Health Education

Six Month Highlights

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What happens around this age?

Somewhere around this time you will notice him or 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.

How should my child be sleeping?

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 changing. Between 6–12 months children develop a more mature sleep/wake cycle and every 2 hours cycle from deep sleep to light sleep. During the light sleep phases, they are more likely to wake.

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, the child needs to learn to fall back asleep by themselves when they happen to wake up in the middle of the night.

How can I encourage healthy sleep patterns at this age?

  • 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 your child falls asleep in your arms, wake him up just a little and then put him back in the crib. Let him fuss a little bit and fall back to sleep. Each night put him down just a little more awake, until he is fully awake when he goes down. There may be some fussing and crying, but let him fuss and he will get it figured out!
  • Once this big skill is conquered, you are ready to let your child fuss and put himself back to sleep during the night. It is okay to briefly go to the door and let him know you are around, but tell him it is time to go back to sleep.
  • If he is 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 him self-settle. 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.

What safety concerns do I need to know about?

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.
  • Child Proofing. Remove all poisonous plants from the house. 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. 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. New recommendations from the American Academy of Pediatrics suggest that children should remain rear facing until 2 years old (although this is not a law). Children who are too big for their infant car seat before their 1st birthday should move into a rear-facing convertible car seat.

What about food and nutrition?

Here’s our recommendations:

  • Continue or start 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.
  • For breastfed babies, we recommend 0.5ml of NovaFerrum daily, a good tasting iron supplement for full term infants 6 months and up as brain development is greatest in the first year of life and proper iron intake is essential for this process.
  • 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).  Advance table foods at your own pace but it may take a while to adjust to each new texture.  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.
  • Honey is not recommended until children are 1 year or older.
  • New research shows earlier introduction to peanuts, starting at 6 months may be helpful in preventing an allergy.  Therefore, peanut products may be introduced at this time if you feel comfortable.
  • Juice is never needed. Juice has very little nutrition and plenty of extra calories. Water is a better choice for a second beverage.
  • 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.