Healthy Start, Grow Smart
Healthy Start, Grow Smart
U.S. Department of Agriculture
U.S. Department of Education
U.S. Department of Health and Human Services
This publication was an initiative of Laura Bush as the First Lady of Texas and sponsored by the Texas Department of Health. President Bush and Mrs. Bush have asked that this series of booklets be revised and distributed by the U.S. Department of Agriculture, U.S. Department of Education and the U.S. Department of Health and Human Services.
We would like to thank the Texas Department of Health for their cooperation and assistance in bringing this publication to families across the United States. In addition, we recognize the contributions that Susan H. Landry, Ph.D., Craig T. Ramey, Ph.D. and many other individuals made in the development of this magazine.
Here’s What’s Inside
Watching Your Baby Grow 1
A Healthy Baby 2
When To Call the Doctor 4
Sleeping Patterns 5
Bowel Habits 5
Feeding Your Baby 6
Formula Feeding 8
Protect Your Baby’s Future Teeth 9
What’s It Like To Be Two Months Old? 10
Baby Movements 11
Baby Games 12
What To Do When Your Baby Cries 13
Keeping Your Baby Safe 14
Crib Safety 15
Single Parents 16
Single Teen Parents 17
Support for the Single Parent 18
Information Resources for Families 18
At two months of age, your baby will begin to notice and reach out to the world around her. She can see better now. She can watch a person or object moving directly in front of her. She is more alert and can respond to you more. The world around her is more interesting to her.
Your baby is gaining more strength in her neck and shoulders. This allows her to hold her head up better and to see more.
Your baby also may begin to make some new sounds. She may start cooing and making sounds like "ah-ah-ah" and "ooh, ooh, ooh." And she may make squeaking and gurgling noises.
Your baby will try to bring her hands to her mouth. She will do this often. When her fingers reach her mouth, she will not be good at keeping them there. She will get better at this as she gets older. She can also tightly hold a toy, such as a rattle, when you put it in her hand. But she will have trouble letting it go.
Her movements are no longer jerky but grow smoother day by day. She may be awake more during the day. If she is an active baby, she may be moving all the time when she is awake.
A Healthy Baby
Your baby needs to see the doctor on a regular basis. These visits are important for her health and development. They are also opportunities to learn more about your baby.
Your doctor can discuss with you whether your baby:
• Is eating well
• Is growing normally
• Is developing social, learning and physical skills properly
While you are at the doctor’s office, you can ask questions about taking care of your baby. You can also talk about any problems you may have being a parent.
During the visit, your doctor will:
• Do a physical exam
• Check her growth and development
• Check her ability to move
• Give her shots to help protect her against a number of diseases
• Do a hearing and eye exam
• Check her height, weight and head size
• Check what she is eating
• Treat any medical problems
At your baby’s two-month checkup, she will be given shots to protect her against illnesses. Ask the doctor or nurse to tell you what kinds of reactions your baby may have to the shots. Also, find out what to do about those reactions. It is a good idea to keep a record of all your baby’s shots.
Find a doctor you like and feel comfortable with. Going to the same doctor each time is a good idea, if you can. Using the same doctor makes it easier to keep track of your baby’s health and growth.
If your baby is eligible for Medicaid, she can get free checkups. You can call your local social welfare, health or family services office to see if you qualify for Medicaid services.
If you don’t have health insurance for your baby, you can learn about resources in your state by contacting the U.S. Department of Health and Human Services Insure Kids Now Program at 1-877-KIDSNOW. You can also visit their Web site at www.insurekidsnow.gov for more information about free or low-cost health insurance for children. Many public libraries offer free access to the Internet and provide help for first-time users.
When To Call the Doctor
At your child’s first checkup, ask your doctor what he or she considers a fever in a baby who is your baby’s age and at what temperature you should call him or her. Also, go over with your doctor what problems you should call about immediately.
When your baby is sick, use a thermometer to check for fever. Place the thermometer under her armpit for four minutes and gently cuddle her while you hold her arm to her side. Always call the doctor when a baby who is three months old or younger has a fever. Your doctor will tell you what to do to help your baby.
When your baby is sick, be sure to pick her up and comfort her. Call your doctor right away if your baby has any of these symptoms:
• A stiff neck, or if she can’t move her head to any position
• A wheezing or crackling noise when she breathes
• Pulling on her ears as if they are painful
• A severe cough or red throat
• A fever of any kind
Two-month-old babies usually sleep better at night. By now, your baby most likely has a routine for sleeping and eating. Probably she goes at least three hours without a feeding. A baby this age usually sleeps longer than a newborn at night, but each baby is different.
After you feed your baby, hold her and rock her for a while. You can put her to bed at night when she is quiet, even if she is not asleep. You can sit down beside her and pat her gently or sing softly. Doing this will help an active baby learn to calm herself down. She may want to suck a pacifier or her thumb or finger as she gets sleepy.
Every baby will have her own pattern. Every baby will have different things she likes to help her to go to sleep.
Baby’s bowel habits may change. Many breastfed babies may change their bowel habits. They may go from having several bowel movements per day to having fewer than one a day. This may have happened earlier, or it may start happening now. This is because breast milk is easy to digest. As long as the bowel movement is soft, the baby is not constipated.
The bowel habits of a formula fed baby are similar to the breastfed baby. Like a breastfed baby, a formula fed baby will start out with several bowel movements each day. This number will decline to about one a day. Your baby may have wet diapers often. This means she is drinking the right amount.
Feeding Your Baby
Breastfeeding is healthy for you and your baby. Here are some reasons why breastfeeding is best:
Breast milk can help protect your baby against illness. It can protect her from allergies. The American Academy of Pediatrics says it’s good for babies to be breastfed for the first year of life.
It’s best for mom. Many breastfeeding mothers lose the weight they gained while pregnant faster than mothers who do not breastfeed.
It creates a bond between mother and baby. You can learn your baby’s signals faster.
Breast milk is easier to digest than formula and you don’t have to prepare bottles or formula. Breast milk is always ready. Babies do not become constipated from breast milk.
Each baby has her own feeding schedule. Some babies need to nurse more often than others do. In general, nursing babies need to be fed at least eight to 12 times in a 24-hour period. That means feedings every two to three hours. If your baby has not fed for several hours and then dozes off after only a few minutes of nursing, gently wake her to encourage her to continue nursing. Try to help your baby feed until your breasts are emptied of milk or at least 15 minutes from each breast.
If you have any questions or problems with breastfeeding, talk to your doctor, nurse or WIC breastfeeding counselor. To learn more about breastfeeding, you may call La Leche League at 1-800-LALECHE or visit their Web site at www.lalecheleague.org/.
Follow your baby’s lead. Babies tend to get as much milk as they need when you let them nurse when they want and for as long as they want. The more your baby nurses, the more milk you will produce. Your milk supply will keep up with your baby’s demand.
How do you know when your baby is hungry? Here are some hunger signs to be aware of:
Early hunger signs:
• Head moves toward voice, mouth opens
• Lips smack, tongue reaches outward
• Hands move "randomly"
• Fists find mouth
• Infant begins fussing
Late hunger signs:
• Brow furrows
• Mouth widens, head moves quickly from side to side
• Fists clench, seeking the mouth
• Baby cries
How you feed your baby is up to you. Breastfeeding is best for you and your baby. But there may be reasons why you will need to feed your baby infant formula.
Remember always to hold your baby while bottle feeding. Never put the bottle in your baby’s mouth and leave her.
Here are the three basic types of formula:
• Powdered formulas that are mixed with water
• Liquid concentrates that are mixed with water
• Pre-mixed formulas ready to put in the bottle or already in ready-to-feed bottles
When you mix powdered formulas or liquid concentrate formulas, follow the package directions exactly and add just the right amount of clean water. Be sure not to add too much or too little water. If the formula is premixed and ready-to-feed, do not add any water.
Talk to your doctor about the best formula for your baby.
Protect Your Baby’s Future Teeth
Even when your baby is only two months old, you should keep her gums healthy and clean. Gently wipe her gums with a wet, clean, soft cloth every day. The most important thing to remember is never to put your baby to bed with a bottle. And never prop up the bottle at any time.
Any kind of drink except water can cause a baby’s teeth to decay, even breast milk and infant formula. Other liquids that cause tooth decay are powdered fruit drinks, soda and juice. Any drink that contains sugar can cause tooth decay when your baby gets older. A two-month-old baby should drink only breast milk, formula or water.
Here are some tips to follow to protect your baby’s teeth:
• Always hold your baby during feedings. Do not prop up the bottle or leave a bottle in your baby’s bed.
• If your baby needs a pacifier at bedtime, make sure it is clean and dry. Do not dip the pacifier in honey or sweet liquids. Your baby might like the sweet taste, but these liquids will cause tooth decay when her teeth come in. Germs in honey can also make a baby sick.
• Help prevent the spread of germs to your baby. You and your family should have regular dental checkups to help keep your own teeth and gums healthy. Clean the nipples of your baby’s pacifiers and bottles by washing with soap and rinsing carefully and thoroughly with clean water. Do not lick your baby’s pacifier or bottle nipples to "clean" them.
What’s It Like To Be Two Months Old?
My head is a little wobbly when I am propped up. Put your hand behind my neck and head for support.
I can hold my head up for a few seconds when I’m on my stomach.
I hold onto things for a little while.
I move my arms and legs. I "bicycle" with my feet when I get excited.
I gurgle, laugh and smile when I am happy.
I cry when I am hungry, scared or uncomfortable.
I am aware of different voices and people.
I stay awake during the day. But I usually take naps throughout the day.
I make cooing sounds.
I begin to stare at my hands.
I follow you with my eyes to watch you move around.
I stare at people and at things.
I smile at other people, not just at my mother.
I quiet down when I suck my fingers, a bottle or a pacifier.
At two months of age, your baby has more control of her body. When she was younger, she may have looked uncoordinated when she waved her arms and legs. Now she can move her arms and legs more smoothly.
She can’t reach yet, but if you touch her hand with a toy, her hand will move toward the toy.
Her hands are above her head when she plays. She can twist her body and head from side to side. She can put her hand in her mouth for sucking.
Some babies may make crawling movements with their knees when lying on their tummies.
You will see changes in how your baby uses her eyes, ears and hands. Here are things to look for in your two-month-old:
She watches her hands more.
She can watch an object several feet away. She especially likes to watch moving objects or people.
She reacts to sounds by looking toward the sound.
When she hears a sound, she may stop moving until she decides where it is from.
Since her hands are open more often, she can touch more objects. She is learning the difference between hard and soft. She likes it when something soft is placed in her fingers.
It is very important to talk to your baby. You may wonder how much of what you say is understood by your baby. But don’t worry. When you talk, your baby is listening. When you talk to babies, use simple words and phrases. You should speak clearly. You can get your baby’s attention by widening your eyes and mouth. You can also change the pitch and tone of your voice. These are your baby’s first lessons in communication.
Here are some tips for talking to your baby:
• Look at your baby’s eyes while you are talking to her.
• Call your baby by her name.
• Keep your talk simple. Say "pretty baby." Use the words "mommy" and "daddy" when you talk to her.
• Watch for your baby’s expressions and listen to her sounds. Make these same sounds and facial expressions back to her.
• Add gestures to your talk. Say "wave bye-bye to the dog" as you wave to the dog.
• Ask your baby questions. "Would Maria like to have her milk now?" "Does Maria want to go outside?" Ask the questions even though she can’t answer.
• Talk about what you are doing. As you dress, bathe and change your baby, talk about what you’re doing.
• Read to your baby. Babies love nursery rhymes and poems. You can even use a lively voice and read your favorite magazine or book to her. If you can, use books with stories that include a baby, a rattle or other common things. (You can find lots of children’s books at your public library.)
• Sing to your baby. It is important while she begins to learn language skills.
• Watch for signals from your baby when you are talking to her. If she is smiling and keeping eye contact, she is saying she wants you to keep on talking.
What To Do When Your Baby Cries
Your baby has an important way of telling you she needs something–crying. Crying can mean many things. Here are a few of the things your baby may be trying to tell you with her crying:
• I am hungry.
• I hurt (gas, colic).
• I don’t feel well.
• My diaper needs to be changed.
• I’m afraid.
• I want to be held.
• I’m bored.
• I’m tired.
• I’m lonely.
Hearing your baby cry can be hard on you. It is natural for parents to want to soothe their baby. Here are several ways of meeting your baby’s needs:
• Hold your baby.
• Rock your baby.
• Walk your baby.
• Feed your baby.
• Burp your baby.
• Check her diaper.
• Pat your baby while she lies on her back.
• Put your baby where she can see activity.
• Talk to your baby.
• Give your baby a pacifier.
Babies should not be left to cry alone. It was once believed that picking up a crying baby would spoil her. We now know that babies cry less if their needs are met. They learn to trust that adults will take care of them. At this early age, one of the best ways to comfort her is to pick her up and hold her.
When an infant’s crying increases for unexplained reasons over a long period of time and nothing you do to soothe her seems to help, consider calling your doctor. Call your doctor if you think pain or illness may be causing the crying.
Keeping Your Baby Safe
Here are some ways to keep your baby safe:
• Never shake your baby, either in anger or in play. Shaking a baby can cause brain injury or death.
• If you smoke, quit! If you can’t quit, smoke outside, away from the baby. Second-hand smoke can cause a number of childhood illnesses or make them worse. These include asthma, ear infections and sinus infections.
• Put your baby to sleep on her back. If your baby has a health problem, your doctor may tell you to put her in another position. Otherwise, always put your baby to sleep on her back. Make sure her crib has a firm, flat mattress.
• Make sure your baby’s crib is sturdy and safe. There should be no loose or missing hardware. Babies can be hurt in an unsafe crib.
• Always use the safety straps in strollers, infant seats, changing tables and baby swings.
• Use an infant car-safety seat according to the directions.
• Never leave your baby alone in a car. Don’t leave her alone for even a few minutes.
• Don’t use necklaces to hold a baby’s pacifier. A necklace or string could wrap around her neck and choke her.
• Don’t leave small children or animals alone in a room with your baby. Even friendly, well-trained children and animals could accidentally hurt a baby.
• Install smoke detectors on each floor of your home. Put them near sleeping areas. Change the batteries as often as the directions say to.
Your baby’s crib needs to be a very safe place. Here are some tips to follow to make sure the crib will not harm your baby:
• If you buy a new mattress, be sure to remove and discard all plastic wrapping.
• The mattress should fit the crib snugly so your baby cannot slip between it and the side of the crib.
• Be sure the crib slats are no more than 2 3/8 inches apart so that your baby’s head can’t get caught between them.
• If you use a bumper pad, make sure that it goes all the way around the crib. Make sure the bumper pad is tied with at least six straps or ties. Ties should be no more than six inches long to prevent strangulation. Make sure your baby cannot get caught between the mattress and the bumper pad.
• Mobiles and other hanging toys should be high enough so that your baby cannot reach them.
• Do not put toys, stuffed animals, pillows or extra bedding in your baby’s crib. These things can block your baby’s breathing.
• Toys should not be tied to the crib because your baby can get caught in the cords.
• Cutouts in the headboard and footboard should be smaller than your baby’s head so she doesn’t get trapped in them.
• Place the crib away from windows. Cords attached to blinds or curtains can choke your baby if she gets caught in them.
Taking care of children is harder for single parents. Single parents often don’t have someone to help take care of the baby. Single parents often don’t have someone to help make decisions. Also, it is harder for single parents to see their friends. Caring for the baby takes up so much time.
But it is important to spend some time with other adults, and not just at work. Go out with friends and family. Make sure your baby is well cared for when you are gone. It is not selfish to have some time for yourself. Take a break once a week to avoid stress.
Your baby, whether a boy or girl, needs to spend time with people of both sexes. Children need to know other adults, both men and women, who are calm, friendly, warm and trustworthy. Also, as children grow up, they need to be with other children. Boys need to play with other boys some of the time. Girls need to play with other girls some of the time.
Single Teen Parents
The teen years are a special time in your life. Being a new parent is also special. Both come with their own joys and problems.
Being a single teen parent is not easy. In order to give your baby the best, you need a lot of love and support.
Many school districts have special programs to help teen parents. Some have programs for pregnant teens and teen mothers that include child care for babies while the teen mom goes to school. Some larger school districts have programs with flexible hours. These programs make it easier for teen parents to work and still go to school. Call your school district to find out if there is a program near you.
There are reasons why school is important to teen parents. Here are some of them:
• You can get a better job if you finish high school. A high school diploma is required for most jobs. A high school diploma is needed if you want to go to college.
• You will be a good example for your child. You will be able to help her when she goes to school.
• Ask your school district if it has a special program for teen parents. Ask about how to get your General Equivalency Diploma (GED).
Support for the Single Parent
Where can a single parent turn for help? Start with your family. Your parents, grandparents, brothers and sisters, and aunts and uncles may be able to help you.
Local churches, synagogues and mosques also may be able to help. Ask them about special groups for single parents.
If you attend school, talk to your school counselor. He or she may be able to help you find resources for parents.
Local public schools or community service groups often have free parenting classes.
There are a number of nonprofit groups that help single parents. Some may have chapters in your area. To find them, look in the Yellow Pages of your telephone book. Look under "Support Groups." The groups may also be listed under "Community Services" or a similar title at the front of the telephone book.
Information Resources for Families
Families who are enrolled in the WIC program (Special Supplemental Nutrition Program for Women, Infants and Children) can get information on breastfeeding, formula feeding and nutrition at their local WIC office. Families eligible for WIC receive nutrition counseling and supplemental foods such as baby formula, milk and cereal. To find the WIC office nearest you, call your state health department or visit the WIC Web site at www.fns.usda.gov/wic/.
For information about early childhood education initiatives, you may contact the U.S. Department of Education at 1-800-USA-LEARN or visit their Web site at www.ed.gov/offices/OESE/teachingouryoungest/.
To learn about child care options, you may contact the U.S. Department of Health and Human Services, Child Care Aware by phone at 1-800-424-2246 or visit their Web site at www.childcareaware.org/.
For more information and resources on postpartum depression, breastfeeding and many other women’s health issues call The National Women’s Health Information Center (NWHIC) at
1-800-994-9662 (1-800-994-WOMAN). You can visit their Web site at www.4woman.gov/.
To learn more about breastfeeding, you may call La Leche League at 1-800-LALECHE or visit their Web site at www.lalecheleague.org/.
To learn more about free or low-cost health insurance for children, you can call the U.S. Department of Health and Human Services Insure Kids Now Program at 1-877-KIDSNOW. You can also visit their Web site at www.insurekidsnow.gov/.
The American Association of Poison Control Centers (AAPCC) poison control hotline, 1-800-222-1222, should be on your list of emergency numbers. To learn more, you can visit the AAPCC Web site at www.aapcc.org/.
Families who cannot afford a car safety seat can contact the National Highway Traffic Safety Administration. They can provide information on resources that help low-income families purchase or borrow child car seats. You may call them at 1-800-424-9393 or visit their Web site at www.nhtsa.dot.gov/.
Coming Next Month
Tips on Pacifiers
You Can Help Your Baby Learn
Exercise Keeps You Healthy
Teach Your Baby To Trust
…and much more!
This pamphlet is distributed by the U.S. Departments of Agriculture, Education and Health and Human Services, and is in the public domain. Authorization to reproduce it in whole or in part is granted. While permission to reprint this publication is not necessary, the citation should be: U.S. Department of Agriculture, U.S. Department of Education and U.S. Department of Health and Human Services, Healthy Start, Grow Smart, Your Two-Month-Old, Washington, D.C., 2002.
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