11 August 1997
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 physician who knows you and cares about you.
Dr. Warren
Thank you for your time,
-DS
Dear DS: The most common causes of children fainting is the onset of an illness. Faintness can also commonly occur when a child is standing still for a long time combined with being overheated. Stress or emotion can also result in fainting. Hypoglycemia (low blood sugar) could cause faintness. It is possible for the blood sugar to return to normal by the time the blood test is done. Further evaluation, should this recur, may require a fasting blood sugar level or even a glucose tolerance test. Recurrent fainting episodes also require evaluation for cardiac and neurological causes.
87/50 is a normal blood pressure for a small child even though it might be low for an adult.
Sincerely,
Dr. Warren
-JL
Dear JL: When an infant keeps his head turned toward one side and holds his head tilted, it usually means that one of the neck muscles is tight. In extreme situations physical therapy may be necessary. In mild cases it may help for the parents to stretch the neck muscle by rotating the head fully to the less used side with each diaper change. This should be done with gentle, slow, steady pressure rather than jerking the head to the side which may cause pain. It may also help to alternate the infant's position in the crib so that he would have to turn his head the other way to see what he prefers to look at.
A less common cause of a head tilt is related to a muscle imbalance in the eyes. If there is no tightness in the neck or the tilt persists an ophthalmologic exam may be necessary.
Sincerely,
Dr. Warren
-LHS
Dear LHS: The most crucial questions about leg pains in children are,
Sincerely,
Dr. Warren
Your expertise would be greatly appreciated by both mom and Rebecca.
Thank you for your time!
-Rebecca's Mom
Dear Rebecca's Mom: The condition you are describing is called "labial adhesions." I am not aware of any association with diapers or the expectation that the condition should resolve with the elimination of diapers. Premarin cream, which is an estrogen cream, can be used to clear the adhesions. It does cause some irritation, so generally it is best to use it for just two weeks. If a longer course of treatment is needed I recommend a two week break followed by resumption of the treatment for two weeks. Clearing the adhesions with Premarin will not prevent their recurrence. If girls keep having recurrences of labial adhesions they can be left alone as long as they are not obstructing urine flow or they're not thick adhesions.
Since your daughter's vaginal area gets sore, it is not that surprising that the raw tissue sticks together and forms new adhesions. The best way to resolve this is for her to take sitz baths (put her bottom in warm water without soap for 10 to 15 minutes) three or four times per day. She should also apply a liberal amount of Vaseline or A&D ointment. She should do this herself so that she can make sure she gets the ointment into the introitus (between the labia) without any discomfort.
Once your daughter reaches puberty, her own hormones will prevent the adhesions form forming.
Sincerely,
Dr. Warren
Thank you for your time,
-LO
Dear LO: Many children are dry at night by 3-1/2 years of age; however, staying dry at night is a matter of central nervous system maturity. Bed wetting generally occurs while the child is asleep and is not under his voluntary control. If your child accepts pull-ups as a way to keep his bed dry, for now it is okay to continue them. Just tell him that if he wakes up and has to urinate, he should go to the bathroom or call for help rather than wetting himself. If he wets the bed without pull ups, he will simply wake up wet and uncomfortable, and his wet bed will probably aggravate you. But he will most likely not wake up until after he wets, so it won't train him. By 5 or 6 years of age, if your child is still wetting you should discuss treatment options with your doctor.
Light hair may remain light forever. Many children who have light hair have significant darkening of their hair by adolescence.
Sincerely,
Dr. Warren
- Sincerely,
Ms. E
Dear Ms. E: Children are born with different personalities and some of them can be difficult. Hopefully, these personality traits translate into positive attributes as children get older. The child who demands her way may have what it takes to be President.
Your child's persistence is not only a matter of will, but a matter of expression. Even though it doesn't get her what she wants, she is giving vent to her emotions. In a way, her carrying on makes her feel better.
It is laudable for a parent to want her children to be happy. Unfortunately, you can't will it, and you can't make her happy by giving her her way. She needs the reassurance that someone is in control, but control does not mean strict military order. While parents should never run their lives around the possibility of their children's tantrums, they should use all their wit and intelligence to control and avoid unnecessary tantrums. Children need to learn what they can't touch and can't do, but when every minute is "NO!!!" children don't have an opportunity to learn what they can and should do or to make a value judgment about which "No's" are important. When a child has only a few rules to follow, and those rules are enforced consistently, they can learn the rules more easily and succeed at pleasing their parents. If there are things that regularly become an issue between you and your daughter, it is worth your while to figure out what temptations can be removed from her path, what distractions and substitutions can dissuade her from her single-mindedness, what minor issues can be ignored for now, and what issues are important enough to enforce firmly, quickly, and consistently.
Sincerely,
Dr. Warren
- Sincerely Yours,
............Navybird
Dear Navybird: I am not aware of race being defined as a matter of law. I would hope it never comes to that in this country. The only place I can think that might provide that information is the census bureau. See if they have an answer.
Sincerely,
Dr. Warren
My 5 yr. old son always has nasal congestion since age 2. With a flashlight, I was able to see the air-way opening is completely blocked most of the time. In his sleep, he had hard time breathing and snores very loud. He is constantly developing bronchitis as well.
On top of the above, he was having an accute Asthma attack last year (May/96).
Please advise. We deeply appreciate it.
Best Regards,
-LM
Dear LM: The subject line of your e-mail said nasal polyps, but you e-mail didn't discuss nasal polyps. When you look inside the nose you are seeing nasal tissue known as nasal turbinates. If a person has allergies the turbinates can become quite swollen. When somebody's nose is stuffed, it isn't only because of mucus. Colds and allergies cause swelling of the turbinates.
If your son's snoring is very loud, especially if there are times when he appears to stop breathing briefly, he should be evaluated by his pediatrician or an Ear, Nose, and Throat Surgeon to see if his adenoids and tonsils are obstructing his breathing.
A child with a history of asthma who has recurrent bouts of bronchitis probably needs better control of his asthma. He may need to go on asthma medicine at the start of a cold or stay on long-term asthma therapy depending on how often he has a problem.
The nasal symptoms and asthma symptoms could both be allergy related. Your son needs an allergy evaluation by an allergist with recommendations for avoiding allergens or administering desensitization therapy.
Sincerely,
Dr. Warren
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