Top 11 Questions Parents Ask at Baby’s 2-Month Checkup
May 4, 2020
Your baby is now 2 months old, you’re finally getting into a rhythm and your little one is rewarding you by being more social and sleeping more at night. Still, there are probably a bunch of things you’re curious or worried about. Here, we answer the top questions parents usually ask us during baby’s two-month health checkup.
At 2 months, baby’s motor skills typically include lifting up their head more when they’re lying on their belly and not clenching their fists so tightly any more. Visually, your child’s eyes are more coordinated and can follow objects past the midline or a full 180 degrees. They can also see farther distances (you may notice they’ll start to visually track you around the room!). Around this age babies will become more social, will recognize you and will reward you with a first real smile. They’ll also begin to make vowel sounds.
Every child will eat a variable amount, and it’s more important to follow your child’s cues in terms of hunger and satiety. The average 2-month-old will eat 3 to 6 ounces per bottle five to eight times per day, while a breastfed infant will feed on demand, approximately five to eight times per day. Again, listen to your child. As long as they’re growing well and have regular wet diapers, try not to compare them to other infants their age who seem to be eating more or less. Every child is unique, and this is true even with eating at this age!
There is no one “best way” to introduce formula or one ‘it’ formula that we recommend. Most children will do well with traditional, cow’s milk-based formulas. Some parents decide to supplement formula with breastfeeding, while others may choose to solely formula-feed. If you decide to supplement, you can first breastfeed and then after offer a bottle of formula. Some breastfeeding mothers find it easier to give solely formula when it may be more convenient, such as while Mom is at work or when another caregiver is feeding the child.
We don’t like wasting breast milk, so most pediatricians recommend that if you’re supplementing after a breastfeed and have a stash of expressed breast milk, try to give the bottle of expressed milk first and then the bottle of formula. If you mix the two and baby doesn’t finish the bottle, you have to throw out the remainder, which includes your precious breast milk. If baby doesn’t initially like the formula, however, you can try mixing a little of the formula in with the expressed breast milk and then gradually increasing the amount of formula while decreasing the amount of expressed breast milk every few days.
At this age your child should start to give you longer stretches of sleep at night, and may sleep for stretches of four to nine hours at night! During the day, baby will be awake for about two hours before becoming sleepy and needing a nap. Sleep often begets sleep, and the better a baby naps during the day, the less likely they’ll be over tired and cranky and the more likely they’ll better sleep at night.
Each year in the United States, scientists and doctors work together to decide the vaccines that are recommended for children and come up with a vaccine schedule for children and adolescents that is then approved by the American Academy of Pediatrics (AAP), the Centers for Disease Control and Prevention (CDC), and the American Academy of Family Physicians. According to the AAP, the schedule and timing of each vaccine is based on when the scientists believe the body’s immune system will be able to provide the most protection after the vaccination. It’s also based on the need to protect children when they’re most at risk for the particular disease.
For the two-month well visit, the following vaccines are recommended:
• DTaP (Diphtheria, tetanus, and acellular pertussis) vaccine. This protects against diphtheria (which can lead to a fever, sore throat, weakness, lymphadenopathy, heart failure, coma, paralysis and death), tetanus (which can cause stiffness in the neck and abdominal muscles, trouble swallowing, fever, trouble breathing and death) and pertussis, also known as whooping cough (which causes a bad cough, trouble breathing, pneumonia and death).
• Hib (Haemophilus influenzae type b) vaccine. This protects against Haemophilus influenzae type b, which can cause meningitis (an infection around the brain), cognitive delays, epiglottitis (a life-threatening infection involving the airway), pneumonia and death.
• Prevnar (Pneumococcal conjugate) vaccine. This protects against pneumococcus, which can cause pneumonia, an infection in the blood, meningitis and death.
• IPV (inactivated poliovirus) vaccine. This protects against polio, which can cause sore throat, fever, paralysis and death.
• Rotavirus vaccine. This protects against rotavirus, which can cause severe diarrhea, fever, vomiting and dehydration.
After the two-month vaccines, baby might have no reaction at all! However, your child also might experience a fever (usually begins within 24 hours and lasts one to two days), local reactions at the site of the vaccines such as redness, swelling and tenderness or other reactions such as sleepiness or crankiness. If your little one is uncomfortable, you can place a cool compress on the area the same day the vaccines were administered and a warm compress on it the next day. You can also give baby acetaminophen to ease any discomfort. The dose is based on baby’s weight, so remember to ask your pediatrician about the proper dose at the visit.
Your little one might experience the side effects of the vaccines that night or the day after, but usually will be back to normal in two to three days. If you’re worried about your child’s reaction to the vaccines, especially if you notice that baby is acting very sick, crying excessively or has usual symptoms such as blood in the stool, then your pediatrician would be happy to discuss what’s normal and what’s out of the ordinary and if your child needs to be seen.
According to the AAP, the best time to stop swaddling is when baby is around 2 months old, before they start to roll. You also want to remove the swaddle before baby starts to break free from it, because if the blanket covers baby’s face, it creates a possible risk of suffocation.
The relationship between a pediatrician and a family is a very personal one, and it’s important that a family feel at ease with their pediatrician. Parents need to trust their doctor’s advice, feel comfortable calling their pediatrician with any concern and generally “connect” with them. If it’s not a perfect match, it’s completely okay (and definitely recommended!) to change to a pediatrician that’s a better fit. Pediatricians don’t get offended by this whatsoever. It happens all the time, and we always want what’s best for the child and family.
If baby just had their shots and you therefore know the cause of the fever, it’s okay to give baby acetaminophen (ibuprofen is not recommended until baby is over 6 months old). However, if a 2-month-old baby has a fever (100.4 to 101 rectally) and you don’t know the cause of the fever, since your child is so young, your pediatrician will want to know about any fever and will likely want you to bring baby in for a visit. Check with your pediatrician first before giving any medication in this circumstance.
There are many reasons why a child is gassy. Some parents use over-the-counter gas drops or probiotic drops, but these remedies don’t always help. Colic, which is associated with fussiness and crying for three or more hours a day for three or more days per week, starts around two to three weeks of life and will peak between six to eight weeks of life. Babies have periods of crying that will typically begin in the evening hours and last until the wee hours of the morning. There is no known cause or treatment for colic, but most parents believe their baby is gassy during this time.
Some parents find it helpful to do bicycle exercises with their child to help their child pass the gas more easily. If you’re breastfeeding, you may wonder about eliminating foods from your diet—but if your child is growing well and otherwise doing well, that may not be helpful. Speak to your pediatrician to see if there are certain foods in your diet that you consume in large quantities or are concerned about. The good news is that the gas will pass in a few short (or long) weeks and usually resolves around three or four months.
Babies can spit up a whole lot in the beginning! Most of the time the biggest issue is all the laundry that needs to be done, but it’s still not fun to see your little one spit up what appears to be everything they just ate. Children who have gastroesophageal reflux (GER) are usually known as “happy spitters.” Happy spitters are not in pain when they spit up, and they typically eat well and gain weight well. The “D” in GERD (gastroesophageal reflux disease) is added when there are complications, such as feeding problems, weight loss or poor weight gain and pain with feeding.
It’s always good to come to baby’s well visit with a list of questions that have come up since your last visit. In addition to the frequently asked questions above, some other common questions include:
- Is my baby on track developmentally? What should I look for developmentally for the next visit?
- Is my baby gaining enough weight and following their growth curve?
- What can I do to stimulate my baby?
- What are signs that I should call you? When should I go directly to the ER? Where should I take my baby if the pediatrician’s office is closed?
- Where should my baby be sleeping?
- Can I take my baby outside?
- If I need formula, what is a good formula to give?
Dina DiMaggio, MD, and Anthony F. Porto, MD, MPH, are pediatricians, official spokespeople for the American Academy of Pediatrics and the co-authors of The Pediatrician’s Guide to Feeding Babies and Toddlers. They write about the latest AAP guidelines, studies and seasonal issues affecting babies and toddlers. Follow them on Instagram @pediatriciansguide.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.