## COVER

**Healthy Start, Grow Smart**

**Your Six-Month-Old**

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**Healthy Start, Grow Smart**

**Your Six-Month-Old**

Prepared by:

U.S. Department of Agriculture

U.S. Department of Education

U.S. Department of Health and Human Services

2002

# Acknowledgments

This publication was an initiative of Laura Bush as the First Lady of
Texas and sponsored by the Texas Department of Health. President Bush
and Mrs. Bush have asked that this series of booklets be revised and
distributed by the U.S. Department of Agriculture, U.S. Department of
Education and the U.S. Department of Health and Human Services.

We would like to thank the Texas Department of Health for their
cooperation and assistance in bringing this publication to families
across the United States. In addition, we recognize the contributions
that Susan H. Landry, Ph.D., Craig T. Ramey, Ph.D. and many other
individuals made in the development of this magazine.

# Here's What's Inside

Your Six-Month-Old 1

Your Baby's Six-Month Checkup 2

Finding a Doctor You Trust 3

Eating New Foods 4

Baby Bottles Can Cause Tooth Decay 5

Let Your Baby Feed Herself 6

Falling Asleep on Her Own 7

Grandparents and Other Adults 8

What's It Like To Be Six Months Old? 9

Guiding Your Active Baby 10

Your Baby's Developing Brain 11

Games To Play with Your Six-Month-Old 12

Floor Time Is Playtime 13

Safety Corner 14

Keeping Your Home Safe 16

Quiet Time Together 17

Information Resources for Families 18

# Your Six-Month-Old

Your baby is halfway through her first year. She is really active now.
She may be grabbing at things and shaking her rattle. She may be sitting
up with support. She babbles and makes a variety of sounds.

She is interested in everything around her. She wants to touch things.
She wants to put things in her mouth. She wants to pull on them. Keeping
up with her curiosity can be a challenge. Have fun with her. Be patient.

Your baby has learned a lot in her first six months. So have you! You
have learned a lot about being a parent. You have learned how to take
care of your baby even though she can't tell you what she needs. You
have learned what her crying means. You can tell that she is hungry by
the way she cries. You can also tell by her crying if she is tired or
needs her diaper changed.

You can help your baby be healthy and safe. You can help her learn many
important things like how to talk, how to walk and how to feed herself.
You can help her learn how to drink from a cup.

# Your Baby's Six-Month Checkup

Your baby needs another checkup at about six months of age. Several
things will take place at this visit. The doctor will check to see how
your baby is developing.

Here are some of the things the doctor will look at:

-   Your baby's ability to control her head

-   Her ability to reach and grab objects

-   Her ability to roll over

-   Her ability to make sounds

-   Her ability to stand while she holds on to someone

The doctor will also check your baby's weight, length, and the size of
her head. Your baby should have what is called a "hematocrit" blood test
to check for anemia. The test is done by pricking her toe.

Your baby will also get the shots she needs to stay healthy. Ask the
doctor for a copy of the shot record.

Your doctor or nurse will talk to you about your baby. They may ask
about her development and about how well she is eating and growing. You
should make a list of questions to ask before you go to the doctor.

They may ask about your baby's sleeping and her behavior and mood. They
may talk about how you can keep your baby healthy. Be sure to write down
any instructions that the doctor gives you.

# Finding a Doctor You Trust

Try to find a doctor you like and trust. It helps if your baby sees the
same doctor or nurse every time. That makes it easier to keep track of
your baby's needs.

If you don't know where to take your baby for care, call your local
health department. The phone number is in the "government" listings of
the phone book. You can also try a local hospital.

Ask a close friend or relative who has children whom she takes her
children to for health care. Ask if she really likes her children's
doctor and if the doctor is good at taking time to explain things and
answer questions.

If your baby is eligible for Medicaid, she can get free checkups. You
can call your local social welfare, health or family services office to
see if you qualify for Medicaid services.

# Eating New Foods

The types of foods your baby eats will change over the next few months.
Breast milk or infant formula is still the most important food for your
growing baby. Sometime between six and eight months of age, your baby
will be able to eat strained or mashed fruits and vegetables in addition
to infant cereal. Try meats if your doctor says your baby needs more
iron. You can tell when she is ready. She will show interest by leaning
forward and opening her mouth. Her teeth may begin to appear. She needs
to be able to sit up and hold her head steady in order to avoid choking.

Use a fork or potato masher to prepare your baby's foods. The
consistency of food you feed your baby should be like mashed potatoes.
Foods such as ripe bananas and cooked apples, squash, carrots or
potatoes are good to use. Be sure to remove any seeds from your baby's
food. Don't add salt, spices or fats to your baby's food. You can also
use baby foods in jars.

Try new foods one at a time. Offer her one to two teaspoons. Wait one
week before trying another new food. Watch her for any reactions like
diarrhea or rashes. Choose plain foods rather than mixtures. Your baby
may not like some foods. Don't force her to eat. Wait for one to two
weeks before trying them again.

# Baby Bottles Can Cause Tooth Decay

If your baby needs a bottle to help her fall asleep, fill it with water
only. Don't put breast milk or infant formula in the bottle at night.
Don't put fruit juice or sweetened liquids

in the bottle. These liquids pool around your baby's teeth while she is
sleeping. They can damage and decay her teeth. Water cannot hurt her
teeth in this way. Any drink other than water in the bottle at bedtime
can cause "baby bottle tooth decay."

Baby bottle tooth decay can cause your baby a lot of pain. Damage to her
teeth may have to be treated in a hospital. Protect your baby's teeth
even before you can see them. Gently wipe inside her mouth with a clean,
soft cloth each day. Be sure to wipe her gums and teeth.

At six months, show your baby how to use a cup. You can put some breast
milk or formula in the cup. By the time your baby is one year old, she
will stop needing a bottle and will use a cup instead. Introducing the
cup now helps prepare her for this development in her life. It also
helps prevent baby bottle tooth decay and give your baby a bright,
healthy smile.

Before bedtime, give your baby a hug. Instead of a bottle, give her
extra attention for comfort. You can also give her a soft blanket or toy
to hold. You are more of a comfort to her than a bottle ever can be.

# Let Your Baby Feed Herself 

Your baby will be a messy eater as she learns to feed herself. She might
put her fingers into her mouth to suck on while she eats. It helps her
swallow solid foods. She might also spit out foods. It will take time
for her to learn to feed herself.

Put a bib or apron on your baby, or let her eat with just her diaper on.
You can put a washable cloth under her high chair to make cleaning
easier. Let her play with her food. Always watch your baby when she is
eating.

She may want to grab a spoon while you feed her with another spoon. If
she drops her spoon on the floor, she will want you to pick it up for
her.

Make sure you know what to do if your baby starts to choke. Call 911
right away if you don't know what to do. To become prepared, you can get
instructions from your doctor or from your local American Red Cross.
After you learn what to do, you will be able to help your baby. Always
keep emergency numbers near your phone.

Try giving your baby a little fruit juice, breast milk or formula from a
cup. When you give her a cup to drink from, help her hold it. Use a
tippy cup with two handles. It is easier for your baby to hold.

Babies with a disability or medical problem may need special help. They
may have physical problems that make it hard to feed themselves or chew.
They may not be able to digest food like other children. Ask your doctor
how best to help your child with solid foods.

# Falling Asleep on Her Own

Question

"My baby wakes up almost every night and cries until I go to her. Then
she wants to play instead of sleep. What can I do?"

Answer

If she wakes in the night and cries for you, wait for about five
minutes. She may be able to fall back to sleep by herself. If her crying
continues, go to her. Speak softly to her to comfort her. You can rub
her stomach, but don't pick her up.

If she needs a diaper change or seems sick, take care of that. Avoid
feeding her unless you think she is truly hungry. Then tell her it is
time to sleep, and leave her alone. Don't play with her, or she will
begin to expect you to play every night.

Most babies will learn to fall back to sleep by themselves. Babies who
wake up a lot or cry for a long time during the night may be sick. Talk
with your doctor or clinic about what to do.

Try this idea as you train your baby to fall asleep on her own:

Your baby needs to learn how to fall asleep by herself. You can help her
by doing the same things each night when you put her to bed. Doing the
same things before bedtime will help her know that it is time to sleep.

At the same time each night, rock her for a few minutes and sing to her
or read her a book. Don't let her fall asleep in your arms. As she gets
sleepy, put her down in her bed. Put a favorite toy in bed with her.
Stay with her for a moment. Then leave her alone to fall asleep by
herself.

# Grandparents and Other Adults

Many people play an important role in your baby's life--mothers,
fathers, grandparents, friends, other relatives. Your baby needs to
spend time with both her mom and her dad. She should also spend time
with other loving adults.

Gentle adults can help your baby feel safe and secure. They can feed her
or give her a bath. These adults can change her diaper or rock her to
sleep. They can do many things with your baby.

Other loving adults are good for your baby. They can take her for a walk
or read her a story. They can get down on the floor to play with her.
They can help her learn something important. She can learn to trust
people and understand them.

Talk to your baby's grandparents. Together, you can find things for
grandparents to do with your baby that they all will enjoy. Grandparents
may play games with your baby. They may bring safe toys that will help
her learn.

Soft toys and balls that make noise are great for a six-month-old. Baby
books that have bright colors and different textures for her to feel
will help your baby to learn.

Grandparents and other adults can:

-   Help teach your baby to talk by imitating the sounds she makes.

-   Help feed your baby.

-   Read stories to her.

-   Tell her nursery rhymes that will help her learn to talk.

# What's It Like To Be Six Months Old?

-   I turn toward voices.

-   I reach for toys and pick them up.

-   I can hold an object in one hand and put it into the other hand.

-   I briefly look for a dropped toy.

-   I pick things up and I shake them.

-   I turn objects upside down to get another view of them.

-   I may roll over from my stomach to my back and from my back to my
    stomach.

-   I play with my toes.

-   I may help hold my bottle.

-   I know my name.

-   I may play games with people I know.

-   I babble, squeal and repeat sounds.

-   I sit by leaning forward on my hands. I can sit with support.

-   I may be afraid of adults I don't know.

-   I know the faces of the people who are around me a lot.

-   I may know what the tone of your voice means.

Each month, Healthy Start, Grow Smart will provide information about how
babies grow and develop. If you have immediate questions or concerns
about how your child is developing, call your baby's doctor.

# Guiding Your Active Baby

At the age of six months, your baby is more active than in past months.
Because she gets around more, it's a good idea to make your home safe
for your baby. Put all cleaning supplies, medicines, poisons and sharp
objects where your baby can't get to them. Be sure that everyone who
cares for your baby knows how to keep her safe.

Sometimes she will reach for things she shouldn't. She may pull at your
jewelry. She may try to eat a piece of paper. A baby this young does not
need to be punished. She is exploring her world. You need to gently
control what she does so she will be safe. She will also know that you
are in charge. Be with your baby as she explores her world.

At this age, your baby is not doing things to upset you on purpose. She
learns by trying new things. She doesn't know the limits. She needs you
to show her what is okay and what is not okay for her to do. She needs
you to show her in a loving way.

Always check on your baby when she cries to be sure that she is okay.
Never leave her alone. Always watch your baby's activities. Praise her
and hug her when she is doing things you like.

Let her know when she is doing something you don't want her to do. If
she starts to yank out an electrical cord, or if she spills out the
contents of a purse, speak to her in a warm but firm voice. You don't
need to raise your voice. Gently take her hand away and give her a toy.
Maybe she'll be too close to the hot stove. Maybe she'll try to grab
something that could break. Gently pick her up and move her away from
the thing she shouldn't touch.

# Your Baby's Developing Brain

Each brain, like each child, is unique. Here are some findings by
researchers that may help you with developing your baby's brain:

-   Your baby may make sounds such as "ba," "ma" and "ga." Sometimes
    parents think these sounds mean more than they do. Wait. Soon your
    baby will attach a meaning to the sounds she makes.

-   Talk to your baby often. This will help her learn to use sounds.

-   Being in a safe and loving place helps your baby to learn. Toys
    bought in stores are not needed. Playing with pots and pans can be
    just as much fun. Playing with simple things is just as good for
    your baby's development.

-   Praising your baby's good behavior is good for both of you. Show her
    that you like the way she is acting. This will help her do more
    things you like.

-   When you take her to new places, your baby will want to reach for
    new objects that she sees. She is not trying to misbehave. Plan
    ahead and bring a favorite toy when you go out with her.

# Games To Play with Your Six-Month-Old

A six-month-old is awake for much of the day, and she wants to play.
Here are some tips for having fun with your baby:

Play naming games with your baby. Point to her nose and say, "nose." Do
the same with her eyes, hands and toys.

Play pat-a-cake with your baby.

Play pop-goes-the-weasel. When you reach the "pop," raise your baby's
arms in the air. Don't jerk her arms or swing her by the arms.

Partly hide a toy under a blanket or piece of cloth. Let your baby grab
the toy and learn to pull the blanket off.

Put several empty plastic cups into a shoebox. The cups can be different
sizes. Reach into the box and take one cup out at a time. Pick out
another cup and do it again. After you do this a few times, your baby
will imitate you.

Put a large picture of yourself and dad near her crib or high chair.
When she says "mama" or "da-da," point to the pictures. Say, "There's
mommy" (or, "There's daddy").

# Floor Time Is Playtime

Babies who are six months old need lots of floor time so they

can learn to crawl and creep. If your baby doesn't like being on the
floor by herself, join her. Play on the floor with her.

Here are two activities that you can do during floor time:

Put your baby in a sitting position. Support her with pillows. Roll a
soft ball to her and clap when she tries to roll it back.

Give your baby two plastic cups. Show her how to bang them together or
to bang them on the floor.

**Safety Corner**

Here are some tips to make sure your baby is safe from harm or injury:

-   Never leave your baby alone in a high place, such as a tabletop, a
    couch or a bed.

-   Don't leave her in a crib with the sides down. She can hurt herself
    if she falls.

-   Never drink, eat, prepare or carry hot things while holding your
    baby.

-   Don't smoke around your baby. Don't allow others to do so.

-   Never give your baby any food or anything that could make her choke.
    Only give her foods that have been mashed.

-   If you can, set the temperature of your hot water heater to 120
    degrees or less. This will protect your baby from burns.

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-   Never shake or hit your baby.

-   Never leave your baby alone with any pet. Even friendly pets can
    harm a baby.

In the car...

-   Buckle your baby in a child seat in the back seat of your vehicle.
    The child seat should face the back of your car, not the front.

-   Babies should never ride in the front seat of a car.

-   Never hold your baby in your lap while you are driving.

-   Never leave your baby alone in a car. Don't do it even if the
    windows are partly open.

In the crib...

-   Crib mattresses should fit the crib snugly. There should be no gaps
    between the mattress and the sides of the crib.

-   Do not cover the mattress with plastic bags of any kind.

-   The slats on the side of the crib should be 2 3/8 inches apart, or
    even closer. Keeping Your Home Safe

Here are things you can do to make your home safe for your baby:

-   Close the bathroom door.

-   Put gates across steps and stairs.

-   Cover unused electrical outlets. Use products that cover outlet
    holes.

-   Keep cords from drapes and blinds and electrical cords out of your
    baby's reach.

-   Put baby locks on cabinets.

-   Protect your baby from furniture with sharp edges. You may be able
    to move the furniture to another room. Or let her play in another
    room.

-   Keep medicines where your baby can't reach them.

-   Move cleaning products from under the sink. Put them where your baby
    can't reach them.

-   Keep small objects and balloons away from your baby.

You can learn more about how to make your home safe for your baby. Call
the U.S. Consumer Product Safety Commission at 1-800-638-2772. The call
is free.

# Quiet Time Together

Be sure to have a little quiet time with your baby every day. Turn off
the TV. Turn off the radio. Have a place and time for you and your baby
to be quiet together.

Your baby needs to get to know you. And you need to get to know her.
Every baby has a different style. Some are active. Some are quiet. Some
do not like changes in their daily routines.

You are your baby's first teacher. She has a lot to learn before she
goes to school. She has to learn to talk, to walk and to feed herself.
But she has much more to learn so she can do well in school later in
life.

During her first three years, your baby learns a lot of important ideas.
Right now, she can pick up a toy or make different sounds.

Your baby needs to learn how to get along with other people. She learns
this from you and your family. She learns this by playing with other
children.

Your baby will learn about the idea of "cause and effect." When your
baby shakes a rattle and laughs at the sound, she is learning that she
can make things happen.

Hold your baby often. It will help her learn to trust. It will help her
learn to love.

You can learn more about how to teach your baby as she grows. Talk to
your doctor or clinic. They may have a list of helpful books, videos or
classes.

# Information Resources for Families

Families who are enrolled in the WIC program (Special Supplemental
Nutrition Program for Women, Infants and Children) can get information
on breastfeeding, formula feeding and nutrition at their local WIC
office. Families eligible for WIC receive nutrition counseling and
supplemental foods such as baby formula, milk and cereal. To find the
WIC office nearest you, call your state health department or visit the
WIC Web site at www.fns.usda.gov/wic/. Many public libraries offer free
access to the Internet and provide help for first-time users.

For information about early childhood education initiatives, you may
contact the U.S. Department of Education at 1-800-USA-LEARN or visit the
Web site at www.ed.gov/offices/OESE/teachingouryoungest/.

To learn about child care options, you may contact the U.S. Department
of Health and Human Services, Child Care Aware by phone at
1-800-424-2246 or visit their Web site at www.childcareaware.org/.

For more information and resources on postpartum depression,

breastfeeding and many other women's health issues call The National
Women's Health Information Center (NWHIC) at 1-800-994-9662

(1-800-994-WOMAN). You can visit their Web site at www.4woman.org/.

To learn more about breastfeeding, you may call La Leche League at

1-800-LALECHE or visit their Web site at www.lalecheleague.org/.

To learn more about free or low-cost health insurance for children, you

can call the U.S. Department of Health and Human Services' Insure Kids
Now program at 1-877-KIDSNOW. You can also visit their Web site at
www.insurekidsnow.gov/.

The American Association of Poison Control Centers' (AAPCC) poison
control hotline, 1-800-222-1222, should be on your list of emergency
numbers. To learn more, you can visit the AAPCC Web site at
www.aapcc.org/.

Families who cannot afford a car safety seat can contact the National
Highway Traffic Safety Administration. They can provide information on
resources that help low-income families purchase or borrow child car
seats. You may call them at 1-800-424-9393 or visit their Web site at
www.nhtsa.dot.gov/.

To learn more about safety, you can call the Consumer Product Safety
Commission at 1-800-638-2772 or you can visit their Web site at
[www.cpsc.gov/](http://www.cpsc.gov/).

Coming Next Month

Your Family's Future

Breastfeeding and Pregnancy

Fathers and Babies Need Time Together

Baby Games

...and much more!

This pamphlet is distributed by the U.S. Departments of Agriculture,
Education

and Health and Human Services, and is in the public domain.
Authorization to reproduce it in whole or in part is granted. While
permission to reprint this publication is not necessary, the citation
should be: U.S. Department of Agriculture, U.S. Department of Education
and U.S. Department of Health and Human Services, Healthy Start, Grow
Smart, Your-Six-Month-Old, Washington, D.C., 2002

To order copies of this publication,

write to: ED Pubs, Education Publications Center, U.S. Department of
Education,

P.O. Box 1398, Jessup, MD 20794-1398;

or fax your request to: 301-470-1244;

or e-mail your request to: edpubs@inet.ed.gov

or call in your request toll-free: 1-877-433-7827 (1-877-4-ED-PUBS). If
877 service is not yet available in your area, call 1-800-872-5327
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deaf (TDD) or a teletypewriter (TTY), should call 1-800-437-0833.

or order online at: www.ed.gov/pubs/edpubs.html/.

This publication is available to download on the Department of
Education's Web site at:
www.ed.gov/offices/OESE/earlychildhood/healthystart/. It will also be
available in Spanish on the Department of Education's Web site in
October 2002.

On request, this publication is available in alternate formats, such as
Braille, large print, audiotape or computer diskette. For more
information, please contact the Department's Alternate Format Center
(202) 260-9895 or (202) 205-8113.