At the 6-month checkup, the doctor will examine your baby. They will ask how things are going at home. This sheet describes some of what you can expect.

The doctor will ask questions about your baby. They will watch to get an idea of your baby's development. By this visit, most babies:

• Know familiar people.
• Roll from tummy to back.
• Lean on their hands for support when sitting.
• Babble and laugh in response to words or noises made by others.
• Reach to grab a toy.
• Put things in their mouth to explore them.
• Close their lips when they don't want more food.

Also, at 6 months some babies start to get teeth. If you have questions about teething, ask your doctor.

To help your baby eat well:

• Start to add solid foods to your baby's diet. At first, solids will not replace your baby's regular breast milk or formula feedings.
• It doesn't matter what the first solid foods are. There is no current research that says introducing solid foods in any order is better for your baby. Usually, single-grain cereals are offered first. But single-ingredient strained or mashed vegetables or fruits are fine too. Avoid honey and large chunks of food that could cause choking.
• When you first give solids, mix a small amount of breast milk or formula with it in a bowl. When mixed, it should have a soupy texture. Feed this to your baby with a spoon. Do this once a day for the first 1 to 2 weeks.
• When giving single-ingredient foods such as homemade or store-bought baby food, introduce one new flavor of food at a time. You can try a new flavor every 3 to 5 days. After each new food, watch for allergic reactions. They may include diarrhea, rash, or vomiting. If your baby has any of these, stop giving the food. Talk with your child's doctor.
• By 6 months of age, most breastfed babies will need extra sources of iron and zinc. Your baby may benefit from baby food made with meat. This has sources of iron and zinc that are absorbed more easily by your baby's body.
• Feed solids once a day for the first 3 to 4 weeks. Then increase solids to 2 times a day. Also keep feeding your baby as much breast milk or formula as you did before.
• Some foods, such as peanuts and eggs, have a high risk for allergic reaction. But experts advise introducing these foods by 4 to 6 months of age. This may reduce the risk of food allergies in babies and children. If your baby tolerates other common foods (cereal, fruit, and vegetables), you may start to offer foods that can cause an allergic reaction. Give one new food every 3 to 5 days. This helps show if any food causes any allergic reaction.
• Ask the doctor if your baby needs fluoride supplements.

• Your baby's stool will change after they start eating solids. It may be thicker, darker, and smellier. This is normal. If you have questions, ask during the checkup.
• Clean your baby's gums and teeth (as soon as you see the first tooth) 2 times a day. Use a soft cloth or soft toothbrush and a small amount of fluoride toothpaste (no bigger than a grain of rice).
• Ask the doctor when your baby should have their first dental visit.

At 6 months of age, a baby is able to sleep 8 to 10 hours at night without waking. But many babies this age still wake up 1 or 2 times a night. If your baby isn't yet sleeping through the night, a bedtime routine may help (see below). To help your baby sleep safely and soundly:

• Put your baby on their back for all sleeping until the child is 1 year old. Use a firm, flat, non-inclined sleep surface. This can decrease the risk for SIDS (sudden infant death syndrome). It lowers the risk of breathing in fluids (aspiration) and choking. Never place your baby on their side or stomach for sleep or naps. If your baby is awake, allow the child time on their tummy as long as there is supervision. This helps the child build strong tummy and neck muscles. This will also help reduce flattening of the head. This can happen when babies spend too much time on their backs.
• Don't put a crib bumper, pillow, loose blankets, or stuffed animals in the crib. These could suffocate a baby.
• Don't put your baby on a couch or armchair for sleep. Sleeping on a couch or armchair puts the infant at a much higher risk for death, including SIDS.
• Don't use an infant seat, car seat, stroller, infant carrier, or infant swing for routine sleep and daily naps. These may lead to blockage of a baby's airways or suffocation.
• Don't share a bed (co-sleep) with your baby. Bed-sharing has been shown to raise the risk for SIDS. The American Academy of Pediatrics advises that babies sleep in the same room as their parents, close to their parents' bed, but in a separate bed or crib appropriate for babies. This sleeping setup is advised ideally for a baby's first year, but at least for the first 6 months.
• Always place cribs, bassinets, and play yards in hazard-free areas. This is to reduce the risk of strangulation. Make sure there are no dangling cords, wires, or window coverings.
• Don't put your child in the crib with a bottle.
• At this age, some parents let their babies cry themselves to sleep. This is a personal choice. You may want to discuss this with the doctor.

Your baby is now old enough to sleep through the night. Sleeping through the night is a skill that needs to be learned. A bedtime routine can help. By doing the same things each night, you teach your baby when it's time for bed. You may not notice results right away. But stick with it. Over time, your baby will learn that bedtime is sleep time. These tips can help:

• Make preparing for bed a special time with your baby. Keep the routine the same each night. Choose a bedtime, and try to stick to it each night.
• Do relaxing activities before bed, such as a quiet bath followed by a bottle.
• Sing to your baby, or tell a bedtime story. Even if your child is too young to understand, your voice will be soothing. Speak in calm, quiet tones.
• Don't wait until your baby falls asleep to put them in the crib. Put them down awake as part of the routine.
• Keep the bedroom dark and quiet. Make sure it's not too hot or too cold. Play soothing music or recordings of relaxing sounds, such as ocean waves. These may help your baby sleep.

• Don't let your baby get hold of anything small enough to choke on. This includes toys, solid foods, and items on the floor that your baby may find while crawling. As a rule of thumb, an item small enough to fit inside a toilet paper tube can cause a child to choke.
• It's still best to keep your baby out of the sun most of the time. Apply sunscreen to your baby as directed.
• In the car, always put your baby in a rear-facing car seat. This should be secured in the back seat. Follow the directions that come with the car seat. Never leave your baby alone in the car.
• Don't leave your baby on a high surface, such as a table, bed, or couch. Your baby could fall off and get hurt. This is even more likely after your baby knows how to roll.
• Never leave your baby alone in or around the bath tub or other water.
• Always strap your baby in when using a highchair.
• Soon your baby may be crawling, so make sure your home is childproofed. Put babyproof latches on cabinet doors, and cover all electrical outlets. Babies can get hurt by grabbing and pulling on things. For example, your baby could pull on a tablecloth or a cord and be hit by hard objects. To prevent this, do a safety check of any area where your baby spends time.
• Older siblings can hold and play with the baby as long as an adult supervises.
• Walkers with wheels are not advised. Stationary (not moving) activity stations are safer. Talk to the doctor if you have questions about which toys and equipment are safe for your baby.
• Never shake, hit, or throw your baby. This can cause serious damage to your baby's brain. There may be times when your baby is crying and you are feeling tired, frustrated, or even angry. The best thing to do is to put your baby in the crib and take a break for yourself or ask for help from family or friends.

At this visit your baby may receive these vaccines:

• Diphtheria, tetanus, and pertussis
• Haemophilus influenzae type b
• Hepatitis B
• Influenza (flu)
• Pneumococcus
• Polio
• Rotavirus
• COVID-19
• Respiratory syncytial virus (RSV) monoclonal antibody

Ask your baby's doctor which shots are advised at this visit. Having your baby fully vaccinated will also help lower your baby's risk for SIDS.