Don't stop believing in vaccinations

At his 6-month well-baby visit, my son received all of his routine vaccinations except for the H. influenzae, type b (Hib) vaccine because of a delay in shipment. I was told to return the following week for the shot. Yes, I brought him back, but I wonder how many children end up missing their doses because of this little inconvenience? Even worse, how many children never even received their first doses because of misinformed caregivers? Vaccines do not only protect those who receive them, but they also help "create a 'herd immunity' a wall of immunized people that prevents spread of disease, so children who are vulnerable — those too young to be vaccinated or who can't be because of immune disorders or other medical problems — are protected." Since the introduction of the Hib vaccine, the number of infections in the U.S. caused by this bacteria has decreased by 99%. Unfortunately, Hib is making a comeback, and it is not a pretty disease. It can cause meningitis (majority of cases), pneumonia, sepsis, epiglottitis (a severe throat infection), skin infections, and arthritis. Children have also died from these invasive bacterial infections.

Protect your children and others; vaccinate your children.

Fear of autism is not a reason to skip vaccines

Many recent scientific studies have concluded that there is no association between the MMR (measles, mumps, rubella) vaccine and autism. Yesterday, the special court experts (Special Masters) ruled that there is no causal link between the MMR vaccine and autism and that thimerosal-containing vaccines (very few of these left on the market) do not contribute to causing immune dysfunction, further confirming what the medical and scientific communities have always believed. I have always been an advocate of vaccinations, and both of my children are up-to-date with theirs. This is also my favorite lecture to prepare and give.

Vaccine schedules for routine vaccines are updated annually in January. Get the facts about vaccines from reputable, unbiased sources (Centers for Disease Control and Prevention, American Academy of Pediatrics, The Children's Hospital of Philadelphia, Immunization Action Coalition, Every Child by Two, Vaccinate Your Baby). Vaccine information sheets for every vaccine are available in multiple languages. As with any medical intervention, vaccinations may have some risks involved. However, the full benefits of vaccinating your child(ren) far outweigh these risks. Want to see some pictures of vaccine-preventable diseases?http://www.vaccinateyourbaby.com/safe/autism/omnibus_proceeding.cfm

Be sure to talk to your child's health care provider before choosing to forgo routine childhood vaccines. What you heard could be a myth (e.g. flu vaccines can give you the flu). Rare side effects (more than just fever or local injection reactions) should be reported to the Vaccine Adverse Event Reporting System to help monitor vaccine safety.

So, are your children up-to-date with their vaccines?

"I like taking my medicine"

My daughter asks for her daily dose of fluoride chewable tablet on a regular basis. She is only 3, mind you.  Get this, not only does she chew it like she's supposed to, she asks for water so that she can swish and swallow afterwards. If I give her apple juice, she'll question me, "take it with apple juice?" I guess I passed down my pharmacist gene to her! While I have been in the habit of tasting all sorts of medicine so that I can tell moms what to expect or how to mask the aftertaste, I did not try this one. I imagine it is sweet. She was not this happy about taking the acetaminophen chewable tablets last summer. Yes, I have to put this bottle out of her reach!

So, is your drinking water fluoridated? Our water is from a well, but you can check yours at the CDC web site. Does your child fluoride supplements? The American Dental Association has recommendations and very good information for the public on their web site. Bottled water with fluoride added is also a good idea.  If you need to double check the dose of the prescribed fluoride supplement, check here. Smile! 

FDA continues to review asthma meds

The FDA continues to review clinical trial data to assess the possible association of mood and behavioral adverse effects related to medicines that affect the leukotriene pathway (montelukast [Singulair], zafirlukast [Accolate], and zileuton [Zyflo]). These medicines may also be used for allergic rhinitis and to prevent exercise-induced asthma. No conclusion has been reached, yet, but this update to the March release informs us that it may take another 9 months.

These medicines are effective in controlling your child's asthma. Please do not stop your child's medicine, but do speak to the pharmacist or doctor if there are any concerns. Monitor your child for any changes in behavior and mood that are untypical, including suicide thinking and behavior. Remember that the evaluation is ongoing, so there is nothing to panic about.

Food allergies and medications

I'm taking my 3 year-old daughter to an allergist today to be tested for shrimp, fish, nuts, and peanuts. She has had fish without a problem, but since there is a strong family history of food allergies to peanuts, beans, fish, and nuts it will be more of a precaution. Her first skin test at 12 months was for beans, fish, shrimp (her eye became swollen after eating a Japanese shrimp chip), and milk (a rash around her mouth developed each time she consumed dairy products). She apparently outgrew her milk allergy when she was tested again at 2 years of age, and actually loves to eat cheese when it was reintroduced to her. Yes, we have an EpiPen Jr. If you do not remember how to give your child a dose, now is a good time to watch the video or ask your pharmacist to show you again. It is crucial to be prepared if your child has known allergies to food or medications; carry the pen and to know how to use it. If your child is old enough, (s)he should be taught, too. Don't forget to teach people who are always with your child to use it (e.g. teacher in school, if there isn't a nurse, older siblings, etc.). Make sure the pen hasn't expired, yet.

Be aware that medications may contain inactive ingredients that should be avoided if your child has allergies to certain foods, like lactose, peanuts, and shellfish. For example, a child with asthma and a known peanut/soybean/soy lecithin allergy should not be given the old CFC-containing Atrovent (ipratropium bromide) metered dose inhaler (MDI) or Combivent (ipratropium bromide and albuterol sulfate) MDI. Some children have had worsened asthma attacks, if not anaphylaxis, after being given the old Atrovent inhalers. Note that the other forms (e.g. brand or generic nebulized solution or the new Atrovent HFA MDI) of these medications do not contain soy lecithin and are fine to use. Other medications to look out for are described in this article. Great information on food allergies in general can be found at the Food Allergy & Anaphylaxis Network, including how to look for the culprit ingredient disguised with a different name.

Ask the pharmacist, read the label, or call the drug company to make sure any new medications are safe if your child has severe food allergies. Update your pharmacy and doctors today about your child's food allergies so that they can document them and help keep your child safe from allergic reactions to medications.

Beware: May be dye-free, but not metal-free

Check those 1 ounce plastic bottles of Mylicon Gas Relief Dye Free Drops (over-the-counter) where you keep your children's medicines, especially if they were bought after October 5, 2008.  The FDA and the manufacturer (Johnson & Johnson - Merck Consumer Pharmaceuticals Company) sent out a recall notification. The lot numbers to look for are SMF007 and SMF008. If you have bottles matching these numbers, throw them out immediately! Some bottles may have been contaminated with metal fragments during the manufacturing process. If your infant has been given some of this medicine in the past and you are concerned, please contact your child's healthcare professional.