Well Child Care, 2 Months

PHYSICAL DEVELOPMENT

The 2-month-old has improved head control and can lift the head and neck when lying on the stomach.

EMOTIONAL DEVELOPMENT

At 2 months, babies show pleasure interacting with parents and consistent caregivers.

SOCIAL DEVELOPMENT

The child can smile socially and interact responsively.

MENTAL DEVELOPMENT

At 2 months, the child coos and vocalizes.

RECOMMENDED IMMUNIZATIONS

  • Hepatitis B vaccine. (The second dose of a 3-dose series should be obtained at age 1–2 months. The second dose should be obtained no earlier than 4 weeks after the first dose.)

  • Rotavirus vaccine. (The first dose of a 2-dose or 3-dose series should be obtained no earlier than 6 weeks of age. Immunization should not be started for infants aged 15 weeks or older.)

  • Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. (The first dose of a 5-dose series should be obtained no earlier than 6 weeks of age.)

  • Haemophilus influenzae type b (Hib) vaccine. (The first dose of a 2-dose series and booster dose or 3-dose series and booster dose should be obtained no earlier than 6 weeks of age.)

  • Pneumococcal conjugate (PCV13) vaccine. (The first dose of a 4-dose series should be obtained no earlier than 6 weeks of age.)

  • Inactivated poliovirus vaccine. (The first dose of a 4-dose series should be obtained.)

  • Meningococcal conjugate vaccine. (Infants who have certain high-risk conditions, are present during an outbreak, or are traveling to a country with a high rate of meningitis should obtain the vaccine. The vaccine should be obtained no earlier than 6 weeks of age.)

TESTING

The health care provider may recommend testing based upon individual risk factors.

NUTRITION AND ORAL HEALTH

  • Breastfeeding is the preferred feeding for babies at this age. Alternatively, iron-fortified infant formula may be provided if the baby is not being exclusively breastfed.

  • Most 2-month-olds feed every 3–4 hours during the day.

  • Babies who take less than 16 ounces (480 mL)of formula each day require a vitamin D supplement.

  • Babies less than 6 months of age should not be given juice.

  • The baby receives adequate water from breast milk or formula, so no additional water is recommended.

  • In general, babies receive adequate nutrition from breast milk or infant formula and do not require solids until about 6 months. Babies who have solids introduced at less than 6 months are more likely to develop food allergies.

  • Clean the baby's gums with a soft cloth or piece of gauze once or twice a day.

  • Toothpaste is not necessary.

  • Provide fluoride supplement if the family water supply does not contain fluoride.

DEVELOPMENT

  • Read books daily to your baby. Allow your baby to touch, mouth, and point to objects. Choose books with interesting pictures, colors, and textures.

  • Recite nursery rhymes and sing songs to your baby.

SLEEP

  • Place babies to sleep on the back to reduce the change of SIDS, or crib death.

  • Do not place the baby in a bed with pillows, loose blankets, or stuffed toys.

  • Most babies take several naps each day.

  • Use consistent nap and bedtime routines. Place the baby to sleep when drowsy, but not fully asleep, to encourage self soothing behaviors.

  • Your baby should sleep in his or her own sleep space. Do not allow the baby to share a bed with other children or with adults.

PARENTING TIPS

  • Babies this age cannot be spoiled. They depend upon frequent holding, cuddling, and interaction to develop social skills and emotional attachment to their parents and caregivers.

  • Place the baby on the tummy for supervised periods during the day to prevent the baby from developing a flat spot on the back of the head due to sleeping on the back. This also helps muscle development.

  • Always call your health care provider if your child shows any signs of illness or has a fever (temperature higher than 100.4° F [38° C]). It is not necessary to take the temperature unless the baby is acting ill.

  • Talk to your health care provider if you will be returning back to work and need guidance regarding pumping and storing breast milk or locating suitable child care.

SAFETY

  • Make sure that your home is a safe environment for your child. Keep home water heater set at 120° F (49° C).

  • Provide a tobacco-free and drug-free environment for your child.

  • Do not leave the baby unattended on any high surfaces.

  • Your baby should always be restrained in an appropriate child safety seat in the middle of the back seat of your vehicle. Your baby should be positioned to face backward until he or she is at least 2 years old or until he or she is heavier or taller than the maximum weight or height recommended in the safety seat instructions. The car seat should never be placed in the front seat of a vehicle with front-seat air bags.

  • Equip your home with smoke detectors and change batteries regularly.

  • Keep all medications, poisons, chemicals, and cleaning products out of reach of children.

  • If firearms are kept in the home, both guns and ammunition should be locked separately.

  • Be careful when handling liquids and sharp objects around young babies.

  • Always provide direct supervision of your child at all times, including bath time. Do not expect older children to supervise the baby.

  • Be careful when bathing the baby. Babies are slippery when wet.

  • At 2 months, babies should be protected from sun exposure by covering with clothing, hats, and other coverings. Avoid going outdoors during peak sun hours. This can lead to more serious skin trouble later in life.

  • Know the number for poison control in your area and keep it by the phone or on your refrigerator.

WHAT'S NEXT?

Your next visit should be when your child is 4 months old.