Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
Because getting rubella or chickenpox during pregnancy can have such negative effects on the fetus, leading to very difficult decisions for mothers, it is probably worth seriously thinking about having your immunity to these two checked several months before you get pregnant, if you can. There are simple, inexpensive blood tests that most insurers will cover as part of preconception counseling; you can do more than these two if you think it would be useful.
Think long and hard before getting vaccinated (or re-vaccinated, or boostered) of you show low or no antibodies for a particular disease, especially if you have been vaccinated, re-vaccinated or boostered recently. Some people never show a good titer, no matter how often they are vaccinated. Unfortunately, the vaccines can still cause problems both for the woman receiving them (which don't work for her) and for any children she might have in the future and, hopefully, breastfeed.
If vaccines do work for you, but you are behind on boosters, make sure you allow a few months delay before getting pregnant. Getting vaccinated while pregnant is very risky.
Well baby visits are the major time and place at which vaccinations are given to babies. In recent years, there has been a great deal of controversy and legal activity surrounding vaccinations. The government provides guidelines for vaccinations by age. This schedule is heavily influenced by the manufacturers of vaccinations, who are protected from most efforts to take legal action against them in the event of a bad effect from the vaccine. There is a special court for compensating victims of bad effects from vaccines. It is currently in the middle of a combined action revolving around the presence of a mercury based preservative (thimerosal) in vaccines and its possible connection to autism and autism spectrum disorders. It is so obvious on the face of it that injecting people with mercury is a bad idea that it is difficult to comprehend why public health workers and organizations have been so energetic in their defense of this preservative, and so adamant that the benefits of vaccines far outweigh any negative results from injecting small babies with large amounts of this preservative.
A few years ago, this preservative ceased to be included in vaccines intended for infants, but the accumulated stockpile of vaccines remained in doctors offices and clinics around the country and has probably only very recently expired or been used up. This preservative is still present in vaccines intended for use in other countries, in this country by adults and for animals.
While I was once a huge believer in vaccinations, this episode troubles me greatly. Many parents are refusing to vaccinate their children at all as a result of this, demanding a new, higher standard of proof before being willing to trust vaccine manufacturers and the health care establishment again. The new chicken pox vaccine raises a number of other issues, including whether we are inadvertantly creating a generation of people whose immunity to chickenpox will wear off as adults, leaving them susceptible to much more serious disease.
Even without these concerns, because schools and many other organizations require participants to have a certain set of vaccinations, vaccine manufacturers are able to use governmental and quasi-governmental power (read: coercion) to sell their product, and then able to use governmental protections to evade any negative consequences associated with use of that product. This is shocking for those of us who value life in a free, capitalist country.
To add insult to injury, you are required to sign an informed consent form before receiving these quasi-mandatory vaccinations.
Between the bad parenting advice propagated by so many pediatricians, the vaccination controversy, and the fact that most well baby visits occur in locations otherwise full of sick people (hospitals, clinics and doctors offices), a parent might well be a bit concerned about taking their baby to well baby visits. Even a vaccination that doesn't cause a serious bad effect will leave an adult feeling under the weather for a day or so. Babies are no different. The advice to find a health care provider before having the baby is in part to ensure that you don't do what common sense would tell any reasonable parent of an obviously healthy baby to do: don't go to the doctor.
Having said all that, we are taking our baby to well baby visits. At those visits we discuss what we have researched with our health care providers. We tell them what we are willing to do, and we of course listen to their information and advice before making our final decision on care for our baby. We are also unfailingly polite, which I will tell you, they probably will not be. Health care professionals believe that patients should comply with their advice, requests and demands. When patients do not comply, they may resort to force, including legal action against the patient to use the courts to coerce compliance (there have been, and continue to be, court-ordered c-sections, court-ordered blood transfusions, etc.). Changing from a world in which doctors order care and patients meekly comply (or, if they don't, are aggressed upon until they do) to a world in which people decide how they want to manage their own health is a slow process. If you choose to take your baby to well-baby visits, you owe it to yourself and your child to find a health care provider that at least claims to believe in patient choice in patient care.
Some readers may know about the recall of an earlier rotavirus due to a bowel side effect that could be quite dangerous. Now there's a new rotavirus vaccination on the market. While babies are being breastfed, they tend to get rotavirus less frequently and, more importantly, they don't get nearly as sick. You might not even realize your breastfed baby had rotavirus. Once you stop breastfeeding, however, the protective effect ends (the protection is because of the additional antibodies you are supplying through the breastmilk; it does not, unfortunately, "build up" protection in your baby). Moral: breastfeed for an extended period of time, and plan to increase the nursing frequency whenever your baby is sick, even after solid foods have been introduced. You'll have a healthier baby and save a lot of money and heartache, and you won't have to agonize about whether to risk the new vaccine.
There are a number of conflicting opinions regarding vaccinations and breastfeeding. The medical estabalishment is adamant that there is little or no risk to the breastfeeding infant if mama gets a rubella shot after the birth. This may be true on average, but then again, if you have a wonky immune system (which you may have or be about to pass on to your baby) you should think hard about this. Absolutely no one warned me that a rubella shot while breastfeeding would pass live rubella on to my baby -- and yet the medical community knows that this happens. The baby does not show symptoms (typically -- but ever? Who knows?), but we know that scheduling two doses of a vaccine close together can cause problems in an otherwise "safe" vaccine. What is the impact on the baby of that post-partum shot followed by the first MMR at 15 months? Certainly inadequate research has been done.
Deciding not to breastfeed so as to get the vaccine would be a terrible decision. The risks of formula numerically far outweigh the risk of vaccination while breastfeeding.
I have also heard, but been unable to find a reliable source, that live vaccines for a baby may not work while the baby is still breastfeeding, in the sense that mama supplied antibodies do a little too good a job cleaning up. The story I've heard says that the MMR is scheduled at 12-15 months so as be given after most women who do breastfeed have weaned. I'm still researching.
Copyright 2006 by Rebecca Allen.
Created February 1, 2006 Updated June 21, 2006