Our role as your child’s pediatrician is not only to see her for acute illness, but to also provide comprehensive well child care. During the first two years of life, we will see your child frequently. Your baby’s growth and development will be followed closely, and immunizations will be given. In the first two years, we will discuss proper nutrition, development, and help you with other problems such as discipline, so that you and your child can build a solid and healthy foundation for future growth and development.

Older children should have yearly check-ups. During these visits, a physical examination will be done to catch any potential problems early in order to treat it well. Also, any problem with discipline, nutrition, bed wetting, school, etc., will be discussed.

Schedule of Visits

1-2 weeks - 6 months - 19-20 months

1 month - 9 months - 2 years

2 months - 12 months - 3 years

4 months - 15 months - Yearly Thereafter

Immunizations

Immunizations have been a godsend in the prevention of many infectious diseases. Every year, they prevent countless serious illness and thousands of deaths from germs such as diphtheria, pertussis (whooping cough), tetanus, measles, mumps, and rubella (German measles).

Vaccines are among our safest and most reliable medicines. Each year in the United States, about 100 million doses of vaccine are given, most to infants and children as part of their routine immunizations.

Vaccines, however, like any medicine, can cause side effects. These are usually mild and brief. Very rarely are they serious. However, the benefits of being protected by immunizations are felt to greatly outweigh any risk from the vaccines.

Below you will find information about commonly given vaccines. This information will be reviewed with you when immunizations are due. If you have any questions, be sure to ask before immunizations are given.

DTaP - DTaP vaccine provides protection against diphtheria, tetanus, and pertussis (whooping cough). The DTaP is administered as an injection or shot. Mild reactions following administration of the DTaP vaccine are fairly common. These include pain at the injection site, mild to moderate fever (100-104, rectally), fussiness, and redness/swelling at the injection site. These side effects usually last only one or two days. A bump at the injection site may last up to two weeks.

Baby acetaminophen (Tylenol) administered just before the immunization and repeated every 4 hours for 1-2 days appears to significantly reduce reactions. Cool compresses on the injection site may also help reduce baby’s discomfort. More serious reactions, such as those affecting the brain or nervous system, have been reported rarely. It has not always been clear in these cases whether the DTaP vaccine or some other factor caused the problem.

Nevertheless, you should call us if your baby exhibits any of the following within 48 hours of a DTaP injection:

• High pitched persistent crying for more than three hours
• Excessive sleepiness (baby may be difficult to wake)
• Unusual limpness or paleness
• Rectal temperature of 104º or higher
• Convulsions/ seizure

Tdap - Tetanus/diphtheria/pertussis booster. The first booster is received 5 years after the completion of the DTaP series. Further boosters are needed every 10 years throughout your child’s life. Boosters are given sooner in the event of dirty wounds and some animal bites.

IPV- Polio - Polio is a paralyzing illness that is no longer seen in the United States but remains prevalent in other parts of the world. The vaccine is a “killed” vaccine and therefore has no risk of causing polio.

MMR - MMR provides protection against measles, mumps, and rubella (German measles). The MMR is administered as an injection or shot. Some children may develop fever after receiving the MMR and a few may develop a mild rash. These generally occur 7-12 days after the vaccination and last only a day or two. You should call us if your child develops a high fever or acts ill. Very rarely (about one in a million doses) the vaccine has been thought to cause more serious reactions such as inflammation of the brain. MMR does not cause autism.

Haemophilus Influenza Type B (HIB) - The HIB vaccine protects against infection with Haemophilus influenza type B, once the most common cause of bacterial meningitis and epiglottis in children under 5 years of age. Side effects are rare and are usually limited to mild fever and local swelling.

Hepatitis B - Hepatitis B vaccine is given as an infant immunization. It is designed to protect your child from Hepatitis B, a potentially serious liver disease. Older children and others living in a household with someone who has Hepatitis B should be immunized if they did not receive it as an infant.

Hepatits A - This vaccine protects children from a virus that causes potentially serious liver disease as well flu-like symptoms, jaundice and severe stomach pain and diarrhea. The virus is found in stool and diarrhea and can be easily passed among household and daycare contacts and from infected food handlers. It is given as a two dose series.

Rotavirus - This vaccine protects against a virus that causes severe diarrhea in babies that is sometimes accompanied by vomiting and fever. The vaccine is orally taken at 2, 4, and 6 month visits. Side effects of this vaccine include mild, temporary diarrhea within 7 days of getting the vaccine.

Varivax - The varicella/chicken pox vaccine is effective in 80-90% of children immunized. The 10-20% of children who do contract chicken pox despite immunization contract a much milder case of chicken pox than otherwise expected. Side effects may include fever and a mild rash within 2 weeks after the immunization.

PCV7 - Prevnar - This vaccine helps prevent childhood diseases caused by the bacteria streptococcus pneumonia, also known as pneumococcus. Pneumococcal infections are the most common invasive bacterial infections in children in the United States. These infections include meningitis (an infection that causes inflammation of the membranes surrounding the brain and spinal cord) and bacteremia (bacteria in the blood). Side effects of the immunization include injection site reactions, fever, irritability, drowsiness, restless sleep, and decreased appetite.

MCV4 - Menactra - This vaccine helps protect against four of the five types of meningococcal bacterium, which can cause meningitis. Infants and adolescents, especially college students living in dorms, have the highest incidence of the disease. Side effects of the immunization can include pain or redness at the sight of injection. The vaccine is not made from whole bacteria so it cannot cause meningitis.

Human Papillomavirus (HPV) - This vaccine protects against the virus (HPV) that causes most cases of cervical cancer in women as well pre-cancerous lesions and genital warts. It contains the most common strains that cause disease. Many teenagers and at least 50% of all adults have acquired at least one type of this virus that is spread by close intimate/sexual contact. The vaccine is given in three doses to females, beginning at age 11 before they are potentially exposed. Patients cannot get HPV from the vaccine. Common side effects are similar to other vaccines and include pain, itching, swelling and redness at the injection site as well as mild fever.