6 Month Well Visit: Information for Parents & Caregivers

Breastfeeding and Bottle Feeding

• Continue breast milk or iron‑fortified formula until your baby is 1 year old.

• Do not give cow’s milk until after 1 year of age.

• Never give your baby a bottle in bed.

• Feed your baby before bedtime, then lay them down when drowsy but still awake.

• If formula feeding, always follow the instructions on the container unless your provider gives other directions.

• If your baby is mostly breastfed, they need extra iron to prevent anemia:

  • Babies need about 11 mg of iron daily.

  • This can come from an iron supplement (such as Fer‑in‑Sol, per package instructions) or iron‑rich foods like infant cereal, lentils, spinach, beans, meats, or fish.

  • Two feedings of iron‑fortified cereal (about 4 tablespoons each) will meet this requirement.

• Offer water from an open cup or sippy cup.

• Fruit juice is not recommended.

Introducing Solids

• If you haven’t started solids yet, you can begin now.

• Signs your baby is ready:

  • Opens mouth for the spoon

  • Sits with support

  • Has good head and neck control

  • Shows interest in foods you eat

• There is no evidence that starting with cereal is better than starting with vegetables or fruits.

• Within a few months, your baby’s diet should include a variety of foods each day: breast milk or formula, infant cereal, vegetables, fruits, and meats.

• By 9 months, most babies eat 3 meals of solids per day.

• Offer solids 2–3 times per day and let your baby decide how much to eat.

• Encourage family meals - eating together supports healthy development.

• Wash fruits and vegetables before serving.

• Do not give honey or corn syrup until after 1 year (risk of botulism).

• Avoid feeding directly from jars; use a small dish and discard leftovers.

• Introduce finger foods once your baby can sit up and bring objects to their mouth. Examples:

  • Small pieces of banana

  • Well‑cooked pasta

  • Finely chopped, well‑cooked chicken

  • Soft vegetables like peas, potatoes, or squash

• To prevent choking, foods should be soft, easy to swallow, and cut into small pieces.

• Foods that may cause choking should be avoided until age 3: nuts, popcorn, pretzels, chips, large chunks of meat, hard candy, gum, whole grapes, raisins, hot dogs, raw vegetables, and spoonfuls of peanut butter.

• Follow your baby’s signs of fullness (leaning back, turning away, closing mouth). Don’t force them to finish food.

• Remember: it may take 10-15 tries before your baby accepts a new food.

Preventing Food Allergies

• Newer research shows that early introduction of allergenic foods (around 6 months) may help prevent food allergies.

• Common allergenic foods: egg, peanut, tree nuts, milk, soy, wheat, sesame, fish, shellfish.

• How to introduce allergenic foods:

  • Egg: fully cooked and include the egg white.

  • Peanut: peanut butter or peanut powder, mixed into a puree so it is not sticky.

  • Once tolerated, give egg and peanut butter/peanut powder 2-3 times per week to maintain tolerance.

• Wait 1-3 days between new foods to watch for reactions such as rash, vomiting or diarrhea.

• If your baby has severe eczema or a known food allergy, they may be at higher risk for food allergies. Talk to your child’s primary care provider about testing before introduction.

  See the Food Allergy Prevention article for more information.

• 400IU of vitamin D is recommended for babies up until 1 year of age.

• Breastmilk is not a good source of vitamin D. This means that all breast-fed infants should be given vitamin D supplements.

• All formula-fed infants who take less than 1000ml (approximately 33 ounces per day) should also be given vitamin D supplements.

• Vitamin D supplements are available over the counter and should be given once daily.

  • There are 2 main types of vitamin D drops available for babies. Check the packaging of the vitamin D supplement you have to make sure you are giving the correct amount.

    • Some have the recommended amount of vitamin D (400IU) in just one drop.

    • With others, you need to give the entire dropper. Use the dropper that came with the bottle of vitamin D.

Learn more about vitamin D for infants here.

• Massage the gums: Gently rub your baby's gums with a clean finger, clean washcloth, or a moist gauze pad. The light pressure can help relieve pain.

• Offer cool items to chew on: Give your baby a clean, firm rubber teething ring to chew on. You can chill the teething ring or a clean, wet washcloth in the refrigerator (not the freezer). Frozen items may be too hard and can hurt your baby's gums.

• Dry the drool: Wipe your baby's face often with a soft cloth to prevent a rash on their chin or cheeks.

• Pain relief medication: If your baby is very fussy and other methods aren't working, ask your pediatrician about using a weight-appropriate dose of acetaminophen or ibuprofen.

• Do NOT use teething gels or creams that contain benzocaine (found in products like Baby Orajel, Anbesol, etc.). They are not safe for children under two.

• Do NOT use homeopathic teething tablets or gels. They may contain harmful ingredients like belladonna.

• Do NOT use amber teething necklaces or bracelets. They are a choking and strangulation risk.

• Keep your own teeth healthy. Go to your dentist twice a year. Healthy parent teeth mean you won't pass cavity-causing germs to your baby.

• Don’t share spoons with your baby or use your mouth to clean their pacifier.

• Don’t put your baby in a crib with a bottle to help them fall asleep. This helps prevent tooth decay.

• Clean your baby’s gums daily with a soft cloth. As soon as you see the first tooth, clean it two times a day with a soft cloth or a soft baby toothbrush.

• Use a small smear of fluoride toothpaste (no more than a grain of rice).

• Your child’s pediatrician can apply fluoride to their teeth as early as 6months of age. Ask us for more information. Read more about fluoride varnish here.

Developmental Milestones at 6 Months

Every baby develops at their own pace. These are common milestones you may notice around this age.

Social and Emotional

• Recognizes familiar people

• Enjoys looking at self in a mirror

• Laughs out loud

• May show fear of strangers

Language and Communication

• Takes turns making sounds with you

• Blows “raspberries” (sticks tongue out and blows)

• Makes squealing noises

• Babbles and squeals loudly

Cognitive (Learning, Thinking, Problem-Solving)

• Puts objects in mouth to explore

• Reaches for toys they want

• Closes lips to show they don’t want more food

• Stretches for objects just out of reach

Movement and Physical Development

• Rolls from tummy to back

• Pushes up with straight arms during tummy time

• Leans on hands for support when sitting

• Begins to sit without help for short periods

Supporting Your Baby’s Development

• Place your baby in a sitting position so they can look around.

• Talk with your baby by copying the sounds they make.

• Read books together and look at pictures.

• Play simple games like peekaboo, patty‑cake, and “so big.”

• Avoid using TV or digital media to calm your baby.

• If fussy, offer safe toys to hold and mouth.

• Make sure your baby gets regular naps and playtime.

• At 6 months, most babies sleep about 12 to 16 hours in 24 hours.

• While many can sleep for longer stretches at night, waking 1 or 2 times per night is still normal. Try to comfort them with a gentle voice or touch rather than picking them up immediately.

• Daytime sleep usually includes 2 to 3 naps.

• Create a consistent bedtime routine (such as bath, book, feeding, lullaby) to help your baby learn when it’s time to sleep.

• Put your baby to bed when they are drowsy but still awake—this helps them learn to fall asleep on their own.

• Always place your baby on their back to sleep, on a firm mattress with a tight‑fitting sheet.

• Keep the crib bare: no pillows, blankets, bumper pads, or stuffed animals.

• Avoid putting your baby to bed with a bottle.

• Some babies may use a pacifier to help soothe themselves to sleep.

• Keep the sleep environment quiet, dark, and smoke‑free.

• Avoid TV or digital media before bedtime.

Car Safety

• Never leave your child alone in a car.

• Your child’s safety depends on your safety. Always wear seat belts yourself. Never drive after drinking alcohol or using drugs. Never text or use a cell phone while driving.

• Use a rear-facing car seat as long as possible—usually until age 2, and often up to age 4. In California, infants must be rear-facing until they are at least 2 years old.

• Switch to a forward-facing seat only when your child is too heavy or too tall based on the limits of your specific car seat.

• Never place a car seat in the front seat of a vehicle.

• Follow the car seat instructions carefully; ask your local police or fire department for help if needed.

• Straps should be snug: you should fit only one finger under the harness at chest level, with the clip at armpit height.

• Keep cords, ropes, and strings away from your baby, especially near the crib. Remove hanging mobiles or toys before baby can reach them.

• Pick up small toys and objects (coins, beads, buttons) that could be swallowed.

• Avoid toys with magnets, button batteries, sharp edges, or loose parts.

• Keep plastic bags and balloons out of reach.

• Avoid foods that can cause choking: candy, hot dogs, peanuts, popcorn, grapes, gum, raw vegetables, pretzels, chips, raisins, and peanut butter by the spoonful.

• Check that smoke detectors are working.

• Keep a fire extinguisher in or near the kitchen.

• Test food temperatures before feeding, especially if microwaved. Check formula temperature carefully - it should be warm or cool to the touch.

• Keep hot food, liquids, appliances, and cords out of reach.

• Use back burners with pan handles turned inward.

• Cover unused electrical outlets and throw away frayed cords.

• Set your water heater to 120°F (50°C).

• Do not use baby walkers—they are unsafe and can cause serious injuries.

• Install safety gates at the top and bottom of stairs.

• Pad or move furniture with sharp edges.

• Lock doors to basements, garages, or other dangerous areas.

• Anchor furniture, TVs, and lamps to prevent tipping.

• Always keep a hand on your baby when on high surfaces.

• Never leave your baby alone in the bathtub - even if they are in a “bath seat” or ring.

• Protect your baby from the sun with clothing and hats.

• Now that your baby is 6 months old, you can start using sunscreen. Start with a small patch on a small area of skin to make sure they don’t have a reaction. Remember to re-apply sunscreen regularly.

• Keep medicines, vitamins, cleaning supplies, and chemicals locked away.

• Pay special attention to laundry and dishwasher pods—they are dangerous if swallowed.

• Use safety latches on cabinets.

• Save the Poison Control Center number (1-800-222-1222) in your phone. Call 9-1-1 in emergencies.

• Babies exposed to smoke have more frequent and severe respiratory infections.

• If you smoke, try to quit. Call 1-800-NO-BUTTS or visit NoButts.org and https://kickitca.org/

• If you cannot quit, never smoke indoors or near children.

• Even small amounts of lead can harm your child’s brain development.

• Lead may be found in old paint, toys, jewelry, or soil.

• We routinely check a lead level at 12 months for all children, and at 2 and 3 years old for some children. Let us know if you are concerned about lead.

• Reduce exposure by:

  • Staying away from home repairs until work is complete.

  • Using approved workers trained in lead-safe practices.

  • Cleaning with a wet mop and wiping shoes before entering the home.

  • Removing toys or jewelry that may contain lead.

  • Checking recalls at the Consumer Product Safety Commission website.

• Immunizations protect your child against serious, life-threatening diseases.

• The routinely recommended vaccines at this well visit are:

  • DTaP (Diphtheria, Tetanus, acellular Pertussis)

  • Hib (Haemophilus influenza type B)

  • Polio

  • Hepatitis B

  • Pneumococcal (PCV20)

  • Oral Rotavirus

  • RSV - This depends on the time of year and whether the birth parent received the RSV immunization during pregnancy.

  • Depending on the season, flu and COVID-19 vaccines may be recommended.

• It is safe for your child to be given all recommended vaccines according to the schedule published by the American Academy of Pediatrics.

• Vaccines are safe, effective, and proven to save lives.

• At CPCMG, we offer combination vaccines whenever possible to decrease the number of injections. At this visit, your child’s primary care provider may recommend a combination vaccine that includes DTaP, Hib, Polio, and Hepatitis B.

• If you have concerns about vaccines, please talk to your child’s primary healthcare provider for accurate information.

• Learn more about recommended immunizations from the American Academy of Pediatrics.

Common side effects from vaccines

• Fever - can be treated with acetaminophen or ibuprofen.

• Soreness - can be treated with a cool compress.

• Swelling at the injection site - can be treated with a cool compress.

For more details, visit the immunizations section on our Health Hub.

Call your child's primary care provider if:

• Your child has a rash or any reaction other than fever and mild irritability.

• Your child has a fever that lasts more than 36 hours.

• More than half of new parents experience “postpartum blues”.

  • This usually starts 3 or 4 days after delivery and usually gets better within 1 to 3 weeks.

  • Symptoms can include tearfulness, feeling tired or sad, and trouble thinking clearly.

  • These feelings are linked to a sudden drop in hormones after birth.

• Many parents feel guilty or confused about these emotions, especially when they expected to feel only joy.

• There are healthy ways to manage postpartum blues.

  • Acknowledge your feelings. Talk with a partner, trusted friend, your healthcare provider, or your baby’s primary care provider.

  • Get enough rest. If possible, sleep when your baby is asleep.

  • Ask for help. Let others help with meals, baby care, or tasks around the home.

  • Stay connected. Try not to isolate - spend time with people who support you.

• If you are still feeling down, please talk to your healthcare provider. You might benefit from counseling or other support.

• If your feelings are making it hard for you to care for yourself and your baby, get help as soon as possible.

  Helpful access and crisis lines:

  San Diego County 888-724-7240

  Riverside County 951-686-HELP (4357)

  Crisis Text Line: 741741 - text any word (like HELP or TALK) to start a discussion

  You can call the National Suicide Prevention Lifeline (text 988) at any time to speak with someone immediately.

  For more information on 10 signs of postpartum depression, click here.

  For more information and resources for therapists and counselors in San Diego County and Riverside County, click here.

• Your family is probably getting used to new routines. Keep in mind that as your baby gets older and changes, the routines will change too.

• If you have older children, the excitement of having a new baby in the home might be fading. You might be noticing more unwanted behaviors from your older children. This is normal and happens often.

  • Find small, but safe, ways for your other children to help with the baby, such as bringing you things you need or holding the baby’s hand.

  • Spend special time with each child reading, talking, and doing things together.

• You may be looking into options for childcare for your baby. It’s normal to feel sad or worried about leaving your baby with someone else. Look for mature, trained, and responsible caregivers.

• Take time for yourself and your partner. Spend time with family and friends.

• Let your child’s primary care provider know if:

  • You feel unsafe or have been hurt by someone close to you. We can connect you with confidential support and hotlines.

  • You are worried about your living situation or having enough food.

• Programs like SNAP and WIC may help with:

  • Buying formula for infants.

  • Getting food for breastfeeding parents and children up to age 5.

  • For more information on the WIC program please ask your doctor or contact WIC directly.

    • WIC San Diego 1-800-500-6411, http://sandiegowic.org/

    • WIC Riverside: 1-800-472-2321, http://cms.sbcounty.gov/wic/Home.aspx

Your baby's next well visit should be at the age of 9 months.

• We will talk about:

  • Taking care of your baby, your family, and yourself.

  • Feeding, sleep, and developmental milestones.

  • Teaching and playing with your baby.

  • Disciplining your baby.

  • Brushing your baby’s teeth and dental care.

  • Keeping your baby safe at home, outside, and in the car

• Bring your child’s immunization card to all visits.

• We are here for you between Well Visits!

  • We understand that it is not possible to address all concerns at the Well Visit.

  • For medical conditions, illnesses, mental health and behavioral health, and other concerns between Well Visits, please schedule an appointment with your child’s primary care provider.

Immunizations

Immunizations protect your child against serious, life-threatening diseases.

The routinely recommended vaccines at the next well visit (the 9 month visit) are:

• Depending on the season, flu and COVID-19 vaccines may be recommended.

• Any vaccines your child might have missed so far.

Learn more about recommended immunizations from the American Academy of Pediatrics