six month well baby visit

The 6-Month Well-Baby Visit

Medical review policy, latest update:, the physical checkup, developmental milestones, read this next, 6-month shots, questions to ask your doctor.

Your baby’s next visit will be at  9 months — don’t forget to get an appointment on the books now!

What to Expect the First Year , 3rd edition, Heidi Murkoff. WhatToExpect.com, How to Wean Your Baby From Breastfeeding , August 2020. WhatToExpect.com, Your Baby's Vaccine Schedule: What Shots Should Your Child Get When? , January 2021. American Academy of Pediatrics, Baby’s First Tooth: 7 Facts Parents Should Know , November 2020. American Academy of Pediatrics, Movement Milestones: Babies 4 to 7 Months , March 2021. American Academy of Pediatrics, Starting Solid Foods , March 2021. American Academy of Pediatrics, AAP Schedule of Well-Child Care Visits , September 2021. American Academy of Pediatrics, Teething: 4 to 7 Months , October 2016. American Dental Association, Baby Teeth . Centers for Disease Control and Prevention,  2021 Recommended Vaccinations for Infants and Children , February 2021. Centers for Disease Control and Prevention, Important Milestones: Your Baby by Six Months , August 2021. Centers for Disease Control and Prevention, Pneumococcal Conjugate (PCV13) VIS , August 2021. KidsHealth From Nemours, Teething Tots , January 2018. KidsHealth From Nemours, Your Child’s Checkup: 6 Months , April 2021. National Institutes of Health, National Library of Medicine, Developmental Milestones Record—6 Months , January 2022.

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KATHERINE TURNER, MD

Am Fam Physician. 2018;98(6):347-353

Related letter: Well-Child Visits Provide Physicians Opportunity to Deliver Interconception Care to Mothers

Author disclosure: No relevant financial affiliations.

The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. A complete history during the well-child visit includes information about birth history; prior screenings; diet; sleep; dental care; and medical, surgical, family, and social histories. A head-to-toe examination should be performed, including a review of growth. Immunizations should be reviewed and updated as appropriate. Screening for postpartum depression in mothers of infants up to six months of age is recommended. Based on expert opinion, the American Academy of Pediatrics recommends developmental surveillance at each visit, with formal developmental screening at nine, 18, and 30 months and autism-specific screening at 18 and 24 months; the U.S. Preventive Services Task Force found insufficient evidence to make a recommendation. Well-child visits provide the opportunity to answer parents' or caregivers' questions and to provide age-appropriate guidance. Car seats should remain rear facing until two years of age or until the height or weight limit for the seat is reached. Fluoride use, limiting or avoiding juice, and weaning to a cup by 12 months of age may improve dental health. A one-time vision screening between three and five years of age is recommended by the U.S. Preventive Services Task Force to detect amblyopia. The American Academy of Pediatrics guideline based on expert opinion recommends that screen time be avoided, with the exception of video chatting, in children younger than 18 months and limited to one hour per day for children two to five years of age. Cessation of breastfeeding before six months and transition to solid foods before six months are associated with childhood obesity. Juice and sugar-sweetened beverages should be avoided before one year of age and provided only in limited quantities for children older than one year.

Well-child visits for infants and young children (up to five years) provide opportunities for physicians to screen for medical problems (including psychosocial concerns), to provide anticipatory guidance, and to promote good health. The visits also allow the family physician to establish a relationship with the parents or caregivers. This article reviews the U.S. Preventive Services Task Force (USPSTF) and the American Academy of Pediatrics (AAP) guidelines for screenings and recommendations for infants and young children. Family physicians should prioritize interventions with the strongest evidence for patient-oriented outcomes, such as immunizations, postpartum depression screening, and vision screening.

Clinical Examination

The history should include a brief review of birth history; prematurity can be associated with complex medical conditions. 1 Evaluate breastfed infants for any feeding problems, 2 and assess formula-fed infants for type and quantity of iron-fortified formula being given. 3 For children eating solid foods, feeding history should include everything the child eats and drinks. Sleep, urination, defecation, nutrition, dental care, and child safety should be reviewed. Medical, surgical, family, and social histories should be reviewed and updated. For newborns, review the results of all newborn screening tests ( Table 1 4 – 7 ) and schedule follow-up visits as necessary. 2

PHYSICAL EXAMINATION

A comprehensive head-to-toe examination should be completed at each well-child visit. Interval growth should be reviewed by using appropriate age, sex, and gestational age growth charts for height, weight, head circumference, and body mass index if 24 months or older. The Centers for Disease Control and Prevention (CDC)-recommended growth charts can be found at https://www.cdc.gov/growthcharts/who_charts.htm#The%20WHO%20Growth%20Charts . Percentiles and observations of changes along the chart's curve should be assessed at every visit. Include assessment of parent/caregiver-child interactions and potential signs of abuse such as bruises on uncommonly injured areas, burns, human bite marks, bruises on nonmobile infants, or multiple injuries at different healing stages. 8

The USPSTF and AAP screening recommendations are outlined in Table 2 . 3 , 9 – 27 A summary of AAP recommendations can be found at https://www.aap.org/en-us/Documents/periodicity_schedule.pdf . The American Academy of Family Physicians (AAFP) generally adheres to USPSTF recommendations. 28

MATERNAL DEPRESSION

Prevalence of postpartum depression is around 12%, 22 and its presence can impair infant development. The USPSTF and AAP recommend using the Edinburgh Postnatal Depression Scale (available at https://www.aafp.org/afp/2010/1015/p926.html#afp20101015p926-f1 ) or the Patient Health Questionnaire-2 (available at https://www.aafp.org/afp/2012/0115/p139.html#afp20120115p139-t3 ) to screen for maternal depression. The USPSTF does not specify a screening schedule; however, based on expert opinion, the AAP recommends screening mothers at the one-, two-, four-, and six-month well-child visits, with further evaluation for positive results. 23 There are no recommendations to screen other caregivers if the mother is not present at the well-child visit.

PSYCHOSOCIAL

With nearly one-half of children in the United States living at or near the poverty level, assessing home safety, food security, and access to safe drinking water can improve awareness of psychosocial problems, with referrals to appropriate agencies for those with positive results. 29 The prevalence of mental health disorders (i.e., primarily anxiety, depression, behavioral disorders, attention-deficit/hyperactivity disorder) in preschool-aged children is around 6%. 30 Risk factors for these disorders include having a lower socioeconomic status, being a member of an ethnic minority, and having a non–English-speaking parent or primary caregiver. 25 The USPSTF found insufficient evidence regarding screening for depression in children up to 11 years of age. 24 Based on expert opinion, the AAP recommends that physicians consider screening, although screening in young children has not been validated or standardized. 25

DEVELOPMENT AND SURVEILLANCE

Based on expert opinion, the AAP recommends early identification of developmental delays 14 and autism 10 ; however, the USPSTF found insufficient evidence to recommend formal developmental screening 13 or autism-specific screening 9 if the parents/caregivers or physician have no concerns. If physicians choose to screen, developmental surveillance of language, communication, gross and fine movements, social/emotional development, and cognitive/problem-solving skills should occur at each visit by eliciting parental or caregiver concerns, obtaining interval developmental history, and observing the child. Any area of concern should be evaluated with a formal developmental screening tool, such as Ages and Stages Questionnaire, Parents' Evaluation of Developmental Status, Parents' Evaluation of Developmental Status-Developmental Milestones, or Survey of Well-Being of Young Children. These tools can be found at https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Screening/Pages/Screening-Tools.aspx . If results are abnormal, consider intervention or referral to early intervention services. The AAP recommends completing the previously mentioned formal screening tools at nine-, 18-, and 30-month well-child visits. 14

The AAP also recommends autism-specific screening at 18 and 24 months. 10 The USPSTF recommends using the two-step Modified Checklist for Autism in Toddlers (M-CHAT) screening tool (available at https://m-chat.org/ ) if a physician chooses to screen a patient for autism. 10 The M-CHAT can be incorporated into the electronic medical record, with the possibility of the parent or caregiver completing the questionnaire through the patient portal before the office visit.

IRON DEFICIENCY

Multiple reports have associated iron deficiency with impaired neurodevelopment. Therefore, it is essential to ensure adequate iron intake. Based on expert opinion, the AAP recommends supplements for preterm infants beginning at one month of age and exclusively breastfed term infants at six months of age. 3 The USPSTF found insufficient evidence to recommend screening for iron deficiency in infants. 19 Based on expert opinion, the AAP recommends measuring a child's hemoglobin level at 12 months of age. 3

Lead poisoning and elevated lead blood levels are prevalent in young children. The AAP and CDC recommend a targeted screening approach. The AAP recommends screening for serum lead levels between six months and six years in high-risk children; high-risk children are identified by location-specific risk recommendations, enrollment in Medicaid, being foreign born, or personal screening. 21 The USPSTF does not recommend screening for lead poisoning in children at average risk who are asymptomatic. 20

The USPSTF recommends at least one vision screening to detect amblyopia between three and five years of age. Testing options include visual acuity, ocular alignment test, stereoacuity test, photoscreening, and autorefractors. The USPSTF found insufficient evidence to recommend screening before three years of age. 26 The AAP, American Academy of Ophthalmology, and the American Academy of Pediatric Ophthalmology and Strabismus recommend the use of an instrument-based screening (photoscreening or autorefractors) between 12 months and three years of age and annual visual acuity screening beginning at four years of age. 31

IMMUNIZATIONS

The AAFP recommends that all children be immunized. 32 Recommended vaccination schedules, endorsed by the AAP, the AAFP, and the Advisory Committee on Immunization Practices, are found at https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Immunizations are usually administered at the two-, four-, six-, 12-, and 15- to 18-month well-child visits; the four- to six-year well-child visit; and annually during influenza season. Additional vaccinations may be necessary based on medical history. 33 Immunization history should be reviewed at each wellness visit.

Anticipatory Guidance

Injuries remain the leading cause of death among children, 34 and the AAP has made several recommendations to decrease the risk of injuries. 35 – 42 Appropriate use of child restraints minimizes morbidity and mortality associated with motor vehicle collisions. Infants need a rear-facing car safety seat until two years of age or until they reach the height or weight limit for the specific car seat. Children should then switch to a forward-facing car seat for as long as the seat allows, usually 65 to 80 lb (30 to 36 kg). 35 Children should never be unsupervised around cars, driveways, and streets. Young children should wear bicycle helmets while riding tricycles or bicycles. 37

Having functioning smoke detectors and an escape plan decreases the risk of fire- and smoke-related deaths. 36 Water heaters should be set to a maximum of 120°F (49°C) to prevent scald burns. 37 Infants and young children should be watched closely around any body of water, including water in bathtubs and toilets, to prevent drowning. Swimming pools and spas should be completely fenced with a self-closing, self-latching gate. 38

Infants should not be left alone on any high surface, and stairs should be secured by gates. 43 Infant walkers should be discouraged because they provide no benefit and they increase falls down stairs, even if stair gates are installed. 39 Window locks, screens, or limited-opening windows decrease injury and death from falling. 40 Parents or caregivers should also anchor furniture to a wall to prevent heavy pieces from toppling over. Firearms should be kept unloaded and locked. 41

Young children should be closely supervised at all times. Small objects are a choking hazard, especially for children younger than three years. Latex balloons, round objects, and food can cause life-threatening airway obstruction. 42 Long strings and cords can strangle children. 37

DENTAL CARE

Infants should never have a bottle in bed, and babies should be weaned to a cup by 12 months of age. 44 Juices should be avoided in infants younger than 12 months. 45 Fluoride use inhibits tooth demineralization and bacterial enzymes and also enhances remineralization. 11 The AAP and USPSTF recommend fluoride supplementation and the application of fluoride varnish for teeth if the water supply is insufficient. 11 , 12 Begin brushing teeth at tooth eruption with parents or caregivers supervising brushing until mastery. Children should visit a dentist regularly, and an assessment of dental health should occur at well-child visits. 44

SCREEN TIME

Hands-on exploration of their environment is essential to development in children younger than two years. Video chatting is acceptable for children younger than 18 months; otherwise digital media should be avoided. Parents and caregivers may use educational programs and applications with children 18 to 24 months of age. If screen time is used for children two to five years of age, the AAP recommends a maximum of one hour per day that occurs at least one hour before bedtime. Longer usage can cause sleep problems and increases the risk of obesity and social-emotional delays. 46

To decrease the risk of sudden infant death syndrome (SIDS), the AAP recommends that infants sleep on their backs on a firm mattress for the first year of life with no blankets or other soft objects in the crib. 45 Breastfeeding, pacifier use, and room sharing without bed sharing protect against SIDS; infant exposure to tobacco, alcohol, drugs, and sleeping in bed with parents or caregivers increases the risk of SIDS. 47

DIET AND ACTIVITY

The USPSTF, AAFP, and AAP all recommend breastfeeding until at least six months of age and ideally for the first 12 months. 48 Vitamin D 400 IU supplementation for the first year of life in exclusively breastfed infants is recommended to prevent vitamin D deficiency and rickets. 49 Based on expert opinion, the AAP recommends the introduction of certain foods at specific ages. Early transition to solid foods before six months is associated with higher consumption of fatty and sugary foods 50 and an increased risk of atopic disease. 51 Delayed transition to cow's milk until 12 months of age decreases the incidence of iron deficiency. 52 Introduction of highly allergenic foods, such as peanut-based foods and eggs, before one year decreases the likelihood that a child will develop food allergies. 53

With approximately 17% of children being obese, many strategies for obesity prevention have been proposed. 54 The USPSTF does not have a recommendation for screening or interventions to prevent obesity in children younger than six years. 54 The AAP has made several recommendations based on expert opinion to prevent obesity. Cessation of breastfeeding before six months and introduction of solid foods before six months are associated with childhood obesity and are not recommended. 55 Drinking juice should be avoided before one year of age, and, if given to older children, only 100% fruit juice should be provided in limited quantities: 4 ounces per day from one to three years of age and 4 to 6 ounces per day from four to six years of age. Intake of other sugar-sweetened beverages should be discouraged to help prevent obesity. 45 The AAFP and AAP recommend that children participate in at least 60 minutes of active free play per day. 55 , 56

Data Sources: Literature search was performed using the USPSTF published recommendations ( https://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations ) and the AAP Periodicity table ( https://www.aap.org/en-us/Documents/periodicity_schedule.pdf ). PubMed searches were completed using the key terms pediatric, obesity prevention, and allergy prevention with search limits of infant less than 23 months or pediatric less than 18 years. The searches included systematic reviews, randomized controlled trials, clinical trials, and position statements. Essential Evidence Plus was also reviewed. Search dates: May through October 2017.

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Baker RD, Greer FR Committee on Nutrition, American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics. 2010;126(5):1040-1050.

Mahle WT, Martin GR, Beekman RH, Morrow WR Section on Cardiology and Cardiac Surgery Executive Committee. Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2012;129(1):190-192.

American Academy of Pediatrics Newborn Screening Authoring Committee. Newborn screening expands: recommendations for pediatricians and medical homes—implications for the system. Pediatrics. 2008;121(1):192-217.

American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.

Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infant > or = 35 weeks' gestation: an update with clarifications. Pediatrics. 2009;124(4):1193-1198.

Christian CW Committee on Child Abuse and Neglect, American Academy of Pediatrics. The evaluation of suspected child physical abuse [published correction appears in Pediatrics . 2015;136(3):583]. Pediatrics. 2015;135(5):e1337-e1354.

Siu AL, Bibbins-Domingo K, Grossman DC, et al. Screening for autism spectrum disorder in young children: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;315(7):691-696.

Johnson CP, Myers SM American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.

Moyer VA. Prevention of dental caries in children from birth through age 5 years: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2014;133(6):1102-1111.

Clark MB, Slayton RL American Academy of Pediatrics Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014;134(3):626-633.

Siu AL. Screening for speech and language delay and disorders in children aged 5 years and younger: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2015;136(2):e474-e481.

Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening [published correction appears in Pediatrics . 2006;118(4):1808–1809]. Pediatrics. 2006;118(1):405-420.

Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;316(6):625-633.

National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. October 2012. https://www.nhlbi.nih.gov/sites/default/files/media/docs/peds_guidelines_full.pdf . Accessed May 9, 2018.

Moyer VA. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(9):613-619.

Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents [published correction appears in Pediatrics . 2017;140(6):e20173035]. Pediatrics. 2017;140(3):e20171904.

Siu AL. Screening for iron deficiency anemia in young children: USPSTF recommendation statement. Pediatrics. 2015;136(4):746-752.

U.S. Preventive Services Task Force. Screening for elevated blood lead levels in children and pregnant women. Pediatrics. 2006;118(6):2514-2518.

Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials . Atlanta, Ga.: U.S. Public Health Service; Centers for Disease Control and Prevention; National Center for Environmental Health; 1997.

O'Connor E, Rossom RC, Henninger M, Groom HC, Burda BU. Primary care screening for and treatment of depression in pregnant and post-partum women: evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA. 2016;315(4):388-406.

Earls MF Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.

Siu AL. Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(5):360-366.

Weitzman C, Wegner L American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics; Committee on Psychosocial Aspects of Child and Family Health; Council on Early Childhood; Society for Developmental and Behavioral Pediatrics; American Academy of Pediatrics. Promoting optimal development: screening for behavioral and emotional problems [published correction appears in Pediatrics . 2015;135(5):946]. Pediatrics. 2015;135(2):384-395.

Grossman DC, Curry SJ, Owens DK, et al. Vision screening in children aged 6 months to 5 years: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;318(9):836-844.

Donahue SP, Nixon CN Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Academy of Pediatrics; American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment in infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

Lin KW. What to do at well-child visits: the AAFP's perspective. Am Fam Physician. 2015;91(6):362-364.

American Academy of Pediatrics Council on Community Pediatrics. Poverty and child health in the United States. Pediatrics. 2016;137(4):e20160339.

Lavigne JV, Lebailly SA, Hopkins J, Gouze KR, Binns HJ. The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol. 2009;38(3):315-328.

American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment of infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

American Academy of Family Physicians. Clinical preventive service recommendation. Immunizations. http://www.aafp.org/patient-care/clinical-recommendations/all/immunizations.html . Accessed October 5, 2017.

Centers for Disease Control and Prevention. Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2018. https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Accessed May 9, 2018.

National Center for Injury Prevention and Control. 10 leading causes of death by age group, United States—2015. https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_age_group_2015_1050w740h.gif . Accessed April 24, 2017.

Durbin DR American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Child passenger safety. Pediatrics. 2011;127(4):788-793.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Reducing the number of deaths and injuries from residential fires. Pediatrics. 2000;105(6):1355-1357.

Gardner HG American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Office-based counseling for unintentional injury prevention. Pediatrics. 2007;119(1):202-206.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of drowning in infants, children, and adolescents. Pediatrics. 2003;112(2):437-439.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Injuries associated with infant walkers. Pediatrics. 2001;108(3):790-792.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Falls from heights: windows, roofs, and balconies. Pediatrics. 2001;107(5):1188-1191.

Dowd MD, Sege RD Council on Injury, Violence, and Poison Prevention Executive Committee; American Academy of Pediatrics. Firearm-related injuries affecting the pediatric population. Pediatrics. 2012;130(5):e1416-e1423.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of choking among children. Pediatrics. 2010;125(3):601-607.

Kendrick D, Young B, Mason-Jones AJ, et al. Home safety education and provision of safety equipment for injury prevention (review). Evid Based Child Health. 2013;8(3):761-939.

American Academy of Pediatrics Section on Oral Health. Maintaining and improving the oral health of young children. Pediatrics. 2014;134(6):1224-1229.

Heyman MB, Abrams SA American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics. 2017;139(6):e20170967.

Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5):e20162591.

Moon RY Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162940.

American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841.

Wagner CL, Greer FR American Academy of Pediatrics Section on Breastfeeding; Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents [published correction appears in Pediatrics . 2009;123(1):197]. Pediatrics. 2008;122(5):1142-1152.

Huh SY, Rifas-Shiman SL, Taveras EM, Oken E, Gillman MW. Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics. 2011;127(3):e544-e551.

Greer FR, Sicherer SH, Burks AW American Academy of Pediatrics Committee on Nutrition; Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183-191.

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Well-Child Visit: 6 Months

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What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on a growth chart .

2. Ask questions, address concerns, and offer advice about how your baby is:

Feeding. If you haven't already, it's time to introduce solids , starting with iron-fortified single-grain cereal or puréed meat. Let your doctor know if your baby has had any reactions (such as throwing up, diarrhea, or a rash) to a new food. Breast milk and formula still provide most of your baby's nutrition.

Peeing and pooping. You may notice a change in your baby's poop after you introduce solids. The color and consistency may vary depending on what your baby eats. Let your doctor know if the poop gets hard, dry, or difficult to pass, or if your baby has diarrhea.

Sleeping. At 6 months, infants sleep about 12–16 hours per day, including naps. Most babies sleep for a stretch of at least 6 hours at night.

Developing. By 6 months, most babies:

• take turns making sounds with you
• blow “raspberries” and laugh
• know familiar people
• like to look at themselves in the mirror
• put things in their mouth to explore
• reach for a toy they want
• roll from their tummy to their back
• push up with straight arms when ontheir tummy
• lean on their hands for support when sitting

Talk to your doctor if your baby is not meeting one or more milestones, or you notice that your baby had skills but has lost them.

3. Do an exam with your baby undressed while you're present. This includes an eye exam, listening to your baby's heart and feeling pulses, checking hips, and paying attention to your baby's movements.

4. Update immunizations. Immunizations can protect babies from serious childhood illnesses, so it's important that your child receive them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

5. Because postpartum depression is common, your baby’s doctor may ask you to fill out a depression screening questionnaire.

Looking Ahead

Here are some things to keep in mind until your next routine visit at 9 months :

• If you're breastfeeding , continue for 12 months or for as long as you and your baby desire. Breastfed babies weaned before 12 months should be given iron-fortified formula. Wait until 12 months to switch from formula to cow's milk .
• If your baby has eczema  or a food allergy, or there's a history of food allergies in your family, talk to your doctor before introducing new foods.
• Begin with a small amount of iron-fortified single-grain cereal mixed with breast milk or formula. You can also offer puréed meat, another iron-rich food.
• Use an infant spoon — do not put food in your baby's bottle.
• Wait until your baby successfully eats cereal or puréed meat from the spoon before trying other single-ingredient new foods (puréed or soft fruits, vegetables, or other cereals or meats).
• Introduce one new food at a time and wait a few days to watch for any allergic reactions before introducing another.
• In the coming months, gradually offer foods with different textures: puréed, mashed, and soft lumps. When introducing finger foods , usually around 9 months, choose small pieces of soft foods and avoid those that can cause choking (such as whole grapes, raw veggies, raisins, popcorn, hot dogs, hard cheese, or chunks of meat).
• Pay attention to signs your baby is hungry or full .
• Do not give juice until your child is 12 months old.
• Talk to your doctor about giving your baby fluoride supplements .
• If breastfeeding, continue to give vitamin D supplements . Breastfed babies may need iron supplements until they get enough iron from the foods they eat.
• Do not put your baby to bed with a bottle .

Routine Care

• Babies' first teeth often appear around 6 months. To ease teething discomfort , rub your baby's gums with a clean finger. Or offer a teething toy or a clean, wet washcloth.
• When your baby's teeth come in, wipe them with a wet washcloth or a soft infant toothbrush . Use a tiny bit of toothpaste (about the size of a grain of rice) to clean your baby's teeth twice a day. To help prevent cavities, the doctor may brush fluoride varnish on your baby’s teeth 2–4 times a year.
• When they're 6–9 months old, babies who had been sleeping through the night may start waking up . Allow some time for your baby to settle back down. If fussiness continues, offer reassurance that you're there, but try not to pick up, play with, or feed your baby.
• Sing, talk, play, and read  to your baby every day. Babies learn best this way.
• TV, videos, and other media are not recommended for babies this young. Video chatting is OK.
• Create a safe space for your baby to move around, play, and explore.
• It's common for new moms to feel tired or overwhelmed at times . If these feelings are strong, or if you feel sad or anxious, call your doctor.
• Talk to your doctor if you're concerned about your living situation . Do you have the things that you need to take care of your baby? Do you have enough food , a safe place to live, and health insurance ? Your doctor can tell you about community resources or refer you to a social worker.
• Place your baby to sleep on the back , but it's OK if they roll over.
• Don't use an infant walker. They're dangerous and can cause serious injuries. Walkers do not encourage walking and may actually hinder it.
• While your baby is awake, don't leave your little one unattended , especially on high surfaces or in the bath.
• Keep small objects and harmful substances out of reach.
• Always put your baby in a rear-facing car seat in the back seat.
• Avoid sun exposure by keeping your baby covered and in the shade when possible. You may use sunscreen (SPF 30) if shade and clothing don't offer enough protection.
• Childproof your home. Get down on your hands and knees to look for potential dangers. Keep doors closed and put up gates, especially on stairways.
• Limit your child's exposure to secondhand smoke , which increases the risk of heart and lung disease. Secondhand vapor from e-cigarettes is also harmful.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.

Ages & Stages

Checkup checklist: 6 months old.

​​​​​Happy half-birthday to your beautiful baby! By 6 months, most babies have doubled their birth weights. Your 6-month checkup will cover a lot, so get your questions ready!

✅ Immunizations

At the 6-month visit, your baby may receive the third doses of the following vaccines​ .

Rotavirus vaccine

Diphtheria, tetanus, acellular pertussis vaccine (DTaP)

Haemophilus influenza type B vaccine (Hib)

Pneumococcal conjugate vaccine (PCV)

Inactivated polio vaccine (IPV)

Hepatitis B vaccine (HBV)

The American Academy of Pediatrics and the Centers for Disease Control and Prevention also recommend the seasonal influenza vaccine (flu shot) for children 6 months of age and older as soon as it becomes available. So, if your pediatrician has the influenza vaccine available, be sure to add that one to your checklist.

Note: Infants and children up to 8 years of age who are getting their flu shot for the first time may need two doses, given at least four weeks apart. Be sure to follow up with your baby's second dose if they get their first one at this appointment.

✅ Screenings

Dental health check: Your pediatrician may apply fluoride varnish after your baby's first tooth appears. Most babies begin to cut teeth around 6 months of age.

Postpartum depression : Your pediatrician will ask you how you are feeling. If you or your partner  are having postpartum issues with breastfeeding, anxiety, or sadness, or anything else, please feel free to discuss it with your baby's pediatrician.

✅Feeding & development

Your pediatrician will measure and weigh your baby to make sure their growth is on track, observe their development and behavior, and perform a physical exam.

Questions your pediatrician may ask

Have you started giving your baby solid foods ?

Is your baby rolling over or able to sit up briefly?

Has your baby first tooth started to come in?

Questions you may have

What's the best way to treat diaper rash ?

When do babies start to crawl ?

How can I help in my baby's language development? Share books with your baby. Here's how .

What should I do if my baby doesn't like trying new foods​ ?

Have you childproofed your home ?

Do you know what to do in a choking emergency ? Once baby is eating solid foods, remember to only give very soft, small bites of finger foods.

How can I reduce my baby's chances of developing RSV and bronchiolitis ?

What should the babysitter know about feeding the baby now? Here's what caregivers need to know about feeding children .

✅ Communication t​ips

Never hesitate to call your pediatrician's office with any questions or concerns—even if you know the office is closed. If your pediatrician is unable to see you but believes your baby should be examined, they will advise you on the most appropriate place for your baby to receive care and how quickly your baby should be seen.

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Baby's doctor visits: The 6-month checkup

At the 6-month checkup, the doctor will weigh and measure your baby, do a complete physical, address any concerns you have, and ask about your baby's eating, sleeping, and development. Your baby will likely get two to five shots and an oral vaccine at this visit. If you have questions about starting solids, teething, or anything else, be sure to raise them.

Do babies get shots at 6 months?

What the doctor will do at the 6-month checkup.

To prepare for your baby's 6-month checkup, learn what will happen at the visit. You may also want to consider the questions the doctor is likely to ask and jot down your own questions beforehand.

Your baby will likely receive the hepatitis B , DTaP , polio , pneumococcal , and Hib vaccines (combined in two or three shots) and rotavirus vaccine (given orally). Your baby is also due for their first flu shot (if it's flu season), and their first COVID vaccine .

A nurse or medical assistant will probably give your baby the vaccines. This is usually done at the end of the appointment in case your baby gets upset (which could make the exam part of the visit difficult), and so you can have some privacy to comfort them.

Find out how to make shots less painful for your baby and more about the immunizations your baby needs .

Weigh and measure your baby

You'll need to undress your baby completely for weighing. The doctor weighs your baby, measures length and head circumference, and plots the numbers on a growth chart .

The chart enables you to see how your baby compares with other children the same age. If your baby's percentiles have changed a bit, don't worry – they're just settling into their own growth pattern.

Do a complete physical

• Heart and lungs: Uses a stethoscope to listen for a heart murmur or breathing problems.
• Eyes: Checks for signs of congenital eye conditions and other problems. Watches how your baby's eyes track objects, and looks for any crossing or asymmetry. May also check for blocked tear ducts and discharge.
• Ears: Looks for signs of infection and observes how your baby responds to sound.
• Mouth: Looks for signs of thrush (an oral yeast infection) and any new teeth , among other things.
• Head: Checks the soft spots (fontanels) and the shape of your baby's head. Also checks to see if your baby's head is developing a flat spot .
• Body: Checks your baby's reflexes and muscle tone, and examines their skin for rashes. Also assesses your baby's muscle control when sitting upright as well as how they reach for and grab things .
• Belly: Presses gently on the abdomen to check for a hernia or enlarged organs.
• Genitals: Opens your baby's diaper and checks for signs of infection.
• Hips and legs: Moves your baby's legs around to look for problems in the hip joints.

Address any other concerns

The doctor will address any other concerns (such as questions about babyproofing your home to keep your active baby safe) ask you some questions (see below), and help you understand what's normal at this age.

Ask questions

• How's your baby sleeping? At 6 months your baby will probably be sleeping about 14 to 15 hours in a 24-hour period.
• Does your baby seem ready for solid food? Four to 6 months is the recommended age to start your baby on solids . The doctor can help you decide how to begin, if you haven't already. Be sure to tell the doctor about any food allergies that run in your family. If you've already started solids, let the doctor know if your baby gags on food or spits up a lot.
• What are your baby's bowel movements like? As your baby starts eating solids, their poop will get firmer and smellier. But in general, your baby's poop should still be fairly soft. Dry or pellet-like stools are a sign of dehydration or constipation , so tell your doctor if you notice this.
• Can your baby roll over or sit up? At 6 months many babies can roll over both ways (front to back and back to front) and sit with support , although some need a little more time to master these skills. If your baby hasn't learned to roll over at least one way, tell your doctor.
• Has your baby started teething ? Some babies get their first tooth as early as 6 months – or even earlier. Your baby may suffer from red, swollen, and tender gums while their teeth are erupting. Your doctor can suggest ways to soothe your baby's gums. Once the first tooth shows up, their doctor may recommend that your child drink fluoridated water or take fluoride drops.
• What sounds does your baby make? At this age your baby's language skills include babbling, squealing, laughing , and imitating others. They're probably also making identifiable sounds such as "ba," "da," or "ma." If your baby doesn't make any sounds or is "talking" less than before, tell the doctor.
• Is your baby interested in the world around them? By now your baby should be well into exploratory play, putting objects in their mouth and banging, dropping, or throwing things. Tell the doctor if your baby doesn't seem interested in toys or other objects.
• How are your baby's fine motor skills? Your baby probably reaches for and grabs things , and they may also use their hands to sweep small objects toward them and transfer things from hand to hand.
• How are your baby's gross motor skills? Your baby should be able to bear weight on their feet when you hold them up. Bowed legs and rounded feet – arched up instead of flat for walking – are normal at this age, but if your baby moves in a way that worries you, favors one leg, seems to tilt sideways when they move, or tends to use only one hand, let the doctor know.
• Have you noticed anything unusual about your baby's eyes or the way they look at things? At every well-baby visit, the doctor should check the structure and alignment of the eyes and your baby's ability to move them correctly. By 6 months, your baby should be able to control their eye movements.
• How's your baby's hearing? If your baby doesn't turn toward sounds, be sure to tell the doctor. The sooner potential hearing problems are investigated, the sooner they can be treated.

Learn more:

• Your 6-month-old baby's development
• Your 6-month-old's sleep
• What's in store at the 9-month doctor visit

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

AAP. 2022. AAP Schedule of Well-Child Care Visits. https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx Opens a new window [Accessed November 2022]

CDC. Recommended Vaccinations for Infants and Children, Parent-Friendly Version. https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html Opens a new window [Accessed November 2022]

U.S. Department of Health and Human Services. 2022. Make the Most of Your Baby's Visits to the Doctor. https://health.gov/myhealthfinder/doctor-visits/regular-checkups/make-most-your-babys-visit-doctor-ages-0-11-months Opens a new window [Accessed November 2022]

Where to go next

Health Library 6 Month Well-Child Visit

Find another condition or treatment, healthy baby development and behavior.

Below are milestones most babies will reach between now and 9 months old. Talk with your doctor at your baby’s next well-visit if your baby is not yet reaching these milestones or there are skills your baby no longer shows each day.

Social and Emotional Milestones

• Is shy, clingy or fearful around strangers
• Shows several facial expressions, like happy, sad, angry or surprised
• Looks when you call their name
• Reacts when you leave (looks, reaches for you or cries)
• Smiles or laughs when you play peek-a-boo

Language and Communication Milestones

• Makes different sounds like “mamama” and “bababa”
• Lifts arms to be picked up

Thinking and Learning Milestones

• Looks for objects when dropped out of sight (like a spoon or toy)
• Bangs two things together

Physical Development Milestones

• Gets to a sitting position by themselves
• Moves things from one hand to the other hand
• Uses fingers to “rake” food toward themselves
• Sits without support

Healthy Ways to Help Your Baby Learn and Grow

Development.

• Hold your baby up while they sit and learn to balance on their own. Encourage them by giving a toy to look at and letting them look around.
• Teach your baby social skills by copying your baby when they smile and make sounds.
• Point to things your baby looks at and name them (for example, a book, tree or cup). Talk with your baby by repeating the sounds they make.
• Sing and play music for your baby. Read together every day, pointing to items in the book and using simple words to talk about the pictures.
• Encourage your baby to crawl, scoot and roll on the ground by placing toys a little out of reach.
• Play games such as peek-a-boo and patty-cake.
• Hold and cuddle with your baby often, giving praise and lots of loving attention.
• If your baby becomes fussy, take a break from whatever you’re doing and offer comfort. Help your baby learn to calm themselves by rocking, singing, sucking their fingers or a pacifier, or holding a favorite stuffed animal.
• Breast milk or infant formula should continue to be your baby’s main source of nutrition until 1 year of age.
• Look for signs your baby is ready for soft foods. Before eating soft foods, your baby should be able to sit with support, have good head and neck control, show interest in the foods you eat, and open their mouth for the spoon.
• When starting new foods, introduce one, single-ingredient food at a time. Wait three-five days before introducing another new food to make sure your baby doesn’t have a reaction. Use a spoon to give food, and don’t mix infant foods in the baby’s bottle. Learn more about introducing solid foods to your baby , including appropriate beginner foods and portion sizes.
• Introduce your baby to a cup with a small amount of water, breast milk or formula.
• Clean your baby’s gums and teeth twice a day with a soft cloth or toothbrush. Use a small amount of fluoride toothpaste, no more than a grain of rice.
• Avoid giving your baby a bottle in the crib. Never prop the bottle.
• Avoid juice.
• Your baby may sleep 12–16 hours each night, with two-three naps during the day. Remember to lay your baby on its back to sleep.
• Calm or rock your baby before bed until they are tired. It is good for babies to be drowsy when put down for bedtime, but allow them to fall asleep on their own.
• Follow a nighttime routine to help your baby feel safe and secure before sleep.

Vehicle Safety

• Use a rear-facing car seat in the backseat of your vehicle. Learn more about car seat safety and installation.
• Never leave your baby alone in a car. Practice safe behaviors that prevent you from ever forgetting your baby in the car, like putting your purse or cell phone in the backseat.
• Learn more about the dangers of hot cars and how to keep your child safe.

Home Safety

• Learn first aid for choking and cardiopulmonary resuscitation (CPR).
• Cover electrical outlets and block stairs with a small gate.
• Lock up medicines and cleaning supplies. Save the Poison Help Line number (1-800-222-1222) in all phones.
• Keep cords, latex balloons, plastic bags and small objects like coins, marbles and batteries away from your child.
• Never leave your baby alone in the tub, near water or in high places like a changing table, bed or couch.
• Your baby is becoming more active and learning to move. Don’t wait to baby-proof your home. Learn more about home safety.

This information is meant to support your visit with your child’s doctor. It should not take the place of the advice of your pediatrician.

Sources: Centers for Disease Control and Prevention, Bright Futures (4th Edition) by the American Academy of Pediatrics

Last Updated 06/2023

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Child's Well Visit, 6 Months: Care Instructions

Top of the page

Your baby's bond with you and other caregivers will be strong by now. They may be shy around strangers and may hold on to familiar people. It's common for babies to feel safer to crawl and explore with people they know.

Your baby may sit with support and start to eat without help.

They may use their voice to make new sounds. And they may start to scoot or crawl when lying on their tummy.

Feeding your baby

• If you breastfeed, continue for as long as it works for you and your baby.
• If you formula-feed, use a formula with iron. Ask your doctor how much formula to give your baby.
• Use a spoon to feed your baby 2 or 3 meals a day.
• When you offer a new food to your baby, watch for a rash or diarrhea. These may be signs of a food allergy.
• Let your baby decide how much to eat.
• Offer only water when your child is thirsty.

Keeping your baby safe

• Always use a rear-facing car seat. Install it in the back seat.
• Tell your doctor if your home was built before 1978. The paint may have lead in it, which can be harmful.
• Save the number for Poison Control (1-800-222-1222).
• Do not use baby walkers.
• Avoid burns. Always check the water temperature before baths. Keep hot liquids away from your baby.

Keeping your baby safe while they sleep

• Always put your baby to sleep on their back.
• Don't put sleep positioners, bumper pads, loose bedding, or stuffed animals in the crib.
• Don't sleep with your baby. This includes in your bed or on a couch or chair.
• Have your baby sleep in the same room as you for at least the first 6 months.
• Don't place your baby in a car seat, sling, swing, bouncer, or stroller to sleep.

Caring for your baby's gums and teeth

• Clean your baby's gums every day with a soft cloth.
• If your baby is teething, give them a cooled teething ring to chew on.
• When the first teeth come in, brush them with a tiny amount of fluoride toothpaste.

Getting vaccines

Make sure your baby gets all the recommended vaccines.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

• Where can you learn more?

Go to http://www.healthwise.net/patientEd 

Enter Y660 in the search box to learn more about "Child's Well Visit, 6 Months: Care Instructions".

Current as of: October 24, 2023

Author: Healthwise Staff 

Clinical Review Board  All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use  and Privacy Policy  .

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.

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Your Baby’s 6-Month Checkup

By 6 months, a baby is sitting up or getting ready to sit up and her back is straightening out. This is an enjoyable new perspective for your baby as she learns to play in more elaborate ways. Everything goes in her mouth — it's her way of exploring.

Preparing for The Visit

Your baby will get a lot of immunizations at the 6-month checkup. Her thigh (or wherever your provider administers these shots) might be redder than before, and she may get a slight fever as a result. These reactions show that your baby is building up a strong resistance to some serious diseases. Be sure to bring her immunization card and your health-insurance card.

Tip: To help ease the pain from the shots, give your baby the infant version of acetaminophen. Your provider will be able to give you samples of this pain reliever. If you have your own, bring the bottle with you so that your provider can show you the correct dose for your baby's age and weight.

At the 6-Month Visit, Your Provider Will Probably:

Weigh and measure your baby. Click here to see our growth chart .

Give your baby the next round of immunizations.

Provide insight into your baby's development, temperament, and behavior.

Help you teach your baby to form a good sleep pattern.

Review safety, as she can get into more things every day now and she'll be on the move soon.

What Your Provider Will Want to Know

Has your baby seen another healthcare provider since the last visit? If so, why? What was the outcome of that visit, and were any medications or treatments prescribed?

Does your baby have any teeth yet? Some do and many don't. Don't worry either way.

What kinds of sounds does your baby make: "ba," "da," or "ma"?

Does your baby "talk"? Describe any babbling, laughing , squealing, imitating, or "coughing" she does. Does she go back and forth with you, and try to imitate your speech?

How does your baby play with things? Does she put things in her mouth, drop them, or throw them? Does she pass things back and forth between her hands?

What can your baby do with her hands? Does she reach for things, take in small objects?

Can your baby sit up with support or by herself? Can she roll over both ways?

Can your baby bear weight on her legs when you hold her up?

Does she turn her head toward you when you enter a room, even before you say anything?

Has your child been ill? Report the details.

Talk It Over

Your baby may be ready or getting ready to start eating solid foods. Tell your healthcare provider about any food allergies, asthma, or eczema that runs in your family. Be sure you know how to proceed.

Talk over any sleeping problems your baby may be having. Your provider will be able to help.

If someone in your household or family has had tuberculosis or any other serious contagious disease, your provider will want to check your baby regularly to be sure he hasn't been infected. Let your provider know as soon as you're aware of it.

Remind your healthcare provider about any special issues identified at your child's birth. They may need to be checked again, through a hearing test or blood test, for example. Get the birth records for review if your healthcare provider doesn't have them.

Does your child need fluoride supplements? It will depend on your local water supply.

Tell your healthcare provider if you're too anxious to let your baby play on the floor or in a playpen, or if you don't know how to play with your baby.

Discuss where to find materials on play, playgroups, parenting classes, or other community resources.

Other issues may concern your healthcare provider. Let your provider know if your baby:

Tends to use only one hand, favors one leg, or seems to tilt to one side when he sits or moves.

Moves in a way that worries or concerns you. Remember though, that bow legs and rounded feet are still normal at this age.

Doesn't turn to sounds or doesn't seem to hear well.

Crosses his eyes, or doesn't seem to see well.

Doesn't make any sounds or makes fewer sounds than before.

Appears pale.

Doesn't roll over.

Shows no interest in toys or objects.

Gags on food, always chokes on liquids in a cup, or can't keep food in his mouth.

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6-Month Vaccines: What You Should Know

• Vaccination Schedule

Diphtheria, Tetanus, Acellular Pertussis (DTaP)

Haemophilus influenzae type b (hib), polio vaccine (ipv), pneumococcal conjugate vaccine (pcv), rotavirus (rv), hepatitis b (hbv), influenza (flu), vaccine side effects, frequently asked questions.

During their 6-month wellness visit, babies are scheduled to receive up to eight vaccines that protect against harmful diseases.

The Centers for Disease Control and Prevention (CDC) recommended  immunization schedule  splits vaccines into a series of doses spread out during early childhood. Six-month vaccines commonly include hepatitis B, pneumonia, polio, rotavirus, and diphtheria, pertussis, and tetanus (DTap).

This article provides an overview of the 6-month vaccines. It also explains how to comfort your baby after getting shots and how to treat mild side effects. 

Verywell / Danie Drankwalter

6-Month Vaccination Schedule

Vaccinations are given to children on a schedule recommended by the CDC and the American Academy of Pediatrics (AAP). They help a baby boost their immune system to prevent harmful diseases.

Alternate Names for Vaccinations

Vaccinations may also be called:

• Injections or shots
• Immunizations
• Inoculation

Most likely, your baby has already received a few vaccinations at birth and their 2- and 4-month check-ups. The following may be recommended at their 6-month check-up:

• Hepatitis B (HepB)
• Diphtheria, pertussis, and tetanus (DTap)
• Haemophilus influenzae type b (Hib)
• Pneumonia (PCV15, PCV20)
• Polio (IPV)

Most vaccinations are given as a shot. However, the rotavirus (RV) vaccine is given by mouth through liquid drops.

Which Vaccines Are Mandatory?

Vaccine requirements vary by state. For the most part, vaccines are only mandatory for children attending daycare or school. If you are uncomfortable with the number of scheduled vaccinations, talk to your child's pediatrician about what you can safely hold off on. Delaying any of the 6-month immunizations may mean your child will need to catch up before starting school.

The second of five doses of DTaP is given at 6 months old. The fifth dose is usually given around 4 to 6 years old. Immunity may start to wear off around 11 to 12 years old. A booster called the Tdap is generally given at that time or later in life as needed. This vaccine helps prevent:

• Tetanus  
• Pertussis (whooping cough)

Pertussis or Whooping Cough?

Pertussis is a respiratory disease that can cause severe coughing. It is commonly called whooping cough because of the sound you make when trying to catch your breath after coughing. 

Haemophilus influenzae type B ( Hib ) is a bacteria that can cause:

• Meningitis (inflammation of the fluid and membranes surrounding the brain and spinal cord)
• Pneumonia (lung infection)
• Sepsis (bloodstream infection)
• Epiglottitis (swelling in the upper airway or windpipe) 

Hib is rare in the United States due to routine vaccination. However, if contracted, it can be severe and sometimes fatal. At 6 months old, your baby is most likely receiving the third out of four doses. The last is given around 12 to 18 months.

Because of its name, Hib is often confused with seasonal influenza ( flu ). However, these are two different diseases. Hib is a bacteria, while the flu is a virus.  

Polio is a disease that causes symptoms that range from a sore throat to paralysis. It was very feared during the late 1940s before the vaccination program began, and infections in the U.S. decreased dramatically.  

Children in the U.S. get a shot called an inactivated polio vaccine (IPV). Other countries may still use an oral polio vaccine (OPV). IPV is given over four doses. At 6 months, your baby is most likely receiving the third dose in the series.

Worldwide Polio Cases

Efforts to eliminate polio worldwide increased in 1988. Since then, the yearly number of cases (about 350,000) has declined by more than 99.9%. It is estimated that 18 million currently healthy people would have been paralyzed by polio without this response.

Streptococcus pneumoniae or pneumococcus are bacteria that cause pneumococcal disease. The PCV is given to protect against pneumococcal disease, which can cause:

• Ear infections ( otitis media , or inflammation and fluid in the middle ear, is common)
• Acute bronchitis
• Sinus infections 
• Meningitis (infection of the brain and spinal cord)

The CDC recommends four doses of PCV to be given at 2 months, 4 months, 6 months, and 12 to 15 months of age.

Rotavirus causes stomach pain, severe vomiting, diarrhea, and dehydration (fluid loss). The RV vaccination is given as drops by mouth rather than as a shot. 

Two brands of the rotavirus vaccine are given in the United States. RotaTeq (RV 5) is given in three doses at 2, 4, and 6 months old. The other brand, Rotarix (RV1), does not include the third dose.  

Hepatitis B is a viral infection passed through body fluids and damages the liver. Babies are vaccinated against hepatitis B in three doses. 

The first HBV dose is usually given within 12 hours of an infant’s life. This is done in case their mother unknowingly passed Hepatitis B to them at birth. The final dose of HBV is given between 6 and 18 months.

Influenza , or the seasonal flu, is a virus that causes respiratory infection. At 6 months old, your baby is due for their first vaccination. Because this is their first flu shot , they usually receive two doses at least four weeks apart. After that, it can be given once yearly during flu season, which typically begins in October and goes through May.

Injection or Nasal Spray

While the influenza vaccine is available as an injection (shot) or nasal (nose) spray, the nasal spray is only approved for children 2 years or older.

In 2023, the CDC added COVID-19 vaccination to the immunization schedules for children and adults. At 6 months, your baby is eligible to receive an mRNA vaccine from either Pfizer or Moderna. Both are updated vaccines that protect against newer variants of the virus.

The Pfizer vaccine is given in three doses, with the first two doses given three weeks apart and the third dose given eight weeks after the second dose. The Moderna primary series is given in two doses one month apart. an updated booster is recommended at least two months after the second dose.

The most common vaccination side effects are tenderness, redness, or swelling at the shot site or a low-grade fever (101 degrees or lower). 

Occasionally the following mild side effects may occur:

• Loss of appetite
• Diarrhea or vomiting

Severe Side Effects Are Rare

Severe side effects or allergic reactions from vaccinations are rare. Those that do occur usually begin 20 minutes to two hours after giving the vaccine. Talk to your healthcare provider before your appointment if you are concerned about rare side effects or allergic reactions.

What to Do if Your Baby Has Side Effects

If your baby experiences mild side effects or reactions, you can use the following techniques at home to help them:  

• Place a cool cloth at the shot site to reduce redness, tenderness, or swelling.
• Give them a room-temperature sponge bath for low-grade fevers.
• Try feeding your baby more often to increase their fluids.
• Give Tylenol ( acetaminophen ) or Motrin/Advil (ibuprofen).

Medications to Reduce Fever and Discomfort

Motrin/Advil and Tylenol are safe for 6 months and older. Children should not receive aspirin unless directed by their healthcare provider.

When to Contact the Pediatrician

If your baby has any of the following symptoms, contact their healthcare provider:

• Temperature (fever) greater than 104 degrees
• Fever lasting more than three days 
• Redness at the shot site larger than 1 inch or lasting longer than three days
• High-pitched crying lasting over one hour
• Nonstop crying for more than three hours 
• Fussiness for more than three days 
• Severe vomiting or diarrhea

When to Call 9-1-1

If you think your infant is having a life-threatening emergency or any of the following rare reactions, call 9-1-1 immediately:

• Trouble breathing
• Trouble swallowing
• Lethargy (not moving or very weak)
• Not waking up

Vaccinations are given to help prevent serious diseases. The CDC and AAP recommend a schedule for children that includes eight vaccines covering 10 diseases given around 6 months old. Side effects or reactions are generally mild and can be treated at home. 

A Word From Verywell 

Parents are often concerned about comforting their babies during vaccinations. Smiling and using a soothing voice are one of the best ways to reassure your 6-month-old during their appointment. It can be helpful to bring their favorite toy or blanket for distraction and comfort during and after their wellness check. 

For babies this age, distraction is a good technique. You can try singing or using toys to get their attention. It’s also helpful to smile and talk in a soothing, calm voice. This helps reassure your infant that everything is ok.

The most common vaccination side effect is soreness at the shot site. Your baby may also experience mild side effects such as a low-grade temperature, fussiness, decreased appetite, or stomach upset. Severe side effects or reactions are rare. 

Centers for Disease Control and Prevention (CDC). Immunization schedule: schedule for infants and children (birth-6 years) .

Centers for Disease Control and Prevention (CDC). State vaccination requirements .

Centers for Disease Control and Prevention (CDC). DTaP (diphtheria, tetanus, pertussis) vaccine: what you need to know.

Hall JM, Bitzer GJ, DeJong MA, et al. Mucosal immunization with DTaP confers protection against bordetella pertussis infection and cough in sprague-dawley rats . Infection and immunity . 2021;89(12):e0034621. doi:10.1128/IAI.00346-21

Immunization Action Coalition. Ask the experts: Haemophilus influenzae type b (Hib) . Immunize.org.

MedlinePlus. Epiglottitis .

Centers for Disease Control and Prevention (CDC). Vaccines and preventable diseases: polio .

Centers for Disease Control and Prevention (CDC). Global immunization: our progress against polio .

Centers for Disease Control and Prevention (CDC). Pneumococcal disease .

Centers for Disease Control and Prevention (CDC). Pneumococcal vaccine recommendations .

Centers for Disease Control and Prevention (CDC). Rotavirus .

Centers for Disease Control and Prevention (CDC). Hepatitis B .

Centers for Disease Control and Prevention. Vaccines for your children: flu (influenza) .

Centers for Disease Control and Prevention. Influenza (flu) .

Wodi AP, Murthy N, McNally V, Cineas S, Ault K. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2023 .  MMWR Morb Mortal Wkly Rep . 2023;72(6):137-140. Published 2023 Feb 10. doi:10.15585/mmwr.mm7206a1

Centers for Disease Control and Prevention. Stay Up to Date with COVID-19 Vaccines Including Boosters .

Seattle Children’s Hospital. Immunization reactions .

Daley MF, O’Leary ST, Nyquist A, Cataldi JR.  Immunization . In: Hay Jr. WW, Levin MJ, Abzug MJ, Bunik M. eds.  Current Diagnosis & Treatment: Pediatrics, 25e . McGraw Hill; 2020.

Immunization Action Coalition. After the shots . Immunize.org.

Centers for Disease Control and Prevention (CDC). Vaccines for your children: 1 to 2 months.

St. Louis Children’s Hospital. Acetaminophen (Tylenol) dose table .

American Academy of Pediatrics. Ibuprofen dosing table for fever and pain . Healthychildren.org.

Contemporary Pediatrics. 2021 CDC vaccine schedule .

By Brandi Jones, MSN-ED RN-BC Jones is a registered nurse and freelance health writer with more than two decades of healthcare experience.

Well Child Visit at 6 Months

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What is a well child visit?

A well child visit is when your child sees a healthcare provider to prevent health problems. Well child visits are used to track your child's growth and development. It is also a time for you to ask questions and to get information on how to keep your child safe. Write down your questions so you remember to ask them. Your child should have regular well child visits from birth to 17 years.

What development milestones may my baby reach at 6 months?

Each baby develops at his or her own pace. Your baby might have already reached the following milestones, or he or she may reach them later:

• Babble (make sounds like he or she is trying to say words)
• Reach for objects and grasp them, or use his or her fingers to rake an object and pick it up
• Understand that a dropped object did not disappear
• Pass objects from one hand to the other
• Roll from back to front and front to back
• Sit if he or she is supported or in a high chair
• Start getting teeth
• Sleep for 6 to 8 hours every night
• Crawl, or move around by lying on his or her stomach and pulling with his or her forearms

What can I do to keep my baby safe in the car?

• Always put your baby's car seat in the back seat. Never put your baby's car seat in the front. This will help prevent him or her from being injured in an accident.

What can I do to keep my baby safe at home?

• Follow directions on the medicine label when you give your baby medicine. Ask your baby's healthcare provider for directions if you do not know how to give the medicine. If your baby misses a dose, do not double the next dose. Ask how to make up the missed dose. Do not give aspirin to children younger than 18 years. Your child could develop Reye syndrome if he or she has the flu or a fever and takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin or salicylates.
• Do not leave your baby on a changing table, couch, bed, or infant seat alone. Your baby could roll or push himself or herself off. Keep one hand on your baby as you change his or her diaper or clothes.
• Never leave your baby alone in the bathtub or sink. A baby can drown in less than 1 inch of water.
• Always test the water temperature before you give your baby a bath. Test the water on your wrist before putting your baby in the bath to make sure it is not too hot. If you have a bath thermometer, the water temperature should be 90°F to 100°F (32.3°C to 37.8°C). Keep your faucet water temperature lower than 120°F.
• Never leave your baby in a playpen or crib with the drop-side down. Your baby could fall and be injured. Make sure that the drop-side is locked in place.
• Place gates at the top and bottom of stairs. Always make sure that the gate is closed and locked. Gates will help protect your baby from injury.
• Do not let your baby use a walker. Walkers are not safe for your baby. Walkers do not help your baby learn to walk. Your baby can roll down the stairs. Walkers also allow your baby to reach higher. Your baby might reach for hot drinks, grab pot handles off the stove, or reach for medicines or other unsafe items.
• Keep plastic bags, latex balloons, and small objects away from your baby. This includes marbles or small toys. These items can cause choking or suffocation. Regularly check the floor for these objects.

How should I lay my baby down to sleep?

It is very important to lay your baby down to sleep in safe surroundings. This can greatly reduce his or her risk for SIDS. Tell grandparents, babysitters, and anyone else who cares for your baby the following rules:

• Put your baby on a firm, flat surface to sleep. Your baby should sleep in a crib, bassinet, or cradle that meets the safety standards of the Consumer Product Safety Commission (CPSC). Do not let him or her sleep on pillows, waterbeds, soft mattresses, quilts, beanbags, or other soft surfaces. Move your baby to his or her bed if he or she falls asleep in a car seat, stroller, or swing. He or she may change positions in a sitting device and not be able to breathe well.
• Put your baby to sleep in a crib or bassinet that has firm sides. The rails around your baby's crib should not be more than 2⅜ inches apart. A mesh crib should have small openings less than ¼ inch.
• Put your baby in his or her own bed. A crib or bassinet in your room, near your bed, is the safest place for your baby to sleep. Never let him or her sleep in bed with you. Never let him or her sleep on a couch or recliner.
• Do not leave soft objects or loose bedding in your baby's crib. His or her bed should contain only a mattress covered with a fitted bottom sheet. Use a sheet that is made for the mattress. Do not put pillows, bumpers, comforters, or stuffed animals in your baby's bed. Dress your baby in a sleep sack or other sleep clothing before you put him or her down to sleep. Avoid loose blankets. If you must use a blanket, tuck it around the mattress.
• Do not let your baby get too hot. Keep the room at a temperature that is comfortable for an adult. Never dress him or her in more than 1 layer more than you would wear. Do not cover your baby's face or head while he or she sleeps. Your baby is too hot if he or she is sweating or his or her chest feels hot.
• Do not raise the head of your baby's bed. Your baby could slide or roll into a position that makes it hard for him or her to breathe.

What do I need to know about nutrition for my baby?

• Continue to feed your baby breast milk or formula 4 to 5 times each day. As your baby starts to eat more solid foods, he or she may not want as much breast milk or formula as before. He or she may drink 24 to 32 ounces of breast milk or formula each day.
• Do not use a microwave to heat your baby's bottle. The milk or formula will not heat evenly and will have spots that are very hot. Your baby's face or mouth could be burned. You can warm the milk or formula quickly by placing the bottle in a pot of warm water for a few minutes.
• Do not prop a bottle in your baby's mouth. This may cause him or her to choke. Do not let him or her lie flat during a feeding. If your baby lies flat during a feeding, the milk may flow into his or her middle ear and cause an infection.
• Offer iron-fortified infant cereal to your baby. Your baby's healthcare provider may suggest that you give your baby iron-fortified infant cereal with a spoon 2 or 3 times each day. Mix a single-grain cereal (such as rice cereal) with breast milk or formula. Offer him or her 1 to 3 teaspoons of infant cereal during each feeding. Sit your baby in a high chair to eat solid foods. Stop feeding your baby when he or she shows signs that he or she is full. These signs include leaning back or turning away.
• Offer new foods to your baby after he or she is used to eating cereal. Offer foods such as strained fruits, cooked vegetables, and pureed meat. Give your baby only 1 new food every 2 to 7 days. Do not give your baby several new foods at the same time or foods with more than 1 ingredient. If your baby has a reaction to a new food, it will be hard to know which food caused the reaction. Reactions to look for include diarrhea, rash, or vomiting.
• Do not overfeed your baby. Overfeeding means your baby gets too many calories during a feeding. This may cause him or her to gain weight too fast. Do not try to continue to feed your baby when he or she is no longer hungry.
• Do not give your baby foods that can cause him or her to choke. These foods include hot dogs, grapes, raw fruits and vegetables, raisins, seeds, popcorn, and nuts.

What do I need to know about peanut allergies?

• Peanut allergies may be prevented by giving young babies peanut products. If your baby has severe eczema or an egg allergy, he or she is at risk for a peanut allergy. Your baby needs to be tested before he or she has a peanut product. Talk to your baby's healthcare provider. If your baby tests positive, the first peanut product must be given in the provider's office. The first taste may be when your baby is 4 to 6 months of age.
• A peanut allergy test is not needed if your baby has mild to moderate eczema. Peanut products can be given around 6 months of age. Talk to your baby's provider before you give the first taste.
• If your baby does not have eczema, talk to his or her provider. He or she may say it is okay to give peanut products at 4 to 6 months of age.
• Do not give your baby chunky peanut butter or whole peanuts. He or she could choke. Give your baby smooth peanut butter or foods made with peanut butter.

What can I do to keep my baby's teeth healthy?

• Clean your baby's teeth after breakfast and before bed. Use a soft toothbrush and a smear of toothpaste with fluoride. The smear should not be bigger than a grain of rice. Do not try to rinse your baby's mouth. The toothpaste will help prevent cavities.
• Do not put juice or any other sweet liquid in your baby's bottle. Sweet liquids in a bottle may cause him or her to get cavities.

What are other ways I can support my baby?

• Help your baby develop a healthy sleep-wake cycle. Your baby needs sleep to help him or her stay healthy and grow. Create a routine for bedtime. Bathe and feed your baby right before you put him or her to bed. This will help him or her relax and get to sleep easier. Put your baby in his or her crib when he or she is awake but sleepy.
• Relieve your baby's teething discomfort with a cold teething ring. Ask your healthcare provider about other ways that you can relieve your baby's teething discomfort. Your baby's first tooth may appear between 4 and 8 months of age. Some symptoms of teething include drooling, irritability, fussiness, ear rubbing, and sore, tender gums.
• Read to your baby. This will comfort your baby and help his or her brain develop. Point to pictures as you read. This will help your baby make connections between pictures and words. Have other family members or caregivers read to your baby.
• Talk to your baby's healthcare provider about TV time. Experts usually recommend no TV for babies younger than 18 months. Your baby's brain will develop best through interaction with other people. This includes video chatting through a computer or phone with family or friends. Talk to your baby's healthcare provider if you want to let your baby watch TV. He or she can help you set healthy limits. Your provider may also be able to recommend appropriate programs for your baby.
• Engage with your baby if he or she watches TV. Do not let your baby watch TV alone, if possible. You or another adult should watch with your baby. TV time should never replace active playtime. Turn the TV off when your baby plays. Do not let your baby watch TV during meals or within 1 hour of bedtime.
• Do not smoke near your baby. Do not let anyone else smoke near your baby. Do not smoke in your home or vehicle. Smoke from cigarettes or cigars can cause asthma or breathing problems in your baby.
• Take an infant CPR and first aid class. These classes will help teach you how to care for your baby in an emergency. Ask your baby's healthcare provider where you can take these classes.

How can I care for myself during this time?

• Go to all postpartum check-up visits. Your healthcare providers will check your health. Tell them if you have any questions or concerns about your health. They can also help you create or update meal plans. This can help you make sure you are getting enough calories and nutrients, especially if you are breastfeeding. Talk to your providers about an exercise plan. Exercise, such as walking, can help increase your energy levels, improve your mood, and manage your weight. Your providers will tell you how much activity to get each day, and which activities are best for you.
• Find time for yourself. Ask a friend, family member, or your partner to watch the baby. Do activities that you enjoy and help you relax. Consider joining a support group with other women who recently had babies if you have not joined one already. It may be helpful to share information about caring for your babies. You can also talk about how you are feeling emotionally and physically.
• Talk to your baby's pediatrician about postpartum depression. You may have had screening for postpartum depression during your baby's last well child visit. Screening may also be part of this visit. Screening means your baby's pediatrician will ask if you feel sad, depressed, or very tired. These feelings can be signs of postpartum depression. Tell him or her about any new or worsening problems you or your baby had since your last visit. Also describe anything that makes you feel worse or better. The pediatrician can help you get treatment, such as talk therapy, medicines, or both.

What do I need to know about my baby's next well child visit?

Your baby's healthcare provider will tell you when to bring your baby in again. The next well child visit is usually at 9 months. Contact your baby's healthcare provider if you have questions or concerns about his or her health or care before the next visit. Your baby may need vaccines at the next well child visit. Your provider will tell you which vaccines your baby needs and when your baby should get them.

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Learn more about Well Child Visit at 6 Months

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• Gender Identity in Adolescents
• Gender Identity in your Adolescent
• Hemoglobin A1c
• Hepatitis B in Children
• Hepatitis B Vaccine
• How to Childproof your Home

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Bright Futures Information for Parents: 6 Month Visit

Here are some suggestions from Bright Futures experts that may be of value to your family.​​

How Your Family Is Doing

If you are worried about your living or food situation, talk with your health care professional. Community agencies and programs such as WIC and SNAP can also provide information and assistance.

Don’t smoke or use e-cigarettes. Keep your home and car smoke-free. Tobacco-free spaces keep children healthy.

Don’t use alcohol or drugs.

Choose a mature, trained, and responsible babysitter or caregiver.

Ask your health care professional questions about child care programs.

Talk with your health care professional​ or call for help if you feel sad or very tired for more than a few days.

Spend time with family and friends.

Your Baby's Development

Place your baby so she is sitting up and can look around.

Talk with your baby by copying the sounds she makes.

Look at and read books together.

Play games such as peekaboo, patty-cake, and so big.

Don’t have a TV on in the background or use a TV or other digital media to calm your baby.

If your baby is fussy, give her safe toys to hold and put into her mouth. Make sure she is getting regular naps and playtimes.

Feeding Your Baby

Know that your baby’s growth will slow down.

Be proud of yourself if you are still breastfeeding. Continue as long as you and your baby want.

Use an iron-fortified formula if you are formula feeding.

Begin to feed your baby solid food when he is ready.

Look for signs your baby is ready for solids. He will:

• Open his mouth for the spoon.
• Sit with support.
• Show good head and neck control.
• Be interested in foods you eat.

Starting New Foods Introduce one new food at a time.

Use foods with good sources of iron and zinc, such as:

• Iron- and zinc-fortified cereal
• Pureed red meat, such as beef or lamb

Introduce fruits and vegetables after your baby eats iron- and zinc-fortified cereal or pureed meat well.

Offer solid food 2 to 3 times per day; let him decide how much to eat.

Avoid raw honey or large chunks of food that could cause choking.

Consider introducing all other foods, including eggs and peanut butter, because research shows they may actually prevent individual food allergies.

To prevent choking, give your baby only very soft, small bites of finger foods.

Wash fruits and vegetables before serving.

Introduce your baby to a cup with water, breast milk, or formula.

Avoid feeding your baby too much; follow baby’s signs of fullness, such as:

• Leaning back
• Turning away

Don’t force your baby to eat or finish foods.

It may take 10 to 15 times of offering your baby a type of food to try before he likes it.

Healthy Teeth

Ask your health care professional ​​​​​about the need for fluoride.

Clean gums and teeth (as soon as you see the first tooth) 2 times per day with a soft cloth or soft toothbrush and a small smear of fluoride toothpaste (no more than a grain of rice).

Don’t give your baby a bottle in the crib. Never prop the bottle.

Don’t use foods or juices that your baby sucks out of a pouch.

Don’t share spoons or clean the pacifier in your mouth.

Use a rear-facing–only car safety seat in the back seat of all vehicles.

Never put your baby in the front seat of a vehicle that has a passenger airbag.

If your baby has reached the maximum height/weight allowed with your rear-facing–only car seat, you can use an approved convertible or 3-in-1 seat in the rear-facing position.

Put your baby to sleep on her back.

Choose crib with slats no more than 2 3/8 inches apart.​

• Lower the crib mattress all the way.​

Don’t use a drop-side crib.

Don’t put soft objects and loose bedding such as blankets, pillows, bumper pads, and toys in the crib. If you choose to use a mesh playpen, get one made after February 28, 2013.

Do a home safety check (stair gates, barriers around space heaters, and covered electrical outlets).

Don’t leave your baby alone in the tub, near water, or in high places such as changing tables, beds, and sofas.

Keep poisons, medicines, and cleaning supplies locked and out of your baby’s sight and reach.

Put the Poison Help line number into all phones, including cell phones. Call your health care professional if you are worried your baby has swallowed something harmful.

Keep your baby in a high chair or playpen while you are in the kitchen.

Do not use a baby walker.

Keep small objects, cords, and latex balloons away from your baby.

Keep your baby out of the sun. When you do go out, put a hat on your baby and apply sunscreen with SPF of 15 or higher on her exposed skin.​

What to Expect at Your Baby's 9 Month Visit

We will talk about:

• Caring for your baby, your family, and yourself
• Teaching and playing with your baby
• Disciplining your baby
• Introducing new foods and establishing a routine
• Keeping your baby safe at home and in the car

Helpful Resources:

• Smoking Quit Line: 800-784-8669
• Poison Help Line: 800-222-1222
• Information About Car Safety Seats: www.nhtsa.gov/parents-and-caregivers
• Toll-free Auto Safety Hotline: 888-327-4236

Consistent with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition

The information contained in this webpage should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Original handout included as part of the Bright Futures Tool and Resource Kit, 2nd Edition.

Inclusion in this webpage does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this webpage. Website addresses are as current as possible but may change at any time.

The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this handout and in no event shall the AAP be liable for any such changes.

Last Updated

American Academy of Pediatrics

Vaccines at 6 Months

Vaccinations are safe and effective for children to receive at the recommended ages.

CDC recommends COVID-19 vaccination for everyone aged 6 months and older. If your child has not gotten vaccinated yet, talk to his or her doctor about getting it as soon as possible.

Vaccines your baby should get

At 6 months old, your baby is ready for another round of vaccines, including their first flu shot. As your little one continues to grow and develop, help protect them from these potentially serious diseases.

3 rd dose of 5

A DTaP vaccine is the best protection from three serious diseases: diphtheria, tetanus, and whooping cough (pertussis). All three of these diseases can be deadly for people of any age, and whooping cough is especially dangerous for babies.

See Related:   DTaP vaccination

3 rd dose of 4

Hib disease is a serious illness caused by the bacteria Haemophilus influenzae type b (Hib). Babies and children younger than 5 years old are most at risk for Hib disease. It can cause lifelong disability and be deadly. Doctors recommend that your child get three or four doses of the Hib vaccine (depending on the brand).

See Related: Hib vaccination

Flu is a respiratory illness caused by influenza viruses. Flu spreads easily and can cause serious illness, especially in children younger than 5 years and children of any age with certain chronic conditions including asthma. Everyone 6 months of age and older should get a flu vaccine every year ideally by the end of October.

See Related:  Flu vaccination

Pneumococcal disease can cause potentially serious and even deadly infections. The pneumococcal conjugate vaccine  protects against the bacteria that cause pneumococcal disease.

See Related:  Pneumococcal vaccination

Polio is a disabling and life-threatening disease caused by poliovirus, which can infect the spinal cord and cause paralysis. It most often sickens children younger than 5 years old. Polio was eliminated in the United States with vaccination, and continued use of polio vaccine has kept this country polio-free.

See Related: Polio vaccination

3 rd dose of 3

Rotavirus can be very dangerous, even deadly for babies and young children. Doctors recommend that your child get two or three doses of the Rotavirus vaccine (depending on the brand).

See Related: Rotavirus vaccination

Additional protection for your baby during RSV season

Babies who are 6 months old should receive an RSV immunization (if not previously received) to protect them against severe RSV disease.

Respiratory Syncytial Virus (RSV)

RSV is a common cause of severe respiratory illness in infants and young children. Those infected with RSV can have difficulty breathing and eating and sometimes may need respiratory support or hydration in the hospital. An RSV immunization uses monoclonal antibodies  to protect infants and young children from severe RSV disease. This immunization gives your baby’s body extra help to fight an RSV infection.

Infants younger than 8 months old during RSV season (typically fall through spring) should get a one-dose RSV immunization to protect them against RSV. This dose should be given shortly before or during the RSV season.

Care for your child after vaccinations

Call 911 if you think your child might be having a severe allergic reaction after leaving the vaccination site.

Give your child extra care and attention

Pay extra attention to your child for a few days. If you see something that concerns you, call your child’s doctor.

• Read the Vaccine Information Sheet(s) your child’s doctor gave you to learn about side effects your child may experience.
• Offer breastmilk or formula more often. It is normal for some babies to eat less during the 24 hours after getting vaccines.

Treat mild reactions

Sometimes children have mild reactions from vaccines, such as pain at the injection site or a rash. These reactions, also called side effects, are normal and will soon go away.

• Use a cool, damp cloth to help reduce redness, soreness, and/or swelling at the injection site.
• Reduce fever with a cool sponge bath.
• Ask your child’s doctor if you can give your child a non-aspirin pain reliever.

See which vaccines your child needs to stay on-track with routine vaccinations.

Birth to 6 years

7 to 18 years

Take a short quiz to get a list of vaccines your child may need based on their age, health conditions, and other factors.

Child vaccine quiz

• How to Hold Your Child During a Vaccination
• Make Shots Less Stressful
• Travel and Vaccines
• Keeping Track of Vaccine Records
• The Vaccines for Children (VFC) Program
• How Vaccines Prevent Diseases
• Vaccines & Immunizations

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