Well Baby Visit, 6 Months

Topics to discuss with patients during their well baby visit at 6 months.

Assess

• anthropometric measurements (link to Optimizing Nutrition for Newborns and Infants/Nutrition Assessment Tools/Term Infant Growth Tools/WHO Growth Charts for Infants 0 to 24 Months)
• physical examination
• adequacy of breast milk or formula intake
• iron intake
  
  • if iron intake is inadequate, especially for breastfeeding infants, then supplements of iron should be continued (1 mg/kg/day).

Discuss

• Beginning complementary foods from all group emphasizing sources of iron
  
  •  One new food should be offered at a time; wait 3 to 5 days to assess for reactions
  • A particular order of introduction of complementary foods is not supported by research
• continue vitamin D at 400 IU/day
• appropriate provision of bottle (if bottle-feeding) includes not putting baby in bed with a bottle (for a nap or the night)
• avoid honey
• if infants are weaned from breast before 12 months, iron-fortified formula should be used
• avoid soy milk, cow’s milk and goat’s milk before 12 months of age
• Avoid juice, but if offered should only be offered in a cup (not a bottle) and limited to 4 to 6 oz of 100% fruit juice

Consider Referral

• Growth faltering (failure to thrive)

Additional Resources

• Gastroesophageal reflux and gastroesophageal reflux disease: Parent FAQs, American Academy of Pediatrics.
• Parent’s Guide to GER (Gastroesophageal Reflux Disease) and GERD (Gastroesophageal Reflux
  Disease) (handout), American Academy of Pediatrics
• Healthy Active Living—Responsive Feeding (handout) American Academy of Pediatrics
• Solid Food (Baby Foods) (handout), American Academy of Pediatrics
• Tips for Introducing Solid Foods (handout), American Academy of Pediatrics