We agonised over the first round of immunisations that were due at 2 months. The controversial MMR jab is months away yet, but we were still concerned about any medical intervention. In this article we put our questions to a Doctor.
A very good friend of ours had a lovely baby girl a month before ours.
She is a General Practioner which makes her an ideal person to put our questions to. As she works as a GP and is bound by professional duties she has asked to remain anonymous so she can give frank honest answers.
Alex:
Firstly thank you for giving us the opportunity to put these questions to you. I suppose most parents have simliar fears. You have a happy healthy baby and you are then asked to give permission for them to be injected with agents you know very little about.
After a long labour we were asked about a Vitamin K injection. I wasn't too concerned about distress to the baby, she had been through so much that a simple injection wouldn't make too much difference so I said yes. I assumed the midwife would know best, and this far she seems unaffected by it. But a friend of ours told us that is was bad news and we should have said no, which leaves me feeling unsure I did the right thing.
Do you think we did the right thing?
GP:
Yes
Vitamin K is a fat soluble vitamin that helps with clotting. As adults bacteria in our gut makes our supply. Apparently 1 in 10,000 to 1 in 25,000 newborn babies may bleed spontaneously a potentially fatal disease. It is felt to be more common after a traumatic birth. It was felt important to introduce a program of supplementation 30 years ago. That is because babies do not initially have bacteria in their gut and hence only get vitamin K in milk. Breast milk has less vitamin K than formula. In my area women are offered oral vitamin K for their babies at birth, 1 week and 1 month.
Vitamin K can be given as an injection or orally for this situation. One dose that is given in hospital is sufficient if your baby is formula fed. Any injection or drug carries a small risk of complications in some rare cases like allergy. The
recommendation is to have the supplement as it is fairly harmless though the risk of the bleeding condition is small. The following site has some alternative thoughts.
http://www.aims.org.uk/Journal/Vol13No2/vitk.htm
Alex:
This same friend told us that she hadn't had her 2 children immunised against Whooping Cough (Pertussis). There was an outbreak at their school and even children who had been immunised against it actualy contracted Whooping Cough. She said her kids recovered quicker than those who had been immunised. Can children who are imunised against certain diseases still catch those diseases?
GP:
The way the immune system works is by recognition. The first time a bug (a bacteria or virus) is exposed in a human the body has produced recognition cells that will activate a search and destroy cascade next time the bug invades. Vaccines are usually designed to resemble the bug without giving the full blown disease to fool the body to produce recognition cells. Unfortunately the body naturally does not always produce a good batch of recognition cells the first time you get an illness or a vaccine. Some people need several doses. That is why the national program has booster doses already in place. Despite this there is no 100% certainty. About 97-98% of children gain an immune response after the boosters. Whooping Cough is a fatal disease in under 6 month year old babies. If you speak to the over 70's they remember siblings under 3 year age dying of measles, meningitis, whooping cough and diphtheria. The wide scale uptake of the vaccination programme in the 70's and 80's has made the likelihood of a doctor seeing a child with these illnesses rare. So the fact the odd child does not raise a full immune response to the vaccine is not a problem. This is known as herd immunity. Currently due to the actions of parents like your friend the rate of measles has reached epidemic status. That is it is highly likely that your child can get this illness if NOT immunized. An immunized child will normally get a milder form of the illness than a non immunized child unless there are other concurrent health problems (eg asthma etc).
Alex:
We don't live in an underprivilaged area, and don't travel to tropical locations. By having our baby immunised are we risking an adverse reaction to our baby for the sake of those who are more likely to contract a serious infection and less likely to have their babies immunised?
GP:
As a responsible parent allowing your baby to be immunized reduces the risk of these illnesses for all children in the community including yours. As long as we live in a community of people and not in isolation these vaccinations will be valuable.
Alex:
To protect my child against these nasty sounding diseases I'm easily prepared for them to suffer some distress and discomfort from the injection, and perhaps a rash or day of feeling unwell. For me (but perhaps not other parents) that would be an easy decision, but if I was risking their long term health in any way the decision would be more difficult.
Given my stance on the issue, is there anything I should be aware of?
GP:
As stated earlier all drugs and injections have a risk of allergic response in some individual children. There have been few documented cases of vaccine related damage to children. The real long term risk of brain damage that getting measles encephalitis or asphyxiation after Haemophilus Influenza (HiB) infection seen in hospitals up to the late 90's is more. Since the recent introduction of HiB vaccination to the programme this difficult scary presentation of a child unable to breathe has vanished. Children died unless someone cut the windpipe under the adams apple. You should not vaccinate your child whilst he has a fever incase the illness worsens and it is blamed on a vaccine response. Each individual vaccine have mild side effects like rash irritability and loose stool as a mild dose of the "disease". You should see your GP if the symptoms are more severe and paracetamol has failed to reduce the temperature.
Alex:
I know this is probably a stupid way to think, but Clare and I were immunised as kids and it hasn't seemed to have done us any harm. We thought that as our baby has a mix of our DNA that this would be an indication she would react in the same way as we did. Is this just nonsense?
GP:
There is some sense that allergy runs in families.
Alex:
I remember having my injections (not as a baby but as a young child),it was no real drama and I think most of us remember the Polio with fondness with the sugar cube and all. Have things changed much since then (I realise you were not a Doctor back then), or is it pretty much the same?
GP:
Yes except polio is part of the injection rather than a liquid on a sugar drop.There are more vaccines offered now in a single vaccine and more injections in the programme.
Alex:
I wouldn't usually ask this question, but as this is an anonymous interview I feel I can ask. What did you decide with your own baby, and could you summarise your reasons for making that decision?
GP:
My baby will have the full vaccine programme. I feel there is a greater risk of harm to her if she does not have the injections. I want her to take part in baby and toddler groups without risk of contracting serious illnesses.
Alex:
Thank you so much for answering these questions, I hope we can call on you again sometime as it would be great to get an opinion on kids health matters from a professional, who is also a mother.
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