What to Expect When You Delay/Select/Decline Vaccinations: The First Year (Happy Birth Day)

This is a series dedicated to what to expect that first year when deciding to go off the CDC’s recommended vaccine schedule.  Also, check out the first and second post in the series, Before Baby Arrives and Discussing Vaccines with Your Partner.

Happy Birth Day

When I think back to the birth day of my first daughter, I can honestly say vaccines were the last thing on my mind. I had delivered her in a hospital and they administered the Hepatitis B vaccine, the vitamin K injection and the antibiotic eye ointment all without consent….though I imagine I had signed somewhere in the initial paperwork that the routine administration of these could be done (the fine print isn’t something you tend to pay attention to when you are in active labor and expecting your first child).

Though, to be fair, what did I expect? For someone to ask me if it would be acceptable? To list the possible the risks, the potential gains? Why it was being done. I guess that’s a bit silly – I mean, they have better things to do with their time then that, huh? To give them a bit of slack, it was my responsibility to be informed.

If that’s the case, why didn’t any of the other mothers tell me about it? Instead the prenatal period was all about the baby shower, decorating the nursery and picking the most adorable baby name.

who is at risk for Hepatitis:

-Healthcare workers and public safety workers with

 reasonably anticipated risk for exposure to blood

-Men who have sex with men

-Sexually active people who are not in long-term,

mutually monogamous relationships

-People seeking evaluation or treatment for a

sexually transmitted disease

-Current or recent injection drug users

-Inmates of long-term correctional facilities

-People with end-stage kidney disease, including

 predialysis, hemodialysis, peritoneal dialysis,

 and home dialysis patients

-Staff and residents of institutions or group

 homes for the developmentally challenged

-Household members and sex partners

 of people with chronic HBV infection

Hepatitis B – Your Baby’s First Vaccine

To begin with, hepatitis is a viral disease associated with precarious lifestyle choices (check out the side bar to see who’s most at risk). The virus has the ability to cause an infection of the liver that can have long-lasting effects. Though its important to note that approximately 50% of people that contract Hepatitis B develop no symptoms at all – with an  additional 30% only developing flu-like symptoms (after natural exposure lifetime immunity is acquired).

Now, for infants – this disease can be exceptionally serious and this is (normally in all cases) found when the mother is positive for the disease.  Now in countries that have a much better infant mortality rate, such as Sweden and The Netherlands, they only administer the vaccine to mothers who test positive for the disease, not all newborns.

It’s also important to note that the World Health Organization only recommends vaccination of newborns for Hepatitis B in areas where the carrier prevalence is greater then 2% - this does not include the United States!

You might say that the vaccine is safe, so why not be extra sure? Do you know how many safety studies have been performed on the Hepatitis B vaccine for infants?

None.

A manufacturer's representative was asked in a 1997 Illinois Board of Health hearing to show evidence that the Hepatitis B vaccine is safe for a 1-day old infant.  The representative stated:

"We have none.  Our studies were done on 5- and 10-year olds." 

[The Congressional Quarterly, August 25, 2000, pg. 647.]

I know the vaccine schedule my family follows is not going to fit every, or any, family. If anything, deciding to delay the administration of the hepatitis vaccine until a child is closer to potential risks would be more mindful. In the very least, read something about it before agreeing to it!

Here are some great links to learn more:

http://www.nvic.org/Vaccines-and-Diseases/Hepatitis-B.aspx

http://www.vaclib.org/intro/hepbinfo.htm

Erythromycin Eye Ointment

Now, this is not a vaccine but it is something I would like to touch upon regarding the very first few minutes of life of your little bundle.

You might think I’m nit-picking but why not at least be a bit informed about it first since we’re doing all this other reading and research? Let’s have at it then-

Here’s just the bare-bones of it:

What is it?

Silver nitrate or similar, antibiotic ointment applied just minutes after birth

Why is this routine?

The administration is required (though is waive-able, but could include a fine of $5.00) in most states. This is on grounds of preventing blindness from exposure to maternal gonorrhea. Keep in mind that it is common practice to screen mothers for STDs during their prenatal care so if you don’t have an STD I’m not sure why they are administering it –doctors might be assuming you are sleeping around while pregnant I suppose)

Is there risk?

-the silver nitrate binds with the membranes of the eyes which causes irritation, swelling, redness and blurred vision.

-The antibiotics in the ointment enter the bloodstream through the eye – the potential for diaper rash, thrush, and digestive problems are all present when this happens.

The bottom line-is it necessary and effective?

According to the medical studies listed below (and in more detail here), that answer is no:

Bell TA, Grayston JT, Krohn MA, Kronmal RA.  Randomized trial of silver nitrate, erythromycin, and no eye prophylaxis for the prevention of conjunctivitis among newborns not at risk for gonococcal ophthalmitis.  Pediatrics 1993 Dec;92(6):755-60.

Chen JY.    Prophylaxis of ophthalmia neonatorum: comparison of silver
nitrate, tetracycline, erythromycin and no prophylaxis.  Pediatr Infect Dis J 1992 Dec;11(12):1026-30.

Krohn MA, Hillier SL, Bell TA, Kronmal RA, Grayston JT.  The bacterial etiology of conjunctivitis in early infancy.  5: Am J Epidemiol 1993 Sep 1;138(5):326-32.

Black-Payne C, Bocchini JA Jr, Cedotal C.  Failure of erythromycin ointment for postnatal ocular prophylaxis of chlamydial conjunctivitis.  14: Pediatr Infect Dis J 1989 Aug;8(8):491-5.

These studies “prove that the eye ointment routinely applied to newborns does not significantly alter eye infections as opposed to no ointment of any kind.  Also, there is evidence that the bacteria which cause these infections are not passed to the infant in the birth canal, but after birth.  Also, it has been found that a significant number of infants develop an infection even though they HAVE received the ointment.” (http://www.unhinderedliving.com/eyeointment.html)

Of course, it’s important that we all make our own decisions regarding the health of our children. I hope this little section here helps regarding the prophylactic eye ointment. With my second daughter, who was born at home, we declined this.

"Vitamin K shots are completely unnecessary

 for your newborn."

- Dr. Cees Vermeer, PhD, Associate Professor of

 Biochemistry at the University of Maastricht, the world’s

 leading specialist in vitamin K

Vitamin K

The injection of vitamin K to every newborn infant was a practice that began1950’s. The reasoning behind this injection is the attempt to alter the naturally occurring level of vitamin k in the baby and to promote blood clotting. You see, there is a rare liver disease (called Hemorrhagic Disease) that occurs approximately about 5 out of 100,000 births – the answer the CDC has come up with to tackle this rare bleeding trauma is to inject all infants with 20,000 times the newborn level of vitamin k.

You might ask yourself, is there an apparent reason why babies are born with a practically low level of vitamin k? Well yes, there is. The newborn’s tight regulation of vitamin k levels control the rapid rate of cell division (which is useful during fetal development). It has been shown the high levels of vitamin k may lead to cancer due to uncontrolled, rapid cell division. (This may explain the link to the prophylactic use of the vitamin k injection and a rise in childhood leukemia.)

If you opt out of the vitamin K injection, the baby will gradually raise their levels after birth by breastfeeding (colostrums is extremely high in vitamin k). You can also give vitamin k drops orally (liquid vitamin K9) which is a significantly lower dose then the 20,000x level of the injectable vitamin k.

If you are mother at higher risk of having a baby with Hemorrhagic Disease or if your baby is at a higher risk, then you may want to consider the vitamin k injection more thoughtfully. Those mothers and babies would be:

-Women on anticonvulsant drugs during pregnancy (for epilepsy)

-Babies that had premature clamping or cutting of their umbilical cord (this deprives the baby of up to 40% of their blood volume which includes platelets which aid in clotting)

-Women who had a vacuum extractor assisted birth (this often causes bruising and internal bleeding)

-Women/newborn on antibiotics

The administration of any injection into the blood stream of a newborn carries risk particularly infection; especially in an environment that contains the most hazardous germs (the hospital). It has also been known that trauma from injections during the first moments of life can jeopardize the establishment of the breastfeeding relationship. Breastfeeding assists vitamin k levels and absorption more then the synthetic vitamin k injection has been alleged to do. If you do decide on the injection, it may be good to decide to wait a few days until your baby has learned to nurse.

So, in a nutshell – I would recommend assessing your risks and your babies risks of Hemorrhagic Disease. The most important decision to avoid this disease would be to make sure your baby receives all of its blood by keeping the cord attached until pulsating stops, having a natural or low intervention birth and, of course, breastfed (just one of the countless reasons to breastfed).

I imagine there is a very delicate, complex relationship between blood clotting levels and a newborn’s cell growth. To go all ‘willy-nilly’ (sorry no other term applies here) and inject a synthetic vitamin in the blood stream (20,000 times higher then normal, a level chosen with no rhyme or reason) to alter something we don’t fully understand seem reckless.

Personally, I choose a system that has been in place for thousands of years, instead of opting on one that’s been in place for less than a hundred. This is your child and you have the right to be informed and to make your own choice – please exercise it!

Great sites to visit when looking for information on vitamin k injections:

http://www.vaclib.org/basic/vitamin-k.htm

http://www.preciouspassage.com/Vitamin%20K.htm

http://www.givingbirthnaturally.com/newborn-vitamin-k.html

Stay tuned for the next posts in this series!

References used in the Hepatitis B section:

http://www.naturodoc.com/library/bio-war/HepB.htm

http://www.vaccineinformation.org/hepb/qandavax.asp  (This site was used to gather ‘at risk’ group listed in the Myth versus Fact blurb)

References used in the Erythromycin Eye Ointment section:

http://www.gentlebirth.org/archives/eyeointm.html

http://www.birthingnaturally.net/barp/eye.html

http://www.givingbirthnaturally.com/silver-nitrate.html

Bell TA, Grayston JT, Krohn MA, Kronmal RA, Eye Prophylaxis Study Group: Randomized trial of silver nitrate, erythromycin, and no eye prophylaxis for the prevention of conjunctivitis among newborns not at risk for gonococcal ophthalmitis.  Pediatrics  92: 755-760, 1993

Krohn MA, Hillier SL, Bell TA, Kronmal RA, Grayston JT, Eye Prophylaxis Study Group: The bacterial etiology of conjunctivitis in early infancy.  Am J Ophthalmol  138: 326-332, 1993

References used in the Vitamin k section:

http://www.gentlebirth.org/archives/vitktop.html

Linda Folden Palmer, DC. The International Chiropractic Pediatric Association Newsletter, September/October 2002 Issue. Found on this link: http://drbenkim.com/vitamin-K-shot-baby.html

http://www.gentlebirth.org/archives/vitktop.html (This site was used to gather ‘at risk’ group listed in the Myth versus Fact blurb)