2 months
Healthy Babies
THE PERMANENTE MEDICAL GROUP

2 month milestones

By 2 months of age, your baby may be ready to …

  • coo, gurgle, and sigh

  • respond to voices

  • hold head up for brief periods of time

  • push up with arms when on stomach

All babies are different and develop at their own special pace, so try not to worry if your baby isn’t doing all of these things just yet. You’ll probably notice these changes soon.  More on infant development.

Nutrition: vitamins your baby needs

Breast milk continues to be the best food for your baby, and provides all the nutrition your baby needs for the first 6 months of life. Continue to feed your baby "on demand" -- letting her decide how often and how much to eat. 

If you’re feeding formula, choose an iron-fortified product. Usually, babies this age eat roughly 2 to 4 ounces every 2 to 4 hours. 

If your baby is breastfed, we recommend you give him or her Vitamin D drops. Breast milk contains some Vitamin D, but not enough to help strengthen baby’s bones. That’s why pediatricians recommend 400 IU Vitamin D drops for breastfed babies.  Formula is fortified with vitamin D, so this isn’t necessary for formula-fed babies.

Remember that your baby eats what you eat.  Make sure you’re eating a balanced, nutritious diet, continuing to take your vitamins, and drinking plenty of water and good sources of calcium, like low-fat milk. Pass on the chips, sodas, and fast foods and choose a variety of healthy foods you enjoy.  Making the effort to eat well will benefit both you and your growing baby.

Also, if you’re planning on returning to work in the next month or two and haven’t started practicing with pumping yet, check out our information on pumping and storing breast milk.

More on your nutritional needs while breastfeeding

Whooping cough

Whooping cough is on the rise in the U.S. Whooping cough, also called pertussis, is a contagious disease that spreads easily through coughing. A person of any age can catch whooping cough. However, it can be life-threatening for babies 6 months and younger, since it can interfere with breathing or make infants cough so much they can't breathe. The good news is that staying current with immunizations can prevent whooping cough and keep your baby safe.

How can I protect my baby from whooping cough?

  • All adults who come into close contact with your baby should get the Tdap booster shot, including parents, grandparents, and day care workers.

  • Make sure that older siblings or other children in close contact with the baby have received their booster shot. Protect infants by ensuring that older children get their Tdap booster beginning at 11 years of age.

  • Make sure your baby is up-to-date with recommended immunizations.

  • If you are not sure if you and your family members have been properly vaccinated against whooping cough, check your immunization records by viewing your Preventive Health Reminders online through your physician’s home page.

  • Learn more about keeping your baby healthy with well baby visits and immunizations.

Talk to your doctor about what is right for you and your family so that you can protect your baby against whooping cough. Also, remind others to cover their mouths when they cough and to wash their hands often.

Healthy habits: immunization schedule

Several immunizations are scheduled for your baby’s 2 month well-check:

  • Diphtheria, tetanus, and pertussis (whooping cough)

  • H. influenza type b (Hib)

  • Hepatitis B

  • Rotavirus

  • Pneumococcal infection

  • Polio

These immunizations are given to prevent diseases that are still common in our communities, but are preventable with vaccination. Immunization is important, not just to prevent your child from becoming sick, but also to prevent the spread of disease within our families and communities.

Many parents find it stressful watching their child receive vaccination shots. Babies often cry and may be fussy after receiving a shot. Talk to your child’s pediatrician about giving your baby acetaminophen to reduce pain and swelling from shots. Our acetaminophen dosing handout can help you determine the right amount to give your child.

If you have specific questions about vaccines, check out the article on immunizations in the 1 month issue of Healthy Babies. And you can find all the details about your child’s immunization schedule in our handout Shots to Protect Your Child.

 

Immunizations: possible side effects

What kind of side effects can I expect after immunizations?
Most babies do not experience any side effects from vaccinations.  Around 2 percent of babies do have mild side effects, which will clear up on their own.

After receiving immunizations, there is a chance that your baby may have:
  • pain or soreness where the shot was given

  • more fussing or sleepiness than usual

  • less interest in eating

  • a low grade fever

  • a mild, non-contagious rash that goes away on its own (after receiving the measles and chickenpox vaccines)

To help with these mild side effects, your doctor or injection clinic nurse may recommend that you give your baby acetaminophen (non-aspirin) infant drops before or after your baby receives shots.  Find out the right amount to give your baby with our dosing chart

More serious side effects are rare.  If your child experiences a reaction to any vaccination, such as a high fever, trouble breathing, or any other unusual symptoms, or if you are worried that your child seems sick, contact your child’s pediatrician or call the advice nurse right away.

Remember, it is much more dangerous for a child to risk getting the diseases than it is to risk having a reaction to the vaccine.

More about what to expect after your baby receives shots

More information about immunizations:

5 things you can do to keep your baby safe

1. Don’t let your baby play with any toy that could be dangerous. Go to our "Common questions" article in this issue for more information on safe toys.

2. Follow your child’s recommended immunization schedule. It’s the single best thing you can do to prevent many common diseases for your child and your family.

3. Give your baby daily “tummy time,” but only when you’re in the room. And don’t leave your child alone, especially if pets are around.  Learn more about tummy time in our "Common questions" article.

4. Always use a car seat when your child is in a car.  For help ensuring your seat is installed correctly, visit a certified car seat inspection station near you

5. Help prevent SIDS (crib death) with these tips:

  • Always put your baby to sleep on his back. The crib should have a firm mattress and be clear of blankets, bumper pads, pillows, and stuffed animals.

  • Avoid overheating the room where your baby sleeps by using a fan or opening a window. A sleep suit or footed pajamas is usually enough to keep your baby comfortable at night.

  • Don’t smoke or expose your baby to smoke on your clothes, in your home, or in your car.

  • Offer your baby a pacifier at nap time and bed time. If he doesn’t want the pacifier, don’t force him to take it, and don’t put it back in his mouth if it falls out while he’s sleeping.

Learn more about keeping your new baby safe.

Common rashes

There are many types of rashes and skin conditions in infants. Here are some of the most common conditions and notes about prevention and treatment.

Cradle cap
Cradle cap can appear as yellow, greasy scales on your baby’s scalp, eyebrows, and behind the ears. It can also spread as a red bumpy rash on the face, neck, and chest, which feels a little scaly or crusty. This is a normal condition and is nothing to worry about. It will generally go away on its own after a few months and usually does not bother your baby at all.

You can use a little baby oil and a soft brush or toothbrush to gently brush your baby’s head. However, this will not “cure” the condition, which must go away on its own.

See what cradle cap can look like .

Baby Acne
Pimples sometimes appear on babies 2 to 4 weeks of age, usually on the face, chest, back, and groin. Acne is caused by an increased exposure to androgens (male hormones) in the womb.

No treatment is typically necessary, and the acne will improve on its own by the time your baby is 3 to 6 months old. Do not use acne products on your child’s skin.

See what baby acne can look like.

Diaper rash
Your baby’s skin can be extremely sensitive, especially in the diaper area. When your baby’s skin is raw and the area becomes moist, there’s an increased risk for getting yeast in the diaper area. This causes a rash.

When you are cleaning your baby’s bottom and genitals, use a soft cloth and water or unscented wipes. Pat at the dirty area, instead of wiping, to cause less irritation. And air-dry your baby’s bottom whenever possible.

If these techniques don’t help, try treating the rash with a combination of 1 percent topical hydrocortisone, miconazole, and a good barrier cream like Desitin or Boudreaux’s Butt Paste. You can also try putting a little corn starch in the diaper area as you’re changing your baby. Usually this combination of treatments will help clear up the rash within a few days. If not, contact your pediatrician.

See what diaper rash can look like.

Choosing quality day care

Returning to work can be stressful, both for you and for your baby. But knowing your child is in good hands during the day makes the transition much easier. But how do you find safe, quality child care? Here are some tips and resources to help you find the right provider to meet your family's needs.

  • Plan ahead. It may take some time to find the right child care, so start researching your options early.

  • Ask friends and colleagues with young children for recommendations.

  • Interview potential providers and ask questions about how they care for children, especially babies. Make sure you agree on how different situations will be handled. Ask for references and check them out.

  • Transition into child care slowly, starting with a few hours a day and working up to longer periods.

  • For assistance locating child care providers in your area, check out these local information and referral networks:

    TrustLine provides a list of in-home childcare providers who have passed a background screening.

    Childcare.gov includes information on getting help paying for child care in English and Spanish.

    Check the Yellow Pages directory for your local child care resources and referral (R&R) agency.  (Depending upon your income, the state may provide assistance in paying for child care.)

Tips for getting back in shape after childbirth

Most new mothers are eager to regain their pre-pregnant shape as soon as possible after birth. But it’s important to remember that it can take a while for your body to recover from childbirth. Don’t expect to jump back into a diet or exercise routine right away, or to be able to wear your skinny jeans.  Be patient with yourself: now’s the time to focus on your health and the health of your new baby.

Eating well 
A sensible, well-balanced diet can help you lose extra pounds gained in pregnancy, maintain your energy level, and recover from childbirth. While you were pregnant, you added extra calories to your diet to help your baby grow and develop. Now that your baby is here, if you are formula feeding, you can start to reduce your calorie intake. But remember: if you’re breastfeeding, you still need up to 500 extra calories a day to help produce the milk your baby needs.

Exercise
You’re probably too tired to even think about exercise right away, but it’s important to know that most doctors advise against starting a regular exercise program until at least 2 to 4 weeks after delivery.

  • A good way to ease back into exercise is to start with walking. Once you’re feeling up to it, take a stroll with your baby in a carrier or stroller. It’s good to get out of the house, and moving will help increase your metabolism and well-being.  Use a pedometer (an easy-to-wear device that senses your body's motion) to count your steps and motivate you to increase your activity. 

  • About 2 weeks after a vaginal birth, you can start mild exercises to improve the muscle tone of your stomach and abdomen. If you’ve had a cesarean birth, wait to start these exercises until your incision has completely healed and is no longer tender.

  • Remember those kegel exercises you did during your pregnancy? Doing them after childbirth will help you regain vaginal and pelvic floor muscle tone.

  • During the first 6 weeks postpartum, avoid full sit-ups, double leg lifts, squats, knee-to-chest exercises, or any other movement that puts strain on your incision or perineum.

  • Find exercises you can do with your baby. This may help motivate you, and your baby will enjoy watching you work out.

  • Don’t overdo it and remember to drink plenty of water during any exercise.  Pay attention to your body, and stop or modify your workout if you feel pain.

If you’re looking for more support in managing your weight, Kaiser Permanente is here to help. We offer a variety of online resources and classes to help you start and  maintain healthy habits.  Visit our Healthy Weight Resources page to learn more.

Common questions

My baby still won't take a bottle. What can I do?
Some babies take to bottle feeding right away, while others need a little coaxing. Here are some tips to help your baby learn to take a bottle. 

  • Experiment with different nipple shapes and feeding times to see what works best.

  • Give yourself a break. Let a very patient partner or grandparent stay with the baby for an hour or so and continue to offer a bottle.

  • A trick that works for some babies is to start nursing at the breast then remove the breast and slip the bottle in the baby’s mouth. Once the baby realizes that bottle feedings also work, then he will be more accepting of it at other times.

  • Sometimes babies will refuse breast milk from a bottle, but will take formula in a bottle instead. Since we encourage you to give the baby as much breast milk as possible, let the baby become comfortable with bottle feeding formula then try switching back to breast milk in the bottle.

How do I know which toys are safe for my baby?
Play time is important for children of all ages, as it helps with brain and muscle development. But not all toys are safe for small children, especially babies, who explore everything with their mouths.

Here are some guidelines for toys to avoid and how to check for toy safety.

  • Don’t allow toys smaller than 1 and 5/8” in diameter or with small, removable parts.  (Insert toys into an empty toilet paper roll to check them; if they fit inside, they could cause your baby to choke.)

  • Check stuffed animals and dolls for loose eyes and noses, and remove them.

  • Avoid toys with strings, cords, or necklaces that could become wrapped around your child’s neck. And don’t string toys over a child’s bed.

  • Don’t allow any toys with sharp or pointed edges.

  • Make sure all rattles, squeeze toys, and teethers are durable and will not break apart.

  • A baby can suffocate on a plastic bag or balloon, so keep them out of reach.

  • Look for products made with non-toxic paints to reduce the risk of your baby being exposed to lead.

  • Read labels and only choose toys designed specifically for your child’s age group.

To know which toys are safe, stay current on the recalls of unsafe toys. You can sign up for email alerts on recalls at cpsc.gov

You can also download a safe toy shopping guide and other toy safety resources from Safe Kids USA.

What's so important about "tummy time?"
Your baby needs to spend supervised time on her stomach when awake to strengthen neck and arm muscles. Since babies spend most of their time on their backs (while sleeping, in car seats, and in bouncers) it’s important to place your baby on her tummy each day for at least a few minutes. 

At first, you can prop her up with a small, rolled up towel under her chest or support her with a curved nursing pillow (such as a Boppy or My Brest Friend.)  She may be frustrated at first, but over time, she will get better at lifting her head and chest, and will eventually push herself up onto her elbows.

“Tummy time” also helps to prevent flat spots from forming on your baby's head. To keep your baby’s head round, lay your baby on her stomach on your chest for cuddling. Or try turning your baby’s head to a different side each time you put her down to sleep or nap.  If your baby has a mobile over his crib or changing table, try moving it to encourage her to turn her head.

More information about your baby's head shape.