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National Newborn Immunization Week
Starting the week of April 23 is National Newborn Immunization Week and for the first time - World Newborn Immunization Week. It is so important to protect your newborn at a time when he/she is so vulnerable to a multitude of diseases. Make sure to get recommended vaccinations at the recommended time to ensure your newborn is protected. Also, all caregivers to a newborn should have an updated Pertussis (Whooping Cough) vaccine and Flu shot to provide a cocoon of safety to your newborn.

Whooping Cough Epidemic Spreading
Whooping Cough (Pertussis) is an upper respiratory infection caused by a bacteria. Usually a severe cough starts 10-14 days after being exposed, but the infection can last up to six weeks. It is called Whooping Cough as when an infected person coughs it creates a deep “whooping” sound. It infects people of all ages, but left untreated in newborns it can cause sever infection and even death.

Ten newborns/babies died in California in 2010 from Pertussis infection. The disease is spreading, reaching epidemic levels in Washington State, Vermont and Oregon. People receive vaccinations for Whooping cough during their routine vaccination schedule from 2 months through kindergarten. Immunity wanes in most, and now it is recommended to receive a booster vaccine after 10. Newborns are the most susceptible as they do not get their first vaccines until 2 mos. The disease affects newborns and people with lung disease the worst. To protect your newborn, all caregivers need to be vaccinated with their booster vaccines to form a protective “cocoon”. Also, limit exposure to others, especially people with colds in your newborn’s first few months.

Newborn Care Vaccines / Vaccinations Information
By Loraine Stern M.D.

The best thing since clean water to ensure your children’s health is vaccinations. The diseases that they protect your child from are deadly and are still around.

There are many newborn vaccines given in the first year:

Newborn VaccinesHepatitis B
Whooping cough
Pneumoccoccus (a bacteria that causes pneumonia and meningitis)
HIB, a bacteria that causes meningitis, bone and joint infections and a life threatening throat infection called epiglottitis among others
Rotavirus (a stomach virus that puts children under 2 in the hospital with dehydration and can kill)
MMR - Measles, Mumps and Rubella
The first hepatitis B shot is given shortly after birth in some but not all hospitals.

Some parents worry that there are so many immunizations but this is far from the limit that children can handle. In fact, every day infants are exposed to new material that their immune systems recognize and react to.

When vaccines are delayed or refused, these diseases come back. Measles, for example, is a vaccine that some parents are refusing because of the mistaken idea that it might cause autism. An unimmunized child in Indiana gave measles to 30 people, 3 of whom were hospitalized, one in the intensive care unit.

When going in for your newborn’s vaccines, hold your infant, comfort her while she is getting the shots and cuddle her immediately after. Realize that you are doing the best possible thing for your child. Newborn Vaccines will be discussed in further detail on the newborn video.

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Schedule of Immunizations
The American Academy of Pediatrics recommends the following schedule for vaccines. If you miss or are late with one, you do not have to start over but just resume the schedule. However, we do not recommend delaying any of them.

In the hospital: Hepatitis B (not in all hospitals)
2 Months: DTaP, Polio, HIB, Hep B, Prevnar, Rotavirus (Rotateq or Rotarix)
4 Months: DTaP, Polio, HIB,
Prevnar, Rotavirus (Rotateq or Rotarix), Hep B (If not given in hospital)
6 Months: DTaP, Prevnar, Rotavirus (Rotateq), HIB
9 Months: Hepititis B
12 Months: MMR, Chickenpox, Prevnar
15 Months: DTaP/HIB, Prevnar (if not given before)
18 Months: Polio, Prevnar (if not given before)
2 Years: Hepatitis A
3 Years: Hepatitis A
4-6 Years: Booster DTaP, Polio, MMR, Chickenpox, TB, Hemoglobin, (can be split over 2 years)
After age 6: Yearly checkups with Tetanus Booster at age 10, Meningococcal at 11-12, HPV vaccine for girls after 11-12

Every fall, all family members should have a flu vaccine.

Vaccines and Tylenol
By Michael Schoenwetter, MD

Many families worry when their babies receive vaccines. Some of the concerns are the pain and possible side effects from the shots. I break down normal vaccine reactions into two main types. The first is a local reaction: mild redness and/or swelling at the injection site. This very common, normal reaction will usually subside in the first day or so. Applying a cool compress may be helpful to reduce the inflammation. Severe swelling or redness that is spreading is not normal and should be seen by your doctor. The second normal vaccine reaction, which is usually more concerning to the family, is a more systemic reaction. This is when the baby's immune system is "turned on" from the vaccination and the baby might feel cranky and/or develop a fever for the first 24-48 hours after the shots. This is a normal, expected side effect that does not happen every time, but is not worrisome or unexpected. If the fever persists, is very high, or the baby seems extremely irritable or lethargic, your doctor should be notified.

Frequently, parents try to prevent the fever and crankiness by pre-medicating their babies with Tylenol (acetaminophen). In the past, this practice was not discouraged. In fact, the CDC's advisory panel says it is reasonable to pre-medicate children at high risk for developing seizures, which can be triggered by fevers. However, a recently published study showed slightly lower protective antibody levels from vaccines in infants who were pre-medicated with Tylenol versus infants who did not receive Tylenol. The effect of the decreased levels might be small, as the vast majority of the pre-medicated infants did achieve protective antibody levels after their booster doses. Even so, the evidence in the study does point to stopping the practice of pre-medicating to try to prevent this reaction. Of importance, there is no evidence that the same decrease of antibody levels occurs when a fever reaction is treated by Tylenol. In summary, not pre-medicating with Tylenol, but giving it if fever develops might give the best benefit of immunization.

Flu Season Update - Drug Approved for Newborn Use

The winter and holiday season has arrived, and so has a potential harmful infection to your newborn: the flu. This is the earliest arrival of the flu season since 2003, which might indicate a long and harsh season. However, based on the data so far, the flu vaccine is a good match for this years strains and thus will be very helpful in diminishing the amount of flu, the complications of the disease, and the risk to your newborn.

It is not too late to get vaccinated, as the Flu could be around for another 3-4 months. Even if you feel like you already got the flu this winter, it is beneficial to get vaccinated to protect against other strains that you might contract later in the season.

Your newborn is risk of developing complications if he gets ill with the flu. Because newborns cannot receive the vaccine until 6 months old, all contacts 6 months and older need to be vaccinated to form a protective “cocoon” and decrease the possibility of infection transmission. A pediatrician will never say there is a bad time to have a baby, but there are better times then in the middle of a flu epidemic. This flu season is the worst in the last decade. Presently 48 states are reporting widespread flu activity. My office, located in California, is seeing scores of very sick children.

The FDA has just approved the drug Oseltamivir (Tamiflu) to be used in children under 1 and in newborns 2 weeks and older. This drug doesn’t kill the flu virus, but reduces severity of the infection. The medicine has to be started within 48 hrs of symptoms to be effective. Young children, including newborns, and the elderly are more susceptible to this flu strain. Protect your newborn by avoiding crowds of people, especially children. Make sure everyone is washing their hands before coming in contact with your newborn. Also, it is not too late to get the flu shot for everyone over the age of six months to form a protective cocoon around your newborn. This years’ vaccine is well matched to the circulating virus.

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