Thursday, December 30, 2010

A CPST Clarifies the Benefits of Rearfacing Beyond Babyhood

Compiled by Jennifer Mann, CPST since 2007. Photos copyright Jennifer Mann.


"As you might have noticed, Facebook has been a bit bombarded by crazy people talking about how babies should stay rear-facing until at least age 2 (gasp! the nerve! the horror! how dare they!).

Oh wait. I'm one of those crazy people, also known as Child Passenger Safety Technicians (CPSTs) certified by Safe Kids Worldwide. I thought I might try to explain why techs, child passenger safety advocates, and concerned parents are so impassioned about this topic.

The Stats
Rear-facing children are FIVE times safer than forward-facing children.

Crash Dynamics
The majority of crashes are frontal collisions. In any crash, everything in the car (people, objects) will travel to the point of impact very quickly (fractions of a second). In a frontal collision, this means you, as adults, will be thrown forward with only your seatbelt and possibly an airbag to slow you down. Likewise, a forward-facing child will have only his or her harness straps to help the body slow down and stop (of course, they don't have the airbag). This leaves nothing to stop the head from continuing to travel forward.

The problem is the bones surrounding a child’s spinal cord do not ossify (harden) until ~3 years old. The spinal cord can stretch ¼ of an inch before detaching. A crash can stretch the spinal cord up to 2 inches, depending on the severity of the crash. So a younger child's spinal cord could detach from the head in a bad crash(known as internal decapitation).

A rear-facing child, however, is thrown into the energy-absorbing foam in the restraint shell, which distributes the crash forces evenly along his or her entire head, neck, and spine, keeping the body in alignment and protecting the spinal cord. This is why children in Sweden ride rear-facing until 4 or 5 years old. Incidentally, Sweden has very low injury and fatality rates as a result of motor vehicle crashes.

The Problems
Okay, so let's break all that down a bit.

1) A forward-facing seat cannot restrain a child's head (in the same way that our seatbelts cannot restrain our heads). The harness can only make contact at the collar bones and hip bones, but the head continues to travel forward.

2) The bones around the spinal cord don't ossify until age 3 on average. So the spinal cord is not adequately protected, especially in a severe crash.

3) Let's face it. Kids have big ol' noggins. My son did/does! "It's like an orange on a toothpick!" (Sorry, that's a line out of one of my favorite movies.) They're bobble heads! Actual numbers now: In a young child, the head makes up ~25% of the total body weight, whereas in an adult, the head is only ~6% of the total body weight.

And in a crash, you take the weight of the object multiplied by how fast the car/occupants are moving to determine the estimated crash force. For example: a 5 lb. head x 20 mph = 100 lbs. of crash force being flung on an inadequately protected spinal cord in fractions of a second. Ouch!


So now let's put those three problems all together:
Unrestrained big, heavy head + inadequately protected spinal cord = real potential for a broken neck/spinal cord and possible subsequent death

There is simply no comparison when you look at the crash tests. Those crash tests convinced me to turn Emily back rear-facing at ~3y8m (no, that's not a typo), after she'd already been forward-facing for two years (she did not resist the switch thankfully because she's an equal opportunist and wanted whatever little brother was getting! No joke!). She finally turned forward-facing again at 4y7m (nearly a year later), when she hit the 33-lb. rear-facing weight limit of her Britax Marathon. Her brother, Zach, was rear-facing from birth to 3y2m, when he reached the rear-facing weight limit.

The Potential
A broken neck. 18-month-old Joel was nearly killed in a crash that broke his neck. His grandfather has now thrown himself into child passenger safety advocacy:http://www.joelsjourney.org/

Micah, who also suffered from internal decapitation:

More links
A new AAP article recommends rear-facing to at least age 2:http://aapnews.aappublications.org/cgi/content/full/30/4/12-a



Awesome summary and answers to other questions, including those pertaining to rear collisions: http://www.cpsafety.com/articles/StayRearFacing.aspx

Another great summary (from overseas, which is why their harnesses look a little different): http://www.childrestraintsafety.com/rear-facing.html

If someone you know has a baby who will be turning a year old soon, please forward this information to him/her.

If you already knew all this but need some YouTube sap to get (usually well-meaning, but misinformed) family and friends off your back, check these out:

Remember that every step toward the adult seatbelt is a step down in safety. Turning your child forward-facing is NOT a milestone to look forward to and it's nothing you want to rush."


Friday, December 24, 2010

Ian Daly's Birth Story (Photo heavy!)

Everyone is here in this photo at about 30 weeks.
Here I am at 40 weeks, 6 days, the day before Ian is born.


Around 1am on September 22nd, I noticed I was having consistent, light surges. But whenever I tried bouncing on the birth ball or walking, they faded away. It wasn’t until about 3am that I noticed I had to breathe through them and nothing was making them fade away. By 5am I was nagging at DH to hurry up with the birth pool.

Dear husband (DH) assembling the birth pool at 5AM.
I asked him to do a cervical check b/c one of my concerns with my first birth (also a homebirth) is that I got into the pool too soon and possibly stalled labor. (Side note: a debatable topic in the birth community.) Anyways, I was still 4cm dilated but 100% effaced. I didn't have to ask him to check me, but I wanted his opinion. Perhaps I felt reservations, remembering my previous birth and how I relied on the birth tub as a form of escaping from the contractions. Was I truly ready to open up to my body and welcome my baby?

The hot pool was wonderful. Around 6am, Zon and my little sister woke up and wandered around, snapping a few photos (thank you, little sis!) Zonnie, unfortunately, could not understand that the baby was NOT going to arrive in 3 minutes like they do on youtube haha. She wanted to see in the pool and see my vagina, b/c as she said, “BABY COME OUT NOW!!!”

My sister and my daughter snoring away while I was in early labor.
Zon thinks a baby is about to pop out any minute!
By 8am, my body was like clockwork running in a pattern of two surges. The first surge was intense and powerful. I was giving in and feeling my body literally opening. Amazing, but not at all like my first birth. These surges were painful, too. Not crippling or excruciating, though. They reminded me of that “last mile” in an exercise routine, where you can choose to fight the pain or give in to the pain. Where that stitch in your side either makes you give up or makes you push harder. For a thousand and one reasons, (the primary one being that I told Ian he was COMING OUT OR BUST haha) I developed that “good anger.” Not sure how to explain, except again if you are an athlete, you know that energy, that emotion? That driving moment where you take a deep breath and dive into it? I was doing it! I was telling those contractions to BRING IT ON! I wasn't running away from them or trying to minimize them.

I moved back and forth during contractions, vocalizing, "oooo" and "aaaa." I also utilized a lot of positive self-talk, saying things aloud such as, "I can do this" and "I am birthing my baby."
The second surge surprised me, though. It was a pushing one. At the end of the surge, my entire body would push and I'd make involuntary grunting noises. For those who have read Zon’s birth story, you know that I never felt the urge to push in labor with her. This was a different animal. I now know what other women are talking about when they compare pushing to vomiting, or claim their “body brought the baby down.” It was amazing. At the same time, I was worried because I have read that pushing too early can irritate the cervix, causing a “lip” that extends labor. I could still feel my cervix and seemed to be at 7cm. I wasn't sure what to do.....should I trust my body and push, or should I try to pant and breathe through them? I decided to compromise and hold off a little bit longer, but not enforce the "rule of 10" in stone. I told myself one contraction at a time.

In between contractions I was breathing, resting, sensing, loving. What you can't see here is my support group. My DH talking quietly and lovingly to me, my sister snapping photos and saying, "Wow! Wow!" at the power of it and my little girl jumping up and down and asking, "Where's the baby?"
So I began to pant through the contractions, then let my body do what it wanted at the end, but I did not add to the pushing. I did this for about an hour until *I* felt instinctively that it was time. I gave over to my body and it started pushing all by itself for every single contraction. I was making these primal grunting noises and holding DH’s forearms, squatting in the birth pool. The power of it was mind blowing. I had surrendered and was completely aware of every little sensation. I could feel him moving down down down. I found it comforting to feel his head, give it a rub and tell him we were almost done! I was also checking to see if I was developing a lip…which I wasn’t! Pretty interesting, huh? I later read more about this and learned that mamas with OP babies might start pushing before full dilation due to the way the baby's head enters the cervix and canal. It triggers pushing sooner. This might not be a bad thing, either, as it seems to aid with positioning and help bring the bigger portion of the baby's head down the canal.

My mom stopped by to drop off some Arnica as I was moving around in the tub. I felt primal, animal at the time and paid very little attention to the conversation, but I remember managing to ask where my other sister was because she was going to videotape and photograph. My mom freaked out as she had forgotten, and ran out the door to grab the camera stuff and my other sister. Zon ran after them and left with them. Surely not an issue I thought. My mom lives 2 miles away.

Well, in the time it took her to drive over there and back, little Ian made his entrance! I felt his whole head move onto my perineum and knew I needed to change position. He was fully Occiput Posterior, also called Sunnyside up (face up). This means the largest part of his head was pressing downwards. It gave me the mental image that my backside was going to split! I moved to all fours and showed DH how to support my perineum. I tried to breathe through the contractions as Ian came onto my perineum. I didn't want to tear. But as I was feeling him and feeling the strength behind those involuntary pushes, I realized it wasn’t happening. His entire head popped out in one contraction, then he rotated and basically shot into DH's hands.

Daddy caught his son! 
That moment of kneeling in the sun, pushing Ian out, hearing the excitement in my husband’s voice and being handed a wet, scrunchy beautiful baby is the best moment of my life. There are no words to describe the way the world stood still as DH and I sat together and took turns holding Ian. I touched him, and smelled him, and squeezed him and listened to his little cries.

The first time I hold Ian, about .2 seconds after he popped out of me lol.
Counting every toe and finger!
Although Zon unfortunately after all that excitement missed the actual birth, she, my mom and sisters literally walked in moments after Ian was born. So she got to see him and hold him immediately.  I moved from the pool to the couch, we cut the now-limp umbilical cord and then Ian had some milkies.

Ian's first latch! I latched him on this way out of habit, but we spent the rest of the day practicing the breast crawl. It was very helpful for my uterus, too. :)
Ian's first smile is reserved for his daddy! 
Trying to fit him into the sling to weigh him. He was 10lbs, 2oz!
The placenta was very sticky, meaning it did not want to detach and I was not clamping down quickly. It was an anterior placenta, too. It took a lot of massaging to coach it out, but we avoided cord traction and inserting anything to remove it of course. I bled during this, but not profusely and once the placenta was out, I was fine. DH later rinsed off the placenta and sectioned it for raw smoothies.

The reality was that I did tear, despite all my efforts. And I decided it was the type of tear that I wanted stitched up, although I encourage mamas to research other options and to realize that going in for stitches is not the only option. My family stayed at my house, held my baby and toddler, took photos, cleaned up the entire place, emptied the birth pool and made lunch while I was getting stitched up at the local hospital. Don't you just LOVE when people do amazing things for you?

The doctor who stitched me was respectful as well and did a very nice job stitching my tear. I also asked the nurses to take a blood sample and run it to check my 'crit (hematocrit) levels due to my slow bleeding. The numbers came back just fine. :) Nonetheless, the ER supervisor tried THREE times to solicit circumcision! Each time I said, "No, thank you" and she continued to pressure me to schedule it. I was tired and wanted to fly under the radar and get home to my baby. I found myself biting my tongue so as not to get into a debate with her. As a staunch advocate for human rights, it was hard!

Hanging out together while I was getting stitched up!
I birthed under the Harvest moon, as captured by http://www.drmomma.org.
Ian was born at home and is a
Cloth diapered (and EC'd on the side)
Sling ridin'
Tandem nursin'
Sleep sharin'
Rear facin'
Vaccine-free
...intact little guy!


Much love and thanks to everyone who helped bring Ian into this world and provided a positive, supportive community, especially Michelle R. for donating her La Bassine birth pool.

Monday, December 13, 2010

Wean Me Gently


"I know I look so big to you,

Maybe I seem too big for the needs I have.

But no matter how big we get,

We still have needs that are important to us.

I know that our relationship is growing and changing,

But I still need you. I need your warmth and closeness,

Especially at the end of the day

When we snuggle up in bed.

Please don't get too busy for us to nurse.

I know you think I can be patient,

Or find something to take the place of a nursing -

A book, a glass of something,

But nothing can take your place when I need you.

Sometimes just cuddling with you,

Having you near me is enough.

I guess I am growing and becoming independent,

But please be there.

This bond we have is so strong and so important to me,

Please don't break it abruptly.

Wean me gently,

Because I am your mother,

And my heart is tender."

~ Cathy Cardall


Saturday, December 11, 2010

A Shot in the Dark Begins at Birth

Here is the 2010 official American schedule for childhood vaccinations: http://pediatrics.aappublications.org/cgi/data/125/1/195/DC1/1

How many parents know what is being injected into their babies? Below I have listed the major ingredients in the vaccines your baby will receive if you vaccinate “the right way” according to your government, CDC and doctor.  
Birth. Before leaving the hospital, your newborn will be injected with these ingredients:

Hepatitis B shot:
10 micrograms hepatitis B surface antigen adsorbed on 0.25 mg aluminum as aluminum hydroxide
4.5 mg sodium chloride
0.49 mg disodium phosphate dehydrate (a buffer)
0.352 mg sodium dihydrogen phosphate dehydrate
*grown on yeast cultures*

At 2 months of age, your child will be injected with these ingredients:

Hepatitis B shot:
10 micrograms hepatitis B surface antigen adsorbed on 0.25 mg aluminum as aluminum hydroxide
4.5 mg sodium chloride
0.49 mg disodium phosphate dehydrate (a buffer)
0.352 mg sodium dihydrogen phosphate dehydrate
*grown on yeast cultures*

Rotavirus oral dose:
Sucrose (quantity not specified)
Sodium citrate (quantity not specified)
Sodium phosphate monobasic monohydrate (quantity not specified)
Sodium hydroxide (quantity not specified)
Polysorbate 80 (quantity not specified)
Cell culture media (quantity not specified)
Trace amounts of fetal bovine serum
Trace amounts of pig virus

DTaP* shot:
(*Note, there are multiple DTaP vaccines in America. Some are also in combo-doses with other vaccines. Please view the package inserts to learn more).

6.7 Lf of diphtheria toxoid
5 Lf of tetanus toxoid
46.8 micrograms of pertussis antigens. This is represented in the final vaccine as approximately 23.4 micrograms of inactivated pertussis toxin and 23.4 micrograms of filamentous hemagglutinin.
Not more than 0.170 mg of aluminum
Not more than 100 micrograms of residual formaldehyde
Unspecified amounts of gelatin
Unspecified amounts of polysorbate 80

HiB shot:
(Label appears to be incomplete on the FDA’s page, which was later removed.)
10 micrograms purified Haemophilus b saccharide
Approximately 25 micrograms CRM 197 protein
single dose 0.5 ml vial contains no preservatives

IPV (Polio) shot:
40 D antigen units of Type 1
8 D antigen units of Type 2
32 D antigen units of Type 3
0.5% of 2-phenoxyethanol
100 micrograms of formaldehyde
less than 5 ng neomycin
less than 200 ng streptomycin
less than 25 ng polymyxin B
less than 1PPM of residual calf serum (cow blood)

PCV-7 shot:
2 μg of each saccharide for serotypes 4, 9V, 14, 18C, 19F, and 23F
4 μg of serotype 6B per dose (16 μg total saccharide)
approximately 20 μg of CRM197 carrier protein
0.125 mg of aluminum per 0.5 mL dose as aluminum phosphate adjuvant.

At 4 months of age, your child will be injected with these ingredients:

Rotavirus dose:
Sucrose (quantity not specified)
Sodium citrate (quantity not specified)
Sodium phosphate monobasic monohydrate (quantity not specified)
Sodium hydroxide (quantity not specified)
Polysorbate 80 (quantity not specified)
Cell culture media (quantity not specified)
Trace amounts of fetal bovine serum
(no preservatives)

DTaP* shot:
(*Note, there are multiple DTaP vaccines in America. Some are also in combo-doses with other vaccines. Please view the package inserts to learn more).

6.7 Lf of diphtheria toxoid
5 Lf of tetanus toxoid
46.8 micrograms of pertussis antigens. This is represented in the final vaccine as approximately 23.4 micrograms of inactivated pertussis toxin and 23.4 micrograms of filamentous hemagglutinin.
Not more than 0.170 mg of aluminum
Not more than 100 micrograms of residual formaldehyde
Unspecified amounts of gelatin
Unspecified amounts of polysorbate 80

HiB shot:
(Label appears to be incomplete on the FDA’s page, which was later removed.)
10 micrograms purified Haemophilus b saccharide
Approximately 25 micrograms CRM 197 protein
single dose 0.5 ml vial contains no preservatives

IPV shot:
40 D antigen units of Type 1
8 D antigen units of Type 2
32 D antigen units of Type 3
0.5% of 2-phenoxyethanol
100 micrograms of formaldehyde
less than 5 ng neomycin
less than 200 ng streptomycin
less than 25 ng polymyxin B
less than 1PPM of residual calf serum (cow blood)

PCV-7 shot:
2 μg of each saccharide for serotypes 4, 9V, 14, 18C, 19F, and 23F
4 μg of serotype 6B per dose (16 μg total saccharide)
approximately 20 μg of CRM197 carrier protein
0.125 mg of aluminum per 0.5 mL dose as aluminum phosphate adjuvant.


At 6 months of age, your child will be injected with these ingredients:

Hepatitis B shot:
10 micrograms hepatitis B surface antigen adsorbed on 0.25 mg aluminum as aluminum hydroxide
4.5 mg sodium chloride
0.49 mg disodium phosphate dehydrate (a buffer)
0.352 mg sodium dihydrogen phosphate dehydrate

Rotavirus dose:
Sucrose (quantity not specified)
Sodium citrate (quantity not specified)
Sodium phosphate monobasic monohydrate (quantity not specified)
Sodium hydroxide (quantity not specified)
Polysorbate 80 (quantity not specified)
Cell culture media (quantity not specified)
Trace amounts of fetal bovine serum
(no preservatives)

DTaP* shot:
(*Note, there are multiple DTaP vaccines in America. Some are also in combo-doses with other vaccines. Please view the package inserts to learn more).

6.7 Lf of diphtheria toxoid
5 Lf of tetanus toxoid
46.8 micrograms of pertussis antigens. This is represented in the final vaccine as approximately 23.4 micrograms of inactivated pertussis toxin and 23.4 micrograms of filamentous hemagglutinin.
Not more than 0.170 mg of aluminum
Not more than 100 micrograms of residual formaldehyde
Unspecified amounts of gelatin
Unspecified amounts of polysorbate 80

HiB shot:
(Label appears to be incomplete on the FDA’s page, which was later removed.)
10 micrograms purified Haemophilus b saccharide
Approximately 25 micrograms CRM 197 protein
single dose 0.5 ml vial contains no preservatives

Fluvirin shot:
Viral antigens
Trace thimerosal (amount not specified)
0.98 mcg mercury
Polymyxin, neomycin, and betapropiolactone (used in manufacturing) cannot be detected in the final product by current assay procedures.

IPV shot:
40 D antigen units of Type 1
8 D antigen units of Type 2
32 D antigen units of Type 3
0.5% of 2-phenoxyethanol
100 micrograms of formaldehyde
less than 5 ng neomycin
less than 200 ng streptomycin
less than 25 ng polymyxin B
less than 1PPM of residual calf serum (cow blood)

PCV-7 shot:
2 μg of each saccharide for serotypes 4, 9V, 14, 18C, 19F, and 23F
4 μg of serotype 6B per dose (16 μg total saccharide)
approximately 20 μg of CRM197 carrier protein
0.125 mg of aluminum per 0.5 mL dose as aluminum phosphate adjuvant.

Remember to gather and review all the information about your child’s vaccinations before it is time for the shots. You need to know ahead of time which vaccine, which brand and which ingredients your child will be exposed to at the visit.

Wondering where to begin? I list pro-vaccine sources and then anti-vaccine sources in a tidy post right here:
http://guggiedaly.blogspot.com/2010/11/what-every-parents-needs-to-read-on.html

Want to make a customized schedule to fit YOUR child’s needs? This is an awesome tool! This calculator lets you customize a schedule based on your child’s age, height and weight. It will add up toxin exposure and alert you to allergen exposure! http://www.vaccine-tlc.org/

Do you need to know more about the vaccines themselves? You can read all about the ingredients and the manufacturing process by reading the actual package inserts:
http://www.vaccinesafety.edu/thi-table.htm

Oh yes! And don't forget: you have the right to refuse vaccinations! Vaccines are not required. You can delay, you can choose some but not others, you can stop until you have decided. If people are harassing you, report them, fire them and hire a doctor who respects you and your children.
*****
Guggie Daly is a mother of two and currently studying to be a neurophysicist. She was started on her journey of vaccine research because she is a vaccine survivor. She hopes to share relevant, up to date information with other parents so that they can take advantage of foresight and not live with hindsight.  You can find more information on her blog at http://guggiedaly.blogspot.com

Thank you, Guggie!  You are an inspiration to so many, I could never thank you enough for the information you have shared with me!  A beautiful and incredibly intelligent woman, mother and friend.

Friday, December 10, 2010

Tis the Season to Lose all Reason!

To the tune of “Chestnuts Roasting Over an Open Fire”

Baxter roasting over a media scandal, 
Novartis failing an insect based vaccine, 
Glaxo strung up on thousands of reactions, 
And folks in line to get it up their nose.

Everybody knows, some beta-propiolactone and taurodeoxycholate, 
Helps make the fourth quarter accounting right.
Tiny tots, with their brains all aglow, 
Will find it hard to breathe tonight.

They know the Vaccine is on its way,
Loaded with lots of chemicals and foreign DNA
And every mother’s child is going to cry
To see if it works or if they all die.

And so I’m offering this simple phrase,
To everyone from 6 months to forty-nine
Although it has been said many times, many ways
Skip all your vaccines; you’ll be 100% fine!
© Guggie Daly 2010



Sunday, December 5, 2010

Mentioning Circumcision: How to Condense the Topic

"My brother and sister in law are about to have a baby boy and they might not take the time to read something regarding circumcision. I need the best links on the subject so that by just seeing it they can see what they are doing. Thank you so much for your help."

It's hard to share information on the topic of circumcision when you only have one conversation, one email, perhaps literally one moment, to make that connection with another parent. You don't want to judge them, confuse them or overwhelm them with information. You need something that will encourage them to look into the subject. What to do?

I prefer what I call the 1-2-3 process. Choose 3 links. One based on the natural state of the body, one informing about what circumcision is or does and then one resource list for additional reading. This way you can adapt to the audience but still touch on the complete picture.

Here is an example for someone who you think might be completely new to the topic, or who is not as close to you as a good friend or family member:

1. What is the foreskin? Here is a video of computer-generated genitalia. It is short, unbiased and easy to understand:http://www.youtube.com/verify_age?next_url=http://www.youtube.com/watch%3Fv%3Dc8voOaGouDM%26feature%3Dshare

2. What is circumcision? Here is a pro-circumcision educational video: http://www.youtube.com/watch?v=MDuDhkiDdns

3. How do I make a decision now that I know what the foreskin is and what circumcision is? This website is nonjudgmental and easy to navigate: http://circumcisiondecisionmaker.com/

What about someone who is already questioning and looking for lots of information? Or someone who is more open or closer to you? Here's another 1-2-3:

1. "I want all the info you have." http://guggiedaly.blogspot.com/2010/05/everything-i-currently-have-on-genital.html

2. "My husband thinks my son will be teased."  http://www.facebook.com/chooseintact

3. "I don't want a mom-blogger post." http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds

What about a face to face situation, where time is limited or you only have a moment to encourage additional research?

1. Be confident. You might be worried about causing an argument or offending, but when a friend sees that you are confident in your decision, it won't wrongly cast you as manipulating or trying to sell something. "I've researched circumcision and it's very troubling. Would you like to learn more?"

2. Be personal. You're living it, whether that's learning from a previous decision or raising intact sons. "My boys are intact and we've never had a problem. I'd love to chat with you about if you have questions." or "I circumcised Jimmy and we really really regret it. I'd love to share my story with you."

3. Be brief. If you're going to make points about circumcision, choose one or two points and avoid statistics or other heavy data. "Most boys are not circumcised around the world."
It's really simple to care for a boy with a natural penis." "Would you like to hear more?"

© Guggie Daly 2010


Friday, December 3, 2010

Let's Learn About Hepatitis B Infection and Vaccination


Due to the overwhelming complexity of the vaccine topic and the overwhelming amount of information available, this post does not represent a debate or assertion. I simply hope to provide basic access to information about the vaccine with some questions tossed in so that parents can begin their own research.



Hepatitis B

Hepatitis B, also abbreviated HBV, is a viral, infectious illness. The virus enters the liver, causing inflammation called Hepatitis. Hepatic (liver) + itis (inflammation) = inflammation of the liver.

The lightest cases are asymptomatic (meaning the person has no symptoms). The general cases include body aches, vomiting, mild fever, dark urine and jaundice. The worst cases develop into liver disease. The illness typically lasts 2-3 weeks, but some people are at risk of becoming chronic carriers or chronically infected.

HBV is transmitted through blood. Transmission routes include sexual contact, blood transfusions, contaminated needles and childbirth. Some people warn that other routes such as sharing razor blades could possibly transmit the virus.

Diagnosis is made by assay (testing) to find evidence of the virus (viral antigens or antibodies). It should be noted that these tests are fairly complicated and unreliable.

You can read a summary of the illness, symptoms and test procedures here:

Hepatitis B Treatment Summary

Like any illness, it runs its course in the average person.

Hepatitis B infection does not usually require treatment because most adults clear the infection spontaneously."
http://www.gastro.theclinics.com/article/S0889-8553(06)00102-6/abstract

That being said, contracting the illness during childhood is the opposite of other mild illnesses. You know how chickenpox is generally mild during childhood but generally severe during adulthood? It appears to be the opposite for HBV. If a child has HBV, he is more likely to have a chronic infection.

What treatments exist? There are seven antiviral medications and an immunoglobulin shot (HBig). For infants, HBig is used and if given within 12 hours after birth, has a 90% protection rate. http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1446.2009.00790.x/abstract

Now, the existence of an immunoglobulin shot made me stop and wonder why infants are being routinely vaccinated if the HBig has a 90% efficacy rate. Most vaccines top out at 85% efficacy and the HepB vaccine in particular has a very spotty efficacy track record.

“Hepatitis B vaccination is recommended for health care workers but has a nonresponse rate of 5% to 32% and an unknown duration of immunity. The duration of immunity imparted by an initial vaccination regimen is not known, and there are no universal recommendations for monitoring immune status and the need for booster doses”

So right off the bat, regardless of the risk of Hepatitis OR the risk of the vaccine, why even bother with the vaccine at all? 

It also casts a different view of the CDC’s advice on HepB administration:

Hepatitis B vaccine (HepB). (Minimum age: birth)
At birth:
• Administer monovalent HepB to all newborns before hospital discharge.
• If mother is hepatitis B surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth.
• If mother’s HBsAg status is unknown, administer HepB within 12 hours of birth. Determine mother’s HBsAg status as soon as possible and, if HBsAg-positive, administer HBIG (no later than age 1 week).

Hepatitis B Vaccine Summary

According to the 2010 CDC vaccine schedule, infants in America will receive the Hepatitis B Vaccine (HepB) at birth, 1-2 months and 6-18 months for a total of 3 doses. Children ages 11-18 then require 2 doses of the booster vaccine, 4 months apart.

Here are the HepB brands available for infant vaccination:



Comvax (Merck) This is a combo vaccine of Hib and Hep B: http://www.merck.com/product/usa/pi_circulars/c/comvax/comvax_pi.pdf

Pediarix (Glaxosmithkline) This is a super combo vaccine of Diptheria, Tetanus, Pertussis, Polio and HepB:

*Twinrix is only for ages 18 and up*

The virus is grown in yeast proteins and 0.5mg (250mcg) of aluminum hydroxide are included as an adjuvant. The aluminum content in all HepB vaccines exceeds the EPA limit of 25mcg for infants.

Adverse Reactions

According to the vaccine insert, these were the recorded adverse reactions during trials:

LOCAL REACTION (INJECTION SITE)
Injection site reactions consisting principally of soreness, and including pain, tenderness, pruritus,
erythema, ecchymosis, swelling, warmth, and nodule formation.
BODY AS A WHOLE
The most frequent systemic complaints include fatigue/weakness; headache; fever (≥100°F); and
malaise.
DIGESTIVE SYSTEM
Nausea; and diarrhea
RESPIRATORY SYSTEM
Pharyngitis; and upper respiratory infection
Incidence Less Than 1% of Injections
BODY AS A WHOLE
Sweating; achiness; sensation of warmth; lightheadedness; chills; and flushing
DIGESTIVE SYSTEM
Vomiting; abdominal pains/cramps; dyspepsia; and diminished appetite
RESPIRATORY SYSTEM
Rhinitis; influenza; and cough
NERVOUS SYSTEM
Vertigo/dizziness; and paresthesia
INTEGUMENTARY SYSTEM
Pruritus; rash (non-specified); angioedema; and urticaria
MUSCULOSKELETAL SYSTEM
Arthralgia including monoarticular; myalgia; back pain; neck pain; shoulder pain; and neck stiffness
HEMIC/LYMPHATIC SYSTEM
Lymphadenopathy
RECOMBIVAX HBR
Hepatitis B Vaccine (Recombinant) 9987433
PSYCHIATRIC/BEHAVIORAL
Insomnia/disturbed sleep
SPECIAL SENSES
Earache
UROGENITAL SYSTEM
Dysuria
CARDIOVASCULAR SYSTEM
Hypotension

According to the vaccine insert, these were the reported reactions in real-world use:

Hypersensitivity
Anaphylaxis and symptoms of immediate hypersensitivity reactions including rash, pruritus, urticaria, edema, angioedema, dyspnea, chest discomfort, bronchial spasm, palpitation, or symptoms consistent with a hypotensive episode have been reported within the first few hours after vaccination. An apparent hypersensitivity syndrome (serum-sickness-like) of delayed onset has been reported days to weeks after vaccination, including: arthralgia/arthritis (usually transient), fever, and dermatologic reactions such as urticaria, erythema multiforme, ecchymoses and erythema nodosum
Digestive System
Elevation of liver enzymes; constipation
Nervous System
Guillain-Barré Syndrome; multiple sclerosis; exacerbation of multiple sclerosis; myelitis including
transverse myelitis; seizure; febrile seizure; peripheral neuropathy including Bell's Palsy; radiculopathy; herpes zoster; migraine; muscle weakness; hypesthesia; encephalitis
Integumentary System
Stevens-Johnson Syndrome; alopecia; petechiae; eczema
Musculoskeletal System
Arthritis, Pain in extremity
Hematologic
Increased erythrocyte sedimentation rate; thrombocytopenia
Immune System
Systemic lupus erythematosus (SLE); lupus-like syndrome; vasculitis; polyarteritis nodosa
Psychiatric/Behavioral
Irritability; agitation; somnolence
Special Senses
Optic neuritis; tinnitus; conjunctivitis; visual disturbances
Cardiovascular System
Syncope; tachycardia.

Here is a compiled list of authoritative, peer-reviewed articles on adverse reactions after HepB administration:
http://guggiedaly.blogspot.com/2011/02/articles-on-adverse-reactions-after.html?spref=fb

Please visit http://www.medalerts.org to search the government VAERS database. This database is maintained by the CDC and FDA to collect vaccine reactions and contains a description of the adverse reaction.

For 2010, there were 938 adverse vaccine reactions.


For 2010, there were 20 deaths (18 infants) reported for the HepB vaccine.

For 2010, there were 2,799 cases of Hepatitis B.

Please visit http://www.cdc.gov/mmwr/mmwr_wk.html to view the mortality and morbidity database. This is maintained by the CDC to collect and report on infectious disease.

Please visit http://wonder.cdc.gov/ to view death cases compiled by the CDC.

I dug around in the infant death section of the wonder site and could not find any reported infant deaths in the earliest record (2005) for Hepatitis B, acute or chronic.


Conclusions

The illness seems to be mild for most adults and does not have high mortality rates. It is not easily transmitted. Adults can receive the 3-dose vaccine series, and indeed, many in the healthcare fields and other at-risk demographics DO get the vaccine. They can also take the immunoglobulin or the available anti-viral medications.

The vaccine is not as bad as other vaccines in terms of ingredients. It does contain a high amount of aluminum for infants. It does contain yeast proteins that might cause an allergic reaction. Since the vaccine series is fairly ineffective and an immunoglobulin exists, it leaves me wondering why this vaccine is even promoted.

The CDC weekly report shows almost 3,000 cases of Hepatitis B for 2010. I find it sad that we have had routine 3-dose vaccination for ALL infants plus a 2-dose vaccination for ALL children for many years now, and we still have a high number of cases.

I would not expose my newborn, infant or child to this vaccination series. If my child became an at-risk demographic as a teenager or young adult, I would review the data at that time and let my child make a choice about her body. The facts just do not add up for this particular vaccine.

What is also troubling to me is a little tidbit I found in the vaccine insert:


the following guidelines are recommended for persons who have been exposed to hepatitis B virus such as through(1) percutaneous (needlestick), ocular, mucous membrane exposure to blood known or presumed to contain HBsAg, (2) human bites by known or presumed HBsAg carriers, that penetrate the skin, or (3) following intimate sexual contact with known or presumed HBsAg carriers.”

Do you see what I see?

Additional Resources:

This site compiled all the HepB vaccines along with ingredients, manufacturer and more:

Ian’s parents call for safer vaccines and better accountability after his death:

Use the vaccine calculator to build your child a customized vaccine schedule:

InsideVaccines has a LOT of information on HepB and the vaccine:

All package inserts are listed here:

One stop shop for all the links you need:

A general overview of how to research any vaccine or illness: