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|Quick reference medical handouts used
by Pediatric offices
Immunizations and Lumps
By six months of age, most babies should have received three injections of
the diphtheria-acellular pertussis-tetanus vaccine (DtaP). A fourth injection
is usually given at 18 months and a fifth at 5 years. The last two shots
are called boosters. These immunizations are usually injected into the outer
half of the upper thigh muscle in the front, side, be or back. Some babies
will develop a mild local reactions consisting of redness, swelling, or
tenderness at the site of the injection after the first three vaccinations.
Sometimes, if the needle accidentally pierces a small vein on the way to
the muscle, blood seeps out and accumulates under the skin. The bluish swelling
that results is, again, a hematoma . Pressing on the swelling stops the ooze,
and eventually there appears a bruise that s soon absorbed. If your baby
has sustained one of these harmless hematomas, you may notice it while you
re still in the doctor's s office.
Other DTaP-related swellings may not appear for several days. The most common
delayed swelling is the DTaP granuloma, which is caused by a low-key inflammatory
reaction to some injected material that remains in the tissues of the baby
s thigh. A DTaP granuloma is a firm, painless lump under the skin, usually
the size of a dime or quarter. The lump can remain on the baby s thigh for
weeks to months but it finally disappears. Parents seldom worry about DTaP
granulomas if they notice them immediately after the immunization. If they
don t happen to see the lumps for a while, the connection with the immunization
is not t so apparent and can become a worrisome mystery. If you re not sure
what caused the lump on your child s thigh, take him back to the person who
gave the injection and ask if the location of the lump is the same as that
of immunization. You should, however, ask the person who gives your child
his next DPT to apply it in a different area, deeper in the muscle, and to
massage the area after giving the injection. The development of a DtaP granuloma
is not a contraindication to future immunizations.
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
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