28 July 2003
Dear Readers: Sincerely,
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that
advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physican who knows you and cares about you.
Dr. Warren
My brother is Italian. I don't know what his fiancee's ethnic background is but she is white with blonde hair. There was a possibility that a black man could have fathered this baby. My brother believes this is his baby. The rest of my family is very confused. The baby looks black. How can we know for sure without starting alot of trouble and hurting anyone? The last thing we want to do is devastate my brother. He is the perfect picture of a proud daddy. This whole situation is tearing my parents apart. They can't share my brothers happiness because they feel the baby isn't his. Please help a family in turmoil.
-MJ
Dear MJ: The baby's scrotum may be dark because of an effect of maternal hormones on the pigmentation of the genitalia; however, your suspicion that your brother is not the baby's father cannot be dispelled by that information. The reality is that only time will tell.
For the sake of your entire family, I suggest that you forget about your suspicions and deal with the reality of the situation as it is. If there is a possibility that a black man has fathered your sister-in-law's child, if you are aware of that possibility, I suspect your brother is too. Yet he has chosen to keep his family intact and love "his" child. Unless he changes his position regarding "his" baby, even if the baby should appear to you to be unquestionably black, your brother will remain the proud father, you will be the aunt, and your parents will be the grandparents. There is nothing you can do with your suspicions that won't devastate your brother. Unless he chooses to bring the issue out in the open, you and your family need to stand firmly behind the proud father, and for the sake of the child, accept the newest member of your family with open arms. No matter what the final outcome, the child is innocent and deserves the love of his family.
Sincerely,
Dr. Warren
-Heather
Dear Heather: Conjunctivitis remains contagious as long as there is any eye discharge. When the eye is no longer red and there is no discharge, it is no longer contagious. Essentially, it is contagious until it is gone, about 3 to 5 days with treatment.
Sincerely,
Dr. Warren
She has always occassionally cried in her sleep even as a baby. We recently switched her from a Home Day Care into Pre school (2nd week of January) which she likes and for a week or two she seemed to sleep better but now she is crying alot in her sleep again. We know that about 6 - 8 months ago she would come home talking about monsters but we thought it was just because a little boy at the Home Day talked about monsters all the time. Could this be part of her problem?
-Mr. & Mrs. V
Dear Mr. & Mrs. V : Night terrors occur while the child is asleep. When the child awakens the night terror is over, and except for a vague sense of uneasiness, the child has no recollection of what happened and does not report frightening dreams or fearful thoughts. It sounds more like your daughter is having nightmares. These are more related to daytime anxieties or internal psychic conflict, whether real or imagined.
If your daughter has developed a fear of monsters, whether or not that fear is fed by psychic conflict or is simply a result of a scary experience or story, it may help to develop some bedtime rituals that will help her deal with these fears. This can include your looking with her at the places she thinks monsters are lurking to show her that there are none, and reviewing procedures for getting rid of monsters. Even though you know they're not real, your daughter still needs to feel that she can deal with them if they show up. The sense of empowerment can ease her anxiety. You could provide her a magic bell to scare away the monsters. Let her make up stories about how you and she will get rid of the monsters.
Aside from providing her ritual procedures to deal with her monster anxiety, you need to look at whether or not there are any daytime anxieties feeding her nighttime anxieties. This requires trying to look at what concerns her from her point of view. Parental reassurances often fall on deaf ears because they cut off childhood discussion. As much as you know monsters aren't real, to her they are. The same can be true of real issues in her life to which you know the answers and don't think that there's a problem. Help her to find and discuss the things that really bother her, and don't be too quick to cut off discussion of her real concerns with parental reassurances.
Sincerely,
Dr. Warren
Thanking You
-Dr. GPM
Dear Dr. M: Cholelithiasis is not common in children. I cannot cite any statistics. Most childhood cholelithiasis is associated with hemolytic disease. The Web is a great place to look for information, but a professional needs to know that his information is reliable. I suggest you look at the following Web sites and determine if you can register with them. The only one that charges a fee is MD Consult. I do not know if all of these sites are open to physicians outside the USA, but if you cannot register, you can contact them to find out how to register. Neither have I checked recently to be sure that all these links are up to date.
Sincerely,
Dr. Warren
-AL
Dear AL: Puberty may begin in girls as early as 8 years of age. Significant breast development at 9 years is therefore, not necessarily abnormal. Issues of pubertal development and growth should be followed by regular checkup at the pediatrician, so if your daughter hasn't had a physical since her breast development began, you should make an appointment.
Sincerely,
Dr. Warren
-Felicia
Dear Felicia: If your son does not have rectal bleeding when he is on Senokot and does have rectal bleeding when he is constipated, then the bleeding is most likely from an anal fissure which results from the constipation. He should stay on the Senokot as long as it controls his constipation. If he has rectal bleeding even when his stool is soft, he needs further evaluation.
People who are overweight are generally not considered to have an eating disorder. That term refers to anorexia nervosa and bulimia. Many people who are overweight do have psychological issues with food which might benefit from counseling. At 5 years of age, the best management for obesity is parental control of diet and encouraging exercise, or at least activity.
Please read my article, Childhood Obesity.
Sincerely,
Dr. Warren
-Concerned MOM
Dear Concerned Mom: A healthy diet should get no more than 33% of its calories from fat. A diet that derives only 20% of it's calories from fat should meet your daughter's nutritional needs. The correct milk for any child over 2 years old is skim (nonfat) milk.
High fat foods include junk foods like chips and pastries and good foods like cold cuts and cheese. Any food that is prepared with additional fat or fried is higher in fat. While fat is an important source of extra calories, it is not the only source of extra calories. Many children consume large quantities of juice. Substituting water can result in a huge calorie savings without significantly altering the child's diet.
Please read my article, Childhood Obesity. Even if your child is not obese, you will find the information helpful.
Sincerely,
Dr. Warren
-(unsigned)
Dear Erin: A recurring cough that sometimes results in coughing up blood could be serious. See your doctor soon.
Sincerely,
Dr. Warren
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