National Infant Immunization Week is April 19-26. Pediatrician Elzbieta Lojewski, M.D., answers the top 5 vaccination questions asked by parents in her office.

Q. How safe are vaccines?
A. Vaccine safety is very important to the American Academy of Pediatrics (AAP) and pediatricians. Vaccines are developed under the strictest safety guidelines and require years of testing before they can even be administered. According to the Centers for Disease Control (CDC), the United States has the safest and most effective vaccine supply in history.

Q. Are immunizations necessary?
A. Immunizations not only protect children from potentially deadly illnesses, they also help to prevent diseases that can have serious health consequences including seizures, brain damage and blindness. Parents are encouraged to talk to their health care provider to ensure that their infant is up-to-date on immunizations.

Q. Do vaccines cause autism?
A. American Academy of Pediatrics (AAP), American Medical Association (AMA) and Centers for Disease Control (CCD) all agree that scientifically there no data to support a link between vaccines and autism.
It has been determined that autism has strong genetic basis. There is a concern that vaccines may make autism symptoms more prominent. However, in addition to vaccines, we need to consider many of the other potentially dangerous substances that child may be exposed to before or after birth as well.

Q. Does a child need to have multiple shots during one visit?
A. The infant immunization schedule, recommended by the American Academy of Pediatrics (AAP), calls for the administering of three to four shots at various check-ups throughout early childhood. The recommended schedule can be altered, such as giving two shots at one visit and two at a second visit a few weeks later, if parents are particularly concerned. The most important element is to make sure your child is immunized.

Q. What if I have doubts about immunizing my child?
A. With so much medical information available to parents on the Internet, they are more informed than ever before. Well-baby and well-child visits are a great opportunity to discuss any immunization concerns. Immunization is a shared responsibility. Families, healthcare providers, and public health officials must work together to help protect the entire community.
Child safety is very important to parents. The decision to immunize should be based on facts not fear.

Does not cause brain damage. Fever turns on the body’s immune system. It is one of the body’s protective mechanisms. Most fevers are good for children and help the body to fight the infection.
Fever is a temperature that is 100.4 F (38.0 C) or greater. The most common causes of fever are colds and viral infections. A fever may be the only symptom for the first 12-24 hours (viral fevers). The onset of the other symptoms like runny nose, cough, diarrhea, etc are often delayed.
A child with the fever is often fussy, irritable or sleepy. A fever makes the child’s heart rate and breathing faster.
Low grade fever is the fever 100 F -102 F
Moderate grade fever is the fever 102 F-104 F
High fevers above 104 F cause more discomfort.
Fevers above 105 F have higher risk of bacterial infections.
Treatment for all fevers:
Give cold fluids orally in unlimited amounts (reason: good hydration replaces sweat and improves heat loss via skin).
Dress child in one layer of lightweight clothing and sleep with one light blanket.
Fever medicine: Give acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for fever greater than 102 F or if your child is uncomfortable. Medicine usually lowers the fever by 2 F-3 F. See the dosage charts.
Bathe your child in lukewarm water if the fever is higher then 104 F and doesn’t come down with acetaminophen or ibuprofen. Alcohol sponging is NOT recommended. It can cause coma if breathed in.
I need to see your child in the office if:
The child has signs of an eye, ear, or throat infection
The child has a persistent cough
The child is under two months of age

Severe pain or discomfort in or around the ear. To stop the pain until your child is seen by the doctor:
Give acetaminophen (Tylenol) or ibuprofen (Motrin, Advil). See the dosage chart.
Use a heating pad to the outer ear to help the pain until medicine takes effect.
Symptoms of the ear infection:
Pain. Infants are irritable and crying. May refuse sucking and swallowing. Children may have trouble sleeping, because laying down may increase the pain.
Ear drainage. Cloudy fluid or pus draining from the ear canal means that there is a small tear in the eardrum and ear infection.
You should call the office and have your child’s ears examined by Doctor.
Your child may need the antibiotics to treat the ear infection.
The fever lasts more than three days

Diarrhea is the sudden increase in the frequency and looseness of bowel movements.
Diarrhea is usually caused by viral gastroenteritis. The illness may start with some vomiting. When the vomiting stops, the infection moves down to the lower intestinal tract to cause diarrhea. Diarrhea lasts a few days (on average 7 days).
Diarrhea is the body’s way of getting rid of the infection.
There are some tips how to keep up with fluid losses and help to repair the inflammation of the intestinal tract:
For infants (<1 year old) give Pedialyte, a special electrolyte solution that prevents dehydration in unlimited amounts. Continue formula or breastfeeding.
Older children (>1 year old) offer unlimited fluids (water or Gatorade). Avoid all fruit juices (fructose makes diarrhea worse). Continue solids; starchy foods are absorbed best. Give dry cereals, bread, crackers, noodles, mashed potatoes, rice, carrots, applesauce, bananas, etc.
You can give yogurt or probiotics (good intestinal bacteria).
Don’t give anti-diarrhea medications. They prolong elimination of the infection from intestinal tract and they are not safe especially in young children.
Call the doctor if the child:
has blood in the stool
has severe abdominal pain
has a high fever or the child appears very sick
appears to be dehydrated
has diarrhea that lasts longer than 14 days
Wash your hands frequently because diarrhea is very contagious.

Cough is the sound made when the cough reflex suddenly expels air and secretions from the lungs. Cough is the indication of an irritation in your child’s air passages.
Main causes of the cough:
Cold or viral infection of the upper airways
Cold – The child will have symptoms of a runny nose that causes mucus to drip down the back of the throat. To loosen the cough and thin the secretions:
Give extra fluids to drink
Use a humidifier/vaporizer
Give the child a cough suppressant, prescription only. This is used only in case of persistent, annoying night cough
Croup – The cough is tight and barky (like a barking seal). The voice or cry is hoarse. Symptoms usually get worse at night. Cold air or steam usually will help. You can take your child outside to breath the cold air or take the child to the bathroom, close the door and run the hot shower. Steam should ease the cough and stridor (harsh, raspy sound heard when breathing in).
Bronchiolitis – The cough is caused by an irritation of the small breathing tubes. It usually starts as a cold, but the cough gradually becomes more pronounced and child may have breathing difficulties.
Call the doctor if your child has:
difficulties in breathing
a fever
a cough that lasts longer than one week or is getting worse