This section is a compilation of the views from the mothers regarding immunisation. Note that these information are provided by the mothers and thus, the facts may not be 100% accurate. Name of members have been intentionally left out.

The MMR ‘debate’ : MyMomsBest is an informed parenting website. It respects and supports the medical advices and recommendations from the Kementerian Kesihatan Malaysia (Malaysian Health Ministry) and the local medical professionals. However, MyMomsBest is aware that there are many parents who are unsure of giving their child protection against Mumps, Measles and Rubella (MMR) because of the media exposure. Therefore, MyMomsBest hopes to present here some of the members’ opinions.

Opinion against giving their children MMR includes:

My GP said you can do it in three seperate doses if you are concerned abt having so many “doses” in one shot. I feel that THREE vaccinations in one is a lot for a young one,and now they r talking abt booster shots. if your doc can split them up so much the better. I also think that it is normal childhood disease, measles, mumps etc. Rubella is if the mother is exposed when pregnant. I dont know why we need to vaccinate, kids STILL get the illness *Shrug* The other vaccinations are fine. I guess it depends on your comfort level.

(Note: It is understood that there is no known suppliers of separate vaccines of M, M and R. Accuracy of the above information is uncertain)
Majority of members have done extensive readings and share here their respective paediatricians’ advices. The following are what some mothers have to say.

This article is prepared by Lilian with medical references provided by Dr Cheang Hon Kit, Consultant Paediatrician/Neonatalogist of a private hospital in Penang.

Vaccination

This topic is popular in our forum at MyMomsBest under Childcare. Questions asked includes:

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What is the recommended vaccination schedule?

The below is a guideline from a private hospital. There may be slight variations depending on each hospital’s policy.

At birth BCG, Polio, Hepatitis B
1 month 2nd Hep B
2-3 mths 1st DTa P*, Polio & Hib
3-4 mths 2nd DTa P, Polio & Hib
5-6 mths 3rd DTa P, Polio & Hib
6 mths 3rd Hepatitis B
> 12 mths Chicken pox
12-15 mths MMR
18 mths DTa P, Polio & Hib - 1st booster
5 years MMR Booster
4-6 years DTa P, Polio - 2nd Booster

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Is my baby going to be sick or in pain after the jab?

Not every vaccination is going to cause fever and pain. However, there are certain jabs that may make a baby feverish. Usually, the doctor will prescribed some paracetamol for your child after taking jabs like DaTP/Polio/Hib, chicken pox, MMR .

* = DTa P (Diptheria, Tetanus & Pertussis combination vaccine) a stands for acellular is a new improved version of vaccine which has been shown to cause less side effects, such as fever, painful swelling, fits, etc. But DTaP is more expensive compare to the older version. Only the private hospitals are using it.

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I heard that there are two options to polio vaccine. What are those?

Polio drops are commonly given by dropping the vaccine in liquid form into the baby’s mouth. The other alternative is the injectable killed polio vaccine. Compared to the widely used oral live attenuated polio vaccine, the new generation injectable polio vaccine has less vaccine-associated complications.

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What is BCG for? Why does it produce a scar?

BCG is to prevent TB, especially TB meningitis and a severe form of TB in the lungs (called miliary TB) in young children. It is just the nature of the vaccine which produce a very intense immune reaction on the injection site, hence resulting in a scar. Some may even have keloid formation. The scar is a clinical evidence to prove that the person has been given the BCG jab. Some countries health ministry gives BCG at the buttocks purely for cosmetic reasons.

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I heard that if I bring my child for the Hib vaccination at an older age, he will get less jabs. Is this true?

Since May 2003, government clinics have started giving HiB vaccines to newborn babies. It is incorporated with the DTP/Polio vaccine according to the Malaysian immunisation schedule at 2,3 & 5 months. For those who has not received this vaccine, the schedule is as follow:….
Between 1-6 months, a baby will be given 3 jabs
If a baby is above 6mth and below 12 months, need 2 jabs
Once a child is above 1yr or up to 4 yrs old, need 1 jab

It is advisable to get a baby vaccinated against Hib (an infection affecting the brain) from an early age because of the severity of the illness. Otherwise, it can be too late for treatment when diagnosis is delayed. The jab given to a smaller baby is in a smaller dosage and thus, more repeats are required.

This article is courtesy of Dr Cheang Hon Kit, Consultant Paediatrician/Neonatalogist of a private hospital in Penang. The hospital has a website with more information on jaundice and G6PD deficiency.

Jaundice in babies

This is a very common condition affecting over 90% of newborns born in South - east Asian region.

Why?

Newborns have a limited ability to conjugate bilirubin (yellow pigments which are breakdown products of haemaglobin) during the immediate newborn period. This transient elevated bilirubin (physiological jaundice) is of little consequence unless other factors which increase the total load of bilirubin come into play. These factors are:
1. Delay in the normal maturation of the liver function eg. In prematurity.

2. Haemolysis (excessive breakdown of red blood cells) eg. In G6PD deficiency. ABO and Rh incompatibility and drug induced

3. Infections

4. Persistent vomiting.

Symptoms

Visible yellowness of skin normally appears on the 3rd day of life. The jaundice peaks around the 5th day and subsides by 7th to 10th day. Jaundice which appear earlier or later than the 3rd day or persists beyond 2 weeks is not physiological and needs thorough investigations to rule out pathological and surgical causes.

Mild to moderate jaundice

Light therapy (phototherapy) provides an effective and reasonably safe treatment for neonatal jaudice. Blue light (wavelength 450 nm) is most effective. Phototherapy works by using light energy to change bilirubin into more water-soluble products to be excreted via the bile and urine.

What parents can do

* Make sure baby has enough nutrition and fluids. Extra fluids in the form of plain boiled water should be given liberally
* Expose baby to indirect blue skylight
* Keep appointment with the doctor during baby’s first weeks of life
* Consult a doctor as soon as possible if baby is off feeds, lethargic and appears visibly more yellow.

What parents must not do

Parents must not bathe baby in herbs, alcohol etc. Babies should only be bathed with water

Nursing mothers should not eat substances which may aggravate neonatal jaundice especially in babies with G6PD deficiency. Chinese herbal drugs which can aggravate neonatal jaundice are Huan Lian, Tong Kwee, Sor Hup, Pak Poh Suah, Kow Cho Suah (terms mentioned in Hokkien dialect), etc.

Parents must not feed baby with traditional medicine. Effective treatment of Neonatal jaundice is light therapy. Severe jaundice is treated with blood exchange transfusion.

Severe jaundice

Light therapy and blood exchange transfusion

Dangers of hyperbilirubinaemia (very high levels of bilirubin in the blood). Brain damage if the unconjugated bilirubin crosses the blood-brain barrier into the brain. It stains the brain cells of the midbrain. When this happens a condition called kernicterus results. (Visit the hospital website for explanation on kernicterus)