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- Should you give tylenol before the shots? / vaccine reaction discussion
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- The Poop series: Chapter #1 Baby poop
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- Nurse Judy' Blog
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- What to expect from the 2016/17 flu vaccine
- Colds/coughs/congestion 2017 (symptomatic treatment/when do you need to be seen?)
Friday, November 18, 2016
When can you take your baby out into this germy world ( 2016)
The discussion with new parents about when it is safe to take the baby out and about and risk exposure to crowds comes up quite a bit. This is one of those questions that gets a lot of differing opinions from anyone you ask. The only opinion that really matters in the end is that of you and your partner. All the well meaning friends, family and healthcare professionals can only advise. It is up to you to pick a path that feels right for you. It is an especially popular question this time of year with the holiday season looming. Many folks have celebrations and gatherings ahead. Lots of folks are considering traveling.
It is often not a black and white case and we end up trying to identify all the considerations specific to your situation. There is a vast difference between a single parent taking the baby with them to get provisions, and the choice to take a newborn out to a crowded concert.
Travel questions come up a lot. I would rather avoid having a very young baby on a full airplane but some travel is worth the risk. I would likely say "go for it" to a baby going to see aging great-grandparents, or to a once in a lifetime family event like a wedding. I would say "are you absolutely nuts???" to a family taking an infant to a beach vacation in Mexico.
What time of year is it? Are there any active viruses circulating? We are just coming into the winter cold and flu season. I am going to be stricter in my recommendations this month. RSV is actively going around. I posted about it a few weeks ago and since that post we have had positive tests in the office. I want my newborns safe.
I have a very different standard when dispensing advice about the under two month crowd. That two month old check up and first set of vaccines is a significant milestone. If you know that you have upcoming travel, bring that up at your early doctor appointments. In our office we can accelerate some of the first vaccinations.
Any fever in a young infant gets my attention. Babies are the most vulnerable the first 6-8 weeks of life. If one of these young babies gets a fever, it is going to be taken very seriously by any doctor that they encounter. In an emergency room, a fever in a young baby will most likely trigger diagnostic testing such as blood work, a urine catheter, x-rays and even a spinal tap. If in fact that baby has a serious infection, early intervention can be life saving, so the doctors aren't kidding around. No one wants their baby to have to go through that.
I know that many new parents get cabin fever, but whenever possible, keep your newborn away from any circumstance that may expose them to anyone who is sick. In general, crowds should be avoided. If someone is coming to the house to visit make sure they are healthy before they come in. If they feel like they may be coming down with something, they are not doing you any favors by exposing you and your newborn. If you have family staying with you I prefer that anyone who is planning on spending time with your baby be vaccinated. Ideally they have gotten the TDaP and Flu vaccines already. It takes a week or so for immunity to take effect. Plan ahead and make sure that family members get the shot now if they haven’t yet. Send them over to a pharmacy for the shots as soon as possible if they haven't gotten around to it. As long as visitors appear healthy and are more help than hindrance, don't hesitate to take advantage of your support network even if they haven't gotten the shots yet. Good hand washing is essential. We haven’t started seeing true influenza, but it is coming.
First time parents have the luxury of protecting and isolating the baby and should take advantage. That being said, in my opinion, a walk outside on a lovely day is usually perfectly fine for even the most conservative family.
Second kids are a different story by necessity. They are often born into the situation where they have a loving, snotty nosed older sibling that wants to kiss and handle them from the start. These babies generally get exposed to things much earlier. Anyone who has multiple kids can tell you that it is really sad watching the young babies struggling with their first illness. As I mentioned in my sibling post, tell your older child or any children who will be in close contact with the baby, that they are in charge of the “germ patrol.” It is their job to make sure that anyone who is going to touch the baby washes their hands first or uses a hand sanitizer. Good hand washing is essential but quarantining your kids from each other is not reasonable. Common sense also dictates that kids are likely contagious before you realized they were getting sick, and by the time you realize that something is up, it is already too late.
When making decisions about how much contact your infant is going to have with the outside world, it is nice to have choices. Unfortunately situations will come up when it’s not so simple. When faced with these types of decisions, recognize that things are usually not clear cut so explore your options. Sometimes they are limited so do the best you can and use your best judgement!
Posted by Nurse Judy at 4:20 PM