2 March 1998
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
-E
Dear E: It is normal for testicles to be retractile, meaning to pull out of the way in response to local stimulation such as cleaning or removing the diaper. When your son is warm and relaxed and nothing is touching him near his testicles, they should hang freely in his scrotum. If the scrotum is small and flat and the testicles almost never appear to be in the scrotum your son should be checked by your pediatrician to make sure that the testicles are adequately descended. If they are not, you will need to consult a pediatric surgeon or pediatric urologist.
Sincerely,
Dr. Warren
-SR
Dear SR: Even though most 8 week olds have more predictable and organized sleep patterns than newborns, they may also be much more awake and responsive to outside stimulation than newborns. Some newborns sleep as much as 22 hours a day, being awake only for feedings. By 8 weeks few infants sleep more than 12 to 16 hours a day, and they don't always go right to sleep after a feeding. This can mean that if you put your baby into the crib thinking he is asleep and he is not in a deep sleep, the change in his position and the absence of your warmth and rhythmic heartbeat and breathing may wake him. It isn't necessary to pick him up just because he cries as he may cry briefly and then fall back asleep, but you shouldn't leave him to scream until he falls asleep exhausted. If he's really awake you should try to comfort him back to sleep. At 8 weeks, it may be too early for some babies to sleep more than 4 hours, even at night. Sometimes taking turns can help you get some sleep.
By 4 months of age you should start trying to put your infant into his crib awake and help him to fall asleep in the crib so that he gets used to sleeping there. Once you have established going to sleep in a crib you should gradually decrease the amount of intervention used to get the baby to sleep.
The only way Isomil is closer to breast milk than Similac is that it has no cow's milk protein in it. In fact it has no milk protein or milk sugar in it, which makes it quite unlike human milk. Some children who have trouble with cow's milk do quite well on soy. It is a perfectly nutritious formula to grow on. Soy is not hypoallergenic. Infants who are severely allergic should be put on protein hydrolysate formulas like Alimentum or Nutramigen rather than soy. Healthy children should not be put on soy instead of cow's milk formula as a matter of course, but there is nothing wrong with being on a soy formula. If your baby is doing well on soy you can feel satisfied that you're giving him a safe, nutritious formula.
Sincerely,
Dr. Warren
-no name please!
Dear No Name: The blockage to your granddaughter's kidney should not be effecting her color or her health or she would require emergency treatment. As to your grandchild's color, even though color is genetic their may be recessive genes in the family which combine to cause dark skin. There may be non-genetic factors affecting the baby's color such as the effect of her mother's hormones during the pregnancy and how high the baby's blood count is. In any event, you should be not looking to do or suggest anything. If you raise a suspicion that your grandchild isn't really your grandchild and you're wrong, you risk alienating both your son and your daughter-in-law. Even if you're right, you may be stepping into something that your son would rather you'd left alone. Your son is an adult. Leave it to him to figure out if he has any doubts about his wife.
Sincerely,
Dr. Warren
-Tyler
Dear Tyler: I'm not sure if you were looking to speak to a podiatrist (foot doctor), but as a pediatrician (kids' doctor) I can't think of any reason your hands would sweat when your shoes are on and stay dry when they're off. You might try powdering your feet and hands and make sure you're wearing light shoes and socks. If that doesn't help you might consult your doctor or a dermatologist about a medication called Drysol.
Sincerely,
Dr. Warren
-LS
Dear LS: Newborns may develop an acne type rash from activation of their oil glands caused by intrauterine exposure to their mother's female hormones. This rash is generally not present at birth, but develops later on. It usually clears up within a few months and requires no treatment unless it is severely inflamed, in which case you should see her pediatrician.
Sincerely,
Dr. Warren
-GW
Dear GW: We often assume, when children are intelligent and understand the words we speak, that they understand our logic, but the truth is that fantasy and fear and a child's unsophisticated understanding of the world make it impossible for children to speak the same language as adults. Now consider that rationale adults cannot simply dispose of a fear because it is illogical. People, adults and children, who have phobias have an intense autonomic nervous system reaction to the things they fear that is beyond their control and beyond logic. That is not to say that they can't overcome their fears, but it takes time, effort, and experience with the feared object. Logic plays very little role in the process except for the most cerebral of people.
Fear serves a purpose in self preservation. Unfortunately, your son's nervous system is tuned just a little too high with regard to his fear response. But while that may be a problem, the absence of fear in a child can cause just as many problems. Your son's reaction to the noise has generalized by becoming a fear of situations where the noise might occur. To treat it requires going back to dealing with the noise. Perhaps you could get a video tape of some fireworks and let him control the volume so that he can gradually adjust to the noise.
In any event, there are so many things that happen at Disney Land that I would think you could find things to do without his being in a situation he fears. Rather than being tempted to push him into things, the best thing would be to show him that you are there to protect him. If necessary, get him a radio or tape player with a good set of headphones that will block out some of the noises he fears.
If there are so many things he would fear at Disney Land that you cannot take such a trip, you might want to consider seeking the help of a child psychologist.
Sincerely,
Dr. Warren
-BF
Dear BF: Some people simply have nosebleeds much more easily than others. Often, the first bleed can lead to others because children find the clot annoying and pick at it. Even when children don't pick at the clot, the clot may get knocked free from activity.
If your child is prone to nosebleeds you can help to decrease their frequency by making sure the air in his environment isn't too dry. This means using a humidifier during the winter, especially when the heat is on. Children have nose bleeds more easily when they have colds. A thin layer of Vaseline inside the nostril to keep it lubricated may help to avoid some of these nosebleeds.
Sincerely,
Dr. Warren
-MF
Dear MF: Three year olds can get yeast infections of the skin in the genital area, but they don't get vaginal yeast infections. There is no association between yeast rashes and urinary tract infections.
Kidney infections can cause back pain, but those would generally cause fever. There might also be associated bladder symptoms such as urinary frequency, burning, and incontinence.
Back pain, fatigue, and malaise may be nonspecific symptoms of a virus infection. There is nothing about your story that makes me think your daughter necessarily has a kidney infection, but if she seems sick, you should make an appointment to have her seen.
Sincerely,
Dr. Warren
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