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While vaccines are one of our great success stories in modern medicine, saving millions of lives over the past several decades, they remain a topic of uncertainty for many parents. You are not alone if you have questions about vaccinations for your growing family. This article will guide you through the most up-to-date newborn-vaccination recommendations to help keep you and your newborn twins safe.

Highlights:

Newborns have a high risk for severe complications from vaccine-preventable illnesses.

All babies should receive the first hepatitis B vaccine within 24 hours of birth.

The CDC recommends COVID-19 vaccines for everyone ages six months and older, including people who are pregnant and breastfeeding.

Pregnant women should also receive a Tdap (whooping cough) and flu vaccine.

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Family members and caregivers should be up-to-date with immunizations and boosters, including whooping cough and influenza vaccines.

Why are vaccines so important?

The simple answer – getting vaccinated is better than getting the disease. Those quick little pokes have saved many children from dying from diseases like meningitis, diarrheal infections, and many more. Since a newborn’s immune system is not fully developed, they are at an even higher risk for severe complications from vaccine-preventable illnesses.

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Are vaccines effective?

Yes! Vaccines do an outstanding job. Many diseases affecting children have been reduced or eliminated thanks to vaccines. Most childhood vaccines are 90% to 99% effective in preventing disease, and if a vaccinated child gets the disease, the symptoms are less severe than the illness of a child who did not get the vaccine.

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Are vaccines safe?

Millions of children safely receive vaccines each year. The most common side effects are pain or swelling at the injection site. Serious side effects from vaccines are rare. For every 1 million vaccine doses, 1 to 2 people may have a severe allergic reaction. Your doctor’s office is well-trained to treat any severe allergic reactions that may occur.

Why do vaccinations start at such a young age? Do I have to stick to the recommended vaccination schedule?

Changing the recommended vaccination schedule is not a good idea. The CDC’s recommended scheduling for each vaccine is based on age and factors like immune response and likelihood of exposure to the disease. There is no research to show if a child would be equally protected with a very different schedule.

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Tips for vaccinating twins

Most new parents cringe at the idea of their newborn receiving their first shot, and this can be double as tough for parents of twins. Here are a few tips to help make the injection go as smoothly as possible:

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Enlist some help: Having an extra pair of hands to help undress, dress, and comfort the babies after the injection can be incredibly helpful. If no one is available to help, ask if a staff member, such as a medical assistant, is available to help during the vaccinations.

Ask for something sweet. A sweet solution of sucrose or glucose (often called sweet-ease) a minute before the shot can help reduce your little one’s discomfort with the injection.

If you are breastfeeding, this can help soothe them after the vaccination. Have your helper hold them during the vaccination and get them dressed, so you can take them afterwards.

For triplets or more: Consider having them vaccinated at different times, especially if you do not have a helping hand.

Vaccines for newborns

Hepatitis B Vaccine

Brand Names: Engerix-B and Recombivax HB (3-dose vaccine series); Pediarix, Vaxelis (4-dose vaccine combination series)

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Hepatitis B is a contagious liver disease caused by the hepatitis B virus. The vaccine is vital in your newborns because approximately 90% of infants who become infected with hepatitis B will become chronically infected (compared to only 2%–6% of adults). Chronic hepatitis B can lead to chronic hepatitis, liver cancer, and death.

All babies should get the first hepatitis B vaccine within 24 hours of birth. The hepatitis B vaccine may be given as a 3-dose vaccine series or as part of a 4-dose vaccine combination series (a vaccine that combines more than one vaccine into one shot). Both series start at birth and are completed by 6-18 months.

Some newborns will have a mild reaction, such as pain at the injection site or a rash. If you are concerned about symptoms, call your pediatrician for guidance. Here are a few tips for comforting your twins after the injection:

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A cool, damp cloth can help reduce any redness and swelling at the injection site.

Some newborns will want to eat slightly less the 24 hours after getting a vaccine and may prefer smaller and more frequent feedings.

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If a pregnant mother tests positive for hepatitis B, the babies will get their first shot of the hepatitis vaccine within 12 hours of birth and receive a hepatitis B immune globulin (HBIG) along with the vaccine to help prevent the disease.

What is the recommendation for the hepatitis B vaccine in premature babies? If your twins were premature and weighed less than 2000g at birth (about 4lbs., 6oz.), the American Academy of Pediatrics (AAP) recommends the hepatitis B vaccine be given at one month of age or when discharged home from the hospital (whichever comes first).

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Vaccines for family members and caregivers

Family members and other caregivers can protect newborns by staying up-to-date on all their vaccinations.

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Whooping Cough Vaccine (DTaP for children and Tdap for preteens, teens, and adults)

Whooping cough can cause severe and life-threatening complications in babies, especially those under six months. About half of babies who get whooping cough will end up in the hospital, about 1 out of 4 will get pneumonia, and 1 out of 100 will die. Whooping cough is very contagious and is transmitted through respiratory droplets. The best way to protect newborns from whooping cough is to ensure pregnant women get a whooping cough shot (called Tdap vaccine) during each pregnancy between 27 and 36 weeks. It’s also crucial that siblings and anyone around the babies are up-to-date.

Influenza Vaccine

Influenza (commonly called the flu) can also cause severe complications like dehydration, pneumonia, and even death in babies less than six months. Because flu vaccines are not approved for use in children younger than six months old, protecting newborns from the flu is especially important. The CDC recommends that all pregnant women get the inactivated flu vaccine (the injection, not the live nasal flu vaccine). All caregivers and household members six months and older should also get the influenza vaccine.

COVID-19 Vaccine

We still have a lot to learn about the risks of COVID-19 in newborns; however, it appears most newborns who test positive for COVID-19 are asymptomatic or have only mild symptoms. The CDC recommends COVID-19 vaccines for everyone ages six months and older, including people who are pregnant and breastfeeding. Booster shots are approved for everyone five years of age and older.

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Helpful resources for parents

To learn more about vaccine ingredients: What’s in Vaccines?

Centers for Disease Control and Prevention (CDC): Vaccines & Immunizations

American Academy of Pediatrics: Conversations About Vaccines

Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 1-800-822-7967. VAERS is only for reporting reactions, and VAERS staff do not give medical advice.

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References

Kempe A, Saville AW, Albertin C, et al. Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics. 2020;146(1):e20193852. doi:10.1542/peds.2019-3852

Child and Adolescent Immunization Schedule. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Published 2022. Accessed September 3, 2022.

Hepatitis B Foundation: Hepatitis B Vaccine Schedules. Hepb.org. Published 2022. Accessed September 5, 2022.

The post Newborn Vaccinations: a pediatrician’s guide to keeping your newborns safe appeared first on TWINS Magazine.

FASDs are a group of conditions that can occur in a person exposed to alcohol before birth. The severity of symptoms varies from child to child, but can include:

• Vision or hearing problems
• Problems with the heart, kidneys, or bones
• Sleep and sucking problems as a baby
• Hyperactive behavior and difficulty with attention
• Learning disabilities (especially with math) and intellectual disability
• Speech and language delays
• Shorter-than-average height
• Abnormal facial features, such as a smooth ridge between the nose and upper lip

What do we know about twin pregnancies and exposure to alcohol?

A study of twins exposed to alcohol in utero shows that similar amounts of alcohol can lead to drastically different levels of neurological damage.¹ While twins with identical DNA had similar fetal alcohol outcomes, non-identical twins could show strikingly different outcomes: one could be born with severe symptoms while the other was only mildly affected.

What does this mean? The risk of damage does not only depend on how much alcohol is consumed during pregnancy, the baby’s genetics also play an important role. The biggest takeaway, to protect all babies, including those most genetically vulnerable, the only safe amount of alcohol is none at all. There is also no safe time during pregnancy to drink alcohol, and all types of alcohol are equally harmful, including all wines and beer.

How are FASDs Treated?

FASDs last a lifetime, and while there is no cure for FASDs, early intervention treatment services can improve a child’s development. Treatment typically includes special education services, behavior therapy, counseling, and medication. In some cases, children with FAD may need to be placed in a special education classroom or receive other types of educational support.

Fetal alcohol disorder is a serious condition. If you’re pregnant or thinking about becoming pregnant, it’s important to avoid drinking any alcoholic beverages so that you can reduce your child’s risk for this disorder. If it is hard to stop drinking, talk with your doctor about getting help. You also can visit the Alcoholics Anonymous website at www.aa.org or call the Substance Abuse and Mental Health Services Administration’s treatment referral line at 800-662-HELP (4357).

References

1. Genetic risks play part in fetal alcohol syndrome. Newsroom.uw.edu. https://newsroom.uw.edu/news/genetic-risks-play-part-fetal-alcohol-syndrome. Published 2022. Accessed September 9, 2022.
2. Alcohol and Pregnancy. Acog.org. https://www.acog.org/womens-health/infographics/alcohol-and-pregnancy. Published 2022. Accessed September 9, 2022.

The post Fetal Alcohol Spectrum Disorders in Twin Pregnancies appeared first on TWINS Magazine.