Your 8-Week-Old Baby: Two Months, Shots and Smiles

An 8-week-old baby has reached the two-month mark, and this week usually has one big event in it: the two-month well visit, with a growth check, a developmental review and, for most babies, the first big round of vaccines. Around that appointment, she’s smiling back at you, making sounds other than crying, and lifting her head on her tummy. This post is about the week itself, the visit and the day or two after the shots. For the whole month in one view, see your 2-month-old.

Eight weeks is the first checklist

Unlike the weeks before it, eight weeks has an official reference point. The CDC’s two-month checklist is the first of its first-year lists, and this is the week it applies. By two months, most babies:

• calm down when spoken to or picked up
• look at your face, and seem happy to see you when you walk up
• smile when you talk to or smile at them
• make sounds other than crying, and react to loud sounds
• watch you as you move, and look at a toy for several seconds
• hold their head up when on their tummy
• move both arms and both legs, and open their hands briefly

If one of those isn’t there yet, it’s a note to bring to the visit, not a reason to panic tonight. The CDC’s own advice is plain: if your baby isn’t meeting one or more milestones, or has lost a skill she had, “talk with your child’s doctor, share your concerns, and ask about developmental screening.” You know her best.

The two-month visit: what actually happens

KidsHealth lays out the agenda, and it’s useful to know it before you walk in. Expect the doctor or nurse to:

1. Measure her: weight, length and head circumference, plotted on a growth chart.
2. Ask about feeding, diapers and sleep. This is where your questions go. Write them down beforehand; you will forget them the moment someone asks how feeding is going.
3. Examine her undressed, including her eyes, heart, pulses, hips and how she moves.
4. Review the newborn screening tests from the hospital and repeat any that need it.
5. Update vaccines. KidsHealth notes that schedules can vary from office to office, so ask your doctor what she’s getting.
6. Check on you. Many offices hand you a postpartum depression questionnaire at this visit. Answer it honestly. That form is there for you.

The shots, and the day after them

The vaccines themselves take a few minutes. The CDC suggests a comforting tone or touch during them, holding her firmly on your lap if you’re allowed, and says babies can be soothed afterwards “through swaddling, skin-to-skin contact, and breastfeeding.” Feeding her right after is one of the easiest comforts there is.

What’s normal afterwards, per the CDC: mild reactions “such as pain at the injection site, a rash or a fever,” which are normal and soon go away. A cool, damp cloth can help with redness, soreness or swelling where the shot was given. It’s also normal for some babies to eat less in the 24 hours after vaccines; offer feeds more often. And the CDC’s best line on the whole subject: “Pay extra attention to your child for a few days. If you see something that concerns you, call your child’s doctor.”

Two things to settle before you leave the office, because at this age they’re your pediatrician’s call, not the internet’s:

• What to do about a fever. Under three months, a temperature of 100.4°F (38°C) or higher is normally an urgent call, any hour. Ask your pediatrician exactly how that applies after shots, and whether, when and how much of any fever medicine to give. Never guess a dose. A rectal reading is the accurate one at this age; a simple digital rectal thermometer like the Frida rectal thermometer is worth having in the house before you need it, and our fever guide has the full by-age table.
• Where the Vaccine Information Statements are. The CDC points parents to these sheets for the possible side effects of each vaccine. Keep them somewhere you’ll find them at 2am.

Then plan a nothing day. Extra feeds, extra holding, no errands.

Smiles and coos this week

The social smile you may have caught in week seven usually becomes reliable around now: you smile, she smiles back, and it happens again. Sounds come with it: small vowels and the first back-and-forth, where you talk, she pauses, and she answers. The CDC’s tips for this age are simple: “act excited, smile, and talk to him when he makes sounds,” and talk, read and sing to her.

Tummy time should be a daily habit by now. The AAP’s target is at least 15 to 30 minutes a day, in short sessions, by seven weeks, so eight weeks is about keeping it going rather than starting. A brief head lift on her tummy is exactly what the two-month list asks for.

Feeding at eight weeks

KidsHealth’s two-month picture: babies may be going longer between feeds but still have times they want to eat more, and most breastfeed about 8 times in 24 hours or drink about 26 to 28 ounces of formula a day. Use that as a rough guide, not a target.

Expect feeding to wobble around the shots: a little less for a day, or a fussier, clingier pattern. That’s covered by the CDC’s “eat less during the 24 hours” note. What isn’t covered: a baby who won’t feed at all, wet diapers dropping off, or feeding getting weaker over several days. Those are calls.

Sleep at eight weeks

KidsHealth says babies at two months are awake and alert for longer in the day and sleep more at night, with breastfed babies often managing a 4- to 5-hour stretch and formula-fed babies 5 to 6 hours, and that waking at night to feed is normal. Shot day can scramble that for a night or two; many babies are sleepier than usual, some are fussier.

The safe sleep floor stays where it is through all of it: on her back, in her own bare bassinet or crib, on a firm, flat surface, every sleep. A sleepy post-vaccine baby who drifts off in the car seat on the way home gets moved to her bassinet once you’re in, rather than left to finish the nap there.

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Call the pediatrician if…

At eight weeks, call for: a fever of 100.4°F (38°C) or higher, including after shots unless your pediatrician gave you different instructions for that visit; a baby who is much harder to rouse than usual, floppy or limp; refusing feeds, or fewer wet diapers than normal; labored breathing, meaning fast breaths, grunting, or ribs pulling in; blue lips or face; forceful or projectile vomiting, or green or bloody vomit; crying that is high-pitched or inconsolable and unlike her; a skill she had and has lost; or anything after the shots that concerns you. The CDC’s line is the right one: if you see something that concerns you, call.

And for you, two months in: if your mood has stayed dark, say so at the visit or call your OB the same day. The Postpartum Support International helpline is 1-800-944-4773.

FAQ: your 8-week-old

Is 8 weeks the same as 2 months?

Close enough that the two-month visit and the CDC’s two-month checklist both apply this week. Two calendar months is a few days longer than eight weeks, so if the appointment is booked for week nine, nothing is wrong.

Is my baby supposed to be fussy after her 2-month shots?

Often, yes. The CDC lists pain where the shot went in, a rash or a fever as mild, normal reactions that soon go away, and says some babies eat less for 24 hours. Feed often, hold her, and call your pediatrician about any fever or anything that worries you.

What comes after eight weeks?

More smiles, more cooing, and slowly sturdier head control on the way to the four-month checklist. The 2-month-old guide covers the rest of the month. Feed on cue, sleep safe, lower the bar. You’re doing fine.