Why does my child need a flu shot part 1

Why does my child need a seasonal flu shot when he got one at 2, 4 and 6 months with a promise of another one at 12 months? 

I hear this question regularly in my office.  The answer is somewhat complicated.  First you need to understand that the vaccine given at 2, 4, 6 and 12-15 months is not a seasonal flu vaccine.

Seasonal flu or influenza is a virus.  That means that it is a piece or several pieces of protein that surround some genetic material, DNA or RNA.  That viral particle is not capable of eating nor is it capable of breathing.

The vaccine your child received at 2,4, 6 and 12 months is against Haemophilus influenza or HIB.  The unfortunate last name makes people think that theser are the same thing.  HIB is a bacterium.  That means that it is a living, breathing, eating organism.

4 doses of the HIB vaccine protect for life.  The seasonal flu (viral) vaccine however, needs to be repeated yearly because the virus changes its genetic code yearly.

I hope that this clarifies things for you some.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
775-359-7111

4 month well child exam

So what do we do at 4 months you ask?

First we again check height, weight and head size.  Are you seeing a theme here.  These parameters are critical for monitoring your child's health and brain development.

Next we again review developmental milestones.  In my office we now start to use a standardized screening tool for development called the ages and stages questionaire.  This test allows us to check for signs of developmental delay that are very subtle and if present allows us to intervene early.

We then perform the usual physical exam.  Close attention this time is paid to the tone of the muscles throughout.  This is the age when cerebral palsy first becomes easily noticed.

Next we discuss and administer the vaccines

Finally we provide guidance and safety teaching.  This is the age when we first introduce solids so alot of time is spent discussing what foods to introduce and how to introduce them.

I hope that this helps.

kevin m. windisch md, faap
sparks pediatric and adolescent medicine
775-359-7111

2 Month Well Child Exam

So What do we do at 2 months of age? 
Well, we start with checking your child's height and weight and make sure that they are growing okay.  We also check her head size and make sure that her hed is growing okay.  A small or large head could indicate some brain or skull abnormality.

We then check development.  We want to see that your child is starting to look around, lift her head up part way and smile, among other things.

Next, we do a complete head to toe physical.  Special attention is again given to the heart and examining the hips for dislocation.  To see how we do these exams you can go to http://www.youtube.com/watch?v=_5jDjBzXJYA (chest exam) and to http://www.youtube.com/watch?v=uPPkrS8ktp8&feature=related (hip exam).  While maneuvering your child around we also pay close attention to muscular tone (strength) as this could be an early sign of cerebral palsy.

After the exam comes parent teaching.  We will cover things pertinent to 2 month babies including preparation for rolling over, sleep positioning and fever management.

Finally we place the vaccines.  At this age your child will get DTAP, IPV, HIB, PCV-13, Rotavirus and Hepatitis B vaccine.

I hope that this helps to demystify what we are doing

2 week well child exam

So what do we do for the two week well child exam you ask?  After all, wasn't my child just there 2 weeks ago?

Well, first and foremost we check the child's weight.  At this time your child should be back to or above his or her birth weight.  If they have not regained their birthweight there is potential for several serious problems to be present.

Next we will address any concerns that the parents may have for the child.  By now many children have dry skin and the parents wonder what to do about this.  Many children are also spitting up and this raises many parental questions.

Finally we do a complete physical.  The artery pressures in the lungs have finally dropped to their normal adult levels making many murmurs not heard at birth now audible.  We check for liver and kidney size and recheck the hips since dysplastic hips can show up any time in the first 18 months of life.

We end with some safety recommendations for parents and set up the next visit.

I hope that this has helped to demistify what we do.

Kevin M. Windisch MD, FAAP
www.facebook.com/sparkspeds.nv

Whooping cough

This is why I'm so strict about children being up to date on vaccines.  (warning this is very graphic and disturbing)  http://www.youtube.com/watch?v=wuvn-vp5InE  There is a large whooping cough epidemic in Sacramento coming to a child near you.  We need to protect our children and vaccination is the only way.