Understanding Your Child's Immunization Schedule: What You Need to Know

Every year, leading health experts—including pediatricians—collaborate to review and update the Recommended Child and Adolescent Immunization Schedule for children and teens up to 18 years old. This schedule, approved by the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and other health organizations, is based on the latest scientific research to ensure each vaccine's safety and effectiveness. Only vaccines licensed by the FDA are included in this schedule.

Is the Recommended Vaccine Schedule the Same for Every Child?

Yes, the recommended schedule is designed to be ideal for all healthy children, with very few exceptions. In rare cases, such as for children with chronic health conditions or those on medications that affect their immune system, adjustments may be needed. Your pediatrician can provide guidance tailored to your child’s specific needs.

How Are Vaccines Administered?

Vaccines can be administered in single or multiple doses. The timing of these doses is carefully determined based on:

  • The age when a child’s immune system is most responsive.

  • The age when the child is at the highest risk for specific diseases.

Pediatricians stay informed about any changes to the immunization schedule, ensuring your child receives the most current and effective protection.

What If My Child Misses a Scheduled Vaccine?

It's important to follow the recommended immunization schedule to keep your child protected. However, if your child misses a dose, there's no need to start over. Simply contact your pediatrician to arrange the next shot and get back on track.

Should Vaccines Be Spread Out Over Time?

Delaying or spreading out vaccines is not recommended. The immunization schedule is designed to provide protection at the optimal times. Delaying vaccines can leave your child vulnerable to serious diseases during their most critical early years. There’s no scientific evidence supporting the safety or effectiveness of an alternative schedule.

Why Are Multiple Vaccines Given Together?

Research shows that it is safe to give multiple vaccines at one time. In fact, your child’s immune system encounters far more antigens daily from natural exposure than from vaccines. Vaccines are thoroughly tested to ensure they work well together without overwhelming your child’s immune system.

Can My Child Be Vaccinated if They’re Sick?

Even if your child has a mild illness like a cold or low fever, they can usually still receive vaccines safely. Vaccinating during a mild illness is both safe and effective, and it helps keep your child on schedule without needing extra appointments.

Why Vaccinate Against Diseases That Are Rarely Seen Today?

While some diseases, like smallpox, have been eradicated thanks to vaccines, others can still spread if vaccination rates drop. Recent outbreaks of diseases like measles and mumps highlight the importance of maintaining high vaccination coverage. Vaccines help prevent the spread of these diseases and protect your child from serious illness.

Can a Vaccine Cause the Disease It’s Meant to Prevent?

No, vaccines do not cause the diseases they protect against. Vaccines contain weakened or inactivated forms of the virus or bacteria, which train your child’s immune system to recognize and fight the real disease without causing illness.

Do Vaccines Cause Autism?

No, vaccines do not cause autism. The misconception arose because autism symptoms often become noticeable around the same time children receive certain vaccines, but extensive research has confirmed no link between the two.

What If My Child Experiences Side Effects?

Mild side effects like a low fever or body aches are common and indicate that the vaccine is working to build your child’s immunity. Serious reactions are very rare, and the benefits of vaccination far outweigh the risks of the diseases they prevent.

Remember

If you have any questions or concerns about your child’s vaccines, don’t hesitate to contact your pediatrician. They can provide the information you need to keep your child healthy and up-to-date with their immunizations.

Recognizing Signs of Breastfeeding Challenges

While breastfeeding is a natural process, it isn't always without its hurdles. If difficulties arise, they can quickly escalate, potentially affecting your milk supply or your baby’s ability to receive adequate nutrition. That’s why it’s crucial to seek support immediately if you encounter any challenges while breastfeeding at home.

Don't Wait to Seek Help

Reach out to your child’s pediatrician as soon as possible, and persist in seeking personalized support until your concerns are addressed. Prompt intervention can help you and your baby continue to enjoy the many benefits of breastfeeding.

11 Signs of Breastfeeding Challenges to Watch For:

  1. Unusually Short or Long Nursing Sessions:
    If your baby consistently nurses for less than 10 minutes during the first few months, they may not be getting enough milk, or your milk production might be insufficient. Conversely, sessions lasting longer than 50 minutes could indicate ineffective suckling or low milk supply.

  2. Baby Still Hungry After Most Feedings:
    If your baby seems unsatisfied after feeding, they may not be receiving enough milk. Consult your pediatrician and ensure your baby is weighed immediately. Meanwhile, double-check their latch and positioning during nursing to improve milk intake.

  3. Skipping Nursing Sessions or Sleeping Through the Night:
    Newborns need frequent, round-the-clock feedings to gain the necessary weight for healthy growth. If your baby regularly misses feedings or sleeps longer than 4 hours at night, wake them up and encourage nursing.

  4. Lack of Audible Swallowing:
    Once your milk has come in, your baby should swallow frequently during feeding. If you don’t hear swallowing, it may indicate they aren’t getting enough milk. Contact their pediatrician right away for further evaluation.

  5. Inadequate Weight Gain:
    By two weeks of age, your baby should be at or above their birth weight, gaining at least 5 to 7 ounces per week. If they aren’t, it’s a strong indication that they might not be receiving enough milk.

  6. Fewer Wet Diapers and Bowel Movements:
    After the first week, your baby should have at least 6 wet diapers and 4 stools per day. Dark yellow urine or dark-colored stool can be signs of inadequate milk intake.

  7. Delayed Milk Production:
    If your milk hasn’t come in by day five, or your breasts don’t feel fuller, have your baby weighed by their pediatrician immediately. A lack of fullness could indicate low milk production.

  8. Severe Breast Engorgement:
    Hard, painful breasts can make it difficult for your baby to latch properly, potentially reducing milk supply. You may need to express milk until your breasts are less engorged to ease the process for both of you.

  9. Persistent Breast Fullness After Feeding:
    If your breasts remain hard and full after feeding, it might mean your baby isn’t consuming enough milk or isn’t suckling effectively.

  10. Severe Pain During Nursing:
    Significant pain could indicate an improper latch. If nursing is painful due to severe nipple pain or cracking, consult a physician or lactation specialist to address potential infections or latch issues.

  11. Lack of Milk Let-Down Sensation:
    If you don’t feel the let-down reflex after a week or two, it may suggest low milk production. Have your baby’s pediatrician evaluate your situation, and consider seeking guidance from a lactation specialist or La Leche League volunteer.

Understanding Measles: Essential Information for Parents

Measles is a highly contagious viral disease that can lead to severe and sometimes life-threatening complications. The good news is that measles can be prevented through vaccination.

While measles was once under control in the United States, recent outbreaks have occurred in areas where vaccination rates have dropped. (For more information, see "School Attendance During a Measles Outbreak" and "Measles Vaccine Requirements for International Travel.")

Given how easily measles spreads, outbreaks can occur rapidly. Typically, children who contract measles either haven't received the recommended vaccines or are too young to be vaccinated.

The U.S. immunization program for children and adolescents has reduced measles cases by over 99% since 1963. However, international travelers can bring measles back to the U.S., spreading it to vulnerable individuals and potentially triggering outbreaks.

Once a case of measles is identified in a community, it’s treated as an outbreak due to the disease’s rapid spread. Local health officials must act quickly to identify and isolate those exposed to prevent further transmission.

Travel Tips for Families with Young Children

  • Infants under 6 months: These babies are too young to be vaccinated but may receive some protection from maternal antibodies. Consider postponing travel to areas experiencing measles outbreaks.

  • Infants 6-11 months: Should receive their first dose of the MMR vaccine at least two weeks before traveling. They will still need the standard 2-dose series later.

  • Children 12 months and older: Should receive the first dose of the MMR vaccine, followed by the second dose 28 days later, along with other age-appropriate vaccines.

  • Before Traveling: Check the Centers for Disease Control and Prevention (CDC) Travel Health Notices for advisories. Additional vaccines may be recommended depending on your destination.

How Contagious is Measles?

Measles is one of the most contagious diseases in the world. If unvaccinated or not immune, 9 out of 10 people exposed to measles will contract it. Even brief exposure to someone with measles in a shared space can result in infection.

When is a Person with Measles Contagious?

Individuals with measles are contagious before they realize they are sick—4 days before the rash appears and up to 4 days afterward.

How Does Measles Spread?

Measles spreads through direct person-to-person contact and via airborne droplets from coughs or sneezes. The virus can survive on surfaces and in the air for up to two hours, making it possible for someone to contract measles simply by entering a room where an infected person had been.

What are the Symptoms of Measles?

Measles symptoms typically start with a high fever, followed by a rash that begins on the head and spreads downward. Additional symptoms may include:

  • Cough, runny nose, and red, watery eyes

  • Small white spots inside the mouth (Koplik spots)

  • Diarrhea

  • Ear infections

Measles can also lead to severe complications such as pneumonia, encephalitis (brain swelling), deafness, intellectual disabilities, and even death.

What to Do if Your Child is Exposed to Measles

Symptoms usually appear 8-12 days after exposure. If you suspect your child has been exposed, contact your pediatrician immediately. They can review your child's immunization records and arrange for a safe examination if needed.

When Should a Child with Measles Stay Home?

Children with measles should remain home from school or daycare until at least 4 days after the rash appears, once they are no longer contagious.

School Attendance During a Measles Outbreak

During a measles outbreak:

  • Children who haven’t been vaccinated should stay home.

  • Unvaccinated children who have no known exposure can return to school after receiving the MMR vaccine.

  • Children exposed to measles who receive the vaccine within 72 hours of exposure can return to school immediately.

  • Those vaccinated more than 72 hours after exposure should stay home for 21 days from the last known exposure.

  • Unvaccinated children who do not receive the vaccine should stay home for 21 days after the last case of measles is reported.

Your pediatrician will advise when it is safe for your child to return to school, helping to protect others who may be unable to receive the vaccine.

Preventing Measles

Measles is preventable through vaccination. One dose of the MMR vaccine protects about 95 out of every 100 people, while two doses increase protection to 97-99%. Follow the recommended vaccination schedule, starting with the first dose at 12-15 months of age and a second dose at 4-6 years. In certain situations, such as during an outbreak, a third dose may be needed.

Remember

Vaccinating your child with the MMR vaccine not only protects them but also helps prevent the spread of measles to others. If you suspect your child has been exposed to measles, contact your pediatrician right away.