Have you heard the news? There has been a documented case of measles in the area and there will probably be more. How can this be? Though we don’t see measles very much, the disease is still around. Most of the time an outbreak can be traced to a case being “imported” in from another country. Before the vaccine in this country, EVERYONE got the measles, mumps and rubella. There were approximately 3 to 4 million cases diagnosed a year. During an outbreak of measles in this country in 1989, 1 out of every 500 people diagnosed died. It is an awful, preventable disease.
None of us like to see our children hurt, and vaccines are not fun for our child. Last night I worked at an immunization clinic in the area and even though I am a firm believer in vaccinating, as I gave those vaccines, the tears tugged at my heart strings. But, I knew that those children were being protected from a disease much worse than the few moments of discomfort resulting in the tears. So with a sticker and a small stuffed dog for each child, there were smiles after the tears and those children left protected.
Here are the most common questions parents have regarding the MMR (measles mumps rubella) vaccine.
1. What about autism?
- There is NO scientific link between the MMR and autism.
- The first study that reported a connection between the MMR vaccine and autism was done by Dr. Andrew Wakefield of the Royal Free Hospital in the United Kingdom in 1998. Dr. Wakefield attempted to link the MMR with bowel problems such as Crohn’s Disease and Autism. The study was based on 12 children. There was no control group; the study did not identify the time period during which the cases were identified, in four of the 12 cases behavioral problems appeared before the MMR. Ten out of 12 of Dr. Wakefield’s fellow researchers have withdrawn their support of this study. The study has been has been withdrawn.
- There are a large number of medical and scientific studies that show no connection between the MMR vaccine and autism. These studies have included thousands of children in many countries and were completed by many different scientists. All of the studies were well controlled and published in well-respected journals.
- The MMR vaccine has NEVER contained thimerosal, a preservative that many tried to link to autism.
2. Aren’t measles, mumps and rubella harmless if my child gets the diseases?
- Measles is a highly contagious disease spread by water droplet. It causes a rash, high fever, cough, runny nose and red, watery eyes.
- Measles can cause encephalitis which can lead to seizures, deafness or brain damage in 1 to 2 of every 2,000 cases.
- In the 1989 -1990 outbreak in the U.S., there were 55,000 cases, 11.000 hospitalizations, and 123 deaths. Most of these cases were in preschool children who were not vaccinated.
- Mumps cause fever, headache and swelling of glands on the sides of the jaw.
- 4 to 6 people out of 100 who are ill with mumps will develop meningitis
- 4 out of every 10 adult men who get the mumps may develop sterility due to inflammation of the testicles.
- Mumps may cause hearing loss.
- Rubella is a mild illness in children and young adults which results in rash and fever for about 3 days.
- Rubella will cause birth defects if contracted by a pregnant mom, there is at least an 80% chance of damage to an unborn child.
3. What is the danger of the MMR vaccine?
- The MMR vaccine is safe and most children have no reactions.
- About 5 to 15% of children will develop a fever 5 to 12 days later.
- About 5% will develop a rash 1 to 2 weeks after the vaccine.
- Central nervous system reactions such as encephalitis have been reported in less than one case per 1 million doses of the vaccine. This is many times lower than the occurrence of serious central nervous system problems after the measles which is 1 in 800 cases.
4. When should my child receive the MMR?
- Your child should receive 2 doses of the MMR. The first dose is recommended on or after the first birthday. The 2nd dose is before entering school between age 4 and 6.
- If your child is behind schedule, they may receive one dose of the MMR and a 2nd dose 4 weeks later.
- 95% of those vaccinated are immune after the first dose, 99.7% are immune after the 2nd dose.
5. What if my child has been exposed and has not been vaccinated?
- The MMR may be effective if given in the first 3 days after exposure to measles. More information can be found at www.cdc.gov/vaccines/pubs.
I know there is so much information in so many different places. It is difficult to decide what is credible and what is not. The fact is, your child is safer and healthier when he or she is fully vaccinated. Don’t take the risk. We are a society that has not seen the devastating results of these preventable diseases because of vaccines. If your child is not fully vaccinated, make that appointment today!
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.
Kaitlyn was a typical toddler, she definitely had an opinion!
You wake up one day, and it is a whole new ball game. You now have a toddler. Toddlers are so much fun, but can also be a challenge. We are not used to our child having an opinion, and a toddler has one and often expresses it very loudly! Toddlers can be having a tantrum one minute and laughing the next!
Your toddler’s biggest developmental task is to start to develop independence. Your child will begin to separate from you at times, and be very clingy at other times. Every day and sometimes every minute,is a new adventure when you have a 1 to 3 year old!
We know that toddlers are a bundle of energy. Everything is an adventure! Kitchen cupboards, knobs and buttons, computers, and even the drain in the tub is interesting. Toddlers are busy discovering and really don’t have time for naps and potty training, although both are important for toddlers! Toddlers are free little spirits and have very little self-control, which often results in your precious child throwing himself on the floor in a fit of frustration and anger. To better understand your toddler, there are a few principles of toddler psychology…..
- A toddler is developing creativity, independence, curiosity, and imagination. The whole world is open and exciting! Your child is not misbehaving when he smashes peas, climbs on the table, or puts his finger in a place it should not be, he is exploring. Exploration is developmentally appropriate for your toddler!
- A toddler has very little self-control and tolerance to frustration. Sometimes it is so frustrating that a puzzle piece will not fit, or he can’t climb on the counter, or you break up his cracker that he wanted whole! Because a toddler has very few words and a limited repertoire to handle frustration, the “logical” thing for him to do is melt down, kick, cry, and let his opinion be heard by all!
- Toddlers want attention. Attention is attention to a toddler, whether it is negative attention or positive attention. As parents, we need to limit our words of explanation to a toddler. A 2-year-old doesn’t really care if he will fall off the table, he just wants to climb on it. You will never convince him otherwise…there will be no moment of epiphany when he understands your safety talk! We must not reinforce behavior by giving extended attention to unwanted behavior. Give lots of positive words to positive behavior….very few words to negative behavior.
- Toddlers need predictability and routine. Your child will behave much better when there is a routine in place at home. The amount of frustration and the number of tantrums will decrease when you establish routines and rituals.
- Toddlers need some sense of control. Give your child true choices. “Do you want the bananas or the apple sauce?” “Do you want to wear this shirt or this one?” “Do you want to read your story before your bath or after?” Do not give choices when there are no true choice. Only ask a yes or no question if you are happy with the answer being “No!”
- Toddler temper tantrums are a result of frustration, being overly tired, being hungry and learning that they work!
Between 12 and 15 months your toddler should:
- Have tripled his or her birth weight.
- Start to combine syllables like saying Ma Ma and Da Da.
- Start walking alone.
- Bang two objects together.
- Like to read interactively.
- Follow one step directions.
- Begin to use spoon or fork.
- Begin to limit pacifier use to the crib only. Use during waking hours will limit speech.
- Like to explore.
- Begin to point. Respond by saying the name of the object he is pointing to.
- Take 1 to 2 naps a day and sleep 11 to 12 hours at night. Be sure to have a good bedtime routine.
By the end of the 18th month your toddler should:
- Be able to walk backwards, walk up steps, and kick a ball.
- Be able to say 10 to 25 words and name 3 body parts.
- Be able to turn pages in a book.
- Be able to stack 2 blocks.
- Play next to a playmate, but not with a playmate.
- Not be able to share! Sharing does not happen without parental guidance until about the end of the 3rd year.
- Attach to a “lovey” if one has been encouraged.
- Continue to love to explore.
- Take 1 nap a day and sleep 11 to 12 hours at night.
- Not separate easily. Separation anxiety peaks between 18 and 24 months.
- Know the difference between how Mom and Dad parent and play. Many will prefer one parent over the other at times. Toddlers cannot intentionally do things to hurt your feelings at this age. Connecting with one parent over the other may be because your toddler is learning male and female roles, may need more nurturing from mom or more physical play from dad. Roll with it!
By age 2 your toddler should:
- Be able to put on simple clothing with some help.
- Be able to stack 4 to 6 blocks.
- Be able to combine words into at least 2 word sentences at age 2. Your child should have a vocabulary of over 50 words and be 1/2 understandable by others.
- To follow two-step directions.
- Know his body parts.
- Continue parallel play with peers.
- Have 1 nap a day and 11-12 hours of sleep at night.
- MAY develop fears. Explain loud noises, show what things are, introduce new people slowly, read books about things he is afraid of, and let him handle objects that are causing fear.
- MAY continue to have separation anxiety. Do not leave without saying good-bye. If he cries when you leave, remind him you will be back. Leaving and coming back helps diminish separation anxiety.
During the 3rd year your toddler should:
- Dress himself.
- Stack 9-10 blocks.
- Walk up steps using alternating feet.
- Be able to jump, hop, walk on toes.
- Use his imagination for play.
- Have a large vocabulary and use 3-4 word sentences. Speech should be 3/4 understandable to others.
- Be able to tell stories, sing nursery rhymes.
- Be able to sort objects by shape and color.
- Be able to play cooperatively now and share and develop friendships.
- Show an interest in words, numbers, and letters. No need to force learning these, but plan activities around this interest. Show your child his name, write it out, point out letters on signs and in books, talk about colors, shapes, and point them out in your child’s world.
- Still sleep at least 11 hours at night and have 1 nap a day or an extended “rest time” without the TV.
Parenting activities for toddlers include:
- Toddler “field trips”. Bring your toddler to museums, parks, library story times, the post office, the grocery store, fire stations, apple orchards, and play groups.
- Play matching games, sorting games, shape and color games and puzzles.
- Read, read, read! Try to read 30 minutes a day broken into short time slots.
- Encourage crayons, finger paints, and clay to develop fine muscle control for writing. Writing on an easel or blackboard is easier for young children because larger muscles are used.
- Encourage water play, sand or dry rice play, filling and dumping.
- Play with puppets.
- Allow your child to feed himself, encourage use of utensils.
- Help to expand your toddler’s language by talking to him. Help him finish words and sentences. If he says “cup”, you can respond, “You want your blue cup with milk.”
- Play pretend with your toddler. Play kitchens, dolls, stuffed animals, trains, cars, dress up….
- Play follow the leader with your toddler.
- Encourage rhymes and songs.
- Play musical instruments with your toddler.
- Respond to wanted behaviors with positive words and ignore unwanted behaviors. Use time outs for behaviors like hitting, biting, and shoving.
At your child’s 18 month and 24 month well child visit, your physician should be screening for signs of autism. Red flags that a parent might see are:
- Your child repeats words but does not try to participate in conversations.
- Your child does not respond to his name when you say it.
- Your child does not make eye contact with you or others.
- Your child avoids social contact or physical touch.
- Your child has not developed speech or is losing words rather than building a vocabulary.
- Your child does not play with toys like his peers and does not use imaginative play.
- Your child seems to be under sensitive or overly sensitive to stimulations such as sound, touch, and texture.
Remember, if your child is reaching developmental milestones, no worries! Many times children will not be able to do something that is expected because they have never been encouraged or have never had the opportunity. Be sure to provide the opportunity for your toddler to reach milestones, even if it takes longer to allow your child to complete a task, or it is messy!! If your child is not reaching developmental milestones, contact your doctor, and refer to your state’s early intervention program. The earlier the intervention, the better the outcome.
Important links that will help you:
- “Learn the Signs. Act Early.” Campaign
This campaign educates parents about childhood development, including early warning signs of autism and other developmental disorders, and it encourages developmental screening and intervention. It will give you tips on how to determine if your child needs screening.
- Overview of Early Intervention
Learn more about early intervention services from the National Dissemination Center for Children with Disabilities. Find out about your state’s early intervention program and how to access it.
- Bright Futures
Bright Futures materials for families are available for parenting tips for children from birth to 21 years of age. This is provided by the American Academy of Pediatrics.
- Developmental Surveillance and Screening Guidelines
This American Academy of Pediatrics website provides guidelines on surveillance and screening for developmental delays in children.
- National Association for the Education of Young Children (NAEYC)
NAEYC provides accreditation for early childhood programs and preschools that meet certain standards. You can search for an accredited program or preschool near you. NAEYC also provides resources, tools, and information for parents.
Toddlers can be exhausting, but exhilarating! Looking through your toddler’s eyes, you will learn to enjoy the small wonders of the world again. Tie up your running shoes, you have a busy toddler!
Take a breath, enjoy the joyful moments of each day, and remember you don’t have to be perfect to be the perfect parent.