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reducing pain in childhood vaccinations
Vaccines are very important to help reduce, or in some cases even eliminate diseases that have caused illness, disability or death in earlier generations. Vaccines are a routine part of healthcare and are the best way to protect children against some very serious infections. The National Advisory Committee on Immunization (NACI) strongly recommends routine immunization. All of your child’s vaccinations should be recorded in their immunization record. Please bring your child’s Personal Immunization Record (yellow booklet) with you to visits, so it can be kept up to date.
We strongly encourage childhood vaccinations at the West Carleton Family Health Team. We wish to make these less painful for infants and children by recommending the following evidence based techniques. Our hope is for parents to work with us to achieve this goal.
Recommendations for parents of infants and children:
Mothers can breastfeed their baby during vaccinations. If the baby cannot breastfeed, the administration of a sweet-tasting solution – like a bottle of sugar water OR a soother dipped in white table sugar – may also help to reduce pain.
Parents hold or cuddle their baby/child during vaccinations.
Tactile stimulation (rubbing) at the injection site prior to injection results in less pain in infants, children, and even adults.
Distraction during injections can help to reduce stress in children. Parents may bring a favourite book or toy to the well baby / child check-up. We have a few tricks which will also be available to the child.
Topical anesthetics – like EMLA cream or patch (Lidocaine-prilocaine 5%), Ametop gel (Amethocaine 4%) or Maxilene cream (Liposomal 4%) – are available “over the counter” at your pharmacy (call us if you require a prescription). The vaccination injection site depends on the child’s age and the vaccine being given. If you would like to apply an anesthetic cream to the injection site prior to vaccinations, please ask your provider before leaving the office where the next injection site will likely be. Please remember to apply the anesthetic product if you so choose 20 to 60 minutes prior to vaccinating (30 minutes works well).
Please DO NOT tell children, “It won’t hurt.” This has not shown to be effective in reducing pain.
** DO NOT ** give your infant / child fever reducing medication – like Tylenol, Tempra, or Advil – prior to immunizations and until at least 4 hours after vaccinations. The administration of any of these products may reduce the level of disease preventing antibodies produced in your infant / child’s body after vaccination.
An electronic medical record of all immunizations given at the West Carleton Family Health Team will be maintained in your child’s medical chart. You can access your child’s entire immunization record, at any time, on our Patient Portal. Please register each child and parent on the Health Portal.
Never use a baby walker. Walkers are dangerous and don’t help babies learn to walk.
Open doors cautiously. Babies can be hidden behind them. When you close a door, make sure baby’s fingers are not in the way.
Never leave your baby in the care of small children.
Keep unsteady furniture out of reach. It can be pulled over easily.
Due to the risk of suffocation, never use ribbons, chains or strings to attach a pacifier.
Beware of electrical outlets; all outlets should have a plastic cover.
Never leave baby alone in the bath. Not even for a few seconds.
Never leave baby near a fire, oven door, electric iron, kettle, or fan.
Keep the crib sides up. Baby can easily topple out at this age.
Never place baby’s highchair near a stove, electric appliance, plants, or in a high traffic area.
Keep babies away from stairs. Stairs are dangerous.
Unplug electric appliances when not in use and keep cords out of baby’s reach as they can bite them or trip over them.
Avoid play areas with sharp-edged tables and furniture, or cover table corners.
Avoid feeding infants hard-to-swallow foods such as nuts, raw carrots, orange segments, candies, chips, gum, grapes, raisins, and hot dogs, as these can choke a young child.
Information containing safety tips as above sourced from: Ontario Medical Association’s Committee on Accidental Injuries
In April 2014, Health Canada, Dietitians of Canada, the Canadian Pediatric Society, and the Breastfeeding Committee for Canada together released updated guidelines for feeding infants aged 6-24 months. Below is a summary of the key points regarding introducing solids to your baby. You will find new recommendations in bold.
The best time to introduce solids may be a few weeks before or after 6 months, based on the readiness of your baby and recommendations from you health care provider.
Breastfeeding (or formula feeding) is the primary source of calories and nutrition for babies, so don’t stop!
Daily Vitamin D supplement (400IU) is recommended for infants and young children who are breastfed ONLY.
Introduction of solid food at around 6 months of age (or 6 month corrected age*) is recommended.
The first foods introduced to your baby should be iron rich foods; single-grain iron fortified infant cereal (oatmeal, rice, or barley) and well-cooked, pureed, minced, mashed, or shredded meat or poultry, low-mercury fish, legumes (beans, lentils, and peas), tofu, or eggs. (NOTE: If your baby was born prematurely, speak to your doctor as they may need an iron supplement). After iron rich foods are introduced and your baby is eating them on a regular and daily basis, you can then introduce fruit, vegetables, grain products and dairy products (with the exception of milk)
There is no recommended order for introducing foods after iron rich foods are introduced.
Offer one new food at a time.
Wait 3-5 days between offering new foods.
Foods can be introduced using a variety of soft textures. *Past advice was to start your baby on pureed food, however, at 6 months of age, babies are able to handle a variety of textures.
Potentially allergenic foods should be part of the first foods offered to babies; this includes eggs, milk, peanuts, seafood, sesame, soy, tree nuts, and wheat. *Contrary to past advice, in order to decrease the likelihood that your baby will develop and allergy, introduce the above foods early (as recommended) and serve them often.
This applies to all babies, including those with a family history of allergies. If you have a strong family history of food allergies, talk to your health care provider about introducing potentially allergenic foods in a safe manner.
There are only 2 exceptions to the “try everything” approach:
MILK: homogenized milk can be introduced to breast or formula fed babies from 9-12 months.
HONEY: avoid honey and all products made with honey until at least one year of age due to risk of botulism.
Toss the sippy cup!
The use of sippy cups is no longer recommended.
The use of regular “open” cups (at 6+ months) is now the gold standard.
The reasoning is that “open” cups support the development of feeding skills.
*corrected age (used for premature babies) = actual age in weeks minus weeks premature.
