Does my child need to wear a mask?

Mask requirements will continue to vary, but most children over the age of 2 can still safely mask in high-risk settings to reduce their risk of contracting and spreading COVID-19. 

How can I prevent my child from getting COVID-19?

COVID-19 vaccine recommendations continue to evolve. In most cases, high-risk children over 6 months of age should still get the Covid-19 vaccine. Other children may receive the vaccine based on parental preferences and discussions with their pediatric provider. As always, hand washing is an easy and effective way to stay healthy. Staying home when sick, and testing for Covid at home are also helpful to prevent any spread. 

Should my child receive the COVID-19 vaccine?

The vaccines manufactured by Pfizer-BioNTech and Moderna are FDA-approved for people ages 6 months and older. The American Academy of Pediatrics recommends that all children ages 6 months or older get the COVID-19 vaccine. If your child is 6 months or older, it’s a good idea to speak with their healthcare provider and decide together if getting the vaccine is the best next step. For more information about the vaccines, head here. 

Your child’s pediatrician or other healthcare professional is a great resource for more information about the COVID-19 vaccine.

If my child has symptoms that might be COVID-19, what should I do?

First, try an at-home test. If you’re not sure of the results, generally, you should re-test your child 24-48 hours later. Although infants and children can get the virus, they typically have more mild cases than older people do[2]. Call your child’s provider to find out what they would like you to do. Depending on the circumstances, they will have a process in place for getting your child the evaluation and care they need, which might include a phone or video appointment. In the meantime, please do not send your child to school or daycare where they will be around other children. Keeping sick family members isolated in their own bedrooms and using a separate bathroom can help decrease transmission within families. Many families will also mask at home when this is not possible.

The FDA has approved the medication remdesivir as an intravenous treatment for children older than 28 days and heavier than 7 pounds who are at risk for severe disease or who are hospitalized. Paxlovid is an oral medication approved for at-home use in children over 12 at risk for serious disease.

What is Multisystem Inflammatory Syndrome in Children (MIS-C)? What do I need to know?

In early May 2020, doctors in the United Kingdom and the U.S. started reporting a few cases of children who were experiencing inflammation in multiple organs that appeared similar to a rare condition called Kawasaki disease[3]. Kawasaki disease causes swelling and inflammation in the blood vessels of the skin, eyes, and heart, causing symptoms like persistent fever, body rash, swelling in the lymph nodes (neck), swelling of the hands and feet, red eyes, and peeling skin[4]. 

Again, children are generally less likely than adults to become sick with COVID-19. Very few children with COVID-19 develop this syndrome and almost all of those who do recover well. However, MIS-C can be severe and should be treated quickly to avoid long-term damage to organs. Treatment tends to focus on reducing the inflammation. 

My child seems really exhausted or has no appetite after having Covid-19. What should I expect?

Recovering from COVID-19 can be challenging and slow-going for adults and kiddos. This is called Post-Covid Conditions (PCCs), and there is support and treatment when necessary. Very young children or babies may have difficulty expressing how they feel – things like explaining that they can’t taste anything or have no appetite can be impossible. It’s important to remember that it can be normal for there to be several weeks or more of “recovery” when your child is tired, has less appetite or has other lingering symptoms. Being in touch with their provider can offer reassurance and check-ins if they need more investigation (everything from a baby who isn’t gaining weight to a teenage athlete who is still short of breath).

Reviewed by the Ovia Health Clinical Team

Your COVID-19 guide

The basics

The COVID-19 vaccine helps you develop immunity to the virus that causes the disease without actually having to get sick.

There are three choices. Pfizer and Moderna are both mRNA vaccines, which work in very similar ways in the body. They may have slightly different trade names in the future – like Spikevax – but the technology to make and update the vaccines is the same. The third choice is Novavax. It is made using slightly different and more traditional vaccine technology, called protein subunit, and also offers excellent protection against COVID-19 infection and spread. What’s available in your area may vary, and only certain vaccines may be approved for use in children. 

How they work

After receiving the mRNA shot (Pfizer or Moderna), your cells will learn to make copies of the spike protein on the surface of the virus. This will then cause the production of T-lymphocytes and B-lymphocytes (T-cells and B-cells for short), which help your immune system create the necessary antibodies that recognize and inactivate the COVID-19 virus, stopping it from being able to enter your cells, reproduce, and cause illness in the future. The process within your body is very similar after getting the Novavax vaccine. Your body learns from a portion of spike protein contained in the vaccine how to make antibodies to a part of the COVID-19 virus. It is important to note that none of the vaccines currently available actually contain the live COVID-19 virus.

Since it takes a few weeks for your body to produce the necessary T-cells and B-cells, it’s possible to contract the virus before the vaccine has a chance to make enough antibodies. The process of building immunity can cause some expected symptoms like a sore arm, fatigue or even fever.  This is normal and shouldn’t last more than a couple of days. And many people don’t experience any side effects.

It’s unclear exactly how long immunity from COVID-19 infection and immunity from the vaccine last. Most folks can benefit from a COVID-19 vaccine once a year, just like for the flu. This is because any type of COVID-19 immunity decreases over time, and COVID-19 variants are constantly changing to escape immunity developed from infection and/or vaccination.

The benefits

The most obvious benefit of getting vaccinated is that it can help you not get COVID.

Although there can be breakthrough infections in those who are fully vaccinated, all three vaccines reduce your risk of getting seriously sick if you do contract the virus.

Beyond your personal health, and time away from work and school, getting the vaccine can help protect people around you, including those at higher risk of becoming severely ill and those who cannot be vaccinated, like newborns. 

The good news is that the vaccines are protecting people from getting sick, and those who do get COVID-19 despite being vaccinated are much less likely to become seriously ill, need hospitalization or die from it. Widespread vaccination is the key to decreasing the number and severity of cases.

Safety

So, how safe is the COVID-19 vaccine? Before any medication, treatment, or vaccine is approved for use in the United States, the FDA (Food & Drug Administration) requires it to go through clinical trials to show that it’s safe and effective. This means the benefits have to outweigh the known or potential risks.

Though the COVID-19 vaccines rolled out relatively quickly due to the urgency of the pandemic, no corners were cut. The data show not only that they’re safe but also that the benefits of getting vaccinated greatly outweigh the potential harm of contracting the virus and spreading it to others.

There are several ongoing safety monitoring systems that look for possible side effects or adverse reactions from the vaccines. In fact, the COVID-19 vaccines are the most intensely monitored vaccines in U.S. history.

There have been reports of inflammation of the heart muscle or the area surrounding the heart in adolescents and young adults who have recently been vaccinated. Various medical groups have acknowledged this increased risk in males younger than 40 when compared to those who do not get the vaccine. But, it’s important to know that research shows that the risk of inflammation is even higher for those who are not vaccinated when they are infected Covid-19.   . 

What to consider

If you’ve experienced severe allergic reactions to other vaccines in the past or have an underlying health condition, chat with your healthcare provider before getting your COVID-19 vaccine.

If you’re breastfeeding

ACOG (American College of Obstetricians and Gynecologists) and the WHO (World Health Organization), recommend the COVID-19 vaccine for those who are breastfeeding. Separately, there’s no need to stop breastfeeding after getting vaccinated.

Reviewed by the Ovia Health Clinical Team

Sources

• “Vaccinating Pregnant and Lactating Patients Against COVID-19.” ACOG. December 21, 2020. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19.
• “Include children in COVID-19 vaccine trials.” AAP. November 17, 2020. https://www.aappublications.org/news/2020/11/17/covidvaccinetrials111720.
• “COVID-19 Vaccines and Pregnancy.” ACOG.  December 21, 2020. https://www.acog.org/en/advocacy/advocacy-and-covid-19/covid-19-vaccines-and-pregnancy.
• “The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know.” World Health Organization. January 26, 2021. https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know.
• Zuin M, Rigatelli G, Bilato C, Porcari A, Merlo M, Roncon L, Sinagra G. One-Year Risk of Myocarditis After COVID-19 Infection: A Systematic Review and Meta-analysis. Can J Cardiol. 2023 Jun;39(6):839-844. doi: 10.1016/j.cjca.2022.12.003. Epub 2022 Dec 12. PMID: 36521730; PMCID: PMC9743686.
• Elizalde MU, Eguinoa FJG, de Las Huertas AGL, Jiménez-González M, Ramírez E. Myocarditis and pericarditis risk with mRNA COVID-19 vaccination compared to unvaccinated individuals: A retrospective cohort study in a Spanish Tertiary Hospital. Biomed Pharmacother. 2024 Feb;171:116181. doi: 10.1016/j.biopha.2024.116181. Epub 2024 Jan 22. PMID: 38262150.

Scrapes

• What they are: Scrapes, medically known as abrasions, occur when the top layer of skin is scraped off leaving a raw, painful area that may bleed from one or more spots. Rug burn and “road rash,” are types of scrapes.  Scrapes are tear-inducing but generally not medically serious.
• What to do: Wash your hands before touching the area. Your first priority is keeping the wound clean to keep it from getting infected. Clean the wound with mild soap and clean water and remove any dirt as best you can before patting it dry. Don’t use alcohol or hydrogen peroxide on the wound (this can actually harm healthy cells in the wound and delay healing!) Instead, apply a thin layer of antiseptic cream and cover with a bandaid. Change the band aid every day and apply a new layer of ointment. Any scab that forms on the scrape should be left to come off on its own, so keep it covered to prevent tiny fingers with other plans from interfering!
• When to call your provider: If you can’t get all the dirt out of the scrape with gentle washing, it’s alright to dry and cover it and let it heal. But if there are pieces of gravel, wood or another material you cannot remove, you should seek medical help. You should also call your provider if the scrape was from metal (rusty or not!) as your child may need a tetanus shot. If the scrape does not show signs of healing in two days, or if it becomes more red, painful, begins to ooze, or your child develops a fever, the wound may be infected and should be seen by a provider ASAP.

Bumps and bruises

• What they are: Bruises happen when your tiny explorer bumps or bangs against something hard enough to break blood vessels underneath the skin. Right away the skin turns bright red and sometimes swells into a “bump.” This is the first stage of the bruise and it happens because blood is flowing to the injury site to help heal it. “Goose eggs,” (as bumps on a forehead are sometimes called) are caused by all this blood coming together in one small area and getting trapped. Sometimes the blood spreads out and the skin remains flat. When the pooled blood at an injury site loses oxygen over time it turns purple and blue and then lightens to green or yellow depending on skin tone. Bumps and bruises look scary, but are often no cause for concern and will heal on their own.
• What to do: If your tiny explorer falls or bangs against something, put some ice or a cold pack on it right away. It will help with pain and also minimize the bruising. Use the ice for 15 minutes at a time and only once per hour. Place a towel or other barrier between the cold and your child’s skin, and use child-appropriate doses of tylenol or ibuprofen (not aspirin) for pain.
• When to call your provider: Bumps or bruises that do not show signs of healing after about a week should be checked out by a healthcare provider. Bruises that keep appearing for no reason are also cause for concern and should be reported to your child’s provider.
• When to seek immediate medical attention: If your child is having trouble moving or using the bruised area, it may mean there is an underlying injury such as a broken bone. For example, a bruised knee should never be so painful on its own that your child cannot stand or walk on it. You should also call your healthcare provider if your child has a bump or a bruise after an injury to the head in order to rule out a concussion. If any of the following things occur after a bump to the head, bring your child to the hospital immediately: loss of consciousness, child appearing drowsy or confused, vomiting, unequal pupils, fluid or blood draining from ears or nose, crying for hours, or child just doesn’t seem like themselves. Should any of these symptoms occur after a blow to the head, bring them to the hospital immediately and do not let them fall asleep.

Sources

• Corbett. H. (8/22/16). “Bruises in Children: What’s Normal and When To Worry.” Riley Children’s Health Website. www.rileychildrens.org/connections/bruises-in-children-whats-normal-and-when-to-worry. Accessed 13 April  2017.
• “Cuts, grazes and bruises.” Women and Children’s Health Network. 22 Aug. 2016. www.cyh.com/HealthTopics/HealthTopicDetails.aspx?id=1889&np=305&p=114#9. Accessed 14 April, 2017.
• “Debunking Myths of Wound Care.” Advanced Tissue Blog. 2 July 2014. www.advancedtissue.com/debunking-myths-wound-care/. Accessed 14 April, 2017.
• “Head Bumps and Bruises: When To Worry About Head Injuries.” Children’s Hospital St. Louis. 29 Mar. 2010. childrensmd.org/browse-by-topic/head-bumps-and-bruises-when-to-worry-about-head-injuries/. Accessed 14 April 2017.

If you’re having doubts about Baby’s pediatrician, remember, politicians have term limits for a reason, and just because doctors don’t have to run for reelection doesn’t mean you shouldn’t have the chance to decide whether they get a second term with your family. On the other hand, dealing with the logistics of Baby’s medical care in the future will go more smoothly if you can minimize the number of times you switch doctors, so if there’s a problem with your pediatrician that you think could possibly be solved by talking it through with him or her, it’s often useful to try. When you’re weighing whether your pediatrician is right for you, here are a few questions to keep in mind:

Does Baby like him or her?

If your little one actually likes his or her pediatrician, your chances of having smooth doctors’ visits as they gets older goes way up. Keep in mind that Baby is getting a lot of shots their first year, so they might not be too happy about any doctor’s visits, and if Baby seems pretty neutral about their doctor, that’s not necessarily a bad sign – they could easily come to like him or her better as they gets older. But if, on the other hand, Baby actively likes your current pediatrician, that should definitely be a check-mark in the ‘pros’ column.

Do you feel listened to?

Having a new baby can be stressful, and it’s important that you feel respected and listened by your pediatrician, since it’s important that you feel comfortable asking any questions or voicing any concerns you might have. If you feel like your pediatrician is in a rush, or you don’t feel listened to, this can be a problem.

Does he or she do well in an emergency?

It’s easy for a doctor to seem reassuring and in control during a routine checkup, but the real test happens when Baby has their first real illness. Doctors aren’t awake and at the office 24/7, but yours should have some sort of plan for handling problems in a pinch. You can ask questions about what happens if you need help at the last minute if Baby gets sick, but there’s no way to really know what a doctor or practice’s response to a sudden sickness will be until it’s put to the test.

Does he or she respect your parenting style?

Parenting is one of those jobs where there are a million possible ways to do it right, but some people get overly attached to their own style or preferences. Doctors are people too, and if your pediatrician disagrees strongly with something about your parenting style, it may affect your relationship with your pediatrician, and your perception of Baby‘s care.

Do you and Baby feel comfortable in the waiting room?

A large part of waiting room comfort just comes from not having to sit there for too long, so the average wait at your pediatrician’s office – now that you’ve been going there a while – is definitely something to take into account. Every office has busy days where the wait is longer, but a habitually long wait could be a problem. Beyond that though, is the waiting room clean? Are the toys or magazines clean and organized? Do you feel like Baby is going to catch something new and horrible every time they waits there for a routine checkup? These are all things to consider.

If you end up deciding your current pediatrician isn’t a particularly good fit, switching to a new one is as easy as finding the new one, going through your usual steps with a new doctor, like making sure they accept your insurance, and then calling the original office to ask for Baby’s records to be sent over to the new one. The inauguration ceremony is optional.

1. Fever over 105 F (40.5 C), or 100.4 F (38 C) for babies under 3 months
   Fevers normally have to be over 106 F (41.1 C) to pose a risk to the brain, but it’s best that you call the pediatrician for any fever over 100.4 F (38 C) in a baby less than 3 months old. If you do notice a high fever, you should also pay attention to any other symptoms your child might be displaying. You may also want to call for a lower fever if it lasts more than a few days, as this is probably a sign of illness.
2. Bloody stool
   If the poop is black, it might mean blood has been digested. This could just be a result of bleeding or cracked nipples while breastfeeding, but could also be a sign of something more serious. Call the doctor regardless, just to be safe. Poop that is mostly bright red with blood is of greater concern, and should lead to an immediate call to the doctor.
3. Intense abdominal pain
   Digestive problems are about as common in babies as trees are in a forest, but you should definitely call the pediatrician if your child is experiencing intense abdominal pain, or if the pain is concentrated in one area.
4. Severe vomiting, or vomiting that lasts longer than a day
   Like abdominal pain, a child is bound to vomit at some point in the early days, but very severe or frequent vomiting, or vomiting that lasts longer than a day deserves a call to the pediatrician.
5. Intense diarrhea or mild diarrhea that lasts for 10 or more days
   Diarrhea is pretty common in babies, but if your child has severe, dehydrating diarrhea, or mild diarrhea that lasts more than 10 days, you should call the doctor.
6. Dehydration
   Common signs of dehydration include a lack of tears when crying, fewer wet diapers than you previously noticed, or going 6 or more hours with a dry diaper.
7. Lethargy, or lack of interest in feeding
   This could be symptomatic of a number of different things, so it’s best to call the doctor if a baby seems more lethargic or less interested in eating than usual.
8. Constant or painful cough
   A small cough that goes away is no big deal, but a cough that is constant, or causes pain should definitely be reported.
9. Breathing problems
   If it seems like there’s some breathing trouble going on, you should call the pediatrician right away. This includes wheezing, or straining for breath.
10. Rash that doesn’t clear within a few days
    Lots of children get rashes, but most clear within a few days. If it doesn’t, it’s a good idea to make the call.
11. If you’re worried
    Last, but certainly not least, you should feel free to call the pediatrician whenever you’re worried. Now, we’re not saying to call about every sneeze and boo-boo, but if a call to the doctor would make you feel more comfortable, you shouldn’t hesitate to make it.

The American Academy of Pediatrics recommends that all healthy infants be put down to sleep on their backs, not their sides or stomachs.

Why should babies sleep on their backs?

This is the safest position to sleep for the first year of life, since it drastically reduces the chance of Sudden Infant Death Syndrome, often known as SIDS.

SIDS is one of the top 5 causes of death for babies under age one. However, the SIDS rate has declined by 50% since experts began recommending that parents place babies on their backs to sleep for every nap and overnight. While experts do not know exactly what causes SIDS, in addition to genetic predisposition, there may also be airway and awareness changes that make it harder for babies on their stomachs to get enough oxygen. 

Doctors used to believe that if babies slept on their backs, if they were to vomit it could cause dangerous blocked airways. Doctors later discovered that babies have little difficulty turning their heads while sick or spitting up, and leaving baby in a stomach down position is far more dangerous. If your newborn has a condition that forces them to remain on their stomachs, consult your pediatrician or family doctor about safe sleep positions. Infants who sleep on their backs are also less susceptible to ear infections, fevers, and stuffy noses.

Even if your newborn is sleeping on their back, it is important to avoid soft surfaces like pillows and comforters, stuffed toys, loose clothing, crib bumpers or any other potentially loose item (like mittens or hats) which can block the airway. A firm crib mattress covered by a tightly fitted sheet is the safest bedding for an infant, even if it seems empty in there! The AAP recommends that infants should be sleeping in their sleep space alone as well.

Parents and caregivers should place infants on their backs for every sleep. Once a baby can roll into their preferred sleep position, you do not need to reposition them as SIDS becomes far less of a risk. 

Reviewed by the Ovia Health Clinical Team 

Sources

• “Frequently Asked Questions (FAQs) About SIDS and Safe Infant Sleep.” National Institute of Child Health and Human Development. U.S. Department of Health and Human Services. Web.
• “Sleep Position: Why Back is Best.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.
• “Sudden Infant Death Syndrome(SIDS).” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, October 3 2016. Web.

Learn how to give a newborn a sponge bath

Doctors recommend washing newborns two to three times per week, so knowing the best way to give Baby a sponge bath is important, especially because newborns shouldn’t go all the way in the tub until their umbilical cords fall off.

Supplies

Before attempting to bathe Baby, make sure you’ve got all your supplies handy. Many parents choose to purchase a newborn bath, but an inflatable tub, a water basin, or even a well-prepared sink will do the trick. You will also need mild baby soap, cotton balls, washcloths, a towel, clean diapers, and clean clothes.

Giving the bath

1. Since you’ll be bathing Baby outside the tub at first, simply fill a bowl or the sink with lukewarm water and wrap them in a towel, then place them lying down on their back.
2. Dip a cotton ball in water and wipe Baby’s eyes, making sure to use a fresh ball for each eye.
3. Next, dampen a washcloth and wipe their face and ears, without using soap. Don’t forget their skin-folds, or behind their ears, but be sure not to wash or let water drip into Baby‘s inner ear canal.
4. Place a little soap on the cloth and wash Baby’s neck, scalp, and the rest of their body. They probably doesn’t have much in the way of hair yet, so rubbing a damp, soapy washcloth over their scalp should keep them squeaky-clean. Newborns who DO in fact arrive with a full head of hair could need a more thorough hair-wash, which you can read more about here.
5. There’s some divided opinion about washing Baby‘s umbilical stump, so check in with the doctor if you’re unsure, but generally, as long as the stump is clean, keeping it clean and dry and untouched by the sponge bath is the way to go. If there’s some crustiness, you can carefully wipe it clean with a clean, damp cloth, and then pat or air it dry.
6. Rinse off the soap and dry, rewrapping Baby with a towel. Baby‘s head is likely to get cold after a bath, especially if they has a luscious head of hair, so covering their head with a dry towel is a great way to keep them from getting a chill.
7. Some newborns come into the world with that fabled soft skin, but others are a little more sensitive, and bathing can dry sensitive newborn skin out even further. If Baby‘s skin is a little dry or peeling, if you want to, you can gently rub some mild baby moisturizer into their skin before popping them back into their onesie.
8. Put on a clean diaper and clothes, and resume cuddling!

Tips and Tricks

Make sure you never take your hands off Baby while bathing them. This is a great time to bond with Baby, so make sure to use it as a fun play-time, not just cleaning. Try dropping a little water on their tummy and watch the laughs roll in. Some newborns have a hard time with the cold, so only expose skin for short periods of time. Remember that Baby does not need to be bathed every day, because this can dry out their skin. You only need to give them sponge baths until the umbilical stump comes off, and then you can transition to the baby bath.

Sources

• Mayo Clinic Staff. “Baby bath basics: A parent’s guide.” Mayo Clinic. Mayo Clinic, October 25 2016. Web.
• “Caring for your baby.” March of Dimes. March of Dimes, 2017. Web.

Fortunately, there’s a lot you can do to help Baby feel good about visiting their healthcare provider—even when shots are involved—and to feel good about being there yourself.

How you can help yourself feel less stressed

Be prepared. Let’s be honest: a lot of parents get stressed about provider visits. And sometimes this stress can arise because there’s fear of the unknown. So if you have any questions about the visit or the immunizations, ask your child’s healthcare provider. You can be in touch before the appointment (by calling or sending a message online) or write down your questions in advance to ask the day of.

Fake it ‘til you make it. If preparation doesn’t help you feel any less stressed, you’ll still want to do all you can to keep your cool so you can best support Baby, help them feel positive about the experience, and make any brief immunization ouchies just one moment in an otherwise nice visit. So if you don’t actually feel calm, it’s advisable to at least act calm and not reactive. Even very small children are incredibly observant, and if they notice that you’re tense, they may start to get worried too.

A note on needle phobia: Some people have a debilitating fear of needles, and this can make provider visits understandably challenging. If this describes you, ask your child’s provider how you can work together to help manage this fear so that you can feel as good as possible about the experience and your little one can still receive their immunizations.

How you can help Baby feel less stressed

• Know the routine. Almost always, the easy part of the visit comes first. Measurements, a chat about health and development, and any other relevant exams are the first part of the visit. Then, your pediatric provider typically leaves and a nurse or medical assistant will come back with vaccines. Pack up during this little break so that you can easily and quickly exit once they’re done!
• Feeding and pacifiers. Most babies respond really well to nursing or using a pacifier during vaccinations. If they’re too upset during the lead up, you can offer either one immediately after the shots are done.
• Stay positive! Talk about all of the fun things that will happen at your little one’s visit to see their healthcare provider. Is there a fish tank in the waiting room? Some cool toys and books that you don’t have at home? You can even get excited about what might bookend your visit—do you get to walk past a park on your way there or will you grab some lunch on the way home? Talk about this in advance of the visit and point out all these exciting things while you’re there. And don’t forget to talk about how visiting the provider helps to keep them healthy and strong. All of this can help Baby build positive associations with provider visits.
• Be honest. The older Baby gets, the more this comes into play. Speak honestly about what happens at a visit to see their provider, which may sometimes include getting shots. It’s especially great to do this as you play pretend together. Improvise with whatever you have on hand — a crayon can easily be a pretend needle. When you give your child a ‘shot,’ tell them that they’ll feel a quick pinch from the needle, but that it will be over quickly and then they should feel just fine. And be sure to take turns and have them give you a ‘shot’ too—after the quick pinch give them a smile and let them know you feel okay!
• Embrace distraction. It’s totally normal for children to feel afraid when it’s time to get a shot, and sometimes tears are inevitable. Distraction before the shot, when the shot takes place, and immediately after that quick pinch can be helpful. You can sing a favorite soothing song, bring Baby‘s favorite blanket, stuffed animal or toy to snuggle with or hold during the shot or to play with immediately after. You can also have them look at, say, the cool giraffe painting across the room or the bright light on the ceiling to have them focus on something other than the needle. Medical professionals are typically pros at helping with all of this, and will behave and speak in a way that doesn’t draw extra attention to any needles, pricks, or ouchies.
• Hold Baby close. The medical professionals at the appointment can help advise you on this too. Generally, vaccines are given in Baby’s thighs. It helps to dress them in something where a thigh can be easily exposed and then covered right up for your quick departure. You’ll want to hold them firmly against your chest, and your medical team may ask you to help keep their leg still. Soothe Baby after the shot. Even with all the prep in the world, that quick pinch can still leave your little one needing some love. After the shot, snuggle Baby and speak in a soft and calm voice. Smiles and reassuring eye contact can also help. Tell them that they’ll be okay soon, did great, and were so brave—even if they were screaming and trying to bolt for the door the entire time.

All of this should help the immunization visit go smoothly. And even if you weren’t both able to be stress-free the whole time, stay positive and do all you can to help your little one feel good about the experience. Remind Baby—and yourself—that they did wonderful and will have a good visit next time too.

Why do toddlers have breath-holding spells?

One of the main reasons breath-holding can be seen as willful, or as a toddler’s way of protest is that it is common for them to happen during tantrums. This is because the emotions that can trigger a breath-holding spell happen pretty commonly during tantrums, although they can happen at other times. These feelings include:

• Fear
• Pain
• Surprise

Breath-holding spells can be more common in children who have a family history of childhood breath-holding, and are somewhat associated with iron-deficiency anemia. This means that if breath-holding spells start to become common, a toddler’s pediatrician might test for anemia.

What do breath-holding spells look like?

There are two types of breath-holding spells, and they’re different both in the way that they look and the triggers that cause them.

• Cyanotic breath-holding: This type of breath-holding is more common, and happens when a child is upset. During a cyanotic breath-holding spell, a child will breathe out, and then not breathe in again for a while, and their parent or caregiver will notice their face start to turn a shade of blue.
• Pallid breath-holding: The less common type of breath-holding spell also takes its name from the appearance of a child’s face during the spell – in this case, a child having a pallid breath-holding spell might turn very pale. Pallid breath-holding spells also have different triggers, and usually happen when children are startled or surprised, which can make them harder to predict.

Breath-holding spells usually last less than a minute, and can look like seizures, though they are not seizures, and do not put children at any higher risk for developing seizure disorders.

When do toddlers have breath-holding spells?

Breath-holding spells can start in children as young as 6 months old, but they’re most common in children between the ages of 1 and 2. Most children outgrow breath-holding by the time they’re 5 or 6 years old.

What should I do if my toddler has a breath-holding spell?

Breath-holding spells look scary, but they’re actually harmless. Still, if your child has a breath-holding spell for the first time, it’s important to seek medical help to make sure that it actually is just breath-holding that’s going on. Parents who notice the beginning of a breath-holding spell should make sure their children are somewhere safe where they won’t hurt themselves if they fall down.

Sources

• Elana Pearl Ben-Josef. “Breath-Holding Spells.” Kids Health. The Nemours Foundation, October 2016. Web.
• Sarah Roddy. “Breath-Holding Spells.” Child Neurology Foundation. Child Neurology Foundation. Web.
• “Breath holding spell.” MedlinePlus. U.S. National Library of Medicine, April 4 2017. Web.

However, you don’t have to go very far—especially online—to find a number of misconceptions about vaccines. And it can sometimes be really hard to parse truth from fiction online; almost everyone has, at one time or another, read something online that they took to be fact and then later realized wasn’t true. Unfortunately, misinformation related to vaccines can be very dangerous; vaccines save lives and skipping or delaying vaccines can lead to serious illness or even death. So we’re here to set the record straight. We hope this information helps you better understand that vaccines are a powerful tool that can help keep your little one safe and healthy.

Myth: Vaccines cause autism.

Fact: Vaccines don’t cause autism.

And yet, this myth continues to be spread, so it’s worth exploring why. In 1998, Dr. Andrew Wakefield published a paper that suggested a link between autism and the MMR (measles, mumps, and rubella) vaccine, and this paper is often looked to as evidence of a connection between the two. However, the paper has since been discredited—it looked at only 12 children who were carefully picked and it didn’t have a control group—most of his co-authors on the paper retracted their support, and the journal where the paper was published retracted the paper itself. Wakefield has been discredited too; in 2010, the British Medical Council stripped him of his medical license, blaming his questionable ethics.

Since then, numerous studies have proven that vaccines do not cause autism, including one study that looked at over a half a million children (who were an ideal study cohort of subjects and controls) and found no link between autism spectrum disorders (ASD) and the MMR vaccine. Long story short? The paper this myth is based on was faulty to begin with, the argument and it’s author has long since been disproven, and the science shows that there is no connection between vaccines and increased rates of autism.

Myth: Vaccines contain toxic ingredients.

Fact: Vaccines don’t contain toxic ingredients.

Increasingly, a lot of people want to be aware of what they put in their body and steer clear of harmful ingredients, which is great. When it comes to vaccines, some people have specific concerns about the use of formaldehyde, mercury, and aluminum in vaccines. These chemicals can certainly be toxic to people at very high levels, but there are only trace amounts—meaning extremely small amounts—in vaccines, and there is no evidence that these levels are harmful to people.

For some perspective, formaldehyde is actually naturally produced by our own bodies at higher levels than the trace amounts found in vaccines. These chemicals help the vaccines to be produced and work well and are present in such small amounts that they can’t cause any harm.

Myth: Vaccines aren’t necessary because the diseases they protect against aren’t around anymore.

Fact: Many diseases that made a lot of people very sick in the past don’t do so anymore thanks to vaccines.

‘Herd immunity’ is a term that describes how when a large enough percent of the population is immunized against a particular disease, it keeps even the unimmunized population protected too. (And some people just can’t get immunized, such as infants and individuals with weakened immune systems.)

With enough people immunized against a disease, that disease does become more rare because it simply doesn’t get a chance to spread, which is why you don’t hear about many cases of, say, smallpox these days. But if more people choose not to get vaccinated, a disease that may seem like it was wiped out can have the chance to spread again, as can be seen with recent measles outbreaks in the U.S. Keeping up herd immunity is especially important to keep diseases that were so common and dangerous in the past from coming back.

Myth: Vaccines cause the diseases they’re supposed to protect against and make people sick.

Fact: Vaccines don’t cause the diseases they’re meant to protect against and are safe for the majority of people.

Some vaccines contain egg protein, so if an individual is allergic to egg, it may not be safe for them to get a vaccine. (Again, this is why herd immunity is so important!) Other than this, vaccines almost never make people sick and don’t cause the diseases they’re meant to protect against. Sometimes people point to disease-like side effects following vaccination as evidence that vaccines cause illness.

There are rare occasions—less than one in a million—when a live vaccine (which contains an extremely weakened form of the germ that causes disease) will cause side effects that might resemble a mild case of the disease the vaccine protects against (like a few spots following the chickenpox vaccine), but this is not actually a sign of the disease, it’s the body’s immune response to the vaccine—and a clear sign that the body is building immunity to the disease.

Myth: Babies’ immune systems can’t handle a lot of vaccines, so it’s better to space them out.

Fact: Babies immune systems can handle a normal immunization schedule.

As soon as a baby is born, they’re exposed to countless germs, and their immune system gets to work fighting these off right away. There is just a very small amount of a part of a germ in vaccines that stimulates the immune system to produce immunity against that disease—this is much less that what a baby is exposed to on an everyday basis and is nothing that a healthy child can’t handle.

While some parents may get nervous about children having so many immunizations in their first year of life, these are scheduled in a way that’s meant to protect a child as early as possible from serious diseases that can be especially harmful if a baby is exposed to them when so young. Combination vaccines—like the MMR vaccine—mean fewer visits, fewer needles, and more protection sooner. Most children are able to proceed with a normal immunization schedule and don’t need to space out or delay any immunizations, and doing so could put them at risk of being exposed to serious diseases.

Myth: Getting sick is a normal part of childhood and “natural” immunity is better than getting a vaccine.

Fact: Vaccines protect children against unnecessary illness.

Sure, all children will pick up colds and coughs here and there. But vaccines protect against serious diseases that can be particularly dangerous for children. The “natural” immunity that a child would get following infection from a disease is quite strong, but first that child would have to fight off and recover from that disease.

The immunity that’s produced after someone gets a vaccine thankfully doesn’t involve that person getting sick first. Vaccines help prevent and protect against serious disease and the process doesn’t involve getting sick before becoming immunized.

Myth: Vaccines aren’t safe.

Fact: Vaccines are an extremely important and safe tool for keeping children and adults protected against serious disease.

While many of the myths listed above have led some people to believe that vaccines aren’t safe, there are no credible studies that show vaccines to be unsafe or to cause diseases or other health conditions. Vaccines are closely studied during clinical trials before they’re made widely available, and then are closely monitored once they’re widely used. Vaccines have been used widely for decades, studies show that they’re safe, and we know that they’re responsible for preventing countless illnesses and deaths.

There’s so much new information you need to take in once you become a parent, and making the right choices about your child’s healthcare can sometimes feel overwhelming. So if you have any questions about vaccines or Baby’s health, you should definitely bring them up with their healthcare provider. They’re there to answer questions about all aspects of your little one’s health and are a trusted resource you can count on. And if you’re ever curious to learn more about vaccines online, make sure you head to trusted medical resources and not sites that may be sharing misinformation and presenting it as fact.

Resources like healthychildren.org (from the American Academy of Pediatrics), the Centers for Disease Control and Prevention, and the World Health Organization all have information based in science that you can trust. We all only ever want the best for our little ones. Thankfully, following a regular immunization schedule is one easy—and powerful—way to help keep all of our kids healthy and strong.

Sources

• “Immunizations.” healthychildren.org. American Academy of Pediatrics. Retrieved January 3 2020. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/default.aspx
• “Making the Vaccine Decision: Addressing Common Concerns.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, August 5 2019. Retrieved January 3 2020. https://www.cdc.gov/vaccines/parents/why-vaccinate/vaccine-decision.html
• “Q&A on vaccines.” World Health Organization. World Health Organization, August 26 2019. Retrieved January 3 2020. https://www.who.int/vaccines/questions-and-answers
• “Vaccines for your children.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, March 18 2019. Retrieved January 3 2020. https://www.cdc.gov/vaccines/parents/index.html
• “Vaccine Safety: Examine the Evidence.” healthychildren.org. American Academy of Pediatrics, July 24 2018. Retrieved January 3 2020. “https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Vaccine-Studies-Examine-the-Evidence.aspx
• “Vaccine Safety: The Facts.” healthychildren.org. American Academy of Pediatrics, October 10 2018. Retrieved January 3 2020. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Vaccine-Safety-The-Facts.aspx
• “Vaccines: The Myths and The Facts.” American Academy of Allergy, Asthma & Immunology. American Academy of Allergy, Asthma & Immunology, August 19 2019. Retrieved January 3 2020. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/vaccine-myth-fact