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Taking Shots at Each Another

Slight corrections made to this article on 3/29/15

Shots. A topic that is getting a lot of attention right now. Many parents feel strongly about shots, one way or another. Others aren't as passionate about the subject. But a rise in measles cases in the US has sparked an outbreak of anti-anti-vaxers fever, if you will, in news and social media. On Facebook, some just post, "Get vaccinated, people!" Others post an article that apparently describes their opinion on why they delay or avoid some or all vaccines and state something along the lines of, "read this to understand why we choose to do what we do." The news media has take on measles to be the hot medical topic of the times now that they've grown tired of Ebola. One blogger called the measles outbreak a "public health emergency." I’m not quite so sure about that, there may be other topics that I’d consider a public health emergency before measles.

You'll see no argument from me about vaccination. I know that vaccines have made huge strides in keeping our country and our world healthier. That’s true. Vaccines are important and beneficial. I lived in a village in West Africa for two years and I saw people who had been affected by polio and tetanus. I had been vaccinated, as had many in the village, but not all were vaccinated. It wasn't pretty. I worked with the one nurse and one midwife in my adopted village each week as we carried out the national vaccination campaign in our village and nearby villages that didn't have a nurse living there. I get it.

However, I do believe in getting information and making choices for our own families. What I don't "get" is parents posting negative comments online vilifying other parents who have carefully made decisions opposite to their own. Or the news media adding music akin to the Jaws soundtrack behind a news anchor who is reporting about parents who may be putting all our children at risk. It's getting ugly. I watch friends on my Facebook feed at-odds about a topic which will cause a rift so deep it will prevent future plans for play dates or even moms' nights out.

I’m not intending to cover the benefits and risks of vaccines here—what I’d like to point out are two things:

1) ultimately, I see a passion for keeping our kids healthy and safe at the root of all the arguments, debates, discussions, dialogues and fights that I see happening online and on TV, and

2) there ARE several other health topics that deserve more attention right now than the measles.

"The Unvaccinated"? It sounds like a blockbuster movie title, doesn't it? Are they a group of people invading a country and bringing with it strife and unrest? Well, that is what the landscape of Facebook and parenting-blog-world looks like right now. Who ARE "the unvaccinated"? Some are children and adults who cannot have the vaccine due to health issues. Others are children whose parents are already so stressed due to financial and social issues that they don't keep the appointments with their child's doctor for well-visits to even talk about getting vaccinated. Many are parents who are well-educated and have thoroughly researched the risks and benefits of vaccines and decided they want to wait or entirely skip vaccines.

Parents are throwing shots at each other online: accusing each other of stupidity and putting other children at risk. Why can't we all just get along? Well, because parenting styles can be a hot topic in today's world.

A dear friend of mine, who IS a health professional and is NOT a parenting blogger NOR one who typically takes to online social media forums to inspire heated debates, recently posted this:

"Ok. I typically stay very quiet but I must address an issue. This is NOT a debate. This about being kind and compassionate to those that surround us. We are already far too harsh on each other and ourselves. I find it difficult that people are posting all this "pro-vaccine, people-that-choose-not-to-vaccinate-are-stupid and people that choose not to vaccinate because Jenny McCarthy told them so" sort of information. Just to be VERY clear, I am pro-choice. Across the board. I am always about choice. Choice in everything, sex, marriage, birth, breastfeeding, and yes, vaccines. Just like birth, I worry deeply about the fear mongering that happens around vaccines. On both sides. Just like anything in life we are always managing the risk vs. benefit for ourselves. There will always be people that make bad decisions for not so great reasons. I do believe that vaccines are an important part of our world health. If I go to part of the world that requires certain vaccines, yes, I get them.

I have one child that is partially vaccinated, another almost fully vaccinated, and one that is has never had a vaccine (or even antibiotics for that matter). We took our decision to vaccinate each child very very seriously. We took into account several factors. As a mother of a child that has multiple disabilities including autism, I don't believe that vaccines made my child autistic. I knew something was up with him starting when he was about 5 months old. Do I believe that the vaccines were hard on his already struggling body? Yes, yes I do. But it wasn't until Trevor, my middlest, had a severe reaction to a DTaP. I'm talking about in and out of hospital for almost 3 weeks. That left him with some lingering effects, that effect him to this day. I was never informed that this was a possibility. No informed consent. The following year we found out that Frankie is part of about 5% of the population that doesn't create antibodies to certain vaccines. I have talked to specialists in 4 states. He just doesn't, it just is. Then there is Vic, we chose not to vaccinate him at all. Instead choosing to revisit this at ages 2 and 5. This wasn't a decision we took lightly. He will probably be vaccinated at some point, when we believe his body and brain can handle the load. We as a family are always discussing the risk vs. benefit of vaccines for our kids. What is safe for them? What is safe for those we are around? All. the. time. SO, please, please, please...Before you post that thing...think carefully...I have a thick skin and can take your criticism about my choices and are firm in them, but another may not. I have certainly felt like I was being judged and told that I was a bad person for making this choice for my family. Just like I know how some of you felt judged for choosing not to breastfed or get an epidural or have that planned c-section. I ask that you don't judge until you know a person's whole story.” [published with her permission.]

That's one parent’s view. I have friends and clients who vaccinate their children and themselves fully and on schedule. Some delay certain vaccines or all but plan to get some or all eventually. Some choose certain ones and refuse others (and sometimes even choose which brand of vaccine and get a special prescription to get it ordered by a pharmacy—and they pay for it out-of-pocket). Some refuse all. Some of the latter group of parents ARE nurses, doctors and other health professionals. All do a LOT of research before deciding what they want to do and OF COURSE, they discuss their options with their child's doctor. They are not reckless parents who don't show up at monthly or yearly checkups. They are not irresponsible parents. They are like you. Doing what they think is best for their children. Which is, of course, their responsibility.

[Warning: the following content may trigger strong emotions related to child injury and loss.]

But is the vaccine issue as big of a deal as some other issues in the parenting world?

Let’s Look at the Numbers

MEASLES

It's always fun to start with data and then look at emotions, right? According to the CDC, between January 1 to January 30, 2015, the number of people with measles was 102 (from 14 states). In 2014, the CDC reports that there were 644 cases from 27 states.* The majority of the people, again according to the CDC, who contracted measles were unvaccinated. (I didn't see any reports about whether they (or their parents) were conscientious objectors to vaccines or didn't get vaccinated for other reasons). NO deaths have been reported.

Is the number of measles cases larger than previous years? Yes.

But let's look at it from a different perspective. Again, there have been no deaths reported.

Children ARE dying (and being injured) due to other causes. The most recent year for which we have data is 2010--I'm sure the fine folks in the government who track health statistics are now working now to finalize 2012 data.

Have we stopped to think about any of the MANY other things that could be highlighted by news and social media (i.e. all of us as members of society) as problems in our culture that lead to illness and even death in children? Yes, death. What if we talk about those issues and the simple and inexpensive things can be done to prevent those? And perhaps compare those to the passion we seem to have for debating measles vaccination.

UNINTENTIONAL INJURY

There are many causes of death tracked by the government. There are top ten lists. But I'd like to highlight two of the top ten of leading causes of death of children. According to the National Center of Health Statistics, in 2010, there were 978 deaths of infants (children between 28 days to 11 months) due to unintentional injury (the 3rd leading cause of death among children).

Let's look at unintentional injury in two areas: in-home accidents and in-car accidents. According to Meghan's Hope, a nonprofit organization dedicated to raising awareness about the danger of furniture and TV tip-over (meghanshope.org), "71 children every single day are injured or killed when a piece of furniture, a TV, or an appliance falls on them. A child dies on average every two weeks. Every 45 minutes a child is seen in the ER because a TV fell on them. The children that survive these accidents may be left with severe and debilitating lifelong injuries. ALL of them can be prevented."

But is the media doing a good job publicizing how to avoid injury and death in our homes? Are the health professionals we take our children to see for well visits allowed enough time and given the motivation to discuss attaching furniture and televisions to walls using inexpensive tools? Are nurses all certified car safety technicians who can check our cars when we leave the hospital to be sure we not only have our baby's car seat attached to the car properly but that it also fits properly in the car and that we know how to safely buckle the child into the seat. NOPE. But yet, according to the CDC, in 2011, "more than 650 children ages 12 years and younger died as occupants in motor vehicle crashes and more than 148,000 were injured." How does that happen? Well, one CDC study found that in one year, "more than 618,000 children ages 0-12 rode in vehicles without the use of a child safety seat or booster seat or a seat belt at least some of the time." Additionally, "of the children who died in a crash in 2011, 33% were not buckled up." The report didn't state the details as to how many of those children were buckled but buckled improperly, which can be just as dangerous as not being restrained.*******

Recently, an insurance company ad during the Superbowl highlighted accidents that can happen and a free resource website to learn how to help prevent those accidents. My friend Kimberly Amato, the founder of the abovementioned organization, Meghan's Hope, was a consultant on the ad campaign. She created the organization and started campaigning at the state and national level for changes in laws related to child safety after she lost her 3-year-old daughter. After the insurance company ad, she received hundreds of messages on her blog and Facebook page about how annoying it was to have such a sad ad in the middle of such a joyful event as a football game. But it got your attention, didn't it? Are those same people complaining on Facebook about measles or about the news report that highlighted the measles epidemic and how it ruined their yummy breakfast?

NECROTIZING ENTEROCOLITIS

Say that five times fast. Necrotizing enterocolitis is a horrible disease of the intestines, also referred to as NEC. Four hundred and nine (409) children--this time newborn babies, those between 0-28 days of life--were lost in 2010 due to NEC, the 8th most common cause of death in newborns in the United States. These deaths are also mostly preventable. How? By feeding all babies, especially newborns, human milk.

(This is NOT being discussed here to inspire a pro-formula debate--yes, formula is a helpful tool to feed our children when human milk is not available and I'm glad it's available but I wish all babies had access to human milk!)

How does human milk protect a baby? Allow Dr. Jack Newman, a world-renowned breastfeeding medicine physician in Toronto, Ontario, Canada, states that, among other aspects, "Several studies indicate that some factors in human milk may induce an infant's immune system to mature more quickly than it would were the child fed artificially. For example, breast-fed babies produce higher levels of antibodies in response to immunizations." In fact, he states, "Doctors have long known that infants who are breastfed contract fewer infections than do those who are given formula." ** Does this mean that being breastfed will prevent infection from measles. No, it doesn't. But it will protect from babies dying of necrotizing enterocolitis of the newborn (NEC).

The American Academy of Pediatrics even has an Executive Summary entitled, "Breastfeeding and the Use of Human Milk" **** which states that "the incidence of NEC is significantly reduced (anywhere from 58% to 83% with the feeding of human milk..." They continue, "the potent benefits of human milk are such that all preterm infants should receive human milk. Milk from the infant's own mother, fresh or previously frozen, should be the primary diet...If the mother's milk is unavailable despite significant lactation support, pasteurized donor milk should be used."

Are hospitals in your area providing banked donor milk to babies in the NICU and healthy newborns whose mothers don't have enough milk in the early days? In my area, the two main hospitals have agreements with the Mother's Milk Bank Northeast but I am told by many parents that they were not offered donor milk for their baby and several told me that when they asked for donor milk the nurse mentioned "something about the risk of HIV" which "freaked" them out and so they accepted artificial baby milk instead, which has known risks.****** Note that, according to an article on CATIE.org, "The AAP states that "donor human milk banks that belong to the Human Milk Banking Association of North America voluntarily follow guidelines of the Centers for Disease Control and Prevention, which include screening of donors for infectious transmissible agents as well as heat treatment of the milk." They further write, "Heating human milk at a temperature of 62.5 degrees Celcius for at least 30 minutes (also known as Holder pasteurization) is the only way to inactivate HIV in human milk. This is the standard used in donor banks in the US." ***** Therefore, the nurse(s) that scare new parents about donor milk are flat out WRONG. Furthermore, the research shows that mothers whose babies receive even one bottle of artificial baby milk are more likely to quit breastfeeding earlier than they had planned.

The statistics show that the number of women who start out wanting to breastfeed is 79.2% (CDC, 2014 Breastfeeding Report Card***) but yet only 18.8% are exclusively breastfeeding at 6 months...that shows that we have a LONG way to go to help moms continue giving their babies the most important immunological "shot" they have for long-term and short-term health. That's a whole other story as to why this is happening, but suffice it to say that the US is getting a pretty fat F when it comes to its success supporting breastfeeding. There are many ways our medical system and our society can improve breastfeeding rates. Where's the media coverage about this?

Okay, deep breath.

CONCLUSION

We live in a world where there is risk all around us. As parents, really as humans, we protect our children and try to protect others, too. We also live in a beautiful world where caring people can make such an impact on others. Instead of taking shots at each other about vaccinations, I propose that we band together and redirect our energy and passion for certain parenting topics/health issues toward the media and our health care providers and administrators. Ask them to help us more when it comes to getting information about vaccines, how we can prevent deaths and injuries at home, in cars and even in hospitals, too.

Let's stop taking shots at one another. Be nice. Be understanding. Ask questions. Stop accusing. Do your research. Be gentle with each other. We all love our kids, that's at the core. Share information with others. Childproof your home, grandma's house and use car seats correctly and for a long time. Make milk if you can and donate it to your local milk bank (mmbne.org in New England). Demand human milk for your babies, particularly if they are in the hospital as infants. Do what you can to make changes for the better.

These are my earnest requests.

Questions or comments, please post below OR email jeanette@babiesincommon.com

REFERENCES

* http://www.cdc.gov/measles/cases-outbreaks.html

** http://www.kellymom.com/pregnancy/bf-prep/how_breastmilk_protects_newborns/

***http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf

****http://www.pediatrics.org/cgi/doi/10.1542/peds.2011-3553

*****http://www.catie.ca/en/catienews/2013-02-07/american-academy-pediatrics-issues-statement-infant-feeding-and-hiv-transmissio

******http://www.naba-breastfeeding.org/images/Just One Bottle.pdf

*******http://www.cdc.gov/Motorvehiclesafety/child_passenger_safety/cps-factsheet.html

ABOUT THE AUTHOR

Jeanette Mesite Frem, MHS, IBCLC, RLC, CCE, CD is a public health specialist, lactation consultant, childbirth educator, birth doula and parenting coach. She was a health volunteer for the Peace Corps in Cote d’Ivoire, West Africa for two years and went on to receive her master’s degree in public health from Johns Hopkins School of Public Health. She moved to the Boston area in 1998, worked with the MA Department of Public Health’s community perinatal primary care programs for two years before moving to Central Massachusetts and continuing her practice as a childbirth educator, birth doula and breastfeeding counselor. She has since become a board-certified lactation consultant and now has her private practice at Babies in Common in Grafton, MA. http://www.babiesincommon.com

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