib. Let her fuss a little bit and fall back to sleep. Each night put her down just a little more awake, until she is fully awake when she goes down. Their may be some fussing and crying, but let her fuss and she will get it figured out!
Once this big skill is conquered, you are ready to let her fuss and put herself back to sleep during the night. If you want to briefly go to the door and let her know you are around, but it is time to go back to sleep, this is usually alright.
If she’s still in the habit of a feeding at these times, you may want to reduce the amount of the feeds by 1 ounce (or 1 minute at the breast) each night until the feed is gone; then let her self-settle (put herself back to sleep). Some parents choose to “go cold turkey” with this feed and just stop it all at once. The choice is yours.
The older the child, the longer it takes to change habits. If you are ready, get started right away.

Safety: Your baby will be exploring a lot sooner and in many more ways than you might think.

Poisons. If you think your child has swallowed something poisonous, the best thing to do is call the Poison Control Center 1-800-222-1222. It is always faster to call poison control although we will be happy to help you sort things out after the fact. They will tell you whether or not your child needs special treatment at a hospital emergency room. Syrup of Ipecac (used to make a child vomit) is no longer recommended.
Child Proofing. Remove all poisonous plants from the house (see our handout for more information on poisonous plants). Move detergents and cleaning products to higher, secure locations. Cover all outlets with safety plugs. Check toys often for loose, small, or sharp parts. Have any peeling/chipped paint tested for lead (kits available at the hardware store). *You may want to provide a “safe drawer” with toys and plastic containers to keep your child busy in the kitchen.
Choking. Under 1 year of age, use back blows and chest thrusts to clear objects from the windpipe (technique to be reviewed at your visit). If you see the object in the mouth, you may pull it out. If it is not visible, do not blindly stick your fingers in a baby’s mouth; this can push the object further down the windpipe.
Falls. Never leave a child somewhere that is high off of the floor, except if he is tightly buckled into a highchair or is secured in his crib. Babies can fall from anywhere at anytime, even if you are 2 feet away.
Car Seats. Infants should face backwards until they are 1 year and 20 pounds. Children who are too big for their infant car seat before their 1^st Birthday should move into a rear-facing convertible car seat. Please review our “Car Seat Handout” for more details.

Food and Nutrition: By this point, you have probably started solid foods. Some babies will have just started cereal, while others may have already sampled several fruits and vegetables. In any case, new foods can be introduced more quickly after you reach 6 months.

Continue to introduce one new food at a time. Try one new food every other day, or every day if things are going well for you.
Place the baby in a highchair for meals.
Start a “Sippy Cup” (water in the cup is fine).
Start simple finger foods when the baby seems ready (usually 7 months or after.) You can try dry cereal, semi-mashed bananas, pieces of cooked pasta, and anything else that seems appropriate. Advance table foods at your own pace.
Juice is never needed. Juice has very little nutrition and plenty of extra calories. Water is a better choice for a second beverage. It may take a while to adjust to each new texture.
NO honey and NO peanut butter before 1 year.
Small amounts of dairy products such as cheese and yogurt are OK for most babies, but breast milk or formula, not cow's milk, should be used for drinking until 1 year. Children whose main beverage under a year of age is cow's milk can have microscopic bleeding from the gut and can develop an iron deficiency, which can slow development. Remember that stool (bowel movements) can change as the diet changes. Bananas can come out looking like tiny worms. Red foods can cause red stool, and green vegetables can make it green. Think about what you have been feeding when you get a strange diaper. If any concerns, give us a call. For dessert: stick with healthy items such as yogurt or fruit.