13 October 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
On 1/9/99 she was prescribed Rondec liquid drops for a runny nose. On 1/16/99, she was prescribed another form of Rondec for a cough. Finally on 1/19/99 she was prescribed an antibiotic called amoxicillin which caused the problems to clear up after three days. She continued the prescription for 7 days.
One week later it was back. She went back on the amoxicillin and again after three days, it was gone. She continued taking amoxicillin for ten days.
Two days ago the whole thing started again. She has no problems with her lungs,the coughing is strictly caused by the flowing mucus. She is teething, no we see none of the usual teething symptoms however - red cheeks, irritability, etc. She has a good appetite. Could she be allergic to formula? She uses Carnation "Follow-up".
We are very concerned about her continuing to take antibiotics.
Your thoughts would be much appreciated.
-SL
Dear SL: Although cough and runny nose could be caused by formula allergy, it is unlikely that these would be the only symptoms of formula allergy, and it is equally unlikely that it would first become evident at 9 months. In addition, although it is possible that it was a coincidence that the cough cleared after a few days on antibiotics, since it happened that way twice, formula allergy seems like an unlikely possibility. The story is most consistent with a sinusitis. Recurrent sinusitis may require a longer course of antibiotics.
Sincerely,
Dr. Warren
Sincerely,
-MM
Dear MM: The course of treatment you have described should be sufficient for any conjunctivitis, although, I often find that ointment is more effective than drops for treating conjunctivitis in infants. If the conjunctivitis is not clearing, it is also possible that the baby has developed a sensitivity to the eye drops with the result being that the eyes are inflamed by the end of a day of use. If the conjunctivitis clears completely, but is recurrent, then you need to see if there is a problem like narrow tear ducts causing the problem. For that, you need to consult an ophthalmologist.
Sincerely,
Dr. Warren
Just some info for ya, don't mean to be bothersome!
Thanks for your time.
-Tracy
Dear Tracy: I'm certain that if Carnation makes an infant soy formula, it is nutritious. I don't know what the differences between their infant formulas and follow up formulas are, but I suspect the differences are subtle. The American Academy of Pediatrics recommends that infants stay on formula or breast milk for a the whole first year. Then they can be switched to whole milk. I'm not aware of any research which recommends a different type of formula for older infants or infants eating solids. Therefore, I'm not sure what the basis is for having both a formula and a follow up formula.
Sincerely,
Dr. Warren
I would love to hear a reply to my answer. We are going for a well-child checkup in about 2 weeks, I plan to mention this to my doctor also. But, I wanted some pre advice as to what her problem might be. Thanks
-AD
Dear AD: Potty training can often make children upset about their normal bodily functions. Many children respond to the effort by holding in their stool and becoming constipated. This can result in pain on defecation and discomfort related to trying not to let the stool out. If your daughter is constipated, she may need some dietary changes or even a stool softener to keep her stool soft.
If you are talking about urination causing her pain (your e-mail doesn't specify what aspect of elimination causes your daughter pain), her response may still be related to her fear of sitting on or using the potty. The complaint, "boo-boo" doesn't necessarily mean physical pain. But you do have to consider the possibility that she finds urination painful, in which case your daughter needs to be examined by her pediatrician and have a urinalysis and urine culture.
I can understand your concern about the prospect that your daughter's complaint could indicate sexual abuse, but given the relationship of her complaints to your recent efforts at potty training, it may be nothing more than her fear of issues related to potty training. Since you didn't see anything suspicious, I think you have to refer the issue to your pediatrician. If your daughter's complaints continue, perhaps you should try to see the pediatrician prior to her checkup in 2 weeks.
Sincerely,
Dr. Warren
Lately, he increased his intake of liquids (mostly vitamin D milk), up to approximately 1 gallon in 4 days. He asks to have his milk bottle with him at all times, including evening and through the night.
Otherwise, he is healthy, eats well, and happy.
What is considered normal liquid intake for his age? If something should be done in a way of limiting his drinking, what should be done and how?
I thank you in advance.
Regards,
Jacob's Father
Dear Jacob's Father: I don't think you need to be concerned about the amount of liquid Jacob is drinking, but you do need to be concerned about his escalating attachment to his bottle. Most people try to get rid of the bottles by two years of age. I don't insist on that, but I do strongly suggest that it's time to limit his use of the bottle if you ever hope to get rid of it. You don't have to decrease the amount of milk he drinks since milk is good food (although 1 quart a day is a lot for a small child). You do need to have him drink his milk in his high chair or whatever other places you deem appropriate and then be done with it. He mustn't have the bottle with him in bed, and he mustn't nurse it all day long. If he does, it will rot his teeth very badly.
If Jacob were drinking so much just because of thirst, he still wouldn't need to carry it with him all day, and at his age, he should be able to handle a cup well enough to meet his fluid needs. I think it's his attachment to his bottle that makes him drink so much rather than a need to drink which makes him demand his bottle.
Sincerely,
Dr. Warren
I would really appreciate your time in answering this question. Thanking you
-EC
Dear EC: Typical coxsackie virus causes canker sores in the throat and may cause blisters on the hands and feet and sometimes going up the legs and onto the buttocks. It does not generally cause blisters on the rest of the body. In the absence of the characteristic cankers in the throat or blisters on the palms and soles, the diagnosis cannot be made on clinical grounds and then could only be made by viral cultures. These are not generally done since there is no treatment for coxsackie and the test results usually become available long after the illness is over.
Sincerely,
Dr. Warren
-DJD
Dear DJD: Something could be disturbing your son's sleep such as teething, but the most likely thing that is causing a problem for you is separation anxiety. Most infants develop separation anxiety between 6 and 10 month of age. Once that starts, they get hysterical if you leave them alone. It is often associated with stranger anxiety. In the extreme situation, the child demands to be in constant physical contact with his mother and cries any time he sees someone he doesn't recognize. Since these infants dread separation so, and sleep represents a separation, they also fight sleep. This can be a long phase. With time, he will learn to deal with the separation. It will help if he can learn to fall asleep in his crib. To accomplish that, you have to put him into his crib drowsy, but awake. When he starts to cry, soothe him without taking him out of his crib. With prolonged repeated experience of falling asleep in his crib, the duration of his crying will decrease and he will learn to put himself to sleep in his crib.
Please read my article, Helping Your Child to Sleep Through the Night.
Sincerely,
Dr. Warren
-LS
Dear LS: Molluscum contagiosum is a kind of wart. It is caused by a virus. It is not related to any other health problems. It may resolve on its own, but if it is causing a problem because the warts are spreading and your son's picking at them is causing skin infections, you may need to consult a dermatologist about removing them. Sometimes, even after the warts are removed they may come back.
Sincerely,
Dr. Warren
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