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Prevention Is the Key!

“An ounce of prevention is worth a pound of cure.” (Ben Franklin)

“Nanay, come quick! I think Aimee was bitten by a mosquito. There’s a red mark on her right arm,” said Jess. Maria walked towards the crib, lifted Aimee and looked at her right arm. “Oh! It’s not a mosquito bite, Jess. It’s due to the injection that was given to Aimee at the hospital so she will be protected from certain sicknesses,” Maria said.

“Ouch! That must have hurt to leave a mark like that,” Jess commented. “Look at your right arm, Jess, you have the same mark,” Maria said. “But it’s not red, Nanay, and it doesn’t hurt, too,” Jess said. “Because it has healed and produced an old scar,” explained Maria.

Immunization (Hepatitis B, BCG)

A newborn must ideally receive the first dose of hepatitis B and Bacillus Calmette Guerin (BCG) vaccines at birth or at least before being discharged from the hospital. The usual side effects are fever within 24 hours, as well as pain or swelling in the area of the injection. Hepatitis B vaccine is injected into the thigh muscle. The second dose of hepatitis B is given one month after the first dose.

The BCG is given under the skin at the area of the upper arm just below the shoulders or at the buttocks to hide the scar, especially in girls. The site of injection undergoes changes in appearance from a red bump to pus formation and eventually a scar in a span of two to three months.

A scar is expected from the BCG vaccine, which means it was effectively given so that it would provide protection against extrapulmonary tuberculosis. There is no way to prevent the scar. Just hope that your baby is not a kelloid former so that the scar is small. Some place it high on the upper shoulder, probably high enough to hide the scar unless she wears a spaghetti strap or a strapless dress.

Certain remedies may be done to offset the side effects of the vaccines. Apply cold compress over the injection site for five to ten minutes two to three times a day for the first 24 hours after the shot. This will numb the pain and reduce the chance of having a hard mass. If you notice swelling or a hard mass or nodule over the injection site, you may apply a warm compress for five to ten minutes two to three times a day after 24 hours from the time of injection to decrease swelling. If it persists for days, continue applying warm compress until the mass disappears. Giving paracetamol is no longer recommended but may be given only if the baby develops fever.

Vitamin K Prophylaxis

Vitamin K is given to the baby as part of routine newborn care to prevent bleeding due to its deficiency. It can occur from birth to 12 weeks of age. The early onset bleeding from the gut and other organs of the body occurs from birth to two weeks of age in a previously healthy newborn and was also known as the classic hemorrhagic disease of the newborn. The late onset bleeding occurs from two to 12 weeks primarily in exclusively breastfed babies who did not receive or got an inadequate dose of vitamin K prophylaxis at birth. The latter can also occur in infants with intestinal malabsorption defects like cholestatic jaundice and cystic fibrosis.

Vitamin K can either be given orally or parenterally. However, the American Academy of Pediatrics has recommended intramuscular injection of Vitamin K1 since it has been shown to prevent bleeding due to vitamin K deficiency of the newborn and young infant. The risks of cancer from its administration has not been proven in scientific studies.

Eye Prophylaxis

Ophthalmia neonatorum or neonatal conjunctivitis or eye infection in the newborn used to be a major health problem in many parts of the world for a long time. It is transmitted from mother to infant during delivery, mostly caused by Neisseria gonorrhea. In 1881, Dr. Karl S. Crede, a German obstetrican and gynecologist, introduced the simple technique of cleaning the eyes of newborn infants with a two percent aqueous solution of silver nitrate. Hence, this practice became known as Crede’s prophylaxis. This practice has already been abandoned in several countries like the united States because it usually causes eye irritation or chemical conjunctivitis. It has also been found to be ineffective against the new and most common cause of sexually transmitted disease (STD), chlamydia trachomatis. The eye prophylaxis now given to newborns is either a 0.5% erythromycin or 1% tetracycline ointment, which is presumed to be more effective in preventing chlamydial ophthalmia. In some countries that have good screening practices for STD’s during pregnancy, no such prophylaxis is given provided the mother has been adequately treated or is negative for STD.


Excerpt from "Your Newborn Is a Blessing (A Guide to Your Baby's Health from Conception to Birth)."

Available at

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