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Georgetown Pediatrics

Inclined Sleepers and Other Baby Registry Items to Avoid

From American Academy Pediatrics:

Having a baby is an incredibly exciting time! Many parents set up baby registries for items that they believe their baby will need. However, it’s important to know that some popular products are unnecessary and can actually be dangerous for infants. Examples include inclined sleepers, positioners, and crib bumpers.

Each year, about 3,400 infants in the United States die unexpectedly during sleep. This can happen from accidental suffocation, sudden infant death syndrome (SIDS), or unknown causes.

To help prevent these deaths, the American Academy of Pediatrics recommends that all infants should sleep on flat and firm surfaces. Babies should sleep by themselves, without any bumpers, soft bedding, pillows, or stuffed toys. Crib bumpers and inclined infant sleeper products can cause a baby to suffocate. We also advise against using products that are for infant bedsharing with parents.

New safety standards on the way

A safe sleep environment is so important that the U.S. Consumer Product Safety Commission (CPSC) approved a federal safety standard for infant sleep products in June 2021. Starting in mid-2022, this standard will help get rid of potentially dangerous baby sleep products such as inclined sleepers, in-bed sleepers, loungers, and travel/compact sleepers. These products will have to meet the same CPSC standards that are already in place for cribs, bassinets, play yards, and bedside sleepers.

Here’s why these and other dangerous infant sleep products should stay off your registry and out of your home.

Inclined sleepers and positioners

These are sometimes called baby nests, docks, pods, loungers, rockers, or nappers. Infant positioners and inclined sleepers have been popular items on baby registry lists for years. But until mid-2022, these products are not regulated and have no safety standards.

The CPSC says that sleep products that incline more than 10 degrees are not safe. Soft and plush sleep surfaces are also dangerous. Inclined sleepers allow babies to sleep at a 30-degree angle. Infants placed in these products may fall asleep in a chin-to-chest position, which can restrict their airway. They can also roll out of the devices and become trapped under them. Inclined sleepers have been tied to at least 94 deaths.

With sleep positioners, babies can suffocate after rolling onto their stomachs since they can’t lift their heads. The soft padding can make it difficult to breathe if a baby’s face presses against it.

Crib bumpers

Crib bumpers were long considered staples of nursery décor. They were originally intended to cushion babies from the crib slats. Crib bumpers are dangerous because of the risk of suffocation, entrapment, and strangulation. Plus, older babies may use the bumpers to stand on and climb out of the crib, creating a fall risk. Crib bumpers have been linked to at least 83 infant deaths in the past 30 years.

In addition to traditional padded bumpers, stores now sell mesh bumpers and vertical crib liners. But even these can get loose and become a strangulation risk. Babies can also get trapped between them and the crib mattress.

There is no evidence that crib bumpers—of any kind—prevent injury in young infants.

Cribs today are regulated by the CPSC and have updated safety standards. The slats are closer together to prevent your baby’s head from getting stuck. This means that bumpers are not only dangerous, but unnecessary. Maybe you’re concerned about your child’s leg getting stuck between crib slats. If so, use a wearable blanket or sleeping sack that’s the right size for your baby.

Why are these products still sold?

Unfortunately, the new regulations don’t take effect until mid-2022, meaning that inclined sleepers and positioners will still be available. As for crib bumpers, the CPSC plans to review federal safety standards for them later this year. We continue to urge the CPSC to ban all these dangerous infant sleep-related products.

A bill that would prohibit crib bumpers was introduced in Congress in 2021 too. Known as the Safe Cribs Act, this bill would make it illegal to sell, distribute, manufacture, or import crib bumpers. The bill’s sponsors are concerned that parents will keep buying these products, not realizing that they’re potentially hazardous.

Some stores, online retailers, cities, and states, have already stopped selling or have banned inclined sleepers and crib bumpers. Some companies have also issued voluntary recalls of these products.

Remember

Even in areas where these dangerous products are banned, they can still turn up at secondhand stores or garage sales. It’s important to check the CPSC website to see if products have been recalled before using them. Also, make sure anyone who watches your child knows about recalled and unsafe products.

It’s also important to keep in mind that your baby should only sleep in products that are designed to be safe sleep spaces, like cribs, bassinets, and portable play yards. Other products like swings, reclined seats, bouncers, and other sitting or positioning devices are not safe for sleep. If your baby falls asleep in one of these, move her to a safe sleep space right away.

If you have any questions about safe sleep products for your baby, talk with your pediatrician.

More information

Georgetown Pediatrics
Newborn News

Colic Relief Tips for Parents

From American Academy Pediatrics:

Does your infant have a regular fussy period each day when it seems you can do nothing to comfort her?

This is quite common, particularly between 6:00 p.m. and midnight—just when you, too, are feeling tired from the day’s trials and tribulations. These periods of crankiness may feel like torture, especially if you have other demanding children or work to do, but fortunately they don’t last long. The length of this fussing usually peaks at about three hours a day by six weeks and then declines to one or two hours a day by three to four months. As long as the baby calms within a few hours and is relatively peaceful the rest of the day, there’s no reason for alarm.

If the crying does not stop, but intensifies and persists throughout the day or night, it may be caused by colic. About one-fifth of all babies develop colic, usually between the second and fourth weeks. They cry inconsolably, often screaming, extending or pulling up their legs, and passing gas. Their stomachs may be enlarged or distended with gas. The crying spells can occur around the clock, although they often become worse in the early evening.

What Causes Colic?

Unfortunately, there is no definite explanation for why this happens. Most often, colic means simply that the child is unusually sensitive to stimulation or cannot “self-console” or regulate his nervous system. (Also known as an immature nervous system.) As she matures, this inability to self-console—marked by constant crying—will improve. Generally this “colicky crying” will stop by three to four months, but it can last until six months of age. Sometimes, in breastfeeding babies, colic is a sign of sensitivity to a food in the mother’s diet. The discomfort is caused only rarely by sensitivity to milk protein in formula. Colicky behavior also may signal a medical problem, such as a hernia or some type of illness.

Although You Simply May Have to Wait It Out, Several Things Might Be Worth Trying:

  • First, of course, consult your pediatrician to make sure that the crying is not related to any serious medical condition that may require treatment.Then ask him which of the following would be most helpful.
  • If you’re nursing, you can try to eliminate milk products, caffeine, onions, cabbage, and any other potentially irritating foods from your own diet.
  • If you’re feeding formula to your baby, talk with your pediatrician about a protein hydrolysate formula. If food sensitivity is causing the discomfort, the colic should decrease within a few days of these changes.
  • Do not overfeed your baby, which could make her uncomfortable. In general, try to wait at least two to two and a half hours from the start of one feeding to the start of the next one.
  • Walk your baby in a baby carrier to soothe her. The motion and body contact will reassure her, even if her discomfort persists.
  • Rock her, run the vacuum in the next room, or place her where she can hear the clothes dryer, a fan or a white-noise machine. Steady rhythmic motion and a calming sound may help her fall asleep. However, be sure to never place your child on top of the washer/dryer.
  • Introduce a pacifier. While some breastfed babies will actively refuse it, it will provide instant relief for others.
  • Lay your baby tummy-down across your knees and gently rub her back. The pressure against her belly may help comfort her.
  • Swaddle her in a large, thin blanket so that she feels secure and warm. 

When you’re feeling tense and anxious, have a family member or a friend look after the baby—and get out of the house. Even an hour or two away will help you maintain a positive attitude. No matter how impatient or angry you become, a baby should never be shaken. Shaking an infant hard can cause blindness, brain damage, or even death. Let your own doctor know if you are depressed or are having trouble dealing with your emotions, as she can recommend ways to help.

Georgetown Pediatrics
Newborn News

Probiotics in Infant Formula

From American Academy Pediatrics:

Probiotics” (meaning “for life”) is a word you may see when shopping for infant formula and supplements. Some formulas are fortified with these probiotics, which are types of live bacteria. Doctors may also recommend probiotic drops or powders for breastfed infants. These are “good” or “friendly” bacteria already present at high levels in the digestive system of breastfed babies.

In formula-fed babies, probiotics in formulas promote a balance of bacteria in your baby’s intestines, and offset the growth of “unfriendly” organisms that could cause infections and inflammation.

Increasingly, parents can find probiotic supplements outside of formula, including for breastfed infants. Research on the benefits of probiotics is ongoing, with some pediatricians embracing their use for infants delivered by C-section or those whose mothers are given antibiotics during labor.

Possible health benefits of probiotics

The most common types of probiotics are strains of bifidobacteria and lactobacilli. Some research has shown these probiotics may prevent or treat disorders such as infectious diarrhea​ and atopic dermatitis (eczema) in children. Other possible health benefits are being studied as well, including the possibility of reduced risk of food-related allergies and asthma, prevention of urinary tract infections, and relief of symptoms of infant colic​.

More research is needed

With many of these health conditions, the evidence confirming any positive effects of probiotic use is limited and more research is needed. At this time, benefits appear to occur only as long as probiotics are being taken. Once your baby stops consuming probiotic-fortified formula, intestinal bacteria levels return to previous levels. This is different from in breastfed infants, where the bacteria in the gut resulting from breastfeeding​ are more resilient and set the stage for healthier outcomes. 

Remember

Before giving your child infant formula fortified with probiotics, discuss the issue with your pediatrician

More information

Georgetown Pediatrics
Newborn News

Tips for Coping with a New Baby During COVID-19

From American Academy Pediatrics:

All babies cry. Most babies cry a lot from two weeks to two months of age. Some cry more than others, and some cry longer than others. For many new parents, crying is one of the most stressful parts of coping with a newborn.

In some cases, extreme stress and a temporary lapse of emotional control in a caregiver can lead to actions that result in abusive head trauma. In fact, the most common trigger for abusive head trauma is simply a crying baby. As an American Academy of Pediatrics policy statement points out, actions that lead to abusive head trauma often happen when caretakers experience stress and get to the end of their rope.

However, there is a bright side: The key to preventing actions that lead to abusive head trauma is to understand how common feelings of frustration, isolation, and exhaustion are during the first few months of an infant’s life.

Helpful tips

Usually, new parents can seek out social supports and external help—but what happens when we are restricted in our movements and our contacts? What happens when grandparents can’t come over to help out, or when neighbors don’t stop by for a cup of coffee? What happens when families face job loss, childcare challenges, and more lingering fallout from the COVID-19 pandemic? Here are a few suggestions:

  • Try all the soothing tricks. Crying babies want to be soothed. You may need to try a few things, over and over, before they calm. Try holding them, feeding them, swaddling them, gently rocking them, singing to them. If these don’t work, put the baby down and take a break. Be sure your baby is in a safe sleep environment (on their back on a firm sleep surface with a tight-fitting sheet, away from soft blankets, toys, pillows, and other bedding materials). While some babies cry for a long time, many parents are surprised at how rapidly babies will cry themselves to sleep.
  • Pay attention to your own needs. The challenges of new mothers can certainly feel overwhelming sometimes. Rest as much as you can—try sleeping when the baby does. Find time for yourself when your partner or other caring adult watches the baby. Put on your headphones, give a friend or relative a call, have a cup of tea, or just relax.
  • Connect with others. Social distancing during the COVID-19 outbreak can be isolating. Try video chats or social media to stay in touch. If you’re a friend or relative on the receiving end of these calls, listen first before offering suggestions. Imagine you are with the young parent, they are crying on your shoulder, and you are offering reassurance without any words. Keeping this image in mind can help you provide the social support that all new parents need.
  • Use your “helpers.” Engage older siblings as much as you can by encouraging them to be your special helpers, so they can help out in developmentally appropriate ways.
  • Seek help. Depression is the most common mental illness in the United States. If you had a history of depression before your baby was born, you may be at higher risk for postpartum depression. Speak with your provider sooner rather than later to help foresee this potential condition. Many doctors, nurses, and mental health providers are now set up for telehealth visits and may be able to help you by video or phone.
  • Reach out. If you are a friend, relative, or neighbor to a family with a newborn, this is the time to reach out. Think about ways you can help. In addition to social support, can you buy diapers or other baby supplies? Can you drop off food or treats for the siblings or adults? Can you safely supervise older children outdoors? Maybe they could come along with you when you walk your dog!
  • Help a co-worker out. If you are a co-worker of a parent returning to work (especially during social distancing) after parental leave, be kind and supportive. If you see or hear the baby on the call, say Hi!
  • Find a forum. New mothers may find it helpful to discuss their experiences with other new mothers. In addition to seeking help from friends, relatives, neighbors, and medical professionals, look for discussion forums and communities of moms dedicated to sharing problems, stories, and tips with each other online (see the list of resources below).
  • Your pediatrician is here to help. Never hesitate to call for advice. Your pediatricians is an excellent resource for understanding your baby and your own needs, including those related to postpartum depression.
  • Resources. Here are a few key resources that may be helpful to you at home:
Georgetown Pediatrics
COVID Newborn News

Simple Ways to Entertain & Boost Your Baby’s Development at Home

From American Academy Pediatrics:

During social distancing to slow the spread of COVID-19, you may be looking for new ways to entertain and play with your young child. Thankfully, all you need is loving attention and some basic household items.

Try these time-tested activities, suggested by age, and let the fun happen!

Newborn to 3 Months

Puppet Play. Make a hand puppet using a sock. Move it up and down and back and forth where your baby can see it, doing a silly dance and singing silly songs. You can even have the puppet give her kisses!

Footloose. Gently dance with your baby positioned over your shoulder. She will enjoy the movement and at the same time will learn to tolerate the slight pressure against her tummy.

Pat-a-Cake. Hold your baby’s hands and gently clap them together to play a game of pat-a-cake:

Pat-a-cake, pat-a-cake, baker’s man (Take baby’s hands through the motions)

Bake me a cake as fast as you can

Roll it (Roll her hands around each other) and pat it (Clap)

and mark it with a B (Guide her finger to write a B in the air)

And put it in the oven for baby and me (Kiss your baby!)

​
Can’t Smile Without You. Lie down on the floor,tummy down facing your baby. Try to get her to smile by sticking out your tongue, smiling at her, and making other funny faces. You may even hear your infant’s first giggle!

4 to 6 months

Little Piggy Game. Hold your baby’s foot up and wiggle each toe while teaching the classic “This Little Piggy” poem in an animated, singsong way. Don’t forget to give your infant a tickle at the end!

This little piggy went to market (big toe)

This little piggy stayed home (second toe)

This little piggy had roast beef (third toe)

This little piggy had none (fourth toe)

And this little piggy went wee wee wee all the way home (little toe)


Mustang Sally. Sit on the floor with your baby sitting on your raised knees. While holding on to her, slowly move your legs side to side and sing “Ride a Little Horsey.” When you say, “don’t fall down,” slide your feet forward!

Ride a little horsey

Down to town

Oops, little horsey

Don’t fall down!


Crocodile Rock. Hold your baby securely, tummy down on your chest. Rock your body from side to side and sing a song like “Row, Row, Row Your Boat.”

​Homemade Toy: Stacking Baby BlocksCollect different-sized clean milk cartons, small boxes and toilet paper rolls. Stuff each with newspaper or tissue paper. Fold the ends down to create blocks​and cylinders, then close them with masking or duct tape. Use a variety of fun colors of contact paper or duct tape to cover each block. ​



Free Fallin’. Stack up some blocks and encourage your baby to bat at and reach for them. Most infants absolutely love to see and hear the blocks tumble to the ground!

7 to 9 months

Fly Me to the Moon. Carefully lift your baby up over your head and back down while playing or singing a song like, “Fly me to the moon!” If your child seems fearful, move more slowly and talk in a calm, soothing voice.

See You Later, Alligator. With your baby seated in front of you, hide a rattle under a blanket or behind your back. Shake the rattle while hiding it and see what happens. If your baby loses interest once it’s hidden, reveal part of the rattle and ask, “Where’s the toy?”

If the Hat Fits. Sit just in front of baby, place a colorful hat on your head and say, “Look! The hat is on my head.” Then remove it and say, “Now the hat is off.” Next, put the hat on and off your infant’s head! Encourage your baby to reach for the hat for more play.

The Humpty Dance. Sit your infant on your lap, either sitting up or tummy down, and gently bounce your legs up and down. For more fun, do this while using a rocking chair!

10 to 12 months

Be-Bop Baby. Seat your baby upright on the floor, legs separated just enough to place a medium-sized ball between them. Show your baby how to roll the ball in your direction, then roll the ball back. Continue taking turns.

Marching On. While seated, stand your baby on your thighs. Hold your baby’s hips and slowly make stepping motions by moving your legs up and down, one side at a time. Sing your favorite song.

You Light Up My Life. Shine a flashlight on the wall. Once your baby sees the light, move it slowly from one side of the room to the other and up and down to encourage visual tracking.

Homemade Toy:​Baby Drums​Cover an oatmeal box or coffee can with colorful contact paper and use plastic baby spoons as drumsticks. (Or, simply give your child a saucepan and a short wooden spoon.) ​



Beat It. Show your baby different ways to tap a drum using the palms of your hands, your fingertips, or a baby spoon. See if your baby can imitate you.

12-24 months

The Big Squeeze. Take colorful kitchen sponges and cut them into fun sizes and shapes to fit into your child’s hand at bath time. Show your little one how to sink a sponge underwater, watch it fill up, then hold it up and squeeze the water out.

​Homemade Toy: Toddler TambourineTape two sturdy paper plates securely together halfway around using colorful duct tape. Fill the tambourine half-full of dry cereal, tape the paper plates together the rest of the way, and shake!​​



Mr. Tambourine Man. Show your little one how to shake and tap a tambourine to make noise. Add more ways, like tapping it against your hip, over your head, and in various directions.

Poking Fun. Show your baby how to press numbers on an old phone or peck on an old keyboard. Glue different textures of fabric at the bottom of each section of an egg carton or old ice tray. Let your baby feel the various textures.

Remember

You have the knowledge and tools to make play a fun and stimulating part of your baby’s daily routine. Keep it simple, be flexible, and do what works for you and your child.

More Information

Georgetown Pediatrics
COVID Newborn News

Bringing Baby Home: How to Prepare for the Arrival of Your Newborn

From American Academy Pediatrics:

One of the most cautious drives you’ll ever take is the one bringing your baby home with you. Newborns look and feel fragile, and they represent a new of world of uncertainty. Here’s what you need to know to make your transition to parenthood easier.

It’s true: There’s no official instruction manual for becoming a parent.

But relax. You’re not the first parent to wonder why you’ve been entrusted with a little person without an instruction manual. The 40 weeks (give or take) of pregnancy allow time for more than just picking out names; it’s your opportunity to plan and prepare. The more you know about your newborn, the better equipped you’ll be when she arrives.

Once your baby is born, doctors will be looking for a few key signs that she is healthy and ready to go home, says Vinod K. Bhutani, M.D., FAAP, professor of pediatrics at Lucile Packard Children’s Hospital at Stanford University School of Medicine. “First they will want to see that the baby is able to breathe well and maintain her body temperature,” says Dr. Bhutani, who is also a member of the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn.

Newborns must also demonstrate that they can feed well. Regardless of whether she’s breastfed or bottle-fed, all babies should be wetting at least three or four diapers in a 24-hour period, says Dr. Bhutani. And while many newborns have some jaundice — a yellowish tint to their skin — their jaundice will be evaluated before they’re sent home from the hospital. If necessary, your pediatrician will discuss a follow-up plan for monitoring your baby’s jaundice.

Healthy at Home

Most healthy newborns go home after two or three days, yet the transition for parents is just beginning. “It’s OK to be a little scared — the first week after babies are born is when they’re most vulnerable,” says Dr. Bhutani. “Newborns can have multiple medical problems that if left unattended can become serious.”

Dehydration is sometimes a concern for newborn babies that can continue once they’ve left the hospital. Your pediatrician will discuss dehydration with you so you’ll know what to look for, how to respond, etc.

Parents should also watch for signs of infection in their newborn. Infections can be picked up during birth or from people other than the parents handling the baby, such as visitors. “Most people think only of fevers, but newborns can have dropping temperatures or a low temperature that’s of concern,” says Dr. Bhutani. It’s always wise to watch for signs of infection around the belly button or circumcised foreskin, such as poor sucking during breastfeeding, a lack of appetite, poor weight gain, weak crying, and increasing irritability.

Jaundice happens in most every baby, peaking in the first week as newborns learn to excrete the yellow pigment called bilirubin in their stools. “Babies tend to have slow liver function at first and may have some evidence of jaundice as their livers quickly mature over the first several days,” write Drs. Laura Jana and Jennifer Shu in Heading Home With Your Newborn. “The bilirubin level generally peaks by about 5 days for term babies and about 1 week for those born prematurely.” If your baby continues to have signs of jaundice — very yellowish skin and eyes — after day four, consult your pediatrician.

Although most babies remain perfectly healthy after they’re discharged from the hospital, it’s important to watch for any signs of illness and take your child to the pediatrician for evaluation within a day or two of leaving the hospital. “Every baby needs to be seen by a pediatrician on day three, four, or five,” says Dr. Bhutani. “It’s a must.”

Finding a Pediatrician

As a new parent, it’s important to find a pediatrician with whom you feel comfortable. If your child becomes ill, you want to have a good working relationship with a doctor you trust and respect, and who will be there to support you.

Begin by evaluating the pediatrician practices in your local area. Determine whether it matters to you if you have a male or female pediatrician. Be aware that while it’s all the same to infants, some children as they get older feel more at ease working with a doctor of the same sex. If possible, visit the offices and meet the physicians in person. Or find out if your hospital has a “Meet the Doctors” night attended by area pediatricians.

Since you’ll be visiting a pediatrician shortly after bringing your child home, don’t leave this task until the last minute. “You have nine months to plan. You should always choose your pediatrician beforehand,” says Dr. Bhutani.

Quick Tips: Time to Call the Doctor

Watch for these signs that it’s time to call your pediatrician:

  • Your newborn’s breathing is faster or irregular
  • You notice blueness or a darkness on the lips or face 
  • Your newborn has a fever 
  • Your newborn’s body temperature has dropped
  • You see signs of dehydration (less than 3 to 4 wet diapers in a 24-hour period)
  • Your baby’s belly button or circumcision area looks infected
  • Your newborn’s jaundice does not decrease by the fifth day 
  • Your baby is crying a lot or appears sluggish
  • You think your baby is not looking or feeling well

Quick Tips: Choosing a Pediatrician

The following are a few questions from the AAP to help you select a pediatrician:

  • What are the office hours? Is emergency coverage available 24/7?
  • Which hospital does the pediatrician use?
  • Do they accept your insurance plan and how does the office process billing and claims?
  • What are the qualifications of the pediatrician? Is he or she an AAP member (i.e., “FAAP,” a Fellow of the American Academy of Pediatrics)?
Georgetown Pediatrics
Newborn News

Newborns and COVID-19

From American Academy Pediatrics:

Congratulations on the birth of your new baby! And kudos for getting fully immunized against COVID-19 during your pregnancy. This protects you—and also passes along protective antibodies that may reduce your baby’s risk of COVID-19 infection. In other words, you likely gave your little one some immunity against SARS-CoV-2, the virus that causes COVID-19, from the moment they were born!

Still, you should strongly consider limiting your newborn’s exposure to others. People who aren’t vaccinated against COVID-19 spread the virus, especially the more contagious Delta variant. Also keep in mind that people aren’t fully vaccinated against COVID-19 until two weeks after the last shot.
How likely are newborns to get sick from COVID?

While serious COVID-19 infections in newborns are uncommon, some babies in this age group have become severely ill. Your baby’s overall fragile immune system, as well as their small airways, developing lungs and breathing muscles leave them more vulnerable to all respiratory diseases, including COVID.

When young infants do get COVID or other airborne illnesses, it’s often because a close contact transmitted it to them. This can happen even if the person or contact doesn’t feel sick.Ways to protect your baby from the virus

  • Face masks. Non-household members over age 2 should mask-up, even if visiting the baby outside or in small gatherings.
  • Physical distancing. Even though everyone wants to hold a new baby, you should insist unvaccinated visitors remain at least 3 feet from the baby. These measures should also be kept in mind when you go out of the house with the baby.
  • Keep visits with your baby short. Also, limiting visits to under 15 minutes may also reduce your infant’s risk of becoming infected with COVID-19.
  • Vaccines. Encourage family members and friends who are eligible for COVID-19 vaccines to get fully vaccinated.

Remember

Having a new baby is a wonderful but exhausting time. Taking these common-sense steps can give you peace of mind that you are reducing your baby’s risk of COVID-19 infection. Vaccine trials are underway in infants 6 months of age and older. Keeping your baby up-to-date on all recommended vaccines is one of the most important ways to protect your baby’s health.

Georgetown Pediatrics
COVID Newborn

Preventive Steps

From the CDC;

Take time to get a flu vaccine.

  • CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
  • Flu vaccines help to reduce the burden of flu illnesses, hospitalizations and deaths on the health care system each year. (Read more about flu vaccine benefits.)
  • This season, all flu vaccines will be designed to protect against the four flu viruses that research indicates will be most common. (Visit Vaccine Virus Selection for this season’s vaccine composition.)
  • Everyone 6 months and older should get an annual flu vaccine, ideally by the end of October. Learn more about vaccine timing.
  • Vaccination of people at higher risk of developing serious flu complications is especially important to decrease their risk of severe flu illness.
  • People at higher risk of serious flu complications include young children, pregnant people, people with certain chronic health conditions like asthma, diabetes or heart and lung disease, and people 65 years and older.
  • Vaccination also is important for health care workers, and other people who live with or care for people at higher risk to keep from spreading flu to them. This is especially true for people who work in long-term care facilities, which are home to many of the people most vulnerable to flu.
  • Children younger than 6 months are at higher risk of serious flu illness but are too young to be vaccinated. People who care for infants should be vaccinated instead.

Take everyday preventive actions to stop the spread of germs.

  • Take everyday preventive actions that are recommended to reduce the spread of flu.
    • Avoid close contact with people who are sick.
    • If you are sick, limit contact with others as much as possible to keep from infecting them.
  • Cover coughs and sneezes.
    • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose, and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated with viruses that cause flu.
  • For flu, CDC recommends that people stay home for at least 24 hours after their fever is gone except to get medical care or other necessities. Fever should be gone without the need to use a fever-reducing medicine. Note that the stay-at-home guidance for COVID-19 may be different. Learn about some of the similarities and differences between flu and COVID-19.
  • In the context of the COVID-19 pandemic, local governments or public health departments may recommend additional precautions be taken in your community. Follow those instructions.

Take flu antiviral drugs if your doctor prescribes them.

  • If you are sick with flu, antiviral drugs can be used to treat your illness.
  • Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.
  • Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick, but starting them later can still be helpful, especially if the sick person has a higher risk factor or is very sick from flu.
  • If you are at higher risk from flu and get flu symptoms, call your health care provider early so you can be treated with flu antivirals if needed. Follow your doctor’s instructions for taking this drug.

Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with flu and have respiratory symptoms without a fever. Visit CDC’s website to find out what to do if you get sick with flu. Learn about some of the similarities and differences between flu and COVID-19, and the difference between flu and the common cold.

Georgetown Pediatrics
Flu

Misconceptions about Seasonal Flu and Flu Vaccines

From the CDC;

Misconceptions about Flu Vaccines

Can a flu vaccine give you flu?

No, flu vaccines cannot cause flu illness. Flu vaccines given with a needle (i.e., flu shots) are made with either inactivated (killed) viruses, or with only a single protein from the flu virus.  The nasal spray vaccine contains live viruses that are attenuated (weakened) so that they will not cause illness.

Are any of the available flu vaccines recommended over the others?

For the 2020-2021 flu season, the Advisory Committee on Immunization Practices (ACIP) recommends annual influenza (flu) vaccination for everyone 6 months and older with any licensed, influenza vaccine that is appropriate for the recipient’s age and health status, including inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV), or live attenuated nasal spray influenza vaccine (LAIV4) with no preference expressed for any one vaccine over another.

There are many vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional.

Is it better to get sick with flu than to get a flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine for everyone 6 months of age and older with rare exception. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu. Additionally, flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed based on which influenza viruses are making people sick.

Why do some people not feel well after getting a seasonal flu vaccine?

Some people report having mild side effects after flu vaccination. The most common side effects from flu shots are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. If these reactions occur, they usually begin soon after vaccination and last 1-2 days. In randomized, blinded studies, where some people got inactivated flu shots and others got salt-water shots, the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got a flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.

Side effects from the nasal spray flu vaccine may include: runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough. If these problems occur, they usually begin soon after vaccination and are mild and short-lived. The most common reactions people have to flu vaccines are considerably less severe than the symptoms caused by actual flu illness.

What about serious reactions to flu vaccine?

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after vaccination. While these reactions can be life-threatening, effective treatments are available.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get flu symptoms, even after they have been vaccinated against flu.

  1. One reason is that some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold, cause symptoms similar to flu, and also spread and cause illness during the flu season. The flu vaccine only protects against flu, not other illnesses.
  2. Another explanation is that it is possible to be exposed to flu viruses, which cause flu, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming ill with flu before protection from vaccination takes effect.
  3. A third reason why some people may experience flu  symptoms despite getting vaccinated is that they may have been exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the viruses selected to make the vaccine and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people. For more information, see Influenza (Flu) Viruses.
  4. The final explanation for experiencing flu symptoms after vaccination is that flu vaccines vary in how well they work and some people who get vaccinated still get sick. When that happens, though vaccination has been shown in several studies to reduce severity of illness in those people who get vaccinated but still get sick.

Can vaccinating someone twice provide added immunity?

In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for children getting vaccinated for the first time, only one dose of flu vaccine is recommended each season.

Is it true that getting a flu vaccine can make you more susceptible to other respiratory viruses?

Flu vaccines are not thought to make people more susceptible to other respiratory infections.

A 2012 study external icon that suggested that flu vaccination might make people more susceptible to other respiratory infections. After that study was published, many experts looked into this issue further and conducted additional studies to see if the findings could be replicated. No other studies have found this effect. It’s not clear why this finding was detected in the one study, but the majority of evidence suggests that this is not a common or regular occurrence and that flu vaccination does not, in fact, make people more susceptible to other respiratory infections.

Does a flu vaccination increase your risk of getting COVID-19?

There is no evidence that getting a flu vaccination increases your risk of getting sick from a coronavirus, like the one that causes COVID-19.

You may have heard about a studyexternal icon published in January 2020 that reported an association between flu vaccination and risk of four commonly circulating seasonal coronaviruses, but not the one that causes COVID-19. This report was later found to be incorrect.

The results from that initial study led researchers in Canada to look at their data to see if they could find similar results in their population. The results from Canada’s studyexternal icon showed that flu vaccination did not increase risk for these seasonal coronaviruses. The Canadian findings highlighted the protective benefits of flu vaccination.

The Canadian researchers also identified a flaw in the methods of the first study, noting that it violated the part of study design that compares vaccination rates among patients with and without flu (test negative design). This flaw led to the incorrect association between flu vaccination and seasonal coronavirus risk. When these researchers reexamined data from the first study using correct methods, they found that flu vaccination did not increase risk for infection with other respiratory viruses, including seasonal coronaviruses.

Misconceptions about Flu Vaccine Effectiveness

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, the benefits of flu vaccination will vary, depending on factors like the characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.

There are many reasons to get an influenza (flu) vaccine each year. Because of the on-going COVID-19 pandemic, getting a flu vaccine during 2020-2021 will be more important than ever. Flu vaccines will not prevent COVID-19, but they will reduce the burden of flu illnesses, hospitalizations and deaths on the health care system and conserve scarce medical resources for the care of people with COVID-19.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

  • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
  • During seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
  • Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.
  • A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.
  • Flu vaccination is an important preventive tool for people with chronic health conditions.
  • Flu vaccination has been associated with lower rates of some cardiac eventsexternal icon among people with heart disease, especially among those who had had a cardiac event in the past year.
  • Flu vaccination can reduce worsening and hospitalization for flu-related chronic lung disease, such as in persons with chronic obstructive pulmonary disease (COPDexternal icon).
  • Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant women by about one-half.
  • A 2018 studyexternal icon that included influenza seasons from 2010-2016 showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent.
  • A number of studies have shown that in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is not old enough to be vaccinated.
  • Flu vaccine can be lifesaving in children.
  • A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu.
  • Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
  • A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.
  • A 2018 study external icon showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
  • *References for the studies listed above can be found at Publications on Influenza Vaccine Benefits. Also, see the A Strong Defense Against Flu: Get Vaccinated! fact sheet.

Misconceptions about the Timing of Seasonal Influenza Vaccination

Should I wait to get vaccinated so that my immunity lasts through the end of the season?

How long you are immune or your “duration of immunity” is discussed in the ACIP recommendations. While delaying getting of vaccine until later in the fall may lead to higher levels of immunity during winter months, this should be balanced against possible risks, such as missed opportunities to receive vaccine and difficulties associated with vaccinating a large number of people within a shorter time period.

Is it too late to get vaccinated after Thanksgiving (or the end of November)?

No. Vaccination can still be beneficial as long as flu viruses are circulating. If you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.

Misconceptions about Physician Consent for Vaccination

Do pregnant women or people with pre-existing medical conditions need special permission or written consent from their doctor to get a flu vaccine?

No. There is no recommendation for pregnant women or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office. With rare exception, CDC recommends an annual flu vaccine for everyone 6 months of age and older, including pregnant women and people with medical conditions.

A variety of flu vaccine products are available (Table 1). Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any contraindications or precautions. Providers also should appropriately screen all people getting vaccinated for allergies to vaccine components or other contraindications. People who have previously had a severe allergic reaction to influenza vaccine or any of its ingredients should generally not be vaccinated.

There are some people who should not get a flu vaccine without first speaking with their doctor. These include:

  • People who have a moderate-to-severe illness with or without a fever (they should wait until they recover to get vaccinated), and
  • People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.

Pregnant women or people with pre-existing medical conditions who get vaccinated should get a flu shot.

If a person is vaccinated by someone other than their primary health care provider, the vaccinating provider should ensure that the patient and, if possible, the patient’s medical provider have documentation of vaccination.

For a complete list of people who should not get a flu vaccine before speaking with their doctor, please review the influenza Vaccine Information Statement for the inactivated or recombinant flu vaccine or live, intranasal influenza vaccine.

Misconceptions about “Stomach Flu”

Is the “stomach flu” really flu?

No. Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to flu — more commonly in children than adults — these problems are rarely the main symptoms of influenza. Flu is a respiratory disease and not a stomach or intestinal disease.

Georgetown Pediatrics
Flu

Healthy Habits to Help Protect Against Flu

From the CDC;

The single best way to reduce the risk of seasonal flu and its potentially serious complications is to get vaccinated each year, but good health habits like avoiding people who are sick, covering your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses like flu. There also are flu antiviral drugs that can be used to treat and prevent flu.

The tips and resources below will help you learn about actions you can take to protect yourself and others from flu and help stop the spread of germs.

  1. Avoid close contact.
    Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
  2. Stay home when you are sick.
    If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.
  3. Cover your mouth and nose.
    Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk.
  4. Clean your hands.
    Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.
    • Handwashing: Clean Hands Save Lives
      Tips on hand washing and using alcohol-based hand sanitizers
    • It’s a SNAP Toolkit: Handwashingexternal icon
      Hand washing resources from the It’s A SNAP program, aimed at preventing school absenteeism by promoting clean hands. From the School Network for Absenteeism Prevention, a collaborative project of the CDC, the U.S. Department of Health and Human Services and the American Cleaning Institute.
  5. Avoid touching your eyes, nose or mouth.
    Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
  6. Practice other good health habits.
    Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Preventing Flu at Work and School

At School

  • Find out about plans your child’s school, childcare program, and/or college has if an outbreak of flu or another illness occurs and whether flu vaccinations are offered on-site.
  • Make sure your child’s school, childcare program, and/or college routinely cleans frequently touched objects and surfaces, and that they have a good supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes on-site.
  • Ask how sick students and staff are separated from others and who will care for them until they can go home, and about the absentee policy for sick students and staff.

Learn more about preventing the flu, common questions and answers, and poster materials for schools: Resources for Schools, Childcare Providers and Parents

Learn more about COVID-19 planning and guidance for promoting safe and healthy learning environments for schools and childcare programs.

At Work

  • Find out about your employer’s plans if an outbreak of flu or another illness occurs and whether flu vaccinations are offered on-site.
  • Routinely clean frequently touched objects and surfaces, including doorknobs, keyboards, and phones, to help remove germs.
  • Make sure your workplace has an adequate supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes.
  • Train others on how to do your job so they can cover for you in case you or a family member gets sick and you have to stay home.
  • If you begin to feel sick while at work, go home as soon as possible.
Georgetown Pediatrics
Flu
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