4 months

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Now your baby is four months old, it is recommended they have another dose of the vaccinations they had at six weeks (combined DTPa-Hib-IPV-HepB, 13vPCV and rotavirus). Each dose strengthens your baby’s immunity to eight diseases.

Two of the vaccines are needles, usually given in the baby’s legs. The other vaccine is given as drops put into your baby’s mouth to swallow.

What diseases do the vaccines protect babies from?

Three vaccines are recommended for babies at four months of age. The technical names for the vaccines are:

  • DTPa-Hib-IPV-HepB (also called ‘combined’ or ‘hexavalent’) which protects against diphtheria, tetanus, pertussis, Hib, polio and hepatitis B
  • 13vPCV which protects against pneumococcus
  • rotavirus which protects against rotavirus.

You can read more about these diseases below:

Diphtheria

Diphtheria is a very serious disease. It can cause a membrane (or skin) to grow over a baby’s throat, which stops them from breathing. You may not have heard of it because it is so rare in Australia now. The vaccine is still used here so that babies and children can’t catch diphtheria from people who have travelled to places where it is more common, including nearby holiday destinations in Asia and the South Pacific 1.

Learn more about diphtheria and diphtheria vaccination
Tetanus

Tetanus is sometimes called ‘lockjaw’. Tetanus affects all the muscles in a baby’s body, including the ones they use for breathing. The germ that causes tetanus lives in the soil, which means babies and children can get tetanus through a cut, a burn, a bite or even just a prick from something like a nail or a thorn1.

Learn more about tetanus and tetanus vaccination

Pertussis

Pertussis is usually called ‘whooping cough’. It spreads very easily from one person to another through the air, like a cold. When someone who already has the disease coughs or sneezes, the pertussis germs float through the air on tiny droplets. If a baby breathes in those droplets, they can catch pertussis, too. Pertussis irritates the airways, which causes long coughing fits that can be very severe. Small babies can die from whooping cough1.

Learn more about pertussis and pertussis vaccination

Hib

Hib causes a variety of serious illnesses, including swelling around the brain (meningitis), blood poisoning (sepsis), swelling in the throat and lung infections (pneumonia). Babies can die from the diseases caused by Hib. Those who survive often have brain damage. Hib spreads from person to person through the air, like a cold1.

Learn more about Hib and Hib vaccination

Polio

Polio causes muscle paralysis in the limbs and can also affect the heart and the muscles that control breathing. It is rare in Australia but still common in countries including Pakistan, Afghanistan and Nigeria. Polio germs are spread through contact which means babies can catch polio when they put things like hands or toys in their mouth after someone with polio has been touching them1. A person with polio can pass on the disease before they even know they are sick.

Learn more about polio and polio vaccination

Hepatitis B

Hepatitis B is a liver infection. Babies usually don’t look or feel sick when they first catch hepatitis B, but it can cause serious liver diseases, including liver cancer, later in life. It spreads from person to person through open wounds or sores. This can happen in households or even childcare settings. People infected with hepatitis B can pass on the disease without even knowing they have it1.

Learn more about hepatitis B and hepatitis B vaccination

Pneumococcus

Pneumococcal disease is caused by germs (bacteria) that can cause swelling around the brain (meningitis), infection in the lungs (pneumonia), ear infections that can damage babies' hearing, and other serious diseases. Babies and children can catch it from each other just like they catch it from each other just like they catch colds1.

Learn more about pneumococcal disease and pneumococcus vaccination

Rotavirus

Rotavirus causes diarrhoea and vomiting (gastroenteritis) that can make babies so sick they need to go to hospital for treatment. Babies and children catch rotavirus when they put contaminated objects like hands or toys into their mouths1. A person with rotavirus can pass on the disease even before they know they are sick.

Learn more about rotavirus and rotavirus vaccination

What do I need to do before our appointment?

There’s no need to do anything special to get your baby ready for vaccinations.

Babies can usually get their vaccinations on time, even if they are feeling a little unwell. If your baby has a high fever or if you are worried they are too unwell to go ahead with the vaccinations, give your doctor or nurse a call. They will let you know if you should come in, or if you need to make an appointment for another day.

Some children feel a little unwell for a day or two after they get their vaccinations. Most babies find sucking comforting and research has found it actually relieves pain, so your baby might want to breastfeed, or suck a dummy more often for a few days.

You’ll need to take your baby’s health record booklet with you (that’s the one you were given in hospital or at the birth centre when your baby was born). Your doctor or nurse will make notes in the booklet about your baby’s growth and development and write down the details of the vaccinations they had.

What will happen when we get there?

Some parents take their babies to their local general practice where the doctor (GP) or practice nurse will give the vaccine. Others take their babies to a vaccination clinic run by nurses. The majority of Aboriginal and Torres Strait Health Services also give vaccinations. Vaccination appointments can run differently in different places but this is a rough guide to what you can expect on the day.

  • Appointments usually begin with a health check. Your doctor or nurse will ask you how you and your baby are going. They will ask if you have any questions for them. They’ll measure and weigh your baby. And they will write some notes in your baby’s health record booklet to help you keep track of how they’re growing and developing.
  • Once that’s done, the doctor or nurse will get the vaccinations ready. Some doctors will ask you to go to another room where a nurse who is specialised in vaccinating children will vaccinate your baby. Three vaccinations are recommended for babies at six weeks. Two are given as needles and one is given as drops.
  • Most doctors and nurses will suggest that you hold your baby during the vaccinations. Research shows that babies feel less pain during vaccinations when they are being cuddled2. Some parents find it upsetting to be there when their babies have needles. If you would rather not be in the room while your baby gets vaccinated, you can have a family member or friend do it for you. If you can’t bring anyone with you, let your doctor or nurse know: they may be able to arrange someone to stand in for you.
  • Your doctor or nurse will usually start by putting drops of the oral vaccine into your baby’s mouth. These contain a pain-relieving medicine2 that makes the vaccine taste a little sweet (which most babies enjoy!).
  • The two needles usually go in the baby’s legs. The doctor or nurse will be as quick and gentle as they can. They might ask a colleague to help so they can give both needles at once – it just makes things a little faster and easier.

The doctor or nurse will ask you to stay at the clinic for about 15 minutes after the vaccinations. This is so they can make sure everything is OK before you and your baby leave.

Take a look at our video: What will happen when I get there?

How can I make it easier for my baby?

No matter how gentle your doctor or nurse is, needles hurt! And most babies cry at least a little after they get a needle.

The good news is that researchers are beginning to understand more about children’s pain and have found some things that will make needles feel less painful.

  • Holding or cuddling babies triggers the release of pain-relieving hormones, so hold your baby firmly in a chest-to-chest position before, during and after the needles2.
  • There are pain-relieving substances in breastmilk so, if your baby is breastfed, you can offer a breastfeed during or straight after the needles2.
  • Suckling also helps relieve babies’ pain. If your baby is no longer breastfeeding, you can offer a dummy or have a bottle of formula ready to go.
  • You can ask your doctor or nurse to give the rotavirus vaccine drops before the needles. The drops contain sugar (also called ‘sucrose’). Sucrose is such an effective pain-reliever for babies that it is often used in hospitals instead of other medicines.

Some parents don’t like needles themselves and find it very hard to watch their children get vaccinated.  If you think watching your baby have a needle will upset you, you can ask a friend or relative take them in for you. If you don’t have anyone you could ask, mention it to your nurse or doctor to see if they can arrange to have someone else help out.

Take a look at our video: How can I make it easier for my child?

How will my baby feel after the vaccinations?

For a day or two afterwards, some children could feel a little unwell. The most common reactions are:

  • redness, soreness or swelling at the spot where the needles went in
  • a small, hard, painless bump (also called a nodule) at the spot where the needle went in
  • loss of appetite
  • mild fever (temperature)
  • grizzly or unsettled behaviour
  • sometimes vomiting or diarrhoea.

Most of these symptoms last between 12 and 24 hours and then get better. Nodules may take a few weeks to disappear.

Read more about these common reactions and how you can look after them at home

If your baby doesn’t seem to be getting better, or you are worried about your baby, you can get help from:

  • your doctor
  • or your nearest emergency department
  • or by calling Health Direct on 1800 022 222.

Are there any rare side effects I need to know about?

Serious side effects are very rare, but they can happen and some parents want to know more about them before they vaccinate their children.

If your baby doesn’t seem to be getting better, or you are worried about your baby, you can get help from:

  • your doctor
  • or your nearest emergency department
  • or by calling Health Direct on 1800 022 222.

Febrile convulsions

About one in every 3,000 babies experience fits or seizures known as ‘febrile convulsions’ after vaccination. Febrile convulsions are scary for parents to see, but babies usually recover quickly without any long-term effects1. Febrile convulsions usually occur when a baby’s temperature goes up very quickly, and stop once their temperature stops rising.

Intussusception

Around 59 babies in every one million who get the rotavirus vaccine experience a blockage of the intestine called an ‘intussusception’1. The blockage gives babies strong bouts of pain in their tummies which can make them look pale, weak and very sick. They may vomit. Babies who have signs of intussusception need to go to hospital quickly so they can get the help they need. Babies who are treated for intussusception usually don’t have any long-term health problems.

Anaphylaxis

‘Anaphylaxis’ is a severe allergic reaction to one of the vaccine ingredients. Less than one in every one million babies who gets a vaccine has this reaction1. Anaphylaxis usually happens within a few minutes of vaccination, before you and your baby leave the clinic. Your doctor or nurse knows what to do to help a baby having an anaphylactic reaction recover quickly.

When do we come back for more vaccinations?

More vaccinations are recommended when your baby is six months old. These will strengthen your baby's immunity to diphtheria, tetanus, polio, pertussis, Hib and hepatitis B.

It is important that babies and children get vaccinated on time because research has found they work best when they are given at these ages.

What if I still have questions?

If you still have some questions about vaccinations for your baby, write them down and make an appointment with your nurse, your doctor, or your health worker so you can ask them.

  1. Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018, immunisationhandbook.health.gov.au
  2. Taddio A, et al. Reducing pain during vaccine injections: clinical practice guideline. Canadian Medical Association Journal 2015;187:975-982 http://www.cmaj.ca/content/cmaj/187/13/975.full.pdf

Video Explainers

What Will Happen When We Get There?

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