Baby vaccinations: the what, when & why

Intro

You do realize now how important last night, for example, when he was so distressed, I thought I just need to give him love, he just needs to know now because he is distressed. This isn’t him being naughty. It’s not him being and, I’ve read your books and on Parent Sense. Right now it’s important as you said, I think on this podcast, shaping them for relationships far into the future. And that’s why even though I would’ve loved to go and lie down and let him wiggle around a bit and make noises. I thought, I just need to hold you in my arms and let him know it’s all going to be okay.—Cass

Max is seven weeks old now, and Cass shares how Max reacted to his first vaccine, which led into a deep dive on the topic, how little ones and moms are affected by vaccines, and a little about the controversy that surrounds them. We go on to talk about soothing babies and the concern about forming habits and how to get the balance right. I touch on the importance of tummy time, why it’s so important and how to encourage it. We also speak about why babies wake after 45 minutes. And when will you get those super long stretches of sleep again? So, stay tuned as we discover more about a baby’s second month through the eyes of Cass and Max.

Welcome to Sense by Meg Faure, the podcast that’s brought to you by Parent Sense, the app that takes the guesswork out of parenting. If you’re a new parent, then you are in good company. Your host, Meg Faure is a well-known OT Infant specialist and the author of eight parenting books. Each week, we’re going to spend time with new mums and dads, just like you to chat about the week’s wins, the challenge, and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg every week to make the most of that first year of your little one’s life. And now meet your host.

Meg: Welcome back. I’m Meg Faure I’m an Occupational Therapist and specialist. I have worked with parents for more than 20 years in my private practice. My specialty is sensory integration, sleep problems, and fussy babies, and I’m delighted to be your host and share my expertise with you. And this week we are welcoming back Cassidy. We’ve been tracking Max’s journey since the day he was born. Cass, we have loved learning about the new aspects of development and parenting through yours and Max’s eyes. Welcome back.

Cass: Thank you. Thank you very much.

Meg: How old is max this week?

Cass: He was seven weeks on Monday.

Meg: Oh, my word. It’s incredible how he’s growing. I saw some pictures of him, and he is a robust little boy.

Cass: Yeah, he is. He was weighed yesterday, he’s 6kgs.

Meg: Wow. So, he’s growing. That’s incredible.

Cass: He is for sure. I mean to pick him up now you have to engage your core a little bit now. You don’t want to get interrupted sleep with those bulky babies because you’re going to break your back.

Meg: Yeah. So how has the week been Cass?

Cass: Wild. Yesterday he had his first vaccinations.

Meg: Okay.

Cass: Yeah. So, I am living off zero sleep today because last night was not a blessing, not nice at all. I mean, it was honestly, I could cry thinking about the moment he had his vaccination. He has now forgotten that that happened to him yesterday, but I’m still traumatized. Because he had his first one and he was smiley while they were giving it. It was an oral for rotavirus, it was like a sweet liquid or something into his mouth. And he was smiling and laughing and then they put the first vaccination in his leg, and he honestly just looked like the whole world had betrayed him. And why was this happening? His face, and he burst out crying. He doesn’t cry, so it’s even more heartbreaking when you do hear him cry. And then it was the MenB vaccination.

So, they say immediately to give him Calpol or paracetamol, infant paracetamol. And then he can have three doses four to six hourly because they do get a temperature from that and feel groggy. And he just was so out of sorts all day. And then last night he couldn’t go down at all. I mean, between my husband and I, I couldn’t tell you when he got up and went down because I think he was just permanently up.

Meg: Yeah.

Cass: He would be up, he just didn’t want to be, he was just uncomfortable, and you can only give, at that age, the doctor says you can only give three doses of the infant paracetamol. So, he’d had his three doses and I didn’t want to give him another one. But I don’t think he was fully recovered. So, it was just heartbreaking and he’s still not a hundred percent today. I think it can last up to a few days they say. So, for any mum, it is the most heartbreaking day and has been tough, because you’re also getting tired and you can’t help them.

Meg: Yeah.

Cass: And so, yeah, it’s been a tough, tough time.

Meg: So, vaccines are quite interesting. So first of all, mums who’re listening in South Africa and America will not be getting those vaccines at seven weeks. And that’s because the vaccine protocols are different in every country. In fact, your first vaccine for South African babies is on the day they’re born. So you, they start early, earlier than the British babies, for sure. So, vaccine schedules are all different. And the other thing that’s different is how the little ones are going to react to vaccines because, and certainly with my three kids, I found that, some of them just sailed through them. Some of them had reactions to certain vaccines, but everybody’s journey is different. And then, of course, there’s also the controversy around vaccines. And one of the things that you highlighted was the giving of paracetamol after the vaccine and that’s even contestant, where people say, should we be reducing temperatures because the body’s doing what it’s supposed to be doing, which is building immunity.

But yeah, by and large, two principles from my perspective. One is vaccinations are, and we know are the greatest development in modern medicine, there’s no question. And I think it’s been quite interesting, the whole vaccine debate where there was a huge drop-off and I’m not talking about the COVID-19 vaccine debate, that’s another story, but the little ones kind of normal childhood illness vaccine debate, what was quite interesting was I heard an incredible podcast sometime last year talking about what was it, why do moms sometimes think they know shouldn’t vaccinate? And one of the things that came up was that it’s because we are too far away from the diseases, we’ve got so much of the immunity now. We haven’t seen the effects of polio, smallpox, and if any of us in our lifetime had ever seen the effects of polio smallpox, we just wouldn’t question those vaccines at all because the effects are terrible. But the further away we get from kind of epidemics, and of course we now in the midst of one, but the further we get away from epidemics, the less worried we are about them. And then suddenly the side effects or the complications or whatever it is of the vaccine outweigh the benefits because we don’t know what the benefits are. We don’t know what the world looked like without the vaccines.

So yeah, from my perspective of being medical, I am pro vaccines and I think that it’s important. And I know that the day around the vaccine can be a bit of an upheaval. And I mean, in fact, just seeing that needle go into his leg can be devastating, kind of the look on his face was probably as painful as the night’s sleep.

Cass: It was. Yeah, it was interesting the nurse who was doing it, rather than saying sorry to him, she said, “Sorry, mom, this isn’t very nice.” And I thought, oh, okay. And it was me that had, I was interested to see how he was going to cope with it anyway. Because when he was born, obviously he had a lumbar puncture within 24 hours, he’s had heel pricked every day because they had to take his blood. So, I thought he might find this easy, and he got over it very quickly. I did hear another baby coming out afterward who was still crying as she was wheeled out. And I thought, oh no. And he was over it. But if it had just been a case of having the vaccine, I wouldn’t have been too traumatized. I don’t think, it was just so tough because of the day that followed and how upset he was.

Meg: He was miserable.

Cass: Yeah. And because he’s such a happy baby, you notice the difference in that. And he’s only just got back to being a hundred percent, his oral thrushes now gone and things like that. So you just think, oh, you poor thing, here we go again.

Meg: What a shame, really tough.

Cass: Yeah.

Meg: But I wanted to ask you a little bit about his development. Are you planning to get in any tummy time and how are you finding that part of his life?

Cass: Yeah, so we’ve been doing tummy time every day, a couple of times a day. I’ve noticed that his tummy time on the floor, he doesn’t seem to be lifting as much as he was when we were first doing it. He was always really high up. I think you saw him in the early days where he was lifting his neck and he holds his head up now, pretty much by himself, but when he is on your chest and things like that, he’s very good at the tummy time, the head lifting. But now he is on the floor, it’s almost like he just quite happy to chill on the floor and lie there. And he also is drooling a lot. And so he just ends up kind of lying in a pool of his drool. And so I’m having to encourage him much more than I was. And I noticed that this morning and I wondered, is that a normal thing or is he just getting a bit lazy?

Meg: Yeah. So the critical thing is that you keep going with the tummy time. It will get better over time. And as he gets a little heavier, his muscles need to work a little harder. And of course, he is doing that at the moment, but at least 10 minutes of tummy time a day should take care of that. A couple of little tips; one is to roll up an old tummy nappy or a muslin towel and put it kind of under his chest so that he’s supported. And also to bring his arms slightly forward, so his elbows are slightly forward of his shoulders and almost prop him up because that’s where he’s going next. That’s what he’ll be doing in the next couple of weeks is propping himself up and then putting interesting toys in front of him. So that, like you can buy this little standup mirrors, look like a triangle and you kind of position that up in front of him or a mobile. So lots of encouragement.

And of course, fascinating thing for him is your face. So lying on your tummy facing him often works well for babies as well, so you can try that side of kind of stimulate it. And then also another nice activity is to lie on your back on your bed and you can start off quite propped up on pillows and eventually be total horizontal and let him lie on your tummy looking at your face and as you go backward, deeper and deeper, he has to work harder and harder. So definitely working on those back muscles and neck muscles is very important at this age.

Cass: Yeah. And I have to say, when you do have him on your chest or tummy, he does well on the tummy time. So I think as you say because he’s wanting to look at our faces, he’s lifting himself. So I’m not too worried because I know I can tell that he can do it. It’s just when he’s lying on the floor, he seems to be a bit solo. And I put him on his, he has a piano in front of him that lights up and sings songs and things like that, and we have the mirror, we are working hard on things to, and this morning I did find myself on my tummy on the floor doing it myself, lifting my head saying, do this.

Meg: No, it’s so important, and it’s so funny because if you’ve been doing it from day one, which is why he tolerates it. But a lot of moms who’re listening right now, their babies won’t even tolerate tummy time. And that’s why we always say get started right from the get-go, from day one. But for anyone who’s listening, who’s got a seven-week-old and you wondering about how to get it going, you’ve just got of practice every single day. And the reason it’s so critically important and Cass I don’t know if know, but when babies are born there in what we call physiological flexion, which means that they’re almost held in a position of curled up flexion and because of the shape and the tummy, of how they are in utero. And then the very first task they have is to uncurl and extend themselves and particularly work their back and neck muscles. And so that’s why tummy time’s so important because when you put them down, they’ve got to work those back and neck muscles. And then what happens at the same time from about four weeks onwards, so we are into that stage now is that he’s got to work his tummy muscles as well. So not just his back muscles, but now his tummy muscles. And he does that by laying under a mobile and lifting his feet to bump the mobile or kind of rolling over to the side, that sort of movement, and that works as tummy muscles. And when we get that balance going between the back muscles and the tummy muscles, that’s when we start to have babies being able to roll.

The reason that tummy time is so important is not for the point of tummy time. It’s because the next milestone, which is rolling is critically important and rolling of precursor milestone to crawling. And so, babies who don’t roll often don’t crawl. And so that’s why it kind of has this whole lead-on effect all the way through. And the reason that crawling is so important is because crawling, develops spatial awareness and it develops your shoulder girdle muscles and your hand muscles. And those are the foundations for fine motor control, and – if you can believe it – maths. So right now at seven weeks old, you’re not thinking about Max’s mathematical abilities, but getting into tummy time is a precursor for this whole chain of events that leads all the way through to eventual mathematical abilities. So, there you go, that’s kind of the physiology in a nutshell.

Cass: Wow. It’s mad, isn’t it the things that are happening and making a difference.

Meg: Yeah, exactly. And it is a case of small little things that kind of have knock-on effects as we go along, so yeah.

Cass: Yeah. I mean, you do realize now how important last night, for example, when he was so distressed, I thought I just need to give him love, he just needs to know now because he is distressed. This isn’t him being naughty. It’s not him being and, I’ve read your books and on Parent Sense. Right now, it’s important as you said, I think on this podcast, shaping them for relationships far into the future. And that’s why even though I would’ve loved to go and lie down and let him wiggle around a bit and make noises. I thought, I just need to hold you in my arms and let him know it’s all going to be okay to tonight. And so every little thing that we’re doing is having far greater impact than we realize in that moment.

Meg: Exactly. And it’s good that you’ve touched on that whole thing of illness and irritability because I think sometimes when we are stuck in the moment of parenting, we think that everything we are doing today we’ll have to do for the next 15 years of our children’s life. And case in point, when you said how big he was at the beginning of the episode, I said, oh, we don’t want to get interrupted sleep. And because he’s going to be heavy and there’ll be lots of moms who I’ve got like very sore backs from rocking to sleep, we know that. But in the moment when you’ve got a little one who’s niggly and miserable and is just not falling asleep specifically because they’re ill, then I always say all the rules go out the window because you can deal with kind of breaking habits later on. But in the moment, if he’s very uncomfortable, you do need to rock and calm him. And so, and I think particularly in the early days, under 14 weeks of age, babies don’t have long-term memory. And so I always say to moms, do what you have to do to cope, to get by, and to calm them. I know Max isn’t irritable, but you can get babies who’re colicky who are crying three hours or more of a day. And then moms are thinking, well, I need to be putting them down because I don’t want to have rock to sleep. But it’s very early on and they’re not going to develop habits at this age. So it is more important, like you said, to take care of their emotional and sensory needs because he also needs a sensory, just the contact with you that was a sensory need in order to calm.

Cass: It’s interesting because this morning, what I have got into is a bit of a habit because I’m busy in the mornings and I have things I need to do. So I wear him and he falls asleep on me like that, and he usually falls into quite a good sleep. But this morning I was tired I had a lot to do and I thought I’m just going to pet him with some relaxing music in a room next door. So our sitting room is adjoined to our kitchen and I just put him in the sitting room with music going. And I thought he might fall asleep by himself, but if anything, so I got him a little bit drowsy and then I put him down with music going and he did fall asleep by himself, which he’s never done just in the room, nothing, I hadn’t turned the lights down because it was in the day, he was downstairs with me and he fell asleep. He only did half an hour and then he woke up again. But it was the first time that had happened. And again, I suppose with that sensory thing that music had calmed him down. It was lovely. I was nearly, yeah. So that was a new experiment that I tried this morning, and it gave me a bit of hope because I thought when we do get to that stage where I can’t rock you to sleep or I can’t wear you and things like that, I know that you are capable of doing that. I’m saying this while I’ve just watched my father walk past the window with him in the pram trying to get him to sleep because he’s not going to sleep right now, but that did happen. And it was an exciting moment and I felt very proud of him for doing that all by himself.

Meg: So let’s talk about how little ones develop habits and how we do get them to fall asleep independently. Right now, he’s seven weeks old, so it’s not a priority, but certainly, by the time he gets to about 14 to 17 weeks old, you do want it to be a priority and you want him to be able to fall asleep independently. So yeah, I mean a couple of principles, and I always say to moms, this is the gold standard and it’s always good to aim for the gold standard, and then to back down, to do what needs to be done. But to have the gold standard in your mind does help. So from about this age from certainly from nine weeks, but so, but from about seven weeks, you can start to put him down in his bedroom, in a darkened space. And one of the things that people often ask me is shouldn’t we only keep dark rooms for nighttime, and light rooms and busyness for during the daytime? But if you get them into a habit from very early on the day sleeps happens in this dark space. It works really well long-term because it means that they just go down in their cot for every single sleep. Now, right now I know he’s probably doing four, maybe so maybe he’s even five sleeps a day if they’re doing very short sleeps, but by six months old, they’ve dropped down to three sleeps by nine months old, they dropped down to two sleeps and by a year they’re down to one sleep. So you get this incremental dropping of sleeps. And so eventually it’ll make sense that, for instance, you want your two-year-old to go down in their bedroom, have a good two-hour sleepover the day, and then wake kind of rejuvenated. So you start the principles early on with going into the darkened room at the right time.

So again, watching the awake times to make sure that they’re not overstimulated or overtired, darkening the room, rocking to drowsy which is kind of just, I always said to parents that don’t fool yourself, because rock to drowsy is not rock to sleep. It’s just rocking to drowsy. It’s making sure that their eyes are kind of heavy and they, I call it their thousand yards stare. They’re kind of staring over your shoulder at nothing and then putting them down. And at this age for babies who like to be swaddled, which is most babies, having them swaddled, and then I like to turn them on their side and just kind of stay with them and pat them until such time as they fall asleep.

And the principle there is that instead of doing it in your arms all the way to sleep, you are doing it lying down in the cut on their own. And then you’re patting them till they’re asleep and then walking out of the room and then they will usually sleep for 45 minutes at a stretch at this age. Often babies at this age are not linking all their sleep cycles during the day and doing that for every single sleep. So that’s kind of where I like parents to aim if they’re not getting it right, there are a couple of things that can help. One of them is swaddling, another one is white noise in the room or as you had lullabies in the room. Another one is a cot vibrator, which is just a little device that you just connect onto the cot. It just kind of creates a little bit of vibration as they’re falling asleep and it just helps them to go to sleep. It’s almost like they’re against your body if they’re getting in the little bit of vibration. So that helps. And then I think I mentioned a few sessions ago, a weighted blanket you can just place on them or as if your hand is staying on them. And I find that those four things along with the soothing beforehand and watching the awake times are like an awesome recipe to get little ones to start to fall asleep independently. And then after a couple of times of getting that one, right, you can start to just put them down like you did with him and kind of leave the room and see what they do. And if at that time they start to, I call it, if and but, like kind of that is just to ignore and see what they do because very often they will start to settle themselves to sleep. And so if they can start to put that in place now it stands him in a very good state, long term.

Cass: Yeah, he’s quiet, I mean at night I have to say if he does wake up soon after we’ve put him down and I mean, 10 minutes after we’ve put him down, he does put himself back to sleep, we don’t go up to him anymore. And I’ve had a couple of occasions in the middle of the night where I’ve thought he was awaking, and I get up and I put my dressing gown on, and then it all goes quiet as I’m ready to go into him. And then I look at the monitor and he’s asleep again. And so I think, well, I’ll just lie in the bags and sure enough in 30 seconds I wake up and then suddenly I find myself waking up an hour later and he’s done an extra hour. So I’ve become more disciplined at not going in as soon as he starts to, as you say, if &but because he is capable of self-settling. But what’s interesting is in the day, anytime I have got him to self-settle, he doesn’t seem to sleep more than that one sleep cycle, unless he is either he’s been rocked to sleep in a car seat that tends to be when he’ll do his longer session or if he’s still in the baby wearer on me, that’s when he’ll do long session.

Meg: And that’s absolutely typical. And it’s probably one of the biggest questions that moms asked me at this age is, why is my baby only doing 45 minutes, you know, 40 to 45? And the reason is that is one sleep cycle. And when they do start to link sleep cycles, I know this feels like a long way away is at six months. And that’s because they’ll be on solid lunch, having lots of yummy lunch proteins, some iron, and then they love little milk feed after that lunch. And then they do that two-hour stretch because they link the 45 minutes twice and maybe a bit more, so one and a half to two hours. But this is the age where it’s that 45-minute sleep cycle, which can be quite frustrating because a few weeks ago he was probably doing much longer sleeps.

Cass: Yeah, you feel like you’re going backward.

Meg: Exactly. But what he’s doing as long as you’re watching the awake times. And I think where what’s important is just watch the awake times, make sure you’re getting him back to sleep. I mean, at this age is awake time is probably an hour and a bit. And as long as you’re watching those, he won’t become overtired. The fact that he’s having a short sleep is not the crisis.

Cass: Okay. Great. Thanks so much.

Meg: Excellent. Well Cass, thank you so much for this week. So much lovely information around vaccines and also about forming habits. So yeah, really super. Thank you so much for touching base.

Cass: Well, thank you so much as always for the advice. Thank you.

Meg: Pleasure, Cass. Thanks so much.

Cass: Okay. Bye.

Meg: Bye. Thanks to everyone who joined us. We will see you the same time next week. Until then download Parent Sense App, and take the guesswork out of parenting.