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Well-Baby Checks and Immunizations

Angela Oswalt, MSW

Pediatricians and family doctors see babies often in the first years of life to make sure that they are growing and developing properly and to address any concerns and needs parents might have. Doctors may have their own preferences about when they want to see babies for well-baby visits, but in general, they occur once in the first two weeks of life and then again at the ages of 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months, and 36 months. At a normal well-baby visit, parents should expect doctors to measure and weigh the baby and to discuss the baby's feeding and elimination, sleep habits, growth, development, and general well-being. Be prepared with a list of any questions or concerns for the doctor to discuss. Parents may also want to create a medical history book for their babies in order to keep track of their growth, medical concerns or difficulties, well-baby visits, and immunizations.

Immunizations

Another important factor in maintaining infant health is building up their immune system, or their ability to fight off serious infections, through immunizations. Parents should talk to their child's doctor about when and how they believe is the best to administer immunizations to their baby; however, there is a general list of immunizations that all infants and toddlers receive. This section will review which vaccines are administered, what they protect babies from, what ages they are administered, and any possible side effects.

Vaccines have been proven safe and effective, and severe reactions are rare. Some parents or caregivers worry about giving vaccines because they believe they contain mercury that could harm the child over time. However, since a public outcry in 2001, almost all vaccine makers have eliminated mercury from their vaccines. Another public misconception is that vaccinations cause autism. No scientific study has shown that vaccinations cause autism. It seems other unrelated factors have made autism rates increase during the same period when immunization rates went up. While no vaccine has a 100% effectiveness guarantee, vaccines are effective 80 to 95 percent of the times. Caregivers should contact their doctor immediately if they notice their baby has a fever of 105 degrees F or above, extreme, inconsolable crying that lasts more than three hours, lethargy or inability to arouse, or convulsions, which are extremely rare.

Diptheria-tetanus-pertussis (DTP or Dtap)

This immunization protects children from diptheria, a severe but rare respiratory disease; tetanus, a disease that can cause paralysis from deep, dirty wounds; and pertussis, or whooping cough, another respiratory disease that can be deadly for infants. DTP immunizations are administered at ages 2 months, 4 months, 6 months, 12 to 18 months, and at 4 to 6 years. After that, children should receive the Dtap booster for diptheria and tetanus every ten years. After injections, some babies may experience injection site tenderness including redness and swelling, and perhaps fever. One myth about Dtap vaccinations is that they cause brain damage. While the older version of this vaccine did have a larger occurrence of severe reactions, the form developed in the 1990s has largely eliminated that concern.

Haemophilus B (Hib)

This immunization protects children from meningitis, a severe disease that can cause swelling of the tissues around the brain and nervous system, and pneumonia, a severe respiratory disease. The Hib shot is given at ages 2 months, 4 months, 6 months, and between 12 and 15 months. Some babies may experience a low-grade fever and a sore injection site afterward.

Hepatitis B

This immunization protects against a virus that can cause severe liver damage and disease. While this virus is rare in children because of its transmission through sexual contact, extended intimate contact, and sharing needles, mothers can pass the virus on to their babies. The Hepatitis B immunization is given four times: between the ages of birth to 2 months, 2 to 4 months, 6 to 18 months, and 11 to 16 years. Like the other immunizations, babies can experience redness and tenderness at the injection site.

Measles, Mumps, Rubella (MMR)

This immunization protects against measles, a rare disease in America that can cause rash, fever, and coughing; mumps, a disease that causes swollen glands, tonsillitis, fever, and can cause sterility in older children and adults; and rubella, a disease that causes fever and a rash that is almost harmless to babies and children, but can cause birth defects in non-immunized pregnant women who are exposed to the virus. This immunization is given twice, once between 12 and 18 months, and again between 4 and 6 years. Five to twelve days after vaccination, children can experience low-grade fever, rash, joint swelling, and drowsiness.

Polio

This immunization protects against polio, a disease that can cause paralysis. There has not been a case of polio in the United States for twenty years. It's important to note that the older oral immunization is no longer given because it can rarely (one in a million times) cause paralysis itself. The injection form of this immunization does not cause paralysis. The polio vaccine is given at ages 6 months, 9 months, 18 months, and 4 to 6 years. Children who receive this immunization can experience soreness at the injection site.

Chicken Pox (Varicella zoster)

This immunization protects children from chicken pox, a contagious disease that can cause fever and an itchy, blistery rash. This shot is administered once between the ages of 12 and 18 months. Side effects of this shot can include sore injection site, fever, irritability, fatigue, and nausea.

Pneumococcus (Prevnar)

This immunization can protect children from common bacteria that cause deadly cases of meningitis, pneumonia, and blood infections. This shot is given at ages 2 months, 4 months, 6 months, and 15 months. It can also cause a tender injection site.

 

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