Growth & Development: 2 Months

2 Month Old Milestones

At 2 Months of age, your baby can:

• Communicate by smiling and cooing. Make sure to respond to your baby's different forms of communication
• Respond with different cries for different needs
• Follow an object, such as a rattle, moved through his or her line of sight
• Hold his or her head up briefly when placed on his or her belly

Over the next one to two months, your baby will learn:

• To bring his or her hands together and open them more
• Reach out and touch objects
• Laugh
• Lay on his or her tummy propped upon forearms

Diet

Breast milk or formula is still your baby’s only food. The average intake is three to six ounces every two to four hours but varies greatly. A breast-fed baby will feed more often during a growth spurt. Cereal and other solids are not recommended until four to six months of age. Supplemental water is unnecessary and could be harmful.

Spitting up is common. It is not concerning unless your baby is not gaining weight properly or chokes and cries often. Elevate your baby’s head after feedings for 30 - 45 minutes and feed them smaller amounts of formula or breast milk more frequently.

Do not prop bottles in bed. Hold your baby semi-upright rather than leaving him or her flat on his or her back for feedings. This decreases the chance of choking and ear infections. Look at your baby and talk to him or her during feedings.

Vitamins

The American Academy of Pediatrics recommends that all infants who are exclusively breastfeeding receive supplemental vitamin D in order to prevent rickets, a bone disease that impairs the growth and strength of the bones. This is best given in the form of an over-the-counter infant vitamin drop: Enfamil Poly-vi-sol®, Tri-vi-sol® or D-ViSol®, or Vi-Daylin® (1 mL daily).

Sleep Routine for a 2 Month Old​

Ensuring your baby sleeps safely is important. The safest position for your baby to sleep is on his or her back and in his or her own bed. Do not allow your baby to sleep in the same position every night or his or her head may become misshapen. The newest recommendations to prevent Sudden Infant Death Syndrome (SIDS) are to sleep with a pacifier and in the same room as a caregiver.

At 2 months of age your baby is likely to follow a more predictable sleep routine. Most babies do not sleep through the night until after four months of age. Most wake up for feedings one to two times throughout the night. Breastfed babies often prefer to be fed more frequently.

To help your baby sleep better at night, put your baby in his or her crib when he or she is drowsy, rather than holding your baby until he or she is sleeping soundly. This will help your baby learn to fall asleep on his or her own, so when your baby awakes in the middle of the night, he or she will be able to fall back asleep on his or her own.

When your baby wakes for a feeding, leave the lights off, talk to him or her as little as possible and put him or her back to bed right after the feeding. If he or she wakes up fussing before a feeding is due, it is perfectly alright to let your baby cry, for a short period of time, after you have ensured he or she is not uncomfortable.

Safety Tips

• Sleep. Continue to have your infant sleep on his or her back only. Your baby should sleep in his or her own crib, bassinet or cradle and close to you. Also, do not put extra pillows, blankets or bumper pads in your baby’s crib.
• Choking. Never leave small objects within your baby’s reach, even for a moment. Learn infant/child cardiopulmonary resuscitation (CPR) so you know what to do if your baby is choking.
• Car seat. A car seat could save your baby’s life. Your child’s seat should be rear facing and in the back seat until two years of age. Make sure the seat is properly installed by reading the instructions that come with the safety seat and the owners’ manual of your car. Never leave your baby in the car alone.
• Falls. Never leave your baby unattended on a changing table, bed or sofa.
• Walkers. Do not purchase a walker for your baby. No other baby product causes as many injuries. Forty percent of infants who use walkers have a serious accident requiring a visit to the emergency department. Walkers may also cause a delay in motor skills and teach babies to walk on their toes. Stationery activity centers (e.g., Evenflo ExerSaucers©) are acceptable to use since they do not have wheels.
• Passive smoking. Tobacco smoke in an infant’s environment is proven to cause more frequent respiratory problems such as colds, pneumonia, asthma and ear infections. It is also associated with SIDS.
• Burns. Never eat, drink or carry anything hot while holding your baby. Protect him or her from scalds by reducing the maximum temperature of your water heater to 120° F. Ensure you have smoke alarms throughout your house. Test the batteries often and change them at least twice a year on a date you will remember. If your baby does get burned, immediately put the burned area in cold water. Then cover the burn loosely and call your doctor.
• Bath safety. Never leave your baby unattended in the bath, even for a second. Babies can drown in two inches of water.
• Sun Exposure. During the summer, the best protection from the sun is covering up and shade. Sunscreen is generally recommended after 6 months of age. If necessary, it may be applied only to small areas that cannot be covered. Babies dehydrate much easier than adults; so do not take your baby outside during extreme temperatures.
• Insects. Insect repellents with DEET are the best. You may use products containing 10-30% DEET once your baby is two months old. Wash it off when returning indoors, and do not use on your baby’s hands.

Illnesses

Colds or Upper Respiratory Infections

Viruses cause colds. They may make your baby fussy, cause a fever or a decreased appetite and typically last 10 - 14 days. Please schedule an appointment if a temperature develops over 100.4° F, your baby appears to have trouble breathing, is not feeding at least half of the normal amounts, or is not showing improvement within 10 - 14 days.

A cool or warm mist humidifier, saline drops and a nasal aspirator will help you clear the secretions from your baby’s nose to make him or her more comfortable. Over-the- counter cough and cold preparations are not recommended at this age. It is typical for children to have six to eight colds per year. Since colds are caused by viruses, they do not respond to antibiotics. Giving antibiotics to your baby can cause unnecessary harm.

Fever

A fever is a sign that your child is fighting off an infection. The elevated temperature is not harmful to your child. Actually, with an elevated body temperature, your child is better able to fight off infection. A temperature over 100.4°F is considered significant at this young age. At this age, ALWAYS check the temperature, either under the arm or rectally if your child feels warm or is showing signs of being ill.

Most infections in older children are due to viruses. However, at this age, we would like to see your child for a temperature greater than 100.4°F, and certainly if it persists more than 24 hours. Please do not give Tylenol® or acetaminophen unless discussed with your doctor.

Vomiting and/or Diarrhea

These two illnesses often occur together and are usually caused by viruses. If your child is vomiting, give small quantities of Pedialyte™ (a few sips to one ounce) every 15 - 20 minutes. Gradually increase the amounts. Do not give juice as it can worsen diarrhea. Also, do not give plain water, as this could lead to serious electrolyte abnormalities.

Once your baby can tolerate two to three ounces without vomiting, you may reintroduce formula or breast milk.

Call your doctor if vomiting persists more than 24 hours; diarrhea persists longer than 10 days or if blood is present in the stool; your baby is not having at least three to five wet diapers per 24 hour period; or if he or she is acting too ill to drink.

2 Month Old Vaccines​

Recommended vaccines at this age are DTaP, Polio, HiB, Hep B, Pneumococcal 13 and Rotavirus. Your child will receive 2-3 injections and one oral vaccine with your permission.

All recommended vaccines are thimerosal free. There is now scientific evidence to prove that there is NOT a link between immunizations and Autism. You can be reassured that vaccines are indeed safe and necessary. In fact, research supports that vaccines have done more to improve the health of children than any other medical treatment.

The most common reaction is mild fussiness, increased sleep, decreased appetite and a fever. Any side effect from the vaccines should resolve within 24 - 48 hours.

If your infant seems uncomfortable you may give him or her acetaminophen drops (e.g., Tylenol®). You may use the following doses:

• 8-9 pounds 1/4 teaspoon (1.25 mL)
• 10-12 pounds 1/2 teaspoon (2.5 mL)
• 13-15 pounds 3/4 teaspoon (3.75 mL) Do not use Ibuprofen (e.g., Advil®, Motrin®) at this age.

ALL infants and children older than six months of age should receive the flu vaccine in the Fall. Children under 9 years of age need a booster four weeks after their very first flu vaccine.

ALL household members and direct caregivers of your baby should also receive a flu vaccine each Fall. Also, to prevent infants from getting whooping cough, all parents, grandparents and caregivers should receive the TDaP immunization.

Well Child Visits

Your baby’s next well-child visit is recommended at four months of age. Immunizations are recommended at this visit.