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ask an expert: Midwife/Clinic Sister

Arlaine Oxenham runs Babies on Beachway, a clinic in the Durban North area offering antenatal classes and post natal advice with the focus being on feeding and sleep issues from birth up to two years of age. Having a new baby is a daunting experience for most people and there is so much contrary advice available that it is easy to get confused. Should you have any issues that you may need some advice on, she is more than happy to answer questions that you may have.
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Q. My baby is 18 months and not walking yet. Should i be concerned - have you seen or met babies at 18 months of age who were not walking yet at 18 months?

A. Most babies do start walking at around 1 year of age but there are many who do not.

You do not mention if your baby is crawling or when it started crawling – a late crawler may lead to a late walker – or if your baby is cruising ie. Holding onto furniture & walking around that. If so, there is a good chance that walking will be soon but if not, it would probably be a good idea to visit your doctor to have an assessment done & also to put your mind at rest.

Q. "My 2 and a half year old daughter has come up with what looks like a bad rash / allergy. It very red and has a map like pattern to it. This is the first time this has occurred. We gave her some Allergex syrup yesterday and by the afternoon the allergy was gone.
Unfortunately, this morning it's back. Very itchy, so she's scratching a lot, but there is no fever. Any ideas as to what it could be and what I can do to treat it?
Thanks. Charlene"

A. It’s quite difficult to diagnose a rash without actually seeing it.  The fact that you say it is very itchy but your daughter has no temperature makes me think it’s not too sinister.
A chickenpox rash usually presents as blisters but is often preceded by cold-like symptoms & fever as is measles & rubella.

The Allergex will definitely help to take away the itch but you can also try calamine lotion to try & soothe her skin. Consider things like a change in diet recently – has she eaten something new or been somewhere different that could have irritated her skin. Have you changed washing powders, soaps or her creams at all?

Most rashes do clear up on their own but if this carries on for more than 3 or 4 days & does not seem to be getting better, I would take her to the doctor for a proper diagnosis & treatment.

"How do we know what vaccinations are best for our baby?
I took my son to the Paed and whilst there I spoke to a lady from the Clinic who told me that they do injections at 8 weeks, not 6 weeks, and it includes a whole long list of medicines. She said the Storks’ Nest gives a different one at 6 weeks. How does this work?
I was told that La Lucia Clinic is like a private facility and it’s for free, but her advice that their quality is not as good as the 8 week injection (which, by the way, costs R1,300).
Please would you give your opinion."
- Julia

A. The immunisation schedule can be so confusing to new mothers as you are bombarded with so much info & you obviously need to make the correct decision for your baby.

The 6 week & 8 week immunisation are exactly the same in that your baby will be vaccinated against the same diseases no matter which clinic you choose. A private clinic has to charge for immunising as we have to buy the vaccinations from the suppliers whilst the state or government clinics do not charge – La Lucia is actually a government clinic & not private.

The difference between the 6 & 8 week jabs is the actual vaccination they use. At 8 weeks, we use a vaccination called Infanrix Hexa which consists of Diphtheria, Tetanus, Polio, Pertussis, Meningitis & Hepatitis B ie 6 diseases in one injection. At the same time, your baby will also receive another vaccination for Pneumococcal disease as well as drops against Rotavirus so it will be 2 injections & 1 set of drops.
At 6 weeks, your baby will be given an injection called Pentaxim which consists of Diphtheria,Tetanus, Polio, Pertussis & meningitis as well as a separate injection for Hepatitis B ( the 8 week one is inclusive of Hep B). The Pneumococcal & Rotavirus vaccinations are also done.

To put it in a nutshell, the only difference is that at 6 weeks your baby will get 3 injections & 1 set of drops whilst at 8 weeks, it is 2 injections & 1 set of drops.
Please also be aware that this whole thing is repeated again. If you start at 6 weeks then the next ones are due at 10 & 14 weeks but if you start at 8 weeks, the next one is at 12 & 16 weeks. There is no Rotavirus  immunisation at 14 or 16 weeks – they only need 2 doses.

I hope this helps to clear up any confusion.

Q. "In the process of moving house a few times recently, and of my son's moving schools constantly, I lost his clinic card. I'm living a life of extreme guilt since trying & failing to locate it. Unfortunately there is no record at his previous schools, and even the paediatrician''s rooms and clinics say they only keep records for 5 years. Please tell me i still have hope of finding it.
How will I tell him when he's grown that his mom has been so useless that she lost his original Birth Certificate and Clinic Card!"

A. Although “the Clinic Card” is a valuable tool in assessing a child’s growth & record of immunisations, please don’t worry if it’s gone. As long as you know that his immunisations are up to date, he will be fine. Some schools do ask for records just to check the immunisations but cannot refuse a child entry if they have not been done or the card is lost. Have you tried asking the clinic you went to for a letter to say that the immunisations are up to date & that they did do the immunisations (or the paed if you did some there.)
As for the birth certificate, you can get a replacement from home affairs & if you want an easier route, I believe the Passport People also offer the service.