The First Six Months: Big Changes – Month Six

This article covers the following topics: The Sixth Month: Sitting Big, A Relief for Parents, Pushing Up and Moving Around, Playpens: Don’t Fence Me In, Raising Healthy Teeth, When should we expect our baby’s teeth to appear?, When should we first take our baby to a dentist?, When should I start brushing baby’s teeth?, Besides brushing, what else can we do to help our baby’s teeth?, Don’t let baby sleep with a bottle of milk or juice.,  What about fluoride? How can I tell if my baby is getting enough?. This is the last part of this article. I hope you found the other five.


The Sixth Month: Sitting Big

From five to six months is a transition stage in baby’s development. Before this period, baby is stuck. He can’t move around or sit and play by himself. In the next stage, six to nine months, he becomes able to do both. In the sixth month, then, baby begins learning to sit and move about, and it is these major milestones that we focus on in the next few pages.

The Sitting Sequence

Learning to sit is the master skill of the sixth month. The sequence of learning to sit from four to six months is one of the most fascinating steps in baby’s development. In the first few months baby seems to have little strength in his lower back muscles. When put in the sitting position he flops forward on his nose. Around three to four months baby shows some lower-back-muscle strength by easing forward, but again goes flop. Between four and five months baby still slumps or topples sideways but begins using his outstretched arms as forward and sideways props. Between five and six months baby may let go. his back muscles are now strong enough to support sitting erect, but usually still with the hands as props. Now sitting is just a matter of learning balance.

Watch how your clever beginning sitter learns balance. When baby starts to let go, first with one hand, then the other, he holds his straight back forward at a forty-five-degree angle. As balance and back-muscle strength improve, he sits erect at ninety degrees to the floor. The novice sitter teeters and wobbles on his rounded bottom while thrusting out his arms like sideways balance beams.

Once he master sitting balanced, baby no longer needs his head and arms for balance props but van use them for communication and play. When the skillful sitter begins turning his head to follow you and lifting his arms to gesture or to play, usually between six and seven months, baby is truly sitting alone.

Helping the Beginning sitter

Because baby does not yet have the strength to right himself from a topple, backward and sideways falls are the price to pay for a good sit. Your baby will learn to sit well if you leave him alone. But if you help your baby enjoy the early sitting experiences, he will realize the increasing views he has in this position and will better enjoy developing his skill. Here’s how to help:

* Cushing the inevitable backward and sideways falls by surrounding baby with pillows. There’s nothing like a fall on a hard surface to scare baby and dampen his motivation to sit.

* To steady the wobbly beginning sitter, place baby in a homemade horseshoe-shaped piece of foam rubber. (Possibly a Nurse Mate pillow purchased as a breastfeeding aid for the early months — a good example of extending the usefulness of an item!)

* For the summer sitter, hollow out an area in the sand. (Cover the sand with a blanket if you don’t want sand in the eyes, mouth, and diaper.)

* When enjoying floor play together, sit baby between your outstretched legs so he can use them as grab rails.

* Use toy interactions to help baby learn balance. When enticed to use his hands to reach for a toy, the sitting baby “forgets” to use his hands as balance props and learns to rely solely on his trunk muscles for balance.

* If baby continues to rest on his hands as forward props, place blocks in front of him to motivate him to lift his hands off the floor by grabbing the blocks.

* To encourage hand play, dangle a favorite toy, eye level, in front of baby. Then move the toy to each side, encouraging baby to move his arms toward the toy while sitting.

During these balance-training exercises, notice how baby uses his arms to maintain balance. At first baby reaches with one hand toward a toy while thrusting out the other for balance. As balance improves, watch baby reach for a toy to one side with both hands and reach behind himself without tumbling over.

A Relief for Parents

When baby can sit along better, parents can sit along longer. Sitting skillfully alone and playing is a major relief milestone for parents. Once he masters sitting, a six-month-old becomes less of a lap baby and carried baby and more of a high-chair and floor baby.

Pushing Up and Moving Around

The sixth month is literally a turning point for baby. Each month baby has been raising more of her torso off the floor. Now she can push her tummy off the ground almost as far as her belly button. Watch what baby can do from the push-up position. She can let go with her hands, raise her feet, and rock on her belly — playing teeter-totter. Or she can keep her hands and feet touching the ground and pivot around in a semicircle in pursuit of a favorite toy. As a finale, the rocker can pivot on her weighty abdomen by the sheer momentum of her wiggling legs and waving arms — playing airplane.

Next come pivoting. Using her arms to steer, baby tries to turn a circle by pivoting on her abdomen, which still seems stuck to the floor. While baby is in the middle of pivot practice, place a favorite toy to one side just beyond her reach. Watch baby pivot around to get hearer the toy. If she is really in a hurry, she may turn a quick flip and roll toward the toy.

Here’s how you can participate in baby’s developing skills.

Chest rest.While a baby likes to play on his tummy, frequent push-ups can tire the young athlete. Also, he may be frustrated by having to use his arms and hands for support and not for play. Place a three-inch foam-rubber wedge under baby’s chest. This prop frees his hands to play with toys in front of him more comfortably and for longer periods without getting tired. He can also roll of onto the carpet without hurting himself.

First scoots.Place an enticing toy just beyond the floor-baby-s reach. Watch baby dig in with toes and fingers and squirm, scoot, or combat crawl toward his target. Some babies can move a foot or two at this stage as they practice their first. crawls.

Playpens: Don’t Fence Me In.

Babies don’t learn much in pens. In the sit-and-play stage some babies may temporarily enjoy their own little “playroom” with lots of stuff within easy grabbing distance. But in later months, as the beginning explorer peers through the net at the whole big room out there, he is likely to protest confinement.

Pens do have their place. A portable pen and a mobile baby may, of necessity, belong together at your place of work. Plopping baby in a pen while you answer the phone or remove dinner from the oven is often a safety saver for the busy parent. But keep the sentence short; put pen and baby within easy relating distance while finishing your work, making sure to frequently acknowledge the inmate.

If you need baby to be in the pen, keep it safe. Beginning sitters and crawlers flop around a lot on the pen floor. Keep hard toys out. Soft, cuddly toys make good pen mates and are safer to fall against.

As baby progresses from the sit-and-play stage to the move-and-explore stage, pack up the pen and put it in its rightful place (perhaps even next to the crib) at your next garage sale and baby proof the whole house.

Raising Healthy Teeth

Going are those adorable toothless grins. Coming is a novel smile each month. Around five to six months, parents become interested in teething. Here are the most common concerns parents have about caring for those precious pearly whites.

When should we expect our baby’s teeth to appear?

When teeth first appear is as variable as the timing of baby’s first steps, but in general expect the first sharp nubbin around six months; some babies teethe earlier, some later. And heredity plays a part. If you check your own baby book, if grandmother was a tooth-record keeper, you baby’s teething schedule may resemble yours.

Actually, babies are born with a full set of twenty primary teeth. They are just buried in the gums, waiting in line for their time to sprout. Teeth push through in upper and lower pairs, usually the lower appear before their upper gum mates, and girls teethe slightly earlier than boys. The “rule of fours” is how teeth usually appear. Beginning around six months expect four new teeth every four months until complete, usually by two and a half years. Teeth come through gums at unusual angles. Some come out straight, others first appear crooked but straighten as they twist their way through. Don’t fret about spaces. It’s easier to clean between spaced teeth, and the spacing of the baby teeth does not necessarily reflect how the permanent teeth will appear.

How much should we expect teething to bother our baby?

As you wonder why your sleeping angel turns night waker, you hear the telltale pin against the spoon or feel the cutting edge. Actually babies don’t “cut teeth,” nor do teeth “erupt.” Teeth slowly slide and twist their way through gum tissue. But sharp teeth pushing through sensitive gums do hurt, and babies protest. Here are the nuisances to expect and suggestions to comfort the budding teether.

Drooling.During teething time expect the saliva faucet to be on. In addition, listen for the young announcer’s voice to sputter. Many of the following aggravations stem from this excessive drool.

Drool rash.Sensitive skin and excessive saliva don’t sit well together, especially when the skin is rubbing against a drool-soaked bed sheet. Expect a red, raised, irritating rash around lips and chin. Place a drool-absorbing cotton diaper under baby’s chin or a towel under the sheet while baby sleeps. Gently wipe excess drool off the skin with lukewarm water and pat (don’t rub) dry. Lubricate with a mild emollient such as Nature’s Second Skin or cold-pressed coconut, almond, or safflower oil.

Drool cough.Besides drooling out the mouth, the excess saliva escapes through the back door, dripping down baby’s throat, causing gagging and irritating cough.

Fever and irritability.The inflammation caused by hard teeth pushing through soft tissue may produce a low fever ((101 degree F/38.3 degree C) and the disposition of someone who hurts. Give baby acetaminophen as needed.

Biting.The budding teether longs for something or some person to gnaw on. Teeth marks on crib rails and clicking gums on silver spoons are telltale signs of sore gums needing relief. Expect these hard gums to clinch your knuckles, arm, finger, and sometimes the breast that feeds baby . Offer something cool and hard. Gum-soothing favorites are a cool spoon, popsicle, frozen bagel, teething ring, and, a favorite, a chicken leg bone stripped of the tiny bone slivers. Try cold teething biscuits for another melt-in-the-mouth teether. We are hesitant to recommend commercial numbing substances because it is difficult to learn their exact contents and find research that validates their safety.

Night waking.Growing teeth don’t rest at night; neither do teething babies and their parents. A previously steady sleeper may frequently awaken during peak teething times and may have difficulty resettling into the pre-teething sleep schedule. Offer a dose of acetaminophen before bedtime, or if baby is in severe pain, a one-time double dose. Repeat the dose four hours later if needed.

Refusing to feed.This is the most variable of all teething concerns. Some teethers never miss a meal, some avid breast feeders accelerate their nursing for comfort, but a few may pass up even their most trusted human pacifier. Offer cool, mushy foods — for example, applesauce and frozen fruit-juice slush. Put these on a cool spoon to make a real hit.

Doctor could it be her teeth?

You may feel that your doctor doesn’t share your degree of concern about your baby’s teething problems. Your doctor is being cautious and has the best interest of your baby at heart. Some medical studies, at odds with mother’s observations, claim teething discomforts are overrated. Another reason for your doctor’s ambivalence about possible teething-related symptoms is the worry that you will attribute a symptom to teething and miss a serious underlying illness. May a doctor has agreed with the mother and considered teething over the phone but diagnosed an ear infection when examining the baby in person.

How can I tell if my baby is teething?

Besides the trademark drool and other related signs, try the gm massage test. (Babies are more likely to accept a finger probing into their mouth than to allow a look.) Run you finger along the front edges of the gums, and you will feel swollen ridges of pre-teething gums.

It is sometimes difficult to tell if a baby is teething because the amount of teething discomfort varies considerably among babies. Some are steady, once-a-month teethers; many teethe in bursts and pauses, where suddenly baby has a miserable week and you feel four swollen ridges along the gum line. Expect the most discomfort when many teeth come through at once. Some babies experience exquisite pain and swelling during molar teething. If allow3f to look, you may notice amount of swollen tissue around a budding tooth. Don’t be alarmed if you notice a mushy blue blister above an erupting tooth. This actually a collection of blood beneath the superficial layer of gum tissue. These painful swellings are best treated by cool compresses (for example, popsicles), which soothe the swelling.

I’ve taken our baby to the doctor several times for what turned out to be false alarms. I thought he had a cold, but it turned out to be teething. How can I tell?

You are right to let your doctor make the decision. When in doubt, don’t attribute baby’s behavior to teething. But here are some general ways to tell the difference between teething and an illness such as an ear infection.

* Teething mucus is clear saliva and doesn’t run out the nose. Cold mucus is think and yellow. A nasal discharge usually means an allergy or an infection, especially if accompanied by eye drainage.

* Teething rarely causes a fever higher than 101 degrees F (38.3 degrees C).

* Teething may be confused with an earache. Babies pull at their ears during teething, probably because of referred pain from the teeth to the ears. Ear pulling in babies is usually an unreliable sign. With an ear infection babies usually hurt more lying down and have accompanying signs of a cold.

* Babies don’t act progressively sicker with teething. As a general rule, when in doubt, check it out with the doctor.

When should we first take our baby to a dentist?

Sometime between baby’s first tooth and third birthday, schedule baby’s first dental checkup. Better early than late. Getting your baby used to painless dental checkups long before the first cavity drilling makes it easier on baby, parents, and dentists. Ask to hold your child during any dental procedures or at least to be present during the exam. Some pediatric dentists ask parents to assist by sitting knee to knee with the child’s head resting on the dentist’s lap. Well-teeth checkups, like well-bay exams with your pediatrician, give the dentist an opportunity to teach you some preventive care, such a proper teeth brushing, avoiding night feedings, and correct fluoride dosage.

When should I start brushing baby’s teeth?

Dentists now recommend cleaning gums with gauze to remove plaque beginning around the time that teeth first appear, usually six to seven months. Try the following brushing tactics.

Model good dental hygiene.Let baby watch you brush. Show excitement, capitalizing on “Brush off the sugar bugs, just like mommy and daddy.” Around his first birthday get baby his own toothbrush and enjoy side-by-side brushing just for play. If you first get baby to enjoy imitating tooth brushing, it will be easier for you to get down to the business of getting germs off little teeth.

First tooth brushing.The best chances for a cooperative baby and clean teeth is to use your moistened gauze-wrapped fingertip as a toothbrush. Gauze also works well in the older baby who refuses to let you invade his mouth with a toothbrush.

Tooth brushing positions.Placing baby on your lap with his head facing you is a good position for a wide-open-mouth entry. Sitting or standing behind baby with him looking up also gives you a good view. An older baby can be held cradled in your arms to one side. Or try the two-person knee-to-knee position or sit on the floor with baby’s head between your legs.

Tooth brushing and toddlers.Once baby gets a mouth full of teeth, especially molars, a toothbrush works better than a mommy-made, gauze-on-finger brush to get in the crevices between teeth. Don’t forget to take a few gentle swipes over the surface of the tongue, which harbors the same bacteria as the gums. Letting your toddler hold the brush while you clean helps his acceptance. Children mostly protest brushing their back teeth for fear of choking, so begin with the front teeth and ease toward the molars.

Which toothpaste?Toothpaste isn’t necessary for starter brushing, but if desired, a half pea-sized dab will do. Dentists caution against letting baby swallow too much fluoride-containing toothpaste. Toddlers enjoy the ritual of putting on the toothpaste, but then they object to the sharp taste. Use a mild-flavored children’s past if necessary.

Which toothbrush?Choose a short brush with two rows of soft bristles on a small head. Store a spare brush. They get lost, get dirty, and wear out quickly. Change brushes when the bristles get bent.

Why all the fuss bout first teeth? Baby will lose all of them anyway.

It’s important to care for the baby teeth. These primary teeth hold the right spaces for the secondary, or permanent, teeth, Healthy first teeth also contribute to proper alignment of the jawbones and eventual bite. And don’t discount the healthy vanity of a smiling preschooler. No one likes to show off a row of rotten teeth.

Besides brushing, what else can we do to help our baby’s teeth?

Here are suggestions for your own home-dental program for cavity-free kids.

Breastfeed.Pediatric dentists who study the effects of breastfeeding on oral development believe that one of the most beneficial contributors to healthy teeth and healthy jaw alignment is a breast in the mouth for as long as mother and baby are willing and able. Apparently the unique sucking action of breastfeeding helps prevent malocclusion. A saying we have heard in dental circles goes, “Your infant’s breastfeeding efforts will be later reflected in his face.”

Avoid sticky stuff.Keep your baby off a steady diet of highly sugared junk foods, especially tacky lollipops, caramel, and hard candy that stick and lodge between teeth and have a long-enough contact time for germs and enamel to get well acquainted. Tooth decay begins with the formation of plaque — a sticky film that forms on the teeth and provides a residence for decay-promoting germs. The bacteria and the plaque react with the sugar in the food, creating a decay -producing acid. The more plaque, the more decay. The goal of dental hygiene, therefore, is to keep the plaque from forming in the first place, by frequent brushing, and keep the sugar off the plaque, by a healthy diet. When toddlers protest tooth brushing, tell them it is to wipe off the “sugar bugs.”

Don’t let baby sleep with a bottle of milk or juice.Bottles are not friendly to a sleeping baby’s teeth. Especially blacklist honey-dipped pacifiers. When baby falls asleep, saliva flow decreases, diminishing its natural rinsing action on the teeth. The sugary stuff bathes the teeth. Plaque and bacteria have an enamel feast, resulting in severe tooth decay called bottle mouth. If a baby is hooked on the nap or nighttime bottle, try watering down the juice or milk, each night diluting it a bit more until it’s all water. If bay clings to his nighttime bottle and won’t settle for any diluted substitute, be sure to brush the teeth well on the first morning trip to the bathroom.

Check out advice on night nursing.

“Nursing caries” does happen to breastfed babies, but buffer in human milk allow it to be tolerated in the mouth, so that tooth decay is much less likely than with bottles of juice or formula. They are most likely to be found in those all-night snacker who feel night nursing tops the list of baby’s bill of rights. Consulting with pediatric dentists who have thoroughly researched the night-nursing concern. Many believe that nighttime breastfeeding only slightly contributes to tooth decay. In many cases the tooth decay would have occurred with or without the night nursing.

If you are still night nursing and it’s working for you, consult a pediatric dentist knowledgeable about the benefits of breastfeeding and oral development. Have baby’s teeth periodically checked to see if they have any beginning decay or enamel weakness that would prompt you to curb night nursing. If you get your dentists OK to continue night nursing, it would be wise, besides your routine before-bed brushing, to start the teeth off each day with a thorough cleaning.

To stop breastfeeding or even night nursing when the teeth come in, as an occasional dentist may advise, is like throwing out the baby with the bathwater. Considering the overall medical and dental health-promoting benefits and the emotional and developmental advantages of long-term breastfeeding, a more prudent approach would be frequent dental checkups and after-nursing brushing.

What about fluoride? How can I tell if my baby is getting enough?

Here’s what every parent should know about fluoride:

* Fluoride helps teeth in two ways: The fluoride that baby ingests (in food or water) enter the bloodstream and gets into the teeth, strengthening the developing enamel, making it more resistant to decay. Fluoride applied topically (through toothpaste or fluoride applications by your dentist) helps strengthen the new enamel that is being formed as teeth repair themselves (called remineralization) from the normal wear and tear.

* While still inside the gums, the permanent teeth begin mineralizing and developing enamel even before birth. Fluoride administered after birth is incorporated into the developing teeth, making them stronger.

* Nature’s own experiment: People living in areas where the fluoride is naturally present in the water supply have 50 percent fewer dental caries.

* Fluoride, unlike many vitamins and minerals, has a narrow range of efficacy-toxicity, meaning the right amount helps, and too much harms the teeth by making them brittle — a condition called fluorosis. This is why fluoride is available only by prescription and must be given to a baby in the exact dosage prescribed.

* Formulas are not made with fluoride-supplemented water.

* A pea-size dab of fluoride-containing tooth-paste is all that bay needs. Do not use both a fluoride-containing toothpaste and fluoride supplements, as this would be too much.

* The amount of fluoride naturally present in drinking water varies in different areas of the country. Check with your dentist or local water company, inquiring how many parts per million. If your tap water contains at least 0.3 parts per million, your baby doesn’t need, and probably shouldn’t have, fluoride supplements.

* The Committee on Nutrition of the American Academy of Pediatrics recommends that if the water baby drinks contains less than 0.3 parts per million of fluoride, baby should be given a daily supplement of 0.25 milligrams of fluoride beginning at age six month and continued (with increased dosage) until adolescence.

* Even though your local tap water may be fluoridated, some infants drink little water, and some are always quenching their thirst. Also, if you drink bottled water, it will not be fluoridated unless you specifically request it.

* Many foods, such as grains and vegetables, naturally contain fluoride. Babies can get fluoride from the following dental sources: fluoride supplements prescribed by your doctor (often combined with vitamin drops or chewable tablets), fluoride applied topically in toothpaste or in dental treatments, and a fluoridated water supply.

* The jury is still out on whether predominantly breastfed babies need fluoride supplements. At this time the evidence suggests they do not, although little fluoride enters the baby through mother’s milk and this amount is not altered significantly by a change in her diet.

There will be more articles on infants, breast or bottle feeding and other related topics to follow. So please keep an eye out for more of my articles.