Understanding newborn vaccinations and medications at birth

What medicines do newborns get right after birth?

Vitamin K shot

Vitamin K helps blood clot properly and keeps a person from bleeding out if they’re injured. Babies don’t make enough vitamin K on their own until a few days after they’re born. So to offer them protection from hemorrhaging — excessive bleeding or bleeding out — the standard of care is to provide newborns with a vitamin K shot at birth.

Vitamin K is given to your baby in the form of a shot, but it is not a vaccine. Your baby may briefly feel pain, and some babies get a rash around the shot site, which is usually the upper thigh.

Antibiotic eye ointment

Newborns’ eyes are sensitive and prone to infections. Antibiotic eye ointment — usually erythromycin — protects your newborn’s eyes from infections caused by certain bacteria like Staphylococcus aureus. 

Gonococcal ophthalmia neonatorum (GON) is one of the most important infections the antibiotic eye ointment protects against. GON is a severe eye infection a baby can get if the person giving birth has gonorrhea, a common sexually transmitted infection. 

Untreated GON can cause serious issues like:

• Scarring of the cornea
• Ocular perforation
• Blindness 

The complications can occur in as little as 24 hours after birth, so applying erythromycin ointment to prevent GON is the standard of care for all babies born in the US, according to the U.S. Preventive Services Task Force (USPSTF). 

What should I expect after my baby gets antibiotic eye ointment?

Erythromycin ointment is safe and doesn’t cause many side effects. The ointment can make your baby’s eyes look glossy or cloudy around the eyelids, and some babies may have some redness or mild swelling in the eye area. This redness usually goes away on its own. 

During your baby’s first few weeks of life, if you notice thick or yellowish discharge from either of their eyes, take your baby to the doctor as it could be a sign of an eye infection.

To discuss the benefits vs. risks of vitamin K injections or antibiotic eye ointment, talk to your local pediatrician or text a Summer Health pediatrician anytime.

What vaccines or immunizations do newborns get after birth?

In addition to vitamin K injections and antibiotic eye ointment, there are some vaccinations and immunizations recommended for newborns at birth. It takes time for a baby’s immune system to develop the cells it needs to fight off germs like bacteria and viruses. Providing certain vaccines gives babies that protection and also prompts their bodies to build up strong defenses against potentially dangerous infections.

Hepatitis B vaccine

Hepatitis B is an incurable disease that can lead to liver damage and liver cancer. It can be passed from mother to baby during birth, so early vaccination within is recommended to protect your baby from getting hepatitis B.

The hepatitis B vaccine is recommended for all babies within 24 hours of birth, although some babies should get the vaccine sooner. This first dose is often called the “birth dose” and prevents long-term, chronic hepatitis B in babies. Babies get their next two doses later during infancy and toddlerhood.

Babies born to mothers with known hepatitis B should get the first dose of their hepatitis B vaccine within 12 hours of birth according to the CDC. Another medication called hepatitis B immune globulin (HBIG) is also recommended to help these babies fight the virus.

Some babies may be sore  where the shot is given or develop a low-grade fever.

RSV antibody 

Respiratory syncytial virus (RSV) is the number one cause of infant hospitalization in the US. Although it can affect anyone at any age, it is most serious in infants and young children. But now there's now an antibody immunization that can protect against serious illness from RSV. 

Traditional vaccines prompt the body’s immune system to make antibodies to fight off certain germs. The RSV antibody immunization works differently. Instead of prompting the immune system to make antibodies, the RSV-fighting antibody is given directly to the person in the form of a shot.

The CDC recommends that babies less than eight months old, including newborns, get protection against RSV to help prevent severe RSV disease and potential hospitalization. Newborns should get the RSV antibody immunization the first week after birth, especially if they are born during RSV season, between the fall and spring, and if their mother did not receive the adult RSV vaccine during the pregnancy

What other immunizations do newborns get through 6 months of age?

After birth, the recommended vaccine schedule includes several important immunizations. Here are routine immunizations recommended through 6 months of age:

• hepatitis B
• rotavirus
• diphtheria, tetanus, and pertussis or whooping cough (DTaP) 
• haemophilus influenzae type B (Hib) vaccine
• pneumococcal conjugate (PCV)
• inactivated poliovirus vaccine (IPV)
• COVID-19
• influenza

Hepatitis B

Dose 1 of the hepatitis B vaccine happens within 12-24 hours after birth. Your baby will be on track for dose 2 between 1 and 2 months old, and dose 3 between 6 and 18 months old.

Rotavirus

Rotavirus infections can be life-threatening for babies and can cause watery diarrhea, vomiting, abdominal pain, and dehydration. Rotavirus is also highly contagious and spreads quickly amongst babies and children. Your baby may get 2 or 3 doses of the rotavirus vaccine during childhood. The first dose is scheduled for the 2-month appointment. 

Diphtheria, tetanus, and pertussis (DTaP)

DTaP protects against 3 serious infectious diseases: diphtheria, tetanus, and pertussis (whooping cough). Whooping cough in particular can be life-threatening in babies. Five doses of the DTaP vaccine are recommended, spread out between 2 months and 4-6 years old. 

You may have heard of the Tdap vaccine as well. DTap and Tdap protect against the same 3 illnesses, but are recommended for people in different age groups. Newborns, infants, and young toddlers get the DTaP vaccine. Older children, adults, and pregnant people get the Tdap vaccine.

Getting Tdap between the 27th and 36th weeks of pregnancy can help protect newborns from pertussis starting at birth. The additional protection is helpful since newborns do not get their first dose of DTaP until 2 months old, making them vulnerable to diphtheria, tetanus, and pertussis (whooping cough) early on.

Haemophilus influenzae type B (Hib) vaccine

Hib disease is a serious bacterial infection that can lead to potentially fatal infections like epiglottitis (a severe throat infection), meningitis, and sepsis. It most commonly affects children under 5 years old. Your baby may get 3 or 4 doses of Hib vaccine during childhood, with the first dose at 2 months of age.

Hib vaccine can be given on its own, or it can be given as a combination vaccine, including Hib vaccine and other vaccines.

Pneumococcal conjugate (PCV)

This vaccine protects your baby from the Streptococcus pneumoniae bacteria that causes pneumococcal disease. Pneumococcal disease can cause mild infections — like ear infections — but can also cause more severe, life-threatening infections like pneumonia and meningitis. Babies get 4 doses of the pneumococcal vaccine between 2 months and 15 months of age. 

Inactivated poliovirus vaccine (IPV)

The poliovirus causes polio, which is most common in children under 5 and can cause paralysis. At 2 months of age, babies their first dose of 4 total immunizations against polio. 

COVID-19

Children can get the COVID-19 vaccine and flu vaccine at the same doctor’s visit. CDC recommends anyone ages 6 months of older get an updated COVID-19 vaccine to protect against serious illness or needing to go to the hospital. 

Influenza (Flu) vaccine

The flu tends to cause more serious complications in babies, young children, and the elderly. An annual flu vaccine is recommended for children 6 months of age or older. September and October are the recommended months to get vaccinated against the flu, but if your child already has a doctor’s appointment in July or August and won’t be able to return in September or October, you may consider getting your child vaccinated then.

Some children need two doses of the flu vaccine. This includes children between 6 months and 8 years old who:

• Are getting the flu vaccine for the first time
• Have only ever had one dose of the flu vaccine in their lifetimes
• Have an unknown flu vaccination history

Children who need two doses of the flu vaccine should get their first dose as early as possible, which may be in July or August. The next dose must be given at least 4 weeks after the first dose.

Other immunizations: measles, mumps, rubella, varicella, hepatitis A

Your child won't get the measles, mumps, and rubella (MMR) and varicella vaccine (chicken pox vaccine) until they are at least one. The CDC recommends 2 doses of the MMR vaccine — one between 12 and 15 months old, and the second between 4 and 6 years old. This is the same schedule recommended for the varicella vaccine. Therefore, many children will receive the combined MMRV vaccine, which protects against measles, mumps, rubella, and varicella.

The hepatitis A vaccine series also starts at 12 months old.

For most families, the 2-month-old appointment is the first appointment where it may be recommended for your baby to get a round of immunizations. Learn more about the 2 month old appointment.

For questions about your baby and medications or immunizations recommended at birth, talk to your local pediatrician or text a Summer Health pediatrician anytime.

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