7 June 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
Thanks
-Dawn
Dear Dawn: If your baby spent a lot of time awake and suddenly started to sleep a lot, it could be a sign of illness, but some babies normally sleep a lot. Normal newborns can sleep as little as 12 hours a day and as much as 22 hours a day. If your infant is alert and vigorous when he is awake and is feeding well and gaining well, you need not worry.
Sincerely,
Dr. Warren
-Concerned Father
Dear Concerned Father: If your daughter currently has middle ear fluid or an ear infection, she could have a conductive hearing loss from the fluid or pus in the middle ear. This will resolve when the fluid or infection clears up. If this is not the case, your daughter should have a complete audiogram (hearing test) performed in a sound proof room by an audiologist. This will clarify the nature of the hearing loss. With that information you can consult an ENT doctor to determine what treatments are available. If your daughter has a sensorineural hearing loss in one ear, she may require a hearing aid.
Sincerely,
Dr. Warren
-AB
Dear AB: By the time a child reaches 4-1/2 and still refuses to have a bowel movement on a toilet, it is difficult and exasperating, but not impossible. It is crucial to keep your son's stool soft at all times. If he is fearful about sitting on the bowl, try to get him to do it with his pants on. Since most BM's occur after a large meal, see if you can get him to sit on the bowl after every meal. Even if you succeed in getting him to poop in his diaper while sitting on the bowl that brings you one step closer to getting him to go into the bowl. Take it slow. Allow him to succeed for a while at any little step that brings him closer to your goal before you try to take a step closer. Read my articles Potty Training and Fecal Soiling.
Sincerely,
Dr. Warren
After reading the information on the internet it seems that there is no real treatment. I am brushing and scraping my tongue constantly and it seems to help some, but then the coating reappears after a couple of hours. As a person often in the public eye this is disturbing to me when I speak to people. I am interested to know if there is anything else I can do to help other than what has been done. It would seem that eliminating stress might help though that might be a problem for me.
The information provided by my doctor about geographic tongue included mention of a vitamin deficiency (she suggested vitamin C), however after reading I discovered that B-12, iron, and others were the possible deficiencies as well. Would specific type of suppliments help?
Finally, I am concerned about the spread of this disease to others. Is it in anyway contageous?
Thank you for taking time to read this. Please respond to this address, however it is my brother's e-mail address and screen name. Please make sure to mark the e-mail for me. Your comments are appreciated.
Thanks!
-Jeff
Dear Jeff: Geographic Tongue, also known as Benign Migratory Glossitis, is not caused by a vitamin deficiency; however, if your diet is not well balanced, a multivitamin supplement wouldn't hurt. Geographic Tongue is actually considered a variant of normal, and to the best of my knowledge, there is no treatment. I have had it myself as long as I can remember, and other than the fact that my tongue sometimes feels inflamed, it presents no problem. Even though you are self conscious about it, I assure you that it isn't that visible. I spend a lot of time face to face with people, and nobody has ever commented on my tongue. And since little kids often speak their minds freely, I'm sure one of my little patients would have asked about my tongue by now if it were obvious to others.
Sincerely,
Dr. Warren
I spoke to my doctor about a possible allergy to milk...she doesn't seem to think that could be. I have changed his formula to soy on my own because I feel it's worth a try. She has put him on one more ten day dose of "stronger" antibiotics, and she said this is the last shot before tubes. Please help...could it be an allergy.
Thank You for your help
-TG
Dear TG: Allergy of any sort can contribute to ear infections. I am not a big believer that milk allergy is a major cause of ear infections, but considering the timing of your son's ear infections after he was weaned from your breast it is certainly reasonable to consider milk allergy as a possible contributing factor toward his ear infections. If you would like to read some of my previous discussions of this subject you can find letters to Dr. Warren regarding ear infections and milk allergy at
You should also read my article, Another Ear Infection!?!
Sincerely,
Dr. Warren
I have read and heard a hungry child will eat. She seems to defy this statement.
Help! any suggestions are appreciated.
Thanks,
-TR
Dear TR: It is true that a "hungry child" will eat anything, but your daughter did not develop her attitudes toward food while she was hungry. She has never known real deprivation, and it would be unreasonable to let her know it to change her attitude.Meat is an excellent nutrient, but it is far overrated in the American diet. Dairy, meaning milk and yogurt, provides the same complete, high quality protein that meat provides. The apple juice, grapes, and Cheerios provide many of the nutrients found in other fruits and in vegetables. Nutrition doesn't have to happen three meals a day. It has to happen over an average. Young children can certainly manage on one good meal a day.
I agree with the idea of setting a time limit for meals. I also agree with the idea that Mom isn't a short order cook preparing multiple meals until she finds something baby is willing to eat. And if baby's behavior disrupts a meal, for example throwing food, I agree with ending the meal and letting the child go without. But good eating habits never develop from a battle of wills, and most of these battles result from parental misunderstanding of what constitutes satisfactory nutrition.
If a child eats good foods like milk and yogurt, those should continue to be offered as the mainstay of the child's diet. A variety of other foods should continue to be offered in a pleasant, pressure free setting. A vitamin supplement or supplement like Pediasure can help to balance the nutritional content of the meal. Cutting down on the amount of fluid intake including milk may help to increase your daughter's appetite for solids, but since milk is an excellent source of nutrition, it shouldn't be eliminated.
Please read my article, Nutrition Without Tears.
Sincerely,
Dr. Warren
Any advice would be most welcome.
Regards
-JP
Dear JP: Impetigo is a superficial skin infection caused by Staph or Strep. These organisms can easily enter the skin through microscopic injuries. The organisms can be carried in the nose or throat of people or even animals who are asymptomatic. Two episodes of impetigo in an otherwise healthy 23 month old does not indicate an increased susceptibility; however, if it continues to recur, you will need to look for possible sources of the organisms and discuss antibacterial cleansers for your son's skin with his doctor.
Sincerely,
Dr. Warren
Thanks a lot,
-Scott
Dear Scott: The pigment that makes eyes blue or brown or any other shade is the same. The thing that makes the eye a certain color is how deep in the iris the pigment is. All babies are born with slate gray eyes. If the melanin (the brown pigment) increases on the surface the eyes turn brown. If the pigment migrates to a deeper layer, the eyes become blue or gray.
Sincerely,
Dr. Warren
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