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Parents often wonder about their child’s health, leading to the frequently asked question: “Is my baby healthy and growing normally?”

These information sheets outline normal and healthy growth and developmental milestones, and common health topics for your baby.

Due to space constraints, some messages are repeated at several ages while others appear once only. Read the complete set of sheets to obtain the entire information.

The Rourke Baby Record (RBR) is a guide that many Canadian doctors and other healthcare professionals utilize for well baby and child visits for babies and children from 1 week to 5 years of age.

photo of a baby with book

6 Months

Keeping Baby Safe

  • Childproof your home. Lock away all medications and cleaning products. Cover electrical outlets and tape down cords. Secure TVs, computers and furniture to prevent them from tipping over. Use window guards and stair gates. Be vigilant about hot liquids on countertops. Find the hazards before your baby does. Have Emergency numbers handy. Use safe toys for your baby`s age and remove loose parts and broken toys to prevent choking.
  • To prevent drowning, never leave her alone in the bath. Do not use baby bath rings or bath seats.
  • To prevent sunburn in your baby, minimize direct sun exposure, wear protective clothing and hats, and properly apply sunscreen with SPF 30 and above.
  • At 6 months, insect repellants with 10% DEET or less can be applied once daily if needed until age 2 years when they can be used up to 3 times daily.
  • Never leave a child unattended in a vehicle

Vaccinations

  • After vaccinations, your baby may have no reaction, or may be fussy or sleep more or less than usual. She may have a mild fever or a little redness or swelling where the needle was given. If needed, you can give her ibuprofen or acetaminophen. Call your doctor if her fever reaches 40oC (104oF), if she is crying/fussy for more than 24 hours, is unusually sleepy or unresponsive, or has swelling at the needle site that is worsening.
  • Children over 6 months should get influenza vaccine

Feeding & Growth

  • At 6 months, she has likely doubled her birth weight.
  • You can continue to breastfeed your baby on-cue until 2 years and beyond. When breastmilk is not available, give commercial, not homemade, formula when your baby seems hungry until between 9 and 12 months. At that time, if he is eating a variety of iron-rich foods, homogenized cow’s milk can be started, and offered in an open cup with meals and snacks.
    • At 6 months of age, he will likely drink about 750 to 1,080 mL (25 to 36 oz) formula per day. The amount of formula may be less as he eats more solid food.
  • Solid foods should be introduced by 6 months. At this age, your baby can hold her head up and sit with little help and open her mouth when food is offered. She can accept food from a spoon and swallow it and can turn her head to refuse food.
    • Stir a little pureed food into some breast milk, formula or water, and give off a spoon.
    • Start with iron-containing foods like meat, tofu, legumes, poultry, cooked eggs, low mercury fish and infant cereals. Offer these foods at least twice a day. You can also offer vegetables, fruits, and dairy products such as yogurt and cheese.
    • Leave 2 days between starting new foods to tell how the first is tolerated.
    • Give a variety of soft textured foods, including purees, lumpy textures, and safe finger foods.
    • Do not feed him honey until 1 year of age due to risk of an infection called botulism.
  • Do not delay introduction of common food allergens. Delaying these foods does not prevent and may contribute to the risk of developing food allergies. This includes nuts, peanuts, fish, whole eggs, sesame, milk, wheat, and soy. Once started, give allergenic foods a few times a week.
  • To prevent choking, avoid small, round, hard, smooth and sticky foods until 4 years of age.
  • Avoid sweetened liquids or fruit juices as they can cause tooth decay, problems with weight gain, or diarrhea, and can take the place of healthy foods.
  • Do not give him a bottle in bed containing anything other than water.

Development

  • At 6 months, your baby should:
    • Turn his head towards sounds.
    • Make sounds while you talk to him.
    • Make different sounds for pleasure and displeasure.
    • Roll from his back to his side.
    • Sit with support. E.g. with pillows
    • Reach and grasp objects.
    • Use both hands equally.
  • Play with your baby. Use songs and stories with actions. Imitate their sounds and reply to them. Help your baby explore their hands and feet. Prop them up and give them toys. Read and sing to them.
  • Report any concerns about your baby’s development, including her hearing and vision, to her physician or other healthcare professional.

Other Advice

  • Your baby may begin teething. The first tooth normally appears on the bottom gums when she is about 6 months old, but this can range from before 3 months to after 12 months. To help soothe your baby, do not give any over-thecounter gels, but you can rub her gums with a cold damp cloth. When your baby’s teeth appear, clean them twice daily with a soft bristle baby toothbrush using only water (if low risk for tooth decay) or a rice grain sized amount of fluoridated toothpaste (if high risk for tooth decay).
  • If you are looking for a child care facility for your baby, ask if it is accredited, what the number of children and staff are, what training the staff have, and what procedures there are for controlling infections, for preventing injuries, and for emergencies.
  • Shoes are for protecting your baby`s feet but are not needed for development. Walking barefoot develops strength and good toe gripping.
  • Second-hand smoke (from cigarettes, E-cigs, cannabis) is harmful to your baby. Ask your healthcare provider for help to quit smoking. Cannabis edibles should be locked away to prevent poisoning.

Resources

For more information on your baby’s health, the top 5 websites cited by the RBR Parent Resources are:

  1. Canadian Pediatrics Society – Caring for Kids (www.caringforkids.cps.ca)
  2. Hospital for Sick Children – About Kids Health (www.aboutkidshealth.ca)
  3. Parachute - formerly Safe Kids Canada (www.parachutecanada.org)
  4. Dietitians of Canada (www.dietitians.ca)
  5. Health Canada (www.hc-sc.gc.ca)

Support and Acknowledgements

The RBR Parent Resources website and this series of information sheets were created by then Memorial University of Newfoundland (MUN) medical student, Dr. Laura Butler, and the RBR authors (Drs. L. Rourke, D. Leduc and J. Rourke). Two MUN Summer Undergraduate Research Awards and MUN Faculty of Medicine Office of Professional Development supported these projects. Evaluation project by Dr Aimee Holla, MUN FM Resident. 2020 brochure revisions by Dr. Anne Rowan-Legg.

Support for the RBR includes the Government of Ontario and MUN's Dr. W. Ingram Award. Licensing contributions for RBR electronic medical record use go to the MUN RBR Development Fund.

As evidence-based information is constantly changing, the Rourke Baby Record and these recommendations should be used as a guide only.

May 2020