Because your baby grows rapidly during these months, your questions may move from simple sleeping and eating concerns to those about physical development and motor skills. Your child's doctor will monitor your baby's progress and answer any questions you may have.

When Will We See the Doctor?

Most likely your baby will now be seen at four months and at six months, but your child's doctor may have his or her own schedule for well-baby visits. Extra visits may be scheduled to check on a problem found at an earlier time.

It is not uncommon for parents to be calling the doctor more frequently about suspected colds or ear infections during these months, especially during the wintertime. Once your baby can reach out and grab objects, and starts having contact with more people, he or she may be at increased risk for contagious illness, particularly if entering a day care or if they have an older brother or sister. Also, much of the immunity that a baby received from his or her mother before birth is "wearing off" now.

What Will Happen at the Office Visit?

Well-baby visits vary from doctor to doctor, but here are some common elements of a checkup:

• Measurement of your baby's length, weight, and head circumference. Growth will be plotted on a growth chart, and you will be advised of his or her progress.
• A physical examination to check for normal function of the eyes, ears, heart, lungs, abdomen, arms and legs, etc. The doctor will check the baby's soft spot (the fontanel) at the top of the head, and he or she may check baby's mouth for signs of teething.
• A review of your baby's physical and emotional development through both observation and your report of his or her progress. Can he or she hold up his head? Is he or she rolling over? Is he or she attempting to sit up after six months? Is he or she trying to use his or her hands more and more? How does he or she react to strangers? Your doctor may ask you these questions and more.
• You may be asked how you are doing with your baby and how the rest of the family is functioning. Your child's doctor may go over safety questions with you: Have you babyproofed your home? Is he or she in an appropriate safety seat while riding in the car? Have you begun removing mobiles and bumpers from the crib if he or she is able to pull himself up?
• A discussion of your baby's eating habits, including the likelihood that solid foods will be introduced soon.
• Advice on what to expect in the coming months.
• Your baby will receive immunizations during some visits (see below).

Sometime during the 6 months before their first birthday babies are checked for anemia (low blood iron). This can be done with a simple finger prick to collect a drop of blood for examination. Other than this test, most babies do not need any routine laboratory tests in the first year of life.

Bring to your child's doctor any questions or concerns you may have at this time. Make sure to write down any specific instructions he or she gives you regarding special baby care. Keep updating your child's permanent medical record, listing information on his or her growth and problems or illnesses.

What Immunizations Will My Baby Receive?

Immunizations generally given at the four-month visit:

• Second diphtheria, tetanus, acellular pertussis (DTaP) vaccine
• Second Haemophilus influenzae type b (Hib) vaccine
• Second polio vaccine (IPV)
• Second pneumococcal conjugate (PCV) vaccine
• Second hepatitis B (HBV) vaccine. (This can vary depending on whether your doctor uses combination vaccines).

At your baby's six-month visit he or she may receive the following:

• Third diphtheria, tetanus, acellular pertussis (DTaP) vaccine
• Possibly the third polio vaccine (IPV) at this time
• Third hepatitis B vaccine (if first two doses have been given earlier)
• Third Haemophilus influenzae type b (Hib) vaccine
• Third pneumococcal conjugate (PCV) vaccine

When Should I Call the Doctor?

Coming down with colds and other illnesses is a normal part of growing up. Your baby is beginning to explore his environment on his or her own, and is probably getting exposure to other children. It might be hard to see your baby fight a stuffy nose or suffer with an ear infection, but rest assured that most children grow out of the frequent-illness stage (though perhaps not for some time). Meanwhile, there are safeguards you can take to try and keep your baby well:

• Breast-feeding your baby will give him or her antibodies and enzymes that help protect from illness.
• Try to keep your baby away from children who you know are sick, especially those with infectious diseases such as chickenpox.
• Family members who are sick should not share food or drink with the baby, and they should wash their hands well before handling the baby and his or her toys.
• Be vigilant about your baby's vaccines. Stick to the immunization schedule recommended by your child's doctor.

Call your child's doctor right away if your baby seems less energetic or lethargic, refuses to eat, suddenly has trouble sleeping, has diarrhea, or is vomiting. Also, temperature over 101 degrees Fahrenheit (38.3 degrees Celsius) should be reported to the doctor immediately, even if your baby seems well otherwise.

Updated and reviewed by: Barbara Homeier, MD
Date reviewed: January 2005
Originally reviewed by: Steve Dowshen, MD