transcript

Speaker 1:
[00:00] Birth with Babylist is made possible by Babylist. Baby gear choices can feel endless, but Babylist makes it simple to get what you need from cash funds to homemade meals, even secondhand gear, from any store, anywhere. And their guides break down what will work best for your family. So you can spend your energy focusing on things like giving birth. Don't forget to create your registry at the end of this episode by going to babylist.com/podcast. Right now, vaccines feel a lot more confusing than they should. Recommendations are shifting, social media is loud, and if you're pregnant or holding a brand new baby, it can feel like every single decision suddenly carries enormous weight. So today, we're cutting through all of the noise. We're talking about what vaccines your baby actually needs in that first year, what vaccines it's safe to get when you're pregnant, and why those vaccines really matter for your newborn's health, what's changed about recommendations, and what hasn't. And how do you make decisions when the internet is screaming at you from all directions? I should let you know we're recording this episode on April 20th, 2026, and things are probably going to change. I want to start off by talking about vaccines in pregnancy, what you should be getting, and why it's important for your newborn's health and immunity. You might not have a pediatrician to talk to about this yet, but you can always ask your OB-GYN for their recommendations. According to the American College of Obstetricians and Gynecologists, vaccines during pregnancy are a routine part of prenatal care. They're not an extra. They recommend a Tdap shot in the third trimester of every pregnancy to protect newborns from whooping cough. They also recommend a flu shot during flu season to reduce the risk of severe illness for both mom and baby. And now, a maternal RSV vaccine in late pregnancy to help shield infants in those first few vulnerable months. We'll be talking more about the RSV vaccines later. They also support staying up to date on the COVID vaccine. The goal here is simple. You want to protect the mother during pregnancy and pass along antibodies that help protect the baby from day one. Here's pediatrician Dr. Molly O'Shea to explain it a little bit better than I can.

Speaker 2:
[02:44] I know parents are so worried usually with their newborn. Oh, you know, they're so fragile. They don't have any protection. Well, actually, the first couple of months of life, you've got all your mom's protection, right? You've got all her antibodies. Your baby's really actually in pretty good stead. They've actually got a lot of immunity from their mom still. And it is when that immunity wanes that it's so important to then give the baby's immune system its first familiarity with risky conditions that would be problematic if the child themself were to become exposed and infected with them.

Speaker 1:
[03:31] Dr. O'Shea explained to me that this is why most, but not all, of the vaccine schedules start at two months for your newborn. And we're gonna get into all of that because I know that there's so much confusion around vaccines. It's also important to note that your pregnant body might respond to vaccines in a different way than it did before you were pregnant. Because during pregnancy, your immune system shifts to support the baby. So you might notice slightly stronger side effects like soreness, fatigue, or a mild fever after the flu vaccine or the Tdap vaccine. According to experts, you might feel no difference at all. Your body's made for this. It's primed to produce antibodies efficiently and pass them on to the baby. That's why the vaccines are timed later in pregnancy. Honestly, for new parents right now, it feels like things are changing every day. Because they are. And I asked Dr. Molly O'Shea to break that down for me.

Speaker 2:
[04:29] Actually, it's a really interesting time because yes, in January, the CDC made recommendations to change the vaccine schedule. And about less than a month ago, the federal court basically said, you don't have the authority to make those changes the way you did. So right now, we're in a little bit of a period of even more upheaval. I recommend, and so do most pediatricians across the country, that families follow the American Academy of Pediatrics schedule of vaccinations, because it is definitely going to provide the most protection for infants and young children at the time when the diseases are most likely to be high risk for them. So and that happened to be the previously recommended CDC schedule. So up until January, we were pretty closely aligned, and then the CDC came in, made some changes to the recommendations, and then about a few weeks ago, the federal court basically said, no, no, no, those decisions don't hold late anymore.

Speaker 1:
[05:46] And of course, parents have a really simple question. Who are you actually supposed to trust to give you all of this information? Because you can Google anything, but that doesn't mean it'll be grounded in real data or real experience. And here's how Dr. O'Shea thinks about that.

Speaker 2:
[06:04] As pediatricians, we're still your most available, relationship-driven place to go for information that is reliable so that you can make decisions about what is best for your child and your situation. And we can help cut through a lot of that noise and answer all the concerns you may have and help you get some clarity around the decisions you need to make.

Speaker 1:
[06:38] And do you want parents asking those questions? If they're nervous, are you happy to have them come in and ask anything? Anything that they're curious about?

Speaker 2:
[06:48] Yeah, absolutely. Because we need parents, first of all, to feel really comfortable, not only asking us anything, but telling us things, right? So throughout the life journey of your child, you're going to notice all kinds of things about your kid. That as a pediatrician, I'm not going to have access to information about. And if you don't feel comfortable sharing things about your child, both the great things and the concerns, if you can't feel like you can ask questions, then I can't do my job to the best of my ability as your medical collaborator in order to help you raise your child in the most holistically healthy way. So the answer is yes. Pediatricians like me and frankly all of us, we want your questions. We need your questions.

Speaker 1:
[07:48] Before we get in the vaccine schedules, I think it helps to understand the basic idea behind vaccines. What is a vaccine and what is it actually doing in your baby's body? I asked Dr. Florencia Segura about that.

Speaker 3:
[08:02] Their immune systems have no experience fighting. I mean, they were in a sterile amniotic sac filled with amniotic fluid, unless mom had a bacterial infection or a complication in pregnancy. The uterus, the amniotic fluid is like a little bubble. They were not exposed to basically anything. They didn't have to mount an immune response for anything. And now they're out in the world and there are very scary diseases. And viruses and bacteria are out there to try to replicate and survive. Basically, what I want to emphasize is that we don't want to experience the natural infection. There is no, we don't know how our body will respond, and especially a little baby's body will respond. So that's why vaccines are important. It's essentially giving a little piece of the protein of the virus or the bacteria that we're trying to protect them against so that their body in a very controlled fashion develops an immune response, has memory antibodies. So if they ever do encounter it, that immune system knows exactly what to do.

Speaker 1:
[09:11] This is the part where things can start to feel like a lot. Up until now, we've been talking about big ideas, what vaccines do, why they matter, why timing is important. And then you get to the actual schedule. You get to doctors actually putting things in your baby's body. And there's a lot of names you might not recognize. There's a lot of appointments, and this can make parents really nervous. It made me really nervous the first time. And it's not because people don't believe in science, and it's not because people are trying to push back. It's because you're sitting in a doctor's office, holding your little baby, and being asked to say yes to something that you desperately want to fully understand. So instead of rushing through it, I want to walk you through what that first year of vaccines actually looks like. Here's Dr. Florencia Segura.

Speaker 3:
[10:06] So at birth, we recommend a universal Hepatitis B dose. The reason why we recommend Hepatitis B is because this vaccine is extremely safe. There are really no downsides to having this vaccine. And Hepatitis B is one of the most transmissible viruses. It's not just sexual activity, blood transfusions or IV drug use like you hear in the news. Those are definite ways that you can get Hepatitis B, but it's a cut. It's a toothbrush with a little bit of blood in it. It's a bite at daycare with a kid with Hep B can infect your kid that doesn't have the vaccine. So that's why we do the universal Hepatitis B dose.

Speaker 1:
[10:53] Does the CDC still recommend the Hep B vaccine at birth?

Speaker 3:
[10:56] They have moved it from the Hep B to high-risk flash shared decision making, meaning if mom has Hep B, they would recommend obviously having the baby Hep B. But we, the AAP, the American Academy of Pediatrics, it should be highly recommended being universal to prevent lifelong infection.

Speaker 1:
[11:17] Okay. So the AAP is the American Academy of Pediatrics. Right. And the CDC is the Center for Disease Control. The AAP is still recommending Hep B at birth.

Speaker 3:
[11:29] Exactly. That has not changed. This is what we've done for the last 20 years. We already had the model that the CDC wants us to do, which is, let's just give Hep B to high-risk moms. And it didn't work. There were still kids that were getting Hep B, because again, household contacts, you know, exposures at daycare. It's a silent disease in the beginning. And there's no cure for it. So once you have it, you have it, and there's nothing we can do to get rid of your Hepatitis B.

Speaker 1:
[12:02] So if you're in a hospital with the CDC's new guidelines, will the doctors still typically recommend it, or is it something you should be asking for?

Speaker 3:
[12:12] That's a great question. So a lot of hospitals have done pushback. So this was never something that like, and like, you know, we've just recently had babies. Like, this is not something that like, you go, you have your baby, and they're whisked away, and they're given the Hepatitis B vaccine without your consent. I mean, even before the CDC changed the recommendations, they would ask you, they always ask the parents, like, hey, you know, your baby is due for Hepatitis B. Do you have, you know, any objections to getting it now? This is highly recommended by your pediatrician, et cetera.

Speaker 1:
[12:48] Yeah, there's a lot of confusion out there. There's a lot of mistrust. I mean, that's part of the reason we want to go over all of this information. You know, what are the benefits to the baby, and are there any possible dangers to the baby of getting the Hep B vaccine?

Speaker 3:
[13:07] No, there are no dangers.

Speaker 1:
[13:08] So, Hep B, that's the only one that's offered at birth, right? And then we skip ahead. We skip ahead to, is it two months? Is two months the next vaccine?

Speaker 3:
[13:21] So, you'll go, you have the Hepatitis B in the hospital, ideally, in an ideal world. You go home, you bond with your baby, you breastfeed your baby, you formula feed your baby. However you feed your baby, you come in for weight checks. Those are non-vaccine visits. These are just weight checks. You have your one-month appointment. There are no vaccines at that visit. And then at two months, typically, is where we do the first kind of round of vaccines at a pediatric office.

Speaker 1:
[13:49] And what are those vaccines that are typically recommended by the AAP at that two-month visit?

Speaker 3:
[13:57] Yes. So you've got the DTaP, which protects against diphtheria, tetanus, and pertussis. And everyone's heard of tetanus, pertussis, and diphtheria. Very scary diseases. You've got the Hib vaccine, which is against hemophilus, which is a very scary bacteria that can cause meningitis, can cause sepsis, bacteremia, pneumonia. You've got the pneumococcal, which is also another type of infectious disease bacteria that causes pneumonia and meningitis. And then you've got polio. And that we know what polio causes paralysis. So that's sort of the first round of vaccines. Plus, one that's given by mouth called the rotavirus. And that protects against a very bad gastrointestinal disease that is very common for little babies, especially in daycare.

Speaker 1:
[14:56] And at two months, would you get a second dose of Hep B?

Speaker 3:
[15:01] You got it.

Speaker 1:
[15:03] OK. OK. So then we skip ahead. What is the next time that a baby would get a vaccine?

Speaker 3:
[15:09] The next visit and all the visits are this is what I tell families, how important the visits are. Like the most important part of my job is giving vaccines. The next visit is at four months. And that's because that's another set of vaccines that we're doing that are very important. And these are all boosters. So none of these are new. And it's going to be the same. It's going to be your DTaP. It's going to be your your Hib, your Pneumococcal and your polio and your rotavirus.

Speaker 1:
[15:40] And then our next visit is six months.

Speaker 3:
[15:43] Six months. And we do the same exact vaccines. We'll do DTaP, we'll do Hib, we'll do Pneumococcal, and we'll also do polio. Keep in mind that many practices like ours, we use a combined one. So we're not giving kids like six different shots. It's usually two or three different shots.

Speaker 1:
[16:03] And then what comes after that? After six months, do we move kind of far ahead?

Speaker 3:
[16:08] So nine months, we usually do at our practice, we'll do the Hep B vaccine at that point. So that's the last of the Hep Bs. And then we usually do other kind of screening. We'll do like iron screening or lead screening. And then we skip ahead to 12 months where we do the MMR, the Varicella.

Speaker 1:
[16:27] And remind me what MMR is.

Speaker 3:
[16:30] MMR is measles, mumps and rubella.

Speaker 1:
[16:33] Okay, okay. And then Varicella, is that one chicken pox?

Speaker 3:
[16:36] That's chicken pox.

Speaker 1:
[16:37] Okay. And then anything else at 12 months?

Speaker 3:
[16:40] Hepatitis A. And in some practices, they will also do the DTaP, the Prevnar and the Hib as well. Those are like the boosters that we've already talked about. In our practice, we do the MMR, the Varicella in the Hep A, and then we do the other three as boosters at 15 months, because these are just boosters. So that's like a very typical kind of schedule.

Speaker 1:
[17:05] When you hear it like that, it can sound like a lot of moving parts. But in real life, this is not something that you have to memorize or manage on your own. It's a schedule that your pediatrician is going to walk you through one visit at a time. We're going to take a quick break here. And when we get back, we're going to talk about some of the questions that pediatricians get from new parents. Babylist is all about making the complicated parts of pregnancy and parenthood feel simpler. There are so many lists, so many opinions. And the truth is, babies really do need a lot of stuff. But how do you know which is the right stuff for you? That's where Babylist has your back. With Babylist, you can register for anything from any store, from cribs to car seats to cash funds, even a postpartum casserole from your favorite cousin. And their tools help you figure out what actually makes sense for your family. Their interactive checklist is a favorite. It's like having a personal shopper to help you prioritize what matters and then skip the rest. And because Babylist is built to fit all kinds of families, you can mix and match however you want. The latest stroller, a hand-me-down crib, or even a meal fund for those first few weeks at home. However parenthood comes together for you, it belongs at Babylist. Get started at babylist.com/podcast. Okay, we're back. One of the questions that pediatricians get a lot of is why not just space the vaccines out more? Why not take the vaccine schedule a little bit slower? I asked Dr. Molly O'Shea to walk me through that question directly.

Speaker 2:
[19:29] I know sometimes parents have concerns about whether or not they're gonna overwhelm their baby's immune system by giving all the vaccines one time and talk about separating vaccinations. And I think that one thing that is valuable to understand is that over the years, our ability to kind of right dose the vaccines has been really well done. So that it is the smallest dose which can give exactly what your baby needs at exactly the right time, so that the immune system is getting just the right amount of stimulation without putting any additional risk on your baby's overall health, because the risk of disease is substantial. And your baby's immune system is ready to respond to this type of stimulation. The amount of immune stimulation your baby receives in one set of vaccines given, let's say, at the two-month visit, is dramatically less than they get in one day of breastfeeding. So even though it's a shot as opposed to drinking, you know, something, it is not a substantially challenging thing for the immune system to take on. And giving all the vaccines together actually enhances the response to any one vaccine. So if you look at overall rates of immune response after vaccination, when given together, you get better immune response in the sense of, you know, how immune are you? If I measure your titer, you'll see better titers when given together as opposed to given separate. So there is value to giving them simultaneously as opposed to giving them drawn out separately.

Speaker 1:
[21:51] That's the piece that a lot of people don't know actually. It's one of the pieces that I didn't know. That spacing out vaccines doesn't help and can actually make them less effective. And it extends the window where your baby is unprotected. The other question that doctors are getting every single day is about safety. Are these vaccines safe? And not in an abstract way, but in a very real way. Is this thing safe for my baby? And there's no shortage of answers that you're going to find online, which is why it is so, so important to directly ask a pediatrician, someone with a career's worth of experience, who can capably answer this question.

Speaker 3:
[22:38] I have been doing my job for 15 years. I have seen at this point probably 10,000 patients, and I have given the same vaccines that I would give to my family members, and I have seen these kids grow into, I've been in practice since 2012. So a lot of my patients are healthy high school patients, and I have never seen a side effect that would give me pause. So these are very safe. If you get, I do tell families that sometimes you do get a little bit of a normal response, which is your immune respond. I wouldn't call it a side effect. I would just call it, it's a normal immune response to have a low-grade fever after your vaccines. Not every baby will get one, but that is very normal. It's usually 24 to 48 hours. Or some babies will have a little bit of swelling where the vaccine site is. And I always say that that is normal. That's your body making an immune response and saying, oh, hey, there's something that we need to respond to and build a memory, just like your baby is putting thousands of things into their mouth. I think that that's probably one of the biggest vaccine myths, is that we're overwhelming their bodies. And when you're compared to what they're actually exposed to, when you start seeing a four-month-old put everything in their mouth or all the stuff they pick up at school or daycare from their siblings, a vaccine that has been studied and has gone through so many trials and is so precise, regulated by the FDA. I mean, you can't even compare that. So those are things that we'll talk about. But yes, exactly. Like asking any, I tell families, tell me something you've seen online. Like, let's look at it together.

Speaker 1:
[24:23] I want to talk a little bit about a relatively new vaccine, the vaccine for RSV. So this didn't exist for my first two babies, and I wanted to know everything about it. Here's Dr. Molly O'Shea.

Speaker 2:
[24:34] So RSV is not a traditional vaccine. It doesn't develop your own immunity. It gives the baby immunity, okay? So it doesn't last forever. It fades out over time. So there's a monoclonal antibody shot available for pregnant people and one available for babies to get in their first RSV season. And the advantage of getting it during pregnancy is that both the parent and the child get protection, and it is passed along through the placenta to the baby. The advantage of the baby directly getting that monoclonal antibody is that they themselves have coverage throughout that whole first season. Like I said, it's a passive immunity. It lasts for the duration of about six months or so is about how long it lasts. So the first two to three months after you receive the shot, you have the strongest protection, and it gradually declines over time. But it has been a game changer. I don't think I've had a kid in the hospital for RSV, an infant, since that has been available.

Speaker 1:
[25:59] One of the most immediate concerns for parents isn't actually the vaccine itself. It's the moment that it happens. The shot, the cry, and the look on your kid's face when they totally don't understand what just happened. So let's talk about that part, and about if there's any ways to make vaccinations less painful, both physically and emotionally, for you and the baby.

Speaker 2:
[26:26] I think the babies tolerate it better than the parents in a lot of ways. Honestly, I think it's always harder for the parent. But we do anything you can do to distract someone when they're getting something done that is gonna be unpleasant is helpful. So whether that's nursing your baby while they receive, their shots are offering a bottle. If you're bottle feeding, that is a wise thing to do. Singing a little song is helpful. I often will have, if they have an older sibling, say, okay, this is the time you get to sing, the Itsy Bitsy Spider or ABCs or whatever. And even if they're only two months old, you'd be amazed at how helpful that little distraction is. And then we actually don't recommend pain relievers like Tylenol unless there are symptoms later that show some discomfort or a little bit of fever, whatever, if there are other cranky symptoms later in the day. Because giving Tylenol can reduce the immune response given ahead of time or right at the time of vaccination.

Speaker 1:
[27:42] Depending on where you're at in your pregnancy, all of this could change again before you give birth. Don't be afraid to ask your current OBGYN any questions that you might have. They're very well-versed in the current science and the recommendations. The majority of doctors are still going by the recommendations from the American Academy of Pediatrics. You can find all their recommendations and so much helpful information at the AAP web page. If you're at all confused, make sure to ask your OBGYN what your hospital's rules are for giving vaccines. The majority of hospitals will also have a pediatrician available to answer all of your questions. And if you already know your pediatrician before you give birth, do not be afraid to reach out early while you're still pregnant and ask them questions. Having an OBGYN and a pediatrician that you trust and you can be honest with is so incredibly important. Keep an open line of communication and don't be afraid to voice your concerns. That's exactly what they're there for. No question is too small or too strange. You've got this. No matter where you are in your journey, it's never too early or too late to get started with Babylist. Their weekly emails keep you connected to your baby's growth, and their expert guides help you figure out what you'll need once they arrive. When you're ready to get real about things like strollers, car seats and cribs, Babylist has your back. You can start your registry anytime at babylist.com/podcast.