• Prevention is best. All babies should see the pediatrician at about 4, 6, and 9 months of age. These visits are not just for shots, but are times when we screen for a variety of subtle problems and are a good opportunity for you to learn more about your baby.


• At 4 and 6 months the baby will receive vaccines again. Mild soreness at the site of the vaccines is likely. Giving Acetaminophen every four hours for a day may prevent or minimize this. The benefits of giving these vaccines FAR outweigh the risks involved. If you want to know more about this, see our more detailed vaccine handouts or ask.
  


• Fever is the body's normal response to any kind of illness and actually HELPS you get better. It is not dangerous and cannot hurt your child. Furthermore, neither the presence nor the height of a fever has any correlation with how dangerous the illness causing it is. Minor viruses often cause very high fevers, while some deadly illnesses cause little fever at all. Thus, it is the OTHER symptoms of illness we are most interested in when evaluating your child.
  


• Fever is uncomfortable, and this is why we treat it.  Use Acetaminophen (Tylenol, many other brands) infant drops according to the instructions in our Acute Illness Guide. Never use aspirin in children.  Sponge baths are also unwise - they actually raise the temperature deep inside the body rapidly while cooling only the surface.  Getting the child with a fever to drink plenty of fluids is important for many reasons, and will help get the fever down as well.
  


• Do not use nonprescription "over-the-counter" medications for coughs, colds, diarrhea, etc. unless directed by a physician. In general, the side effects far outweigh the minimal benefits in this age group.
  


• Teething can start anytime from 3 - 15 months, and is somewhat painful. It can cause drooling, a runny nose, poor sleep, irritability, and even pulling at the ears. It does not cause fever, vomiting, diarrhea, or a rash however. It is best to avoid "rub on" teething medications - babies can overdose on these.  Use Acetaminophen for the pain and give the baby something to chew on to speed up the process.  A bagel often works better than conventional teething rings, especially beyond 6-7 months age.
  


• Even a minor illness that doesn't seem be getting better after 7-10 days should be seen by the doctor.

• Continue to use your car seat at all times. Change from an infant car seat to a convertible car seat once manufacturer's weight & height limit have been met, however continue to keep the seat rear-facing until 2 years of age. Remember, car accidents are the SINGLE BIGGEST THREAT to your babies health.
  


• Test baby's high chair before you buy it.  The base should be wide and stable so it will not fall over if bumped by another person or if the baby tries to crawl out.  NEVER leave the baby alone in a high chair.
  


• Don't put the baby in a walker.  They lead to falls, poisonings, and chokings.  Swings, playpens, and "johnny jumpers" are all much safer. 
  


• Now is the time to "Childproof" your home.  Be sure all small objects that the baby could choke on are both out of reach and out of sight (e.g. buttons, coins, bottle caps, pins, nuts, raisins, older child's toys). Put "shock stops" in all unused electrical outlets and move all cleaning fluids, medicines, etc. to high cabinets. Don't rely on so-called "Childproof" cabinet latches - they don't work. Make sure your water heater is set not to exceed 120ºF.
  


• Never turn your back on a baby in a bath, on a changing table or on a bed EVEN FOR A SECOND!

• Introduce solids anytime between 4 and 6 months. Usually your baby will tell you he is ready by watching you eat with intense interest and by being somewhat less satisfied after a breast or bottle feeding.
  


• Start slowly - at first this is a new experience. Your baby will need time to learn. When the baby starts to spit or push the spoon away - stop, don't push it. There will be plenty of interest later.
  


• Initially feed your baby one solid meal per day. Space it in between breast or bottle feedings so that you are not giving milk right after or right before; that way the baby is not full, nor are you "rewarding" him or her for stopping by giving milk at the end of the meal.
  


• Start with rice cereal mixed with formula, breastmilk, or water. You can introduce a new food every 4-5 days, never more that one at a time so that if one causes a problem you'll know which it was. Once the baby has tried several different cereals, move on to white fruits (apples, bananas, pears) and after that yellow vegetables (squash, sweet potatoes, carrots). Beyond that the "sky's the limit" although it is a good idea to read ingredient labels and avoid things which contain long lists of ingredients or lots of chemical additives.
  


• When the baby readily takes about 2 oz. at a meal, he is ready for a second daily meal. When he takes 4 oz. (1 standard baby food jar) at each meal, introduce a third. It doesn't matter which meal you start with, but feedings should be at consistent times every day.
  


• Foods to avoid in the first year: Citrus fruits/juices, eggs, fish, nuts, wheat. This is particularly important in families with allergic histories, much less so in non-allergic families. Wheat can be hard to avoid - it "hides" in "mixed" cereal, baby cookies and toasts, and many other baked goods. Eggs are also commonly "hidden" ingredients you must be on the lookout for.
  


• Continue using breastmilk or an iron-fortified formula as the main drink throughout this age group. Both have many distinct advantages over regular cow's milk that your baby still deserves the benefit of. Also, avoid juice. Even "natural" juice is little more than sugar and water, your baby needs it about as much as you need beer.
  


• It's a good idea to inspect bottles of baby food before you buy them. Avoid ones that look "beat up", have peeling labels, dented caps, etc. Indeed, you may want to avoid stores that stock bottles in that condition on their shelves at all.
  


• Babies under one year of age should not consume honey
  
  
• Breast & Bottle-fed babies should be taking a liquid multi-vitamin (Poly-vi-sol with Iron).

• By four months your baby is a very capable person! He or she is vocalizing constantly, rolling over, reaching and grasping objects, and clearly differentiating you from strangers. Everything goes in the mouth, as this is the most discriminating sense organ at this age. Weight will soon be double what is was at birth!
  


• Around 6 months your baby will sit without support and pass objects from one hand to another. Soon consonant sounds such as ba-ba or ma-ma will be added to vocalizations. Often the latter starts with tongue thrusting games such as blowing bubbles or "raspberries". By 9 months your repeated expressions of delight at hearing "ma-ma" or "da-da" will be starting to teach the baby that words have meaning and that you are called by that name!
  


• By 9 months babies are also starting to become much more mobile. They may crawl or creep (although many children skip this), or they may be beginning to "cruise" - pulling themselves up on furniture and getting around by hanging on. Appropriate toys for this age group include any brightly colored, noise-making objects small enough to be grasped by little hands yet big enough not to present a choking hazard. You want to expose the baby to a wide variety of shapes, colors, sounds, and textures.
  


• Also by 9 months certain key signs of normal thinking abilities should start to appear.  The most importance of these are "joint attention" and "object permanence".   Joint attention is when the baby actively "shares" his or her attention to something fun or interesting with someone else - usually a parent or sibling.  They might point and laugh, and look back and forth from the object to the other person to gauge the other person's response.  Object permanence means that just because something is out of sight, it's not gone.  Children who have object permanence will understand that a hidden object can be retrieved, and will start to enjoy the game of "peek-a-boo".

Ointment is better than powder for protecting against diaper rash, but it really doesn't matter which ointment you use. Powders (all types) can also be dangerous if accidentally inhaled. Soap is very drying to the skin, even "baby soap". Dove is the mildest and probably the best. Avoid deodorant soaps.

Are there things you enjoy but haven't done since baby arrived? Get back to them now! Set aside time to be with your partner by getting a babysitter. Spend some special time alone with the baby's older siblings. Maintain your hobbies, interests, career, etc.

It is normal and very common for parents to feel depressed, anxious, and overwhelmed. It may seem hard to cope with a screaming baby and you may even feel as if you're about to lose control. Help is available. Call us or call:

Parental Stress Line # 1-800-632-8188

Other important telephone #'s to keep by your phone:

Pediatrician 978-975-3355

National Poison Control Hotline 1-800-222-1222

Police/Fire/Ambulance - 911