IMMUNIZATIONS: Pediarix, Prevnar and Rotateq

 
It is hard to believe that half a year has already passed. The next six months will be just as much fun. Soon to come, walking and talking!
 
At six months, your baby should be transferring objects from hand-to-hand, starting to sit with support, respond to your voice, coo and babble, roll both ways, and start to creep and crawl. By the nine month visit, your baby should be crawling and starting to pull up.
 
By six months of age, you should begin feeding solids. If the baby is already on solids, you may add meats and start three meals a day with two to three items per meal. Not all babies will take meats or 3 meals a day right away.
 
If you like, you may puree table food instead of giving prepared baby food. Please continue giving iron fortified baby cereal, however.
 
Breast milk or formula should be continued for at least three more months. You may decrease the bottles to two to three times a day plus juice. Do not give a bottle in bed as this may lead to cavities. With breast fed babies, you may start using a training cup with juice. For breast fed children, starting vitamins (i.e. Tri- Vi Sol) is important.
 
At this age, teeth begin to appear. The first two teeth are usually the center, lower teeth. It can take weeks to months for teeth to rupture so teething can be persistent. Teething rings help as well as teething biscuits as long as you are nearby in case of choking. Teething gels and acetaminophen may also help. Frequently, while teething, an infant may catch a virus. a fever develops, use acetaminophen, but contact us if he/she looks sick.
 
This is a good time to talk about fevers, Babies and children can have higher fevers than adults and it is common to have temperatures of 103 to 104. The important thing is not the height of the fever, but rather his/her activity. Babies usually sleep more with a fever, but at times he/she should still be active, responsive and make good eye contact with you. If he/she isn't, call us. If there is continuous vomiting with a fever, call us. Fever with a cold does not always need to be seen as long as the child is active and has no other complaints. If you are worried, call during office hours and we will gladly check him/her. Some children do have febrile seizures, which are caused by sudden changes in body temperature. Call us immediately if this occurs. Occasionally, a child will vomit during a seizure. Turn his/her head to the side while he/she vomits. Though these seizures scare us, they usually are not harmful to the child.
 
If your child is tugging at his/her ear or is complaining of an earache, call us before 11 pm. Earaches during the middle of the night can wait until the morning with a dose of acetaminophen and a heating pad to the ear.
 
Protecting your child from accidental poisoning is now a concern. Should your child swallow something harmful, CALL POISON CONTROL IMMEDIATELY (1-800-521-6110). This is one of the few medical emergencies we ask you to call someone other than us for. If they say give Ipecac, do so. If they tell you the child should be seen, call us and we will arrange for that in our office or the emergency room.
 
PREVENTION STRATEGIES FOR INJURIES - 6 MONTHS
 
CHOKING/ASPIRATION/SUFFOCATION

• Learn what to do when a child chokes.
• Use a crib with slat spacing of not more than 2 3/8 inches and a snug-fitting mattress.
• Remove hanging mobiles or toys before baby can reach them.
• Allow no cords near crib or around neck.
• Keep plastic bags, balloons, and baby powders out of reach.
• Keep sides of mesh playpens up.
• Use only unbreakable toys without sharp edges or small parts that can come loose.
• Avoid foods on which child chokes easily (hot dogs, peanuts, popcorn, chewing gum, and hard fruits and vegetables).
  Cut food into small pieces.

FIRES AND BURNS

• Never eat, drink, or carry anything hot near or while holding a baby or child.
• Turn down water heater so water from the hot water tap is no more than 120 degrees.
• Develop and practice a fire escape plan.
• Install and maintain smoke detectors.
• Keep a fire extinguisher in or near the kitchen.
• Treat a burn immediately with cold water, and then call your doctor.
• Check formula, food, and drink temperatures carefully.
• Don't smoke near the baby.
• Keep hot foods and liquids out of reach.
• Put shock stops in unused electrical outlets; put cords out of reach.
• Keep hot appliances and cords out of reach.
• Keep all electrical appliances out of the bathroom.
• Don't cook with child at feet, use playpen, high chair or crib as a safety area for small child.
• Provide non flammable barriers around hot home heating surfaces and fireplaces.
• Insulate junctions of extension cords with electrical tape.

MOTOR VEHICLE ACCIDENTS

• Never leave a child unattended in car.
• Parents should wear their seat belts.
• Correctly use an approved car safety seat in the infant position.
• Be prepared to switch to toddler car seat and position.

FALLS

• Never step away when the baby is on a high surface.
   Keep crib sides up.
• Use playpen with sides locked in up position as an "island of safety".
• Avoid using walkers.
• Install safety gates (NOT accordion style) to guard stairways.
• Lock doors to dangerous areas like the basement and garage.
• Check stability of drawers, tall furniture, and lamps before child cruises; remove tablecloths.
• Make sure windows above first floor are closed or have screens or guards that cannot be pushed out.

ANIMAL BITES

• Don't leave a child alone with pets.

PEDESTRIAN/PEDAL CYCLE INJURIES

• Avoid carrying child as a passenger on adult's bike except in special seat, helmeted and off street.

DROWNING

• Make sure that an adult bathes the baby.
• Remain in the room during every second of a bath.
• Provide unbreachable barrier around pool or spa.
• Continuously supervise child around any water.

INJURIES FROM FIREARMS

• Unload and lock away all firearms.

POISONING

• Keep all medicines, vitamins, cleaning, plumbing, gardening, painting, refinishing, and agricultural chemicals and supplies out of reach, preferably locked away, or dispose of after use.
• Remove all poisonous plants from the home.
• Install safety latches to delay access to cabinets.
• Put poison center number on all phones; call if child puts something in his mouth that may be poisonous.
• Buy syrup of ipecac; use only if directed to do so.
• Purchase all medicines in containers with safety caps.

CUTS

• Remove (or pad) low furniture with sharp corners from child's living area.