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Pediatrics/Measles OR MMR vaccination at 9 month

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Question
Dear Respected Sir,
Kindly guide regarding WHICH VACCINE TO GIVE AT 9 MONTHS OLD BABY.

Old recommendation is 9 month = only plain MEASLES
New Recommendation IAP Oct 2014 is 9 month = MMR-1 (NOT Plain Measles) and
15 month = MMR-2

NOW...U please Suggest and Guide Sir at 9 month???

ALSO

2) DO WE NEED/NECESSARY/RECOMMENDED TO GIVE VITAMIN A DROPS AT 9 MONTH??

3)For Breastfed + Weaning Infant,
is there a NEED/NECESSARY/RECOMMENDED for

CALCIUM  + VITAMIN D......
IRON Supplement.....
Vitamin Supplement??

KINDLY GUIDE SIR...
THANKING YOU IN ANTICIPATION.
----Dr. Manish.

Answer
Hi Dr. Manish,

Here are the answers:

1. I follow latest IAP recommendations for immunization: Hence, MMR-1 is recommended at 9 months and MMR-2 at 15 months (Plain measles vaccine not required at any age; No need of MMR at 4-6 years of age)

I would also like to inform you that very soon, even in National Schedule (UIP), MR (Measles-Rubella) vaccine would be initiated at 9 months of age. After that plain measles would not be available in the country.

2. Vitamin A is there in UIP: It is a national program: hence, theoretically, every baby should be getting it. However, in personal practice, I do not recommend it at least in babies from urban settings as such mega-doses of Vitamin A might be harmful in a child who is not deficient in Vitamin A (since as you know, Vitamin A is a fat soluble vitamin and any excess Vit A would be deposited in body and would have adverse effect)

3. Iron requirement in 6-12 months of age is highest in whole life: and is unlikely to be met by ususal diet. Hence, every baby in this age group needs iron supplement, IN ADDITION to iron-rich diet. Some authorities recommend Iron supplement even till 18 months of age.


Babies do not usually require calcium supplement. However, MOTHERS should continue calcium supplement in addition to calcium rich diet (milk and milk products) till they breastfeed: That way, babies would get adequate supplement.

Every baby needs Vitamin D supplement, since the amount of Vitamin D in breastmilk and usual diet is negligible and the biggest source of Vitamin D (sunlight) is hardly available to babies these days.

Many authorities recommend multi-vitamin supplement in babies routinely.


Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

+91-9818356846, +91-11-45535647

www.KumarChildClinic.com  

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Dr. Puneet Kumar

Expertise

I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query requiring specific diagnosis of a particular subject.

Experience

I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 15 years of experience in the field.

Organizations
Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (http://www.kumarchildclinic.com)

Publications
(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. http://www.pediatricsciences.com/issue/view/1050000010 (f) Regular column, “How do I treat” in Pediascene (www.pediascene.com) (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 (http://www.pediascene.com/page.php?cid=6&catid=9&id=132 ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

Education/Credentials
After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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