2 Month Check-up 

(Children 2 – 4 Months Old)

Feeding: Babies who breastfeed may nurse every 2-4 hours in the day, and 1-2 times at night. Babies who drink formula should take 3-6 ounces every 3-4 hours, depending on their size. They may feed at least one time at night. Again, babies at this age do not need any extra water. Babies are unable to digest the larger sugars in cereals and baby food until around 4 months old, therefore, we recommend waiting until 4-6 months of age before starting cereals, fruits, or vegetables. Additionally, most 2 month olds do not have a swallowing mechanism that is coordinated enough to consistently swallow solids without choking. For now, breast milk or formula is all your baby needs. If your baby is not tolerating his/her current formula, make sure to ask you doctor about alternatives. Although breast milk is an excellent source of nutrition for your child, there is not enough vitamin D in breast milk to completely supply your child’s needs. Infants who receive less than 500 ml (about 17 ounces) of formula each day should receive vitamin D supplements. One brand that is available at most pharmacies is Poly-vi-sol with iron or D-vi-sol.

Sleeping: Most (but not all) babies may now sleep for 5-6 hours at night. Remember that it is not unusual for a baby to wake for a short period of time at night and make a little noise now and then. Don’t feel obligated to go in and pick up or feed your child every time he/she stirs at night, this can lead to sleep problems later on. If he/she wakes at night for feeding or diaper change, dim the lights and be quiet to keep your baby calm and learn the difference between night and day. Always put your baby to sleep on his/her back in a separate bed. This may help prevent SIDS (“Sudden Infant Death Syndrome”). Do not put pillows or stuffed animals in the crib. You do not need to use any devices to maintain this sleep position. Once your child is rolling, you do not have to keep going back into the room to turn him/her over if he/she rolls on his/her side or stomach. Now is a good time to start bedtime habits and even read or sing to your baby before sleep.

Development: Below is a list of things most babies this age can do:

• Lift head and hold it up a lot better than when she/he was born.
• Respond to sounds in the room.
• Begin making cooing sounds and smile at you.
• Follow objects and faces with eyes around the room.

Diaper habits: Babies should have 5-8 wet diapers each day. Stools may change from day to day. It may be normal to have 2 or 3 a week or even 5-6 a day. They may also be green or brown from time to time. If you think your baby is constipated or has very hard or painful stools, call your doctor or nurse before trying medicines.

Illness: If your baby is in daycare or around other children, he or she may catch a cold or other illness. Call your doctor for a rectal temperature over 100.4°F. For colds, the only thing safe to use is saline nose drops and a nasal bulb to help remove mucus from your baby’s nose. The best times to suction the baby’s nose is before eating or before sleeping. Vaporizers may also help. Smoking around your baby may increase the chance of ear infections, colds, and wheezing. Always smoke outside or quit smoking. Make family members wash their hands when they get home to decrease transmission of germs.

Immunizations: Your baby will receive vaccines today. You may give acetaminophen (Tylenol) every four to six hours as needed for the first 24-48 hours if he or she seems fussy or runs a fever. If your baby likes the bath, soaking his/her legs in warm water may also help with the soreness. Your baby will likely get the same vaccines again at the 4 month checkup. Below are some websites with trusted vaccine information.

Safety: Car accidents are a major danger to your baby’s life and health. Make sure to place your child in the car seat at all times when you are in your car. Read the instructions for your car seat. Be sure to send in the product registration card for the car seat and any other products you buy for your child, so you will bee notified of any safety hazards or recalls. Make sure your hot water heater is turned down to 120°F or to the setting marked “low”, and assure that your smoke detectors are working. Never leave your child alone in the bathtub, even for a few seconds. A baby can drown in very shallow water. Be aware that some children roll over between 2 to 4 months of age. Never leave them alone in top of a changing table or bed, they may roll off and get hurt. Never shake a baby.

* * *

For additional information the American Academy of Pediatrics has a website with general information: www.heathychildren.org

Your next appointment will be at 4 months old.