30 May 2005
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
-Concerned Grandmother
Dear Concerned Grandmother: There is no one condition or set of conditions likely to affect a child conceived through incest. Children with serious disorders can be born to unrelated mates and children conceived through incest can be perfectly healthy. Because relatives already share some genetic material, there is a greater risk that incest will result in a child who has a rare genetic disorder carried as a recessive trait. Recessive traits may cause no symptoms at all in those that carry the genes, but when combined can result in seriously affected offspring. The closer the relationship of people in an incestuous relationship, the greater the risk that they both carry the same recessive genes; however, it is also possible that neither person is carrying any harmful genes in which case the child produced has no greater risk of disease or malformation than any other child.
Some congenital malformations are not the result of genetic diseases carried by the parents but rather result from a complex variety of causes which could include virus infections, genetic mutations, exposure to toxins, abnormal division of cells, age of parents, and physical causes. None of these would be affected by incest.
Sincerely,
Dr. Warren
Thankyou.
-DM
Dear DM: Lactose intolerance is caused by an inability to fully digest lactose, the sugar in milk. It can cause gas pains, diarrhea, and increased spitting. It is not an allergy and does not affect the skin. It may be worth trying your son on a lactose free formula.
Your son could have some gastroesophageal reflux. Whether or not to go for further evaluation depends on how well he is growing and how much discomfort he has. All babies have some degree of reflux and spit up. If your son is gaining and growing well he must be retaining an adequate amount.
Some infants prefer solids over formula. It's unusual at 5 months, but as long as your son is growing well and his diet has adequate nutrients, that's not a problem.
Sincerely,
Dr. Warren
Thanks.
-Concerned Parents
Dear Concerned Parents: A normal blood test doesn't tell you much. There are many blood tests one could run, and since I don't know what test was normal, I don't know what conditions your doctor feels have been ruled out. Infants should not lose weight. Continued weight loss should be taken seriously and be reevaluated.
Many infants have a drop off in appetite between the first and second year because of the normally slower growth rate. Sometimes the decrease in appetite may be initiated by an illness and may even result in some temporary weight loss. Some infants who are overweight and overfed may have a significant change in their growth curve.
Your expectations of what your child needs to eat may be exaggerated because he had a large appetite previously. Many children who "don't eat" their meals manage to consume a reasonable number of nutritious calories during the day on snacks. I would suggest that you keep a written log of what your baby actually eats for a few weeks and then make a follow up appointment with the baby's pediatrician to review the baby's diet and check his weight. Review your son's growth curve with the doctor so he can show you if your son's growth is following the curve properly. If there is indeed a problem, at that point further evaluation should be started.
Sincerely,
Dr. Warren
-Davy
Dear Davy: If the parents' blood types have been accurately determined to be O+ and O-, and there isn't some other unusual genetic condition in which one of the parents actually have the genes for A blood type, their baby would have to be O- or O+.
Sincerely,
Dr. Warren
-EH
Dear EH: Rashes are best diagnosed by seeing them. Yeast infections in the skin cause red bumps, not whiteheads, but any rash could become raw and open from scratching and end up burning when hit by urine. If the rash persists or keeps recurring, your daughter will need to see her pediatrician.
Sincerely,
Dr. Warren
-VC
Dear VC: Any color of yellow, brown, and green is okay for stool. The Zantac has probably made the transit time of stool through the intestines a bit faster resulting in the bile pigment being more visible. This is not a cause for concern if your baby is otherwise doing well.
Sincerely,
Dr. Warren
-SS
Dear SS: Most nursing newborns should nurse about every 2 to 3 hours. Formula fed infants should feed every 2½ to 4 hours. Average feedings are 2 to 4 ounces. There's considerable variation. I've seen fat little babies consuming the smallest amount and skinny little babies eating the most.
Sincerely,
Dr. Warren
I apologize for bothering you, but my family also has a number of women who are nurses and each of them know everything, and will also be very circumspect about what is going on so as not to worry the rest of us. I am not a nurse, so have no idea of what this (the bleeding) might mean for the baby. As I am concerned, I was hoping for some information that might help me understand the problems. As I stated, this is for myself. The baby is being cared for and the mother will be cared for by her immediate family. I have no idea if this is something that with proper immediate care, will be corrected, or is this is life threatening, or what.
Thank you for your time.
-SL
Dear SL: I wish I could be more help to you, but I'm working with very little information. You are most likely talking about an intraventricular hemorrhage (IVH). The degree of neurological injury and the risk of hydrocephalus requiring placement of a shunt is proportional to the amount of hemorrhage. Infants do recover from IVH, so your prayers are not in vain. If you are talking about hemorrhage that resulted from birth trauma or clotting abnormalities in the infant, a lot depends on the size and location of the bleed. Since the infant's fontanel and suture lines between skull bones are open, a hematoma could be evacuated surgically without significant damage being done.
Sincerely,
Dr. Warren
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