Category: News/Blog

Vaccinations for Expectant Parents

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Question: My wife and I are expecting our first child. My primary care physician suggested we get our vaccinations updated prior to the baby arriving and make sure our families are vaccinated as well. We were both vaccinated as kids. What type of immunizations should we be planning for?

Answer: Congratulations on your first baby! There are a few vaccinations that are important for your wife to get during pregnancy, because they will also protect your child before he can get his own vaccines. The vaccines are important for you and any close family members who will be frequently around the baby to get as well. Even if you were immunized as a child, you may be due for a booster because immunities can fade over time, or if a vaccination wasn’t available when you were young.

These are the vaccinations that the U.S. Centers for Disease Control and Prevention (CDC) recommend for both parents and other family members.

THE FLU VACCINE

The flu vaccine protects against three strains of influenza virus. The CDC recommends that everyone, every year, get a flu vaccine. It’s especially important for pregnant women to get because the immunity can be passed through to the fetus, helping protect the baby when it’s less than 6 months and too young to get the vaccine. It’s also important that anyone who lives with or cares for babies less than 6 months gets the vaccine.

THE CHICKEN POX VACCINE

Chicken pox tends to be a more serious illness in adults than in children. If a woman catches chicken pox while pregnant, she could get really sick. There’s also a small chance it could affect the fetus. The vaccine is the best way to prevent chicken pox. If you’re not immune (if you’ve never had it or been vaccinated), you should get the vaccine. Pregnant women who are unsure of their immunity should be tested and will be given the first dose right after giving birth.

THE TDAP VACCINE

The CDC recommends the Tdap (tetanus, diphtheria and pertussis) for all adults; women should get it during each pregnancy. Anyone with regular contact with babies under a year of age should get a Tdap shot as soon as possible (at least two weeks prior to contact is recommended). Pertussis can be life-threatening for babies, and they’re most likely to catch it from a family member. It’s highly contagious and causes severe coughing attacks that can last for months.

THE HEPATITIS A VACCINE

Hepatitis A is prevalent in many parts of the world. It causes jaundice, diarrhea and flu-like symptoms that can be severe. The CDC recommends anyone adopting or caring for a child from a country outside of the US, Western Europe, New Zealand, Australia, Canada or Japan should be vaccinated.

THE MMR VACCINE

The MMR vaccine protects against measles, mumps and rubella (German measles). Anyone born after 1956 that hasn’t gotten the vaccine, or hasn’t had a positive result on a blood test for rubella immunity should be vaccinated. If you’re pregnant, you’ll have to wait until after the baby is born to get the shot. Some adults, not all, are immune to German measles. However, if it is contracted during pregnancy, you could miscarry or give birth to a child with serious birth defects.

If you have questions about these vaccines, please contact your primary care physician. They should have your immunization records and will work with you and your wife on your specific needs and testing for immunities.

This article was originally published on September 22, 2014, and was updated on March 28, 2017.

The importance of yearly physicals

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As pediatricians, we are frequently asked why a child needs a yearly physical, even if they seem perfectly healthy. At each well visit, your provider will ask questions, examine your child and discuss any recommended vaccines. At each age milestone, different screening tools and tests may be recommended in addition to the traditional physical exam.

Children are constantly growing and a lot can change in a year. We measure height and weight to ensure adequate growth. We plot these measurements on a growth curve which shows projected growth patterns. Variations in this curve can indicate nutritional deficiencies, hormone deficiencies, as well as other major medical problems.

Between two and six-years-old, children grow at a faster rate than almost any other time during their development. During this time, we can monitor their growth rate, size, weight and blood pressure to help determine if early action is needed to combat issues that may arise later in adolescence. Children who are overweight at age five have a much higher percentage of being obese in adolescence and later in life.

When your child hits the “tween” age, around eight to 12-years-old, growth patterns and timelines for development can vary. Because your child is starting toward puberty, getting a yearly physical can help us prepare them (and you!) for hormonal changes as well as other physical and emotional changes that occur during these times.

These yearly physicals allow us an opportunity to address important topics such as ways to ensure your child’s safety, healthy sleep habits, goals for adequate nutrition and more. Through these visits, we work to identify any physical, emotional, developmental or social concerns and begin to address them. The “sick visit” is a time to address an acute illness or check in on an ongoing specific condition. In contrast, the well visit (or physical) is a time for the provider to do a more thorough evaluation. It also gives the patient, family and provider an opportunity to work together to ensure quality overall health.

Additionally, if your child plays a sport, the state of Michigan (MHSAA) requires that students receive a physical AFTER April 15, 2017 in order to play sports in the 2017-2018 school year. Act now to schedule your child’s physical for this spring/summer. You can schedule online or by calling your child’s office. We look forward to seeing you!

The importance of colon cancer screenings

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For most adults, screening for colon cancer starts soon after turning 50. This because the chances of getting colon cancer increase as you get older. According to the CDC, 90% of cases occur in people 50 years or older. However, this doesn’t mean that adults younger than 50 can’t develop colon cancer and it’s important to know if you are at risk.

A history of colon cancer in the family means it could be genetic. If a close relative, generally your parent, sibling or child, has had colorectal polyps or colon cancer it is important to get screenings at a younger age. This risk is even higher if that family member was younger than 45-years-old when they were diagnosed with cancer, or if more than one close relative is affected. Additionally, if you have inflammatory bowel disease, your risk of colon cancer is increased.

Colon cancer forms when abnormal growths, called polyps, form in the colon or rectum. These polyps can mutate into cancer and spread throughout the colon. Thankfully, screening tests like a colonoscopy can find the polyps and your physician can remove them during a colonoscopy before they turn into cancer.

Colon cancer is one of the most treatable forms of cancer and there are a number of lifestyle factors that you can be aware of to actively reduce the risk of getting colon cancer. These include getting the recommended amount of physical activity, eating a healthy diet with fruits and vegetables, maintaining a healthy body weight and watching your consumption of alcohol and tobacco.

Even without inflammatory bowel disease or a family history of colon cancer, it is vital to listen to your body. If you think something is wrong, make an appointment with your doctor.

Fun with fiber!

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Fiber has many wonderful characteristics! Fiber can lower blood sugar, cut cholesterol and may even help prevent colon cancer. But few people are getting enough! Women should get about 25 grams each day, and men at least 35-40 grams. However, the average person only gets about 15 grams per day.

Many people rely on whole grains and salads to provide their daily fiber intake, which is definitely a good start. But, lettuce alone isn’t enough. In fact, iceberg lettuce only has about 0.5g per cup! Try adding some artichokes, which provide about 10.3g, or avocado, which provide 6.7g per half, to your salad. Additionally, adding beans to your meals also helps increase your fiber intake. One cup of white beans is about 12g of fiber, while one cup of black beans is about 15g.

If you’d rather get your fiber from a dessert, try black bean brownies. It may sound odd, but you can’t taste the beans, and the brownies contain more than 22g of fiber total.

You can also try incorporating flaxseed into your diet, by adding this to your oatmeal, smoothies or yogurt. A two-tablespoon serving of flaxseed contains 3.8g of fiber, and also gives you a dose of omega-3 fatty acids! Chia seeds offer 5.5g of fiber per tablespoon and are great for thickening smoothies or puddings, and for replacing eggs in most baked good recipies!

Some other high fiber foods include corn (2g per ear), brown rice (3.5g per cup), lentils (15.6g per cup), pears (skin intact, 5.5g per pear), and broccoli (5g per cup).

Eating your recommended daily amount of fiber can be fun! Push the limits and try some new fiber filled recipes! Your colon will thank you!

Sleep training your baby

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Typically, when your baby is about six-months-old, their circadian rhythms stabilize and they start to wake up less and less during the night. This is a great time to work on sleep-training, or trying to get them to learn to fall asleep on their own and stay asleep during the night. There are a variety of commonly used methods, however, one that worked for your friend or coworker may not work for your baby.

 

The most common are:

Pick-up-put-down: this is a gentle technique that is exactly what it sounds like. When a baby is fussy and it’s time to go to sleep, pick them up and comfort them until they’re calm and drowsy, but not yet asleep. Put them back in their crib to sleep, and repeat until they’re finally asleep. This requires a lot of patience, and not every baby will like this method. For some, it’s overstimulating and can make them fussier, rather than coax them to sleep.

Fading sleep: this method consists of helping your baby fall asleep by rocking or feeding, but shortening the amount of time you rock/feed each night, which allows your baby to do more to get themselves to fall asleep. This also requires a lot of patience, but this works very well for families who want to minimize crying.

Chair method: This method doesn’t involve picking up your baby at all. Begin with your normal bedtime routine and put a chair very close to the crib while your baby falls asleep. The goal is to reassure baby that you’re nearby, but you don’t help them calm down or give them any attention after you’ve put them to bed. Each night, you move your chair farther and farther away until you’re right outside the door and no longer need the chair at all. This method can be very difficult on parents and baby, but for some, it can work well.

Ferberizing (check and console): This technique allows you to check the baby at timed intervals while allowing them to learn to console themselves. Your goal is to reassure baby that you’re nearby while reassuring yourself that they’re ok. When you check on baby, don’t pick them up, simply tell them that they’re ok and pat or rub their back for two-three minutes before leaving. Over time, increase the amount of time between checks. Start with 10 minutes between checks and increase by five minutes each night. This method helps baby learn to fall back asleep in the same environment they wake up in each night.

Cry it out (sleep extinction): This is the most commonly known method. The idea is you do your normal bedtime routine and put the baby to bed, but do not check on them again, instead of letting them fall asleep on their own. This can be hard for parents to not console their child when they’re crying, but the idea is that if you go in after a certain amount of time, your child will expect you to do that every night.

There is no “one-size-fits-all” method of sleep training. You may find a hybrid of these methods works best for you, or something that’s not listed here at all. If you need help finding a way to sleep train your baby, or talking through some of the ideas listed here, talk to your pediatrician. They can offer some helpful suggestions about what to try and what might work for you and your baby.