1 February 1999
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.
-Lissette
Dear Lissette: At 3-1/2 months of age your baby has not yet established a mature sleeping pattern. Even though he is not sleeping through the night, he will get the sleep he needs at other times. There is no need to be concerned that he will suffer any ill effects from inadequate sleep. Your only concern in this instance is whether there is a problem disturbing your infant's sleep or whether this is just a result of not having learned good sleep habits, perhaps aggravated by the huge appetite necessary to sustain his rapid growth rate.
If your baby seems to be uncomfortable both day and night formula intolerance may be an issue. In that case, rather than trying a soy formula, I recommend trying a hypoallergenic formula such as Alimentum or Nutramigen.
You may simply have a colicky baby. Colic is no picnic for parents, but it generally improves around 4 months of age. For information about a device that can help extremely colicky babies check the following Web site:
This advice assume that your baby has been found to be in good health by your pediatrician. If you are convinced that your baby is uncomfortable with abdominal pains or that his sleep is disturbed by digestive problems, you might wish to consider evaluation by a pediatric gastroenterologist.
Sincerely,
Dr. Warren
-FB
Dear FB: Newborns have a shallow hip socket. Some newborns have such a shallow socket that the thigh bone pops out of the socket easily. Since the large muscles of the thigh pull the thigh bone upward, if the thigh bone isn't kept in the socket a false socket develops higher up. This can result in an arthritic hip. If the thigh bone is kept in the socket, the socket grows around the thigh bone. As the socket grows and becomes less shallow, the hip is no longer dislocatable and the condition is cured. Early detection ad treatment of dislocatable hips in newborns results in complete cure without complications. The Pavlik brace holds the thigh bone properly in the hip socket so that the socket develops normally. If the brace fits properly you should not feel or hear the thigh bone popping in and out of the hip socket since the brace should be maintaining the bone in the socket. You should have your orthopedist check the baby with the brace on to be sure it is adjusted properly and that you know how to put it on correctly.
Sincerely,
Dr. Warren
-S
Dear S: I am curious regarding how you can tell that your 3 month old has a scratchy throat. If your child has some minor cold symptoms, I would not give him any medication. Colds go away on their own. The presence of a symptom is not a reason to medicate since all medicines, including OTC medicines, have side effects. Keep in mind that cold medicines and scratchy throat medicines relieve symptoms, but don't cure anything. They are not essential medications and should only be used when the symptoms are bothersome.
Sincerely,
Dr. Warren
He developed crying spells and on the 2nd day home, we of course panicked and contacted the Ped. After being examined nothing was found to be unusual. He continued "random" crying periods and after a week of my wife repeatedly concerned and calling his office, our Ped advised us to switch formulas (our son was 9 days old when we switched to the Soy).
He described our son as being a "bit colicky". We were feeding him Enfamil and was suggested a Soy formula, namely Isomil.. As you probably already know, the switch to Soy has provided absolutely no positive response whatsoever.
My concern is 1) we switched to the Soy product to quickly and 2) having our son remain on it. I feel as if the Ped suggested doing so as a result of the numerous telephone calls placed to his office by my wife. More or less a means of showing two nervous parents that "he was doing something"
The birth mom had numerous other children none that were allergic to milk and all used Enfamil. Our son has extreme bouts with gas and appears uncomfortable and in agony most of the the time. Prior to switching the formula, he did not appear to have a fraction of the gas he currently experiences.
Our Ped informs us that we can stay with the Soy or switch back to Enfamil. It is our call. We are told the formulas both do the same thing, and the Soy will not negatively effect our son. I would like to switch from the Soy product if we can not expect any results that are positive from Soy.
I am interested in learning your opinion on the above and will anxiously look forward to your response.
-Dan
Dear Dan: Sometimes telling the difference between normal crying and discomfort in a baby is a matter of degree. All babies cry and have fussy periods, but most are not described being in agony or crying all the time. If that is truly the case, trying something that will hopefully make a difference is quite reasonable. Many colicky babies try a number of different formulas. Some get great relief from the formula change and others do not.
Soy is a perfectly healthy formula to grow on, and is useful for babies who are lactose intolerant or sensitive to cow's milk proteins. Soy is, itself, a potent allergen. An allergic child may have as much difficulty with soy as milk based formulas. For that reason, if I'm going to try a formula change, I usually try a hypoallergenic formula such as Nutramigen or Alimentum.
At this time, you could switch your son back to Enfamil. If you find he is worse when you make the switch, you can always backtrack. If you really feel that your son's crying is extreme and the result of gas pains, it would be worth trying a hypoallergenic formula first.
Sincerely,
Dr. Warren
Thankyou for your advice
-Mr. & Mrs. A
Dear Mr. & Mrs. A: A woman is most fertile around ovulation. Ovulation occurs regularly 2 weeks before menstruation. If someone has a 4 week cycle, her fertile period is 2 weeks after her last menstruation began. If someone has a 5 week cycle, her fertile period is 3 weeks after the start of her last menstruation. If a woman's cycle is 3 weeks, ovulation would occur 1 week after her period began. If she menstruates for a week, she will be ovulating, and therefore fertile, just at the end of menstruation. If her cycle should be even shorter, she could ovulate during menstruation. Keep in mind that you never know the actual length of a cycle until the next period begins.
Sincerely,
Dr. Warren
Thanks much!
-SM
Dear SM: Since I'm not an oncologist, I'm not familiar with the latest treatments, and therefore, I'm not sure what the nature of radium treatments is. If your father is receiving treatments that involve exposure to any kind of radiation, it is perfectly safe to be near him after a treatment. If he has radioactive material implanted or concentrated in a particular part of his body, being with him is safe, but close and prolonged exposure to the area that has the radioactivity may not be.
For example, a father of one of my patients is being treated for prostate cancer with radioactive implants, and he has been told not to have his daughter sit on his lap. Your father should check with his oncologist for specific restrictions associated with his treatment.
Sincerely,
Dr. Warren
She has been a very healthy child until August when we enrolled in preschool. Every bug imaginable finds its way into our home. But no other children at the preschool has been sick this past week. Could you tell me what could possibly be going on here?
My regular pediatrician is too busy to see her today. But I have an appointment tomorrow.
-DER
Dear DER: A person could have intermittent vomiting with an intestinal virus which could persist for the length of time you describe. It would be a bit unusual for this to occur mostly during sleep. The absence of diarrhea makes the diagnosis of intestinal virus a bit less likely.
Your daughter could have gastroesophageal reflux which is aggravated by lying down. She may be waking with esophageal pain when stomach contents come up into her esophagus, vomit from the reflux, and then go back to sleep until the next time the reflux occurs.
If your daughter has a post nasal drip that might upset her stomach when she is lying down, but the vomiting would most likely result from severe coughing. If she is not coughing, this possibility is unlikely.
Sincerely,
Dr. Warren
I am worried because someone at work mentioned a tick bite. It's been so cold I can't imagine there are still ticks, but we do bring wood in from the outside now (and we have a dog).
I have cleaned it with hydrogen peroxide and covered it with a bandaid. What do you think?
Thank you so much.
-BB
Dear BB: It is highly unlikely that a tick would attach to the bottom of the foot since the tick must stay attached for a while to feed and the bottom of the foot is callused making it a poor site for a tick to attach. From your description, I would think more of a plantar wart, but since I haven't seen it, I can't possibly know what it is.
I am concerned about your description of a red line coming form the "boo-boo" since this is what we see with lymphangitis. Lymphangitis, which is also known as blood poisoning, is the spread of infection up the lymphatics. It requires antibiotic treatment. Even though you say the lump is not red, you could be describing an abscess or a foreign body (splinter, piece of glass) in the foot.
If the area is infected it requires treatment. I would suggest seeing your pediatrician.
Sincerely,
Dr. Warren
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