What's Up, Doc?
If there's a Murphy's Law that applies to parenting, it has to be this one: "The seriousness of your baby's illness will always be inversely proportional to the ease in which you can get in touch with your baby's doctor." In other words, you can expect your baby to come down with a raging fever exactly 10 minutes after the doctor's office shuts down for a holiday weekend. While you always have the option of finding an after-hours clinic or dragging your sick baby down to the hospital emergency department, that usually means sentencing yourself to an interminably long wait in a stuffy room that is overflowing with sick and crying children and their totally stressed-out parents—definitely a less-than-ideal state of affairs.
In this chapter, we're going to talk about the important role you have to play in keeping your baby healthy. We'll start out by talking about the importance of "well-baby checkups" (your child's nonemergency visits to the doctor's office) and immunizations for ensuring your child's continued good health. Then we'll look at ways of treating some of the most common types of childhood illnesses and swap strategies for staying sane if your baby ends up being hospitalized. At that point, we'll move on to a detailed discussion about some important safety practices: what you can do to reduce the risk of Sudden Infant Death Syndrome (SIDS), the steps you should take to babyproof your home in order to minimize the risk of injury to your child, and what you can do to keep your baby safe when you're traveling by car. Finally, we'll wrap up the chapter by touching upon a subject that most of us would prefer to ignore and that you will hopefully never need to draw upon: how to survive the death of a child.
How Often Should Your Baby See the Doctor?
Your nine months of prenatal checkups were mere training for what lies ahead: years and years of kid-related doctor's appointments! While hanging out in the waiting room at the doctor's office can be tedious at the best of times (unless, of course, you get a kick out of reading magazines that are old enough to earn a place of honor in the Smithsonian Institution!), it's important to keep the big picture in mind: Well-baby checkups allow your doctor to keep tabs on your baby's overall health and troubleshoot any problems that arise sooner rather than later.
What to expect
At each appointment during your baby's first year of life, you can expect your doctor to check your baby's height and weight; give him a head-to-toe examination to ensure that he's developing normally; provide immunizations at the appropriate intervals (see material on immunizations that follows); and to ask you questions about your baby's overall health. These visits provide you with the ideal opportunity to ask some baby-related questions of your own. (Trust me, there are bound to be plenty—so many, in fact, that you might want to get in the habit of keeping a running list of questions to bring to your baby's next checkup. Of course, if it's a pressing question, you'll want to call your health unit or your doctor's office right away rather than wait for the next checkup to roll around.)
As a general guideline you can expect your baby to visit the doctor's office at ages 2 to 4 days, 1 month, 2 months, 4 months, 6 months, and 12 months, although, of course, you'll be trekking to the doctor's office more often than this if your baby ends up being susceptible to ear infections and other such illnesses.
The Facts on Immunizations
While they've been the subject of much controversy over the years, immunizations continue to play a vital role in helping to protect children against disease—so vital, in fact, that the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) have all spoken out strongly in favor of the current practice of routinely immunizing infants against a number of potentially life-threatening diseases.
While there are some side effects associated with immunization, the vast majority tend to be relatively minor and short-lived. Given the overall benefits to public health, the case for having your child immunized is pretty compelling. Here are some noteworthy statistics from the Centers for Disease Control and Prevention:
How immunizations work
Immunizations help the body produce antibodies against a particular disease. Still, as much as they have revolutionized pediatric health, they aren't always 100-percent effective. Studies have shown that up to 15 percent of children will fail to build up antibodies to a particular disease after receiving the appropriate immunization.
Here's what you need to know about the immunizations given to American babies. (See the Recommended Childhood Immunization Schedule for when these immunizations typically occur.) [RCI Schedule is not available online]
DTaPThe DTaP immunization provides protection against three different diseases:
The diphtheria and tetanus portions of the vaccine may lead to pain and swelling at the injection site and—in rare cases—a skin rash that develops within 24 hours. The pertussis portion of the vaccine may cause heat, redness, and tenderness at the site of the injection in about half of children receiving the vaccine. It may also cause fever and irritability and, in approximately 1 in 110,000 immunizations, inflammation of the brain may occur. (According to the American Academy of Pediatrics, because this complication is so rare, it is not known for certain whether the brain inflammation is caused by the vaccine itself or by some other substance or infection.)
Here's something else you need to know about the pertussis portion of the vaccine. The newer acellular version of the pertussis vaccine (DTaP instead of DTP), has been proven to be every bit as effective as the earlier version, with substantially fewer side effects. Furthermore, administering acetaminophen at the time of injection and four and eight hours after the injection can help to decrease fevers and local reactions.
Polio
The polio vaccine provides protection against polio—a serious disease that can result in muscle pain and paralysis and death. The vaccine used to be given either orally or by injection. The oral form provides slightly better protection than the injection form, but there is a slight risk (1 out of every 2.4 million doses of the vaccine) that the child or another family member could develop polio. This explains why the inactivated, injected form of the vaccine is now the only one in routine use in the United States.
Haemophilus Influenza Type B Vaccine (Hib)
The Hib vaccine provides protection against haemophilus influenzae type b (Hib), a disease that can lead to meningitis, pneumonia, and a severe throat infection (epiglottitis) that can cause choking. Your baby may develop a mild fever after having the injection. Note: Approximately 1 percent of children receiving the vaccine will experience some soreness, redness, or swelling around the injection site.
Measles, mumps, rubella (MMR) vaccine
This vaccine provides protection against three diseases:
While most children who have the MMR vaccine experience few, if any, side effects (e.g., when such reactions occur, they tend to be limited to a rash or fever that develops 5 to 12 days after the immunization or a swelling of the glands in the neck), some children react to the vaccine by developing a high fever that may lead to convulsions. This type of reaction is more common in children who have reacted to a previous immunization or whose parents or siblings have experienced convulsions following an immunization. In rare cases, a child may develop meningitis (an infection of the fluid lining covering the brain and the spinal cord) or swelling of the testicles in response to the mumps portion of the vaccine. Be sure to warn your pediatrician ahead of time if reactions run in the family, or if your child has experienced a reaction to previous immunizations.
About the Chickenpox Vaccine
Most American toddlers are now immunized against chicken pox (varicella), a generally mild and non-life-threatening disease that can, in some cases, lead to a number of potentially serious complications including pneumonia (an infection of the lungs) and encephalitis (an infection of the brain).
The chickenpox vaccine can be given to your child shortly after his first birthday (at the same time that the MMR vaccine is administered, but using a separate syringe and a separate injection side), but is not recommended for babies under one year of age. It's also not recommended for babies who are allergic to any of the vaccine compounds (including gelatin and neomycin); who have a blood disorder or any type of cancer that affects the immune system; who are taking medications to suppress the immune system; who have active, untreated tuberculosis; or who have a fever. Note: If your child does not receive the chickenpox vaccine at the same time as the MMR vaccine, he must wait an additional four weeks before receiving the chickenpox vaccine.
The chickenpox vaccine is 98 percent effective against the most severe forms of chickenpox, and has only minor side effects: redness, stiffness, soreness, and/or swelling at the immunization site; fatigue; fussiness; fever; nausea; and, in 7 to 8 percent of cases, a temporary outbreak of small bumps or pimples at the immunization site approximately one month after the child has been immunized. Some babies still develop a mild case of chickenpox (typically 50 spots or fewer as compared with the up to 500 spots that can accompany a full-blown case of the chickenpox) after having the vaccine.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.
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