Baby Care

What to Expect and Soothing the Pain

Nobody looks forward to their baby’s vaccinations, but they’re crucial for long-term health. Your child’s first major round of shots comes around 2 months. They’ll receive several injections, as well as liquid drops, that teach their immune system to fend off life-threatening diseases.

Here, we break down what to expect with 2-month vaccinations, including potential side effects and how to soothe your baby’s pain.

How Do Vaccines Work?

The tiny amounts of weakened or inactivated viruses and bacteria (known as antigens) in vaccines trigger the immune system to create antibodies that fight against them. These antibodies are prepared to attack if the body is exposed to those viruses or bacteria again in the future.

Vaccines Given at Your Baby’s 2-Month Appointment

At their 2-month appointment, you can expect your baby to receive anywhere from three to five needle sticks (depending on whether combination vaccines are used) and a liquid vaccine. Together, these shots will guard against seven separate diseases.

Here are the 2-month shots your baby should receive, according to the Centers for Disease Control and Prevention (CDC):

  • Rotavirus
  • Inactivated polio vaccine
  • Pneumococcal conjugate
  • Haemophilus influenza type b disease (Hib)
  • Diphtheria, tetanus, and pertussis (DTaP)
  • Hepatitis B (If they were given a dose of the hepatitis B vaccine during their 1-month visit, however, they’ll have one less injection).

Your baby also may get a respiratory syncytial virus (RSV) immunization if they have not received it already. The American Academy of Pediatrics recommends that infants born shortly before or during the RSV season (fall through spring) receive this vaccine during their first week of life. This vaccine guards against RSV, which is known to impact breathing, and is recommended for babies younger than 8 months old.

“It’s important to get vaccines on schedule to give your baby the best protection,” says Rebecca Pellett Madan, MD, a pediatric infectious disease specialist with NYU Langone in New York City.

Getty Images / Karl Tapales

Possible Side Effects of Baby Vaccinations

After vaccinations, it’s common for a baby to experience a minor reaction, says Patricia Stinchfield, a pediatric nurse practitioner and senior director of infection prevention and control for the Children’s Immunization Project at the Children’s Hospitals and Clinics of Minnesota in St. Paul. “These are actually encouraging signs that the immune response is working.”

Vaccine side effects in babies might include the following:

  • Redness, swelling, and soreness at the injection site
  • Mild fever
  • Fussiness
  • Loss of appetite
  • Vomiting and diarrhea

Most often, your baby will experience these mild side effects within the first 24 hours after they are vaccinated. While the redness, swelling, and soreness usually last about three to five days, the symptoms may linger as long as seven days with the DTap (diphtheria, tetanus, and pertussis) vaccine. If they experience a fever, this will usually resolve in about one to two days.

Ease your baby’s discomfort by applying a cool, damp cloth to the injection site. You can also reduce a mild fever with a sponge bath. If you want to use an over-the-counter pain reliever, the CDC recommends talking to your baby’s pediatrician first, especially since dosing is based on your baby’s weight.

Soothing a Fussy Baby After Shots

Even though 2-month vaccinations are crucial to their long-term health, seeing your infant upset or in pain is difficult for any parent. But, research shows you can play a crucial role in relieving the side effects of vaccines and making the process more comfortable for both of you.

A study funded by the Canadian Institutes of Health Research focused on parental awareness and adoption of pain-relief strategies during infant immunizations. Through hospital prenatal programs at Mount Sinai Hospital in Toronto, the researchers worked with parents to create educational tools for reducing vaccination distress for babies.

After parents received the tools, the researchers found parents increased the use of pain interventions at future infant vaccinations. Plus, they demonstrated more knowledge, skills, and confidence in their abilities to manage infant pain, says Anna Taddio, PhD, professor of pharmacy at the University of Toronto, who researches pain reduction during vaccinations.

Hopefully, evidence-based health information for soothing babies during shots will get into the hands of new parents sooner. That’s partly because proactive pain control can go a long way toward preventing medical phobias later on, says Dr. Taddio. “The impact of repeated pain during injections can lead even healthy babies to develop a fear of doctors and needles.”

In the meantime, follow this advice to take some of the stress out of your own baby’s experience, and learn how to soothe a fussy baby after shots.

Hold them in your lap

One efficient strategy for reducing the pain of shots? Hold your baby on your lap (rather than having them lie on the examination table) and let them nurse, drink a bottle, or suck on a pacifier dipped in a sugar-water solution, says Dr. Taddio. “Physical comfort, sweet taste, and sucking reduce pain in young children.”

Wendy Sue Swanson, MD, a board-certified pediatrician, agrees. “Often, babies are soothed so quickly by feeding that they stop crying before they even leave the exam room.”

Some pediatricians and pediatric nurses prefer positioning babies on their backs on the exam table for injections. If that’s the case, ask if they’d be open to allowing your child to be in your lap in one of the holds recommended by the CDC.

Request a topical anesthetic

If your baby seems to be highly sensitive to pain during their shots, ask the health care provider about an over-the-counter or prescription topical anesthetic for next time. Put the cream on their skin before the injection, following your health care provider’s instructions, to desensitize the area.

You also can request a cooling spray (vapocoolant). This spray can be applied on your child’s arm or leg right before they receive the injection.

Be a calm presence

If you’re anxious, your baby will pick up on that and might get worried too, says Roy Benaroch, MD, adjunct professor of pediatrics at Emory University, in Atlanta. “Try to be calm, matter-of-fact, and loving, but not overly apologetic.”

Bring their favorite things

You also may want to bring a toy, blanket, or book that your baby seems to particularly like. This object can help distract your baby; attempt to keep them focused on the object instead of the needle. You also can talk to your baby or make silly faces so that they stay focused on you instead of what the doctor or nurse is doing.

Offer acetaminophen

If your little one is inconsolable after their vaccinations or continuing to show signs of discomfort in the following hours or days, consider giving them a dose of infant acetaminophen (infant Tylenol) with your health care provider’s instructions. Just don’t give it to your baby beforehand in an effort to head off their agony, since there’s no data that preventive painkillers work, says Dr. Benaroch.

Always consult with a pediatrician or health care provider before giving your baby medication. Follow their instructions for dosage, which will be based on your baby’s weight and symptoms.

Try a mini baby massage

Apply gentle pressure to your baby’s leg immediately following the injection to dull the pain from both the superficial poke to the skin and the vaccine entering the muscle, recommends Dr. Swanson. Just be gentle in doing so. Babies have sensitive muscles so you do not want to press too hard.

Offer cuddles and comfort

After your baby receives their vaccines, you should cuddle them, offer hugs, and console them if they’re crying. You also can try swaddling young infants as well as offer soft whispers, reassuring them that everything is going to be fine.

Importance of Childhood Vaccines

“There is no intervention, other than clean water and sanitation, that has saved more lives than childhood immunizations,” says Stinchfield.

When to Contact a Health Care Provider

Serious side effects from vaccines in babies are rare. However, if they’re crying inconsolably for more than three hours or they develop seizures, trouble breathing, swelling of the face, or limpness, or other concerning symptoms. get immediate medical help. Also seek care for any fever in babies less than 12 weeks old.

Anaphylaxis, which is a severe allergic reaction that impacts breathing, is rare. But if your baby is going to have a severe allergic reaction to a vaccine, this will usually start about 20 minutes after the shot, or as much as two hours later. The key is to get your baby immediate medical attention if they are having trouble breathing or swallowing, are not waking up, not moving, or appear very weak.

You also should get immediate medical care for severe vomiting, a rash that occurs after shots, or a fever that returns. Also, let your baby’s health care provider know if the redness around the injection site seems to be spreading, the swelling is getting worse, or they seem to be fussy for longer than three days.

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