Your Baby’s Six Month Well Child Visit: What to Expect

Congratulations!  Your baby is now a half-year old!  She should be starting to coo, laugh and respond to you.  Well-child visits are an essential part of keeping your baby healthy and safe.  Here is what to expect at today’s visit.

SUMMARY

Here’s a quick rundown on today’s visit:

  • Measure weight, length, and head, and head-to-toe exam.
  • Check on your baby’s development.
  • Update health information.
  • Check risk of tuberculosis, anemia, hearing and vision problems.
  • Check mom’s risk of postpartum depression.
  • Discuss starting baby food.
  • Vaccines

See below for more information on each of these topics.

What’s NEW at this visit

  • Flu vaccine can begin at 6 months of age. It is usually given from September-March before and during flu season. Two doses are needed the first year, one month apart.
  • Evaluating your child’s risk of oral health problems and lead poisoning.

Key issues at this age

  • Starting solid foods

Checklist for today’s visit

  • Update us on any visits to other doctors, hospitals, or urgent care, as your child’s medical home.
  • How your baby is doing, especially feeding and development
  • How you and your family are doing
  • Measure your baby’s weight, length, and head circumference and plot them on a growth curve
  • Head-to-toe physical exam
  • postpartum depression screening for mom
  • Checking your baby’s risk for hearing and vision problems and tuberculosis
  • Vaccines

Checking your baby’s risks

Today we will check your baby’s risk for:

  • tuberculosis
  • high blood pressure
  • hearing problems
  • lead poisoning
  • vision problems

Physical exam

At every well-child visit, we do a full physical exam and check every part of your baby’s body, but at each age we look for a few things in particular:

  • Head: We are checking head shape, soft spots, and any flattening from sleeping on his back.
  • Eyes: We check babies at every well visit for a red reflex when shining a light in the eye (like a red eye in a picture). Babies can have cataracts or eye tumors, and since the brain is still developing, it is critical to correct vision problems immediately. Eye crossing is normal at this age and should go away by 4 months old.
  • Neck: We check for any cysts in the neck that babies can be born with, plus any thyroid enlargement.
  • Heart: We listen for any murmurs or irregular heart rhythm or rate.
  • Abdomen: We check for tumors, swollen organs, and the belly button.
  • Genitals: We check for any new problems, and in boys, that the testicles are descended. In circumcised boys, we check for healing and to be sure the skin is being pulled back so no scars or problems develop.
  • Hips: We push and pull on your baby’s hips to be sure the hip joint has developed properly.
  • Skin: Cradle cap is common at this age. Seborrheic dermatitis and eczema can also appear at this age.
  • Nervous system: We check your baby’s reflexes and development to be sure their brain and nerves are working and developing properly.

Vaccines for parents

  • Everyone who cares for your baby should get a flu vaccine during flu season.
  • We can give these vaccines to parents who need them.

Free book!

We are a Reach Out and Read site. That means that your child will receive a brand-new book at every well-child visit from 6 months to 5 years old! Partnering with Reach Out and Read is part of our early literacy and school readiness initiatives. Learn more about our partnership with this amazing program.

Vaccines usually given at this visit

These are the vaccines we usually give at this visit. The vaccines given today are in most cases exactly the same as those given at the two and four-month visits. Georgia requires all of these vaccines, except rotavirus, for school and daycare attendance unless you refuse to give the vaccines for religious reasons.

Your child’s schedule may differ from the usual schedule. You can view your child’s vaccine record on the portal and compare it with the standard schedule.

Vaccines are among the most researched and safest treatments for children (and adults). They are highly effective at preventing severe illness and death and save hundreds of thousands of children’s lives every year. For centuries, these diseases were the most common cause of death in children, and all of them are still present and a threat to the health and lives of infants and children. Visit our Vaccine Center for more information.

The DTaP vaccine protects against three diseases: diphtheria, tetanus, and pertussis (whooping cough). These germs infect infants and often cause severe illness or death. Infants in our area are at risk; tetanus lives in the dirt and is always around. Diphtheria outbreaks occur in other countries and may travel here. We still see cases of whooping cough in our area. Children should not delay getting this vaccine.

Children usually receive five doses of DTaP, usually at the following ages:

  • Two months
  • Four months
  • Six months
  • 15–18 months
  • 4–6 years

More information

The Hib vaccine protects against a bacteria called Haemophilus influenzae type B. This bacteria causes meningitis and other infections in infants, leading to serious illness, brain injury, and death. It was quite common in infants and toddlers before the development of the vaccine. Children should not delay getting this vaccine.

More information

The IPV (polio) vaccine protects against the poliovirus, which can cause paralysis. It can occur at any age. The paralysis can be permanent and affect only the arms or legs affect the chest, causing breathing difficulty. These patients have to live inside an iron lung for the rest of their lives.

More information

The PCV13 (pneumococcal) vaccine protects against a common bacterial infection in children. It causes common conditions, such as ear infections, and more severe infections, including sepsis and meningitis. The vaccine prevents severe illness and has also made ear infections much less common. It is the most common cause of serious bacterial infections in infants and toddlers. Infants should not delay getting this vaccine.

More information

The rotavirus vaccine is an oral vaccine, not a shot, that protects against an extremely common virus. Almost all children caught it before the vaccine. Rotavirus causes vomiting and diarrhea and is a leading cause of death in children worldwide due to dehydration.

More information

The influenza (flu) vaccine is recommended during flu season for all children. Children less than nine years old need two doses this year if they have not had at least two doses before. The vaccine is usually given between October and March each year. The vaccine is important at this age because infants are at higher risk of severe illness from the flu than older children, and they tend to catch viruses easier than older children.

More information

Hepatitis B is a virus that causes liver disease. Hepatitis B often stays in the liver and never goes away, causing chronic liver disease and liver failure. It can also cause liver cancer. It spreads through blood and body fluids. Babies can get it during birth if their mother is infected. Infants and children can get it through close contact with body fluids from someone with it. Unfortunately, if babies catch it, it is often much more severe than in adults. The first dose is given at birth to prevent transmission from the mother, who may not know she is infected. Children receive two more doses in the first two years of life.

More information

Giving medication for fever or pain before the vaccines is not recommended, and it is not needed for fever after the vaccines either. Fever will not harm your child, and it helps the vaccines work. You only need to treat discomfort. If your child is cranky, fussy, or uncomfortable, give some pain medication (acetaminophen or ibuprofen). See After Vaccine Care for more information.

You can learn more about each vaccine from the CDC Vaccine Information Statements (VIS). There is a link above for each vaccine and a copy in a notebook in your exam room. You can also ask for a paper copy at your child’s visit.

Information for you

  • Caring for your six month old

Related Information

Postpartum depression screening

Most moms experience the “baby blues” to a certain degree, with symptoms of exhaustion, moodiness, crying, and sadness. However, between 10-20% of moms will experience postpartum depression, a more serious condition. Since moms see pediatricians far more often than their OB/GYN or other doctors, pediatricians now screen moms for symptoms of postpartum depression. Learn more.

Visit the portal

  • All your child’s information is available on the portal: growth charts, vaccines, medications, and more!
  • Use the portal to contact us, schedule your next appointment, and much more!

Learn more about the portal and how to get started.

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