Children's health

Make an informed decision for your child 

Immunisation is recommended as part of pregnancy and routine child health care. Your LMC, family doctor and their team can help provide accurate reliable information. Here are some basic facts about vaccines and immunisation: 

• immunisation is a very safe and effective way to help prevent potentially serious diseases 
• immunisation teaches the immune system how to recognise and fight specific diseases if we come in contact with them at a later stage 
• having the recommended immunisations during pregnancy is safe and can protect both the parent and their unborn baby, and later their newborn baby, from serious illness 
• if most people are immunised, the spread of the germs is reduced and the chance of getting a disease is much lower 
• pregnant women, babies and children need to have all the recommended immunisations on time every time for the best possible protection 

The National Immunisation Schedule is the series of vaccines that are offered free to babies, children, adolescents and adults. Vaccines on the schedule for children up to the age of thirteen years protect against preventable diseases: 

 

• If enough people are immunised against diseases they don’t spread as easily.
• Immunisations are free to all children and help to protect against eleven serious diseases: diphtheria, tetanus, pertussis (whooping cough), polio, hepatitis B, Haemophilus influenza type B (Hib), pneumococcal, measles, mumps, rubella, and human papillomavirus.
• Immunisations work by making baby’s immune system respond to the vaccine in a similar way it would to the disease.
• Having all the immunisations is important to fully protect your child. If a dose is missed at the right time you can still catch up – you don’t need to restart.

 Tips for the immunisation visit 

At the doctors 

• remain calm and relaxed 
• bring along a stuffed toy or blanket for your child to hold during the immunisation, or use it to distract them 
• hold your baby or child during the procedure 
• after being pricked by the needle your child may cry for a brief time, it’s their way of coping. Your job is to comfort, hold, and talk to them supportively 
• feeding your baby during or straight after their immunisation will help them settle 
• you will need to remain in the clinic for 20 minutes after the immunisation. Use this time to help your child settle, this can help make the next visit easier 

Afterwards 

Most children experience little or no ill effects after immunisations. Some of the minor effects reported are tenderness or swelling and redness at the site of the injection, mild fever is also common. Here are some ways to make your baby or child more comfortable after their immunisation: 

• don’t rub the injection site 
• give lots of cuddles and lots of fluids 
• if you are breastfeeding, give lots of feeds 
• an ice pack wrapped well in a dry cloth or better still a cool cloth, can be held over the injection site if it is sore 
• if your child gets hot, undressing them down to a single layer, for example a singlet and nappy, can help 
• keep the room not too hot or too cold 

Routinely giving Paracetamol before or after immunisation is not recommended because high fever and pain are not common responses. Only use Paracetamol if your child is very uncomfortable and seek medical advice for the correct dosage. 

This advice differs for bexsero (meningococcal vaccine). Routine paracetamol is recommended for all bexsero doses in children under 2, whether given alone or at the same time as other vaccines. This is to reduce the risk of high fever and injection site pain which are more common with this vaccine. Paracetamol should be given ideally 30 minutes before bexsero followed by two further doses 4 to 6 hours apart. It does not reduce the effectiveness of the vaccines. Bexsero is now routinely offered at the 3 month, 5 month and 12 month immunisations. Certificate 

An immunisation certificate may be needed when you enrol your child at an early childhood centre, kohanga reo or primary school. This is completed at your family doctors.

Here are some places to go for more information on these diseases and the vaccines that prevent them: 

Immunisation Advisory Centre: immune.org.nz or call free: 0800 IMMUNE (466 863) to talk to Healthline.

NZ Ministry of Health: moh.govt.nz

World Health Organization: who.org 

Diphtheria: A serious bacterial infection affecting the throat, causing a membrane that can obstruct breathing and producing toxins damaging the heart and nerves. The death rate is around 10%. It is rare in New Zealand and typically occurs through travel.

Tetanus: Caused by a toxin from bacteria found in soil and animal feces, it enters through wounds. Unimmunized individuals are at risk, with symptoms including muscle rigidity and spasms. The death rate is about 10%.

Whooping Cough (Pertussis): A highly contagious bacterial infection causing severe coughing spells, often lasting up to three months. Infants are particularly vulnerable, with a hospitalization rate of 70% among those under six months.

Polio: An intestinal disease caused by poliovirus, which can lead to meningitis and paralysis. Though largely eradicated in New Zealand, it remains a risk from overseas.

Hepatitis B: A liver infection transmitted through blood and body fluids, potentially leading to chronic illness, cirrhosis, and liver cancer. It can be asymptomatic in many cases.

Hib Disease: Caused by Haemophilus influenzae type b, it primarily affects infants and young children, causing severe throat infections and meningitis. Cases are rare in New Zealand due to vaccination.

Pneumococcal Disease: Caused by Streptococcus pneumoniae, it leads to pneumonia and other serious infections. Children under two and the elderly are at higher risk for severe outcomes.

Measles: A highly infectious viral disease presenting with fever, runny nose, and a rash. Complications can include pneumonia and brain inflammation, with periodic outbreaks in New Zealand.

Mumps: A viral infection leading to swelling of salivary glands, with serious complications such as viral meningitis and deafness more common in adults.

Rubella: Generally mild in children, but can cause severe congenital defects in babies if the mother contracts it during pregnancy.

Meningococcal Disease: Caused by Neisseria meningitidis, it can lead to pneumonia, meningitis, and blood infections. Early symptoms can mimic influenza.

Rotavirus: An intestinal virus causing severe diarrhea and vomiting, particularly in young children. It was a leading cause of gastroenteritis before the vaccine was introduced.

Chickenpox: A contagious viral disease characterized by fever and a blistering rash. While usually mild, it can lead to serious complications, especially in immunocompromised individuals and newborns.

Immunisation is crucial for the prevention of many of these diseases.

Food allergy affects around 10% of kids. Many will grow out of these allergies in late childhood due to the development of their immune system, particularly allergies to milk and eggs. Some children have a higher risk of developing a food allergy, but when introducing high-allergen foods, the approach is the same for all children. 

Tips for introducing high-allergen foods 

The best way to reduce the risk of food allergies is to offer high-allergen foods early and frequently The most common allergens 

• egg 
• peanut 
• cow’s milk (dairy) 
• tree nuts (cashews, almond walnuts etc) 
• soy 
• sesame 
• wheat 
• fish and other seafood (i.e. shellfish) 

Give only one high-allergen food at a time. This makes it easier to identify what food caused the allergy and offer it 2-4 times separately before adding to the overall diet (non-high allergen foods can be offered together). 

Give high-allergen foods earlier in the day - and if possible, when another person is around. 

Give only a small amount when offering for the first time. Peanuts - small amount (1⁄4 tsp) mixed into yoghurt or in milk. Eggs - in baked goods or a small amount of cooked egg. 

The signs of a food allergy are the same as for any allergy 

Allergies 

If your infant already has an allergic disease (such as severe eczema or food allergy), you should discuss what specific measures might be useful with your healthcare provider. 

What is the difference between sensitivity and an allergy? 

When you have a food allergy, your immune system causes the reaction. If you have a food sensitivity or intolerance, the reaction is triggered by the digestive system. 

Symptoms of food intolerance occur over hours/days and include gas, bloating, diarrhoea, constipation, cramping, and nausea, irritability, fussiness, over-activity and awaking throughout the night, frequent regurgitation of foods, nasal and/or chest congestion, and red, chapped or inflamed eczema-like skin rash 

Symptoms of food allergy occur immediately or within an hour & include hives, swelling, itching and anaphylaxis. 

Dust mite allergy

Dust mite allergy can trigger allergic rhinitis (hay fever) and typically begins to develop in children as young as two. It can also trigger eczema.

The common symptoms of allergic rhinitis include your child breathing through their mouth, having a stuffy nose all the time or during specific seasons, dark circles under their eyes or snoring at night. Left untreated, allergic rhinitis can have a detrimental effect on your child’s learning and behaviour.

For diagnosis, an experienced GP, paediatrician or an allergy specialist will take a history of reactions, examine your child and possibly arrange for allergy tests. These are either skin prick tests or blood (RAST) tests. With a diagnosis, you can get trusted information and support on how to manage your child’s allergy by contacting Allergy New Zealand.

Allergy New Zealand – for a free information pack go to www.allergy.org.nz

Care of the first teeth

Baby Teeth are important.

Healthy teeth are essential to a healthy childhood.  Your child needs them for chewing, speaking clearly and having a great smile.  They also help guide the adult teeth into position.  So, as a parent you can play the most important role in your child’s own dental health.  Begin the habit of teeth cleaning as soon as the first teeth appear.

Show you care

Show you care about your own dental health and they will follow.  Set a good example with your own habits, be the cheerleader, and your child will keep enthusiastic and motivated.  They will learn to love the ritual, your interest, the super feeling of a clean mouth and their brilliant smile.  Praise goes a long way.

Keeping teeth healthy

Tooth decay (holes) and gum disease are preventable, yet 47% of New Zealand’s five year olds have holes in their teeth.  Your child does not need to be part of these statistics.

To help prevent tooth decay teach your child to brush her teeth with a fluoridated toothpaste in the morning and before bed.  For the first 3-4 years, you will need to be doing most of the cleaning.  Make a game of it; let your child brush your teeth, take turns and remember generally children under the age of eight will need help brushing their teeth.

Be very gentle when brushing their teeth; use a small, soft bristle brush with an easy hold handle.  One of the easiest ways to brush is to sit the smaller child on your lap.  As she gets older continue to approach cleaning from behind. That toothbrush will soon be well used so look to replace it when it begins to show signs of wear – before it is dog-eared.

Fluoride

Fluoride is naturally occuring and has been proven to be beneficial to teeth.  It helps prevent tooth decay and strengthens teeth.  We get fluoride from toothpaste, supplements and fluoridated tap water.

Before brushing place a smear of fluoridated toothpaste on the toothbrush.  Teach your child to spit out and not swallow or rinse after cleaning.  Low-fluoride children’s toothpastes have not been shown to be as effective in preventing decay and are not currently recommended in New Zealand.

Begin the habit of teeth cleaning as soon as the first teeth appear.

If your tap water is not fluoridated, your child is at greater risk of decay and because we try to minimise toothpaste swallowing they may miss out on the benefits of swallowing fluoride brings to developing teeth.  You can make your own fluoridated water by dissolving fluoride tablets in water.

Food and drink

Without a doubt, these early days are so important.  Begin now with healthy time choices.  Resist giving your child sugary foods and drinks, especially between meals.  Give them healthy snacks like bread, cheese and fruit and keep those sweet treats for meal times only.

Tooth decay

Tooth decay is caused by the bacteria in plaque (a colourless sticky film constantly forming on teeth) using the sugars in food and drink to produce a tooth destructive acid.  Drinks and food that are acidic will also contribute to tooth decay, so keep clear of fizzy drinks and undiluted fruit drinks.  In particular, avoid frequent snacking on sweet or acidic food or drink.

At night

The only safe drink at night is water.  Many other drinks can cause severe tooth decay in infants.  As soon as it is practical teach your child to drink from a cup or with a straw.

Going to the dentist

As soon as your child turns one enrol him at the local school dental clinic and organise a visit to the school dental therapist.  This is a free service that can provide you and your child with care and advice.

Cleaning checklist:

• start cleaning baby’s teeth as soon as they appear.
• use a small smear of fluoride toothpaste on the toothbrush and teach your child to spit out after brushing.
• encourage the use of the bathroom mirror to watch all those tooth surfaces being cleaned.
• use a small headed, soft-bristled brush with an easy to hold handle.
• avoid sharing brushes between family members.
• make brushing a family affair, set a good example and your child will watch and imitate.
• brush along the chewing surfaces of the teeth, then in a circular motion on the outside surfaces, being sure to brush the gums gently.

Eating and drinking checklist:

• the only safe drink at night is water.
• avoid the prolonged use of milk or sweetened or acidic liquids in bottles during the day.
• use cheese, bread and fruit as in between snacks.  Keep snacks sugar free.
• don’t dip dummies in sweet foods like honey.
• the best time to eat sweet food is during mealtimes.
• drink lots of water.

Second-hand smoke can have a serious impact on health.  Every time someone smokes around you, you and your baby are exposed to the harm and danger of second-hand smoke. Second-hand smoke is a mixture of smoke breathed out by the smoker and smoke released from the lit cigarette.

The Damage

It has been estimated that each year in NZ, second-hand smoke causes:

• More than 27,000 GP consultations for asthma and other respiratory problems
• 1000 cases of glue ear
• 50 cases of meningococcal disease
• 20,000 asthma attacks in children
• 50 deaths from SUDI (cot death)

Having a smoke-free home and car is one easy way of protecting your children from second-hand smoke.

If you would like to smoke less or quite, call Quitline 0800 778 778 or talk to your midwife, or other health professional.

Smoke-free signs/stickers for your home and car are available from your Public Health Unit.

Smoke

The research has shown that second-hand smoke in a car is more than 20 times more toxic than in a house.  Opening or winding down a window will not remove the poisons.

A wind strength of a tornado would be needed to clear all the smoke from your car.