5 December 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
-SP
Dear SP: Hand, foot, and mouth disease is caused by coxsackie virus. There is no specific treatment for the illness. Children sick with this infection can be treated with Tylenol or ibuprofen for fever and discomfort. If the sore throat is severe the child can suck on ices or ice pops for fluids. The illness will run it's course within a week.
Sincerely,
Dr. Warren
Thank you.
-Kim
Dear Kim: Estrogen creams can be applied for up to 2 weeks for treatment of labial adhesions in infants. The estrogen cream is used because it often successfully opens the adhesions and is safe in short courses. Prolonged use can be irritating to the baby's vaginal area and may allow enough absorption of estrogen to cause breast enlargement.
In cases where the adhesions don't open completely or recur, I recommend treating for 2 weeks followed by a 2 week break in which just Vaseline is applied with light pressure, followed by another course of the estrogen cream. Situations where the adhesions are thick or result in complete fusion sufficient to obstruct urine flow are uncommon. For that reason, if there is sufficient opening and an infant has repeated adhesions, I leave them alone. Just as the estrogen cream opens the adhesions, so will the hormones associated with puberty open the adhesions, therefore, a thin membranous adhesion will not result in future sexual dysfunction.
Thick adhesions which don't resolve with treatment require treatment by a urologist.
Sincerely,
Dr. Warren
I am writing to you because she is now refusing to drink the formula. I have tried getting faster nipples for existing bottles with no success. Recently I switched nipples. After trying two different Gerber nipples and the standard playtex she finally accepted the playtex orthodonic version for 3 days. Now she is refusing that as well. She begins to cry right from the start of the feeding during the day. I have had moderate success feeding her at night when she wakes up to be fed. I am wondering if it is the formula or some other problem. Her crying seems to be picking up as well. I also thought it might be that she was using her pacifier too much, so tried to withhold that as much as possible and it doesn't seem to make a difference.
My questions are 1) Should I try a different formula?---My mother is suggesting goat's milk, is that an option? 2) I have already tried various nipples, should I keep searching, stick to the playtex, or go back to the original avent bottles? 3) What do you think is going on? I am really worried. At her 8 week examination she was in the 25% for height and weight. The doctor said that was o.k. At that time we weren't experiencing this problem. I called the doctor about this, but so far the only advice I'm getting is too keep trying the Alimentum and to hang in there. Please give me any information you think may help....
Thank You.
-SK
Dear SK: Any chance you could resume nursing, or have you lost your milk? Continued nursing and working with your diet would have been my first choice.
If your baby is allergic to cow's milk, she may tolerate goat's milk, but we feed infants formula instead of regular cow's milk, because cow's milk does not have the optimal mix of nutrients for human babies. The same would apply to goat's milk. I'm not aware of a formula made from goat's milk.
Since your baby is willing to suck on a pacifier, it seems unlikely that the nipple is causing her to refuse feedings. You could try a different formula. I have on occasion had a patient who fed poorly on one formula but took another better; however, the screaming suggests some discomfort. Hunger is a pretty strong drive. If every attempt at feeding your infant results in refusal and crying, perhaps she should be evaluated by a pediatric gastroenterologist t make sure she isn't having pain from GE reflux.
Sincerely,
Dr. Warren
-Jenn
Dear Jenn: The mood swings you are experiencing are the result of physiologic changes that occur in your body associated with your menstrual cycle. Of course you can try to combat the feelings using meditation, relaxation, or self hypnosis, but these moods come from deep within your body and are not the result of your interaction with the outside world, even though they affect your relationship with the world. You really should see your gynecologist for a complete physical to be sure that you are not suffering as a result of any hormone imbalance. If everything is okay, then you need to discuss your options in terms of medical treatment.
Sincerely,
Dr. Warren
-Chris
Dear Chris: Even though you have a family history of Raynaud's phenomenon, given your degree of symptoms and your age, if you haven't had a full physical recently, you should. If everything is okay, your doctor can prescribe Drysol for you to put on your palms to control the sweating (I presume that's what you mean by clammy).
Sincerely,
Dr. Warren
-DV
Dear DV: You've asked for a whole chapter or several chapters of a book. I cannot answer such a large question. Fortunately you can find many of the answers you're looking for at the Parents' Place web site.
The common illnesses of that age are basically the same for most of pediatrics - upper respiratory infections (including sore throats and ear infections), gastroenteritis, fevers, rashes, asthma.
Sincerely,
Dr. Warren
Our problem is that it has been one month and his diarrhea hasn't been cured. Doctors tried the cause of being Lactose Intolerate but to no avail. Gave us some medicine ( flagyl, pediachlor fre??? forgot this one ) but still none worked like a charm.
We had his stool examined 2 weeks ago and they found traces of Amoeba in it (0 /1) no pus cells = 0 /2 . and bacteria = many. The other day we gave another stool sample to the doctor now amoeba was gone and also the parasites. Bacteria was many but now it drops to a mediun range. But now they found that his stool ahs mocous in it. We are really confused, usually when a baby has amoeba they would be in a weak stage. But he is as active as before. Nothing has changed and he keeps on gaining weight.
We need your advise on this. Our doctor said to confine him but we need some second thoughts ( it may be teething or something else )
Please...
Thanks.
-NEL
Dear NEL: Amebic infections are fairly uncommon in the USA, especially in 5 month olds. If you are writing from another country, I would still wonder how a 5 month old contracted an ameba. Does someone in the family have it? Since one test was positive, one negative test is not sufficient to be sure the ameba is gone, but only your doctor is in a position to determine if your child's condition warrants repeating the test.
How much diarrhea is your son having? Is he running fever, having pain, losing his appetite, losing weight or gaining poorly? All these questions must be answered to decide how far to go in evaluating your son. If your doctor feels that your son has no infection, and if the persisting symptoms are severe, then you should consult a gastroenterologist.
Sincerely,
Dr. Warren
Is there anything I can do to fix the problem????
Please help.
-SS
Dear SS: The underside of the glans penis, the V shaped area where the foreskin attaches to the head of the penis, is rich in nerve endings. These are generally more sensitive in uncircumcised men since the area is protected and lubricated by the foreskin. The area becomes somewhat desensitized in circumcised men. Touching that area should generally result in intense sensations, however, the sensation should be one of pleasure and excitement, not pain.
If the head of your penis sticks out beyond the foreskin when you have an erection that is normal; however, the skin is generally pliable enough to pull back over the head of the penis even if the foreskin is relatively short. If your foreskin is tight so that it constricts the head of your penis when you have an erection and that is the reason you cannot pull the foreskin back over the head of your penis, that certainly could cause pain and should probably be evaluated by a urologist. A tight foreskin does not require a circumcision. A ventral slit should be sufficient to solve the problem.
Sincerely,
Dr. Warren
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