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THYPHOID and HEP A IMMUNISATION in 5 months baby.

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Can I take a 3 to 5 month old infant to Botswana? The CDC website recommends that all travelers to Botswana get immunized against typhoid and Hep A, but an infant that young is too young to be immunized. Would you recommend taking the infant or leaving leaving him the US, which might impact breast feeding?


Category: Pediatrician

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Category: ICU/ Critical Care Specialist
Dr. Saptharishi L G is online now

Expert:  Dr. Saptharishi L G replied 4 Days.

Update: Reply by the Paediatrician.
<Both Typhoid and Hepatitis A are transmitted via contaminated water/food. The infection spreads by the oro-fecal route.
In case of exclusively breast-fed infants, there is no risk of transmission of these two infections.
Strict precautions should be taken by not giving any top feeds/ water/ food. Continue exclusive breast feeding and your baby should be safe from these two infections.
So answering your question, there is no need to worry about TYPHOID or HEP A. However, one cannot be too sure about other infections like malaria, yellow fever, etc.
Travelling with a 3-5 month old infant to a totally different epidemiological zone should be avoided wherever possible. The baby would be exposed to a completely new set of antigens/ infectious agents. The baby would have no immunity/exposure to any of these agents. The best recommendation is to not shift the baby between such significantly different ecological zones.
Feel free to discuss further.
Regards,
Dr.Saptharishi L. G.
Consultant Paediatrician.>>
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Patient replied :

In that case, would it be ok to leave my young infant in the US (with his grandmother) for a week while I go to Botswana alone? Would that impact breast feeding, attachment or be traumatic for the baby?
My brother is getting married in in Botswana next summer, and I'm currently 12 weeks pregnant, due in February. The date would either be in May or July of 2015. Would July (the baby would be 5 months old) be significantly better/safer/healthier for leaving an infant as opposed to May (baby would be 3 months old)?


Expert:  Dr. Saptharishi L G replied 3 Days.

Dear potential parent,
I appreciate your planning and the in-depth thought process behind it.
The problem that you have presented is not a strictly 'medical' one, so I ll present my opinion'. These opinions may be different even among paediatricians.
Leaving behind an infant less than 6 month old is not a good option.' Separating the baby-mother duo can lead to multiple problems in some cases. This change in the feeding habits of the baby can be detrimental.
Firstly, it can cause secondary lactation failure, meaning, when you get back from Botswana, the baby may not want to latch and breastfeed anymore because now he/she knows that food would be dropped into his mouth using a spoon/bottle/whatever was used during the interim period.
Secondly, it can cause breast engorgement and other problems in the mother during the period of separation. So, you would have to express your milk and discard it multiple times every day to ensure that you do not develop any problems.
But, if you feel it is absolutely necessary to leave your baby back in US and travel alone to Botswana, then you may do so more safely in his fifth month when he can also be given complementary feeds (at home in the US). That may be easier for the both of you.

Regards
Dr. Saptharishi L G


Patient replied :

Thank you for your advice! It seems like I am stuck between two options that both carry risks--bringing my baby to a new country with the chance of infectious disease, or leaving my baby and impacting breast feeding. In your opinion, which is the more acceptable risk? I would be traveling to Gaborone, the capital of Botswana, where there is no malaria risk, and Botswana does not have yellow fever. I realize this isn't exactly a medical question but would still love to hear your opinion.


Expert:  Dr. Saptharishi L G replied 2 Days.

Hello. Thank you for the follow up.
Dear Parent,
MY call: Take your infant to Gaborone, preferably during 5th month. Continue exclusive breastfeeding. Make sure that you do not ingest any potentially infectious foods. Take adequate precautions for the baby, Eg: mosquito nets,etc
Enjoy your trip and your bro's wedding.
Feel free to discuss further,
Regards.


Patient replied :

Thank you!



Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
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