Mosquito Protection For Infants

For Indian kids especially kids growing up in villages, mosquitoes are a part and parcel of life. Especially in the times of harvesting and all, all the mosquitoes in the farms and fields land up in our houses come evening, actually the menace would be there whole day around.. so we just need to close all the doors and windows or at least the mesh doors/windows to curb their entry into the house. I personally use sambarni poga in the house in the evening. In spite of taking a lot of care, some clever ones manage to settle inside, so for those these days we have mosquito bats, I use All-Out liquid, take out all the lights in the house, put on all the fans, put saambrani poga and after 5 minutes open all the doors, switch on the lights outside in the varendah and in the yard... believe me, all the mosquitoes will vanish within 15 minutes.. then close the doors and enjoy a mosquito free night.

Phew.. there are certain creams like odomos and all available in the Indian market but my doctor and I personally am against it cos the tends to put hands legs and whatever they can into their mouths, so there is a lot bigger problem than mosquitoes.. the toxic ointment ingestion :(. The best advise is put them in full sleeves, long pants, socks, monkey caps if it is winter and put them in mosquito nets... doma teralu in telugu...

I personally avoid Jet coils as well because I kind of choke on the fumes from the coil, so don't want the kid to be exposed either..

However, for kids from US who have never been exposed to a mosquitoes ever, first visit to India during this mosquito season might be a problem... so here go suggestions from a few moms..

The mosquito repellent 's name is "NATRAPEL". It can be found in TOYSRUS or BABIESRUS. In all the other stores it can be found only in summer.

Any other insect repellent can also be used like "OFF" and "CUTTER". But dont spray it on the baby's or the kid's body directly, instead spray it on the baby's clothes and so it everytime you change the clothes.

Vaccination and Fever

When the vaccine is administered, either due to the process of immunization or due to the pain of the needle prick, the kid might develop mild to moderate degree of fever which is very natural. There is a popular myth that one should get fever in order for the vaccine to be effective. No, it is absolutely fine even if the kid does not have fever and it is also absolutely fine if the kid has low-grade fever. Just ensure that you monitor the baby for fever or any signs of pain all the time. A fever below 100 is normal. However if is consistently above 100 not dropping even with wet-cloth wipes, then better consult the doctor.

Administer Calpol/Tylenol (check about the latest recall before you administer) drops immediately after the vaccine.. yes, they are the fever drops but also used for pain control. If the child still suffers from fever despite of giving Calpol drops 3 times a day, wet-cloth wipes, etc. then it is a case of concern.

One of the main reasons to ensure fever control with or without vaccination is that some kids tend to develop high temperatures and in extremely rare cases it might give way to febrile seizures.. so fever control in a kid is absolutely must. It is easy to control, but once it goes out of hand, then starts aggressive medical intervention. So, better be safe than sorry.

Also, once the vaccine is administered ensure that you keep holding the needle-pricked area for a while and then rub it mildly thereafter. Also, keep checking if there is swelling or redness in that area and if the swelling continues, do hot-water compresses.. if the redness and swelling persists beyond a couple of days and the kid is in very severe pain, just call the doctor or take the kid. However, simple and constant care and monitoring will not let things go far, so be alert and cautious the day of vaccine administration and keep a watchful eye.

It is advised not to give the kid anything including water or milk for 30 minutes to an hour after the vaccine, so better ensure that the kid is well-fed, non fussy by the time of the appointment. Do not overdo with giving fever drops/syrup until it is an absolute must. If it is just a low-grade fever of say 99, see if it still persists after a nap or some time and only then go for the medicine.

Usually for the first vaccine the kid might just cry a little while at the time of the prick but just forget it later on, it is only at the later stages when they realize pain that they tend to cry for a longer time. My personal experience says that first time the parents cry more than the kid and from the next on both of them get used to it :).

Good luck and yeah, the moms/dads out there do not cry, easy to say.. i did cry and the doctor still jokes that I had flooded his office on Sreya's first vaccination :). dont wince, dont cry, just take care of the baby. :).

IPV vs OPV

Polio -- this is the one word which kind of changed the dimension of my life. Born a healthy child and supposedly infected by it after being administered the drops at the age of 6 months, the trauma I had to go through to get my kid immunized with it is unspeakable and cannot be expressed.

Though, the final report is that my leg problem is not polio, it is the muscle wastage because of some nerve damage due to incorrect needle prick rather than anything.. the term still scares the hell out of me... limping for life, termed handicapped by many, looked down upon unnecessarily, it is the one word that kind of describes my existence, survival or whatever.

So, when it was time for Sreya to be put through this ordeal, one can only imagine as to what all the thought process went into it... so, the doctor seeing me scared the hell out of my wits gave me whole lot of reassurance and helped me out in a lot of ways treating and preparing me mentally before treating Sreya for which I would be eternally thankful to him. He assured me that it was not VAPP (vaccine-associated poliomyelitis paralysis) that I have and however, he suggested me an option for my fear, IPV, God-send for the paranoid me.

Eradicating that very deadly polio is very very important for our future generations and in almost all the developing countries OPV (oral polio vaccine) is widely distributed and administered free of cost and it is ensured that the message is reached far and wide and every single kid benefits from this. However, IPV (inactivated polio vaccine) is something like a dead-virus vaccine in layman terms which eliminates even the remotest possibility of VAPP... How???

How does a vaccine work.. in layman terminology is an effective method of containing infectious diseases.. the bug (bacteria/virus) either killed or inactivated in the form of vaccine is introduced into the body and the body cells fight against it and develop an immunity towards that particular agent (as far as I can gather). So, in very remote cases, there is a possibility that the induced bug acts up and the vaccine becomes the source of infection, very very very minimal, but still there is a possibility. IPV is thus an inactivated form of the vaccine which contains all the three serum types of the vaccine which eliminates even that remotest possibility.

Then, how come it is not available to all the people.. because of the incremental cost of producing the vaccine. OPV is easy to administer, even a layman can do that, just giving the drops and like they say something is better than nothing and since polio is almost eradicated, it is just a post-eradication measure, the mass polio vaccination, that is. It is also believed my some people that once complete eradication of the disease is declared OPV may be the only mode of acquiring the disease (an assumption at this point). So, IPV at any rate is better than OPV.

However, there is something called secondary immunization following exposure to the same or closely related antigen..like say, we exposed the kid to polio vaccine and then we need follow that exposure with secondary immunization just to be sure. So, my pediatrician says it is always a good idea to take the kid to OPV camps when they are announced just to ensure the secondary immunization.

I did extensive reading on this, brain-picked my pediatrician and finally went ahead with IPV.. a simple choice for many parents but a crucial one just for me because of my problem.

So, done with IPV for the kid, I would just follow it through with OPV at the designated time at a designated place.

Good luck with vaccines guys!!!

For more reading on the same..

http://www.abtassociates.com/reports/2003412377280_88928.pdf

check the link.

Vaccination Schedule -- India.

At Birth
BCG -- This vaccine site should bulge or come up as a mark within a month of its administration, the typical teeka maccha for Indian kids. We need to inform the doctor if the site does not show any change after a month or so.
OPV0 -- oral polio vaccine
Hepatitis B1

(got it done 3rd day of life)
*****

6 Weeks
DPTw1/DPTa1
OPV1/IPV1
Hepatitis B2
Hib1

(Got the combo vaccine Pentaxim which was supposedly the fever-less vaccine with IPV HIB, TT and all put together for 5 diseases -- It was purely personal choice, please follow your doctor's advise).. so it was just 2 needle pricks for her, instead of 4 or 3 on both the thighs.
*****

10 Weeks
DPTw2/DPTa2
OPV2/IPV2
Hib2

(Got the combo vaccine Pentaxim which was supposedly the fever-less vaccine with IPV HIB, TT and all put together for 5 diseases -- It was purely personal choice, please follow your doctor's advise).. so it was just 1 needle prick for her, instead of 3 on both the thighs..
*****

14 Weeks
DPTw3/DPTa3
OPV3/IPV3
Hepatitis B3
Hib3
(Got the combo vaccine Pentaxim which was supposedly the fever-less vaccine with IPV HIB, TT and all put together for 5 diseases -- It was purely personal choice, please follow your doctor's advise).. so it was just 2 needle pricks for her, instead of 4 or 3 on both the thighs.

9 Months
Measles/OPV

1 Year
Chicken Pox
Hepatitis A first dose (optional).

15-18 Months
DPT wB1/DPT aB1 (booster dose)
OPV B1/IPV
HIB B1 (booster dose)
MMR -- Measels/mumps/rubella
Hepatitis A 2nd dose (optional)

2 years
Typhoid 1st dose

5 years
DPT wB2/DPT aB2
OPV B2/MMR
Typhoid 2nd dose

10 Years
TT 3rd Booster

15 Years
TT 4th Booster

Also, there are some optional vaccines
ROTARIX between 2 to 6 months... 2 doses (liquid drops). Got this done.
Varicella vaccine -- less than 15 months of age
Hepatitis A
Pneumococcal Conjugate Vaccine -- greater than 6 months of age.
Prevenar -- consult doctor for dosages

Different doctors have different approaches and treatment, so consult and discuss with your pediatrician and get his/her opinion before going ahead with any choice. Some conservative physicians do not prefer the combination vaccines and some do not inform all the parents because of the price factor as they are slightly on the expensive side for the fear of an allegation of minting money and let us know only if we can afford it.

Combination or single, all of them have the same effect.. claiming fever-less and painless and all is secondary, the fact is that the child gets immunized properly.

First Aid Box and Emergency Meds -- India

Back in India, we get medicines in the medical hall as and when we want to just by showing the prescription or even over-the-counter.. no specific restrictions.

The number of drops to be given and the brand name given varies from doctor to doctor. The number of drops to be administered is critical and varies from kid to kid based on the kid's weight, so just make sure you get yourself updated with the doctor as to how much of what drug should be administered.

DO NOT USE MEDICINES UNLESS ABSOLUTELY NECESSARY AND YOUR DOCTOR PRESCRIBES IT.

So, I would list out the contents of Sreya's medicine kit..

1. Cotton.
   
2. Vicks VapoRub (when the kid is a little older say 3 months or so)
3. Vaseline (in case of constipation/touch the tip of an earbud with vaseline and insert in the bottom when the baby is struggling to pass the stool). DO NOT OVERDO THIS.
4. Fever/pain drops.
5. Saline nasal drops for cold.
6. Drops for Cough -- if the cough persists, we need to see the doctor immediately to be treated with antibiotics, so better be very cautious not to expose them to cough and cold.
7. Drops for Vomiting -- slight spitting is normal, spit while burping is normal.. if they vomit more than 10% of what is fed to them continuously, then we need to inform the doctor.
8. Drops for diarrhea -- it is normal to pass stool after each feed especially when breast-feeding and so do not worry about the number of times unless it is really really watery and way too many times.
9. Oral rehydration salts in case of excess vomiting/diarrhea.
10. Drops for Tummy ache/colic -- if the baby folds her legs, stiffens the body in pain, or winces in pain when the tummy is touched it is stomach pain.
11. Drops for earache.
12. Drops for eyes -- when the eyes are tearing and crusting, clean the eyes with cotton balls dipped in clean drinking water very gently and mildly.
13. Syrup for constipation/tight stool -- It is normal for kids not to poop for more than a day, so no worries if it doesnt happen every single day and the baby has no crankiness or hard tummy.. in fact, my doc says it is okay up to 3 days to go without stool and only then it is a problem. So, if it goes beyond that or if the baby is really straining hard and unable to bring out the stool, then go for these drops.
14. Fudic cream -- When Sreya had some skin tear at the ear because of her ear rings, the doctor suggested this. She asked to avoid powder like Nebasulf because it tends to form a layer and tighten on the skin and tough to get it out and that creams are a better option for infant.. external application only.
15. Earbuds -- only for external clearing of the ear.. never inside the canal.
    

I also have Zinda Tilismat which is a Unani medicine to apply on her chest and back and the nose if she has cold which works wonders.. I personally take it internally as well but for Sreya, strictly topical application.

Some doctors also give vitamin drops..
My doc gave me Zincovit and Sunzyme, the digestive enzyme drops.
Iron drops can be done away with because the kids can have severe constipation issues with them unless absolutely necessary and doctor says it is a must.