19 July 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
I am a Mexican male. I have black hair and brown eyes. My parents are both Mexican and their parents before them. My wife is half Philipino and half white. She has brown hair and brown eyes. Her mom has dark skin and black hair and eyes. Her father has dark hair and brown eyes. Now my daughter has blonde hair (and I mean white blonde hair) blue eyes and ghostly white skin.
| More information: | My blood type is 0+ |
| My wife's blood type is AB+ | |
| My daughter's blood type is AB+ |
-FR
Dear FR: Since light hair an eyes are recessive genetic traits, it is possible that your family and your wife's family could be carrying these traits for generations without having any light haired or blue eyed family members. When you married, these recessive genes combined to produce a child with light hair and blue eyes.
Another possible explanation is that your daughter could be an albino. Even though she may have the genetic traits for dark hair and eyes, albinos don't produce pigment so that their skin is ghostly white as you described and their hair is white (not just gold blonde, but white).
The blood type is a bit more complex. If you are O+ and your wife is AB+, your child could be A+ or B+, but not AB+; however, since blood type information can easily be in error, you should not jump to any conclusions without having your blood type retested and consulting a genetic counselor.
Sincerely,
Dr. Warren
I have considered, ear infection, nightmares, teething, etc. but just can't pin point the cause or how to prevent it.
I am WORN OUT! Help! Thanks.
-Jennifer
There are many things that could cause a 10 month old to awaken at night - gas pains, teething, a cold, an ear infection. Generally these things should be somewhat evident during the day as well. If you have some reason to suspect a problem, have your son checked by his pediatrician.Even babies with good sleeping habits can learn bad habits very quickly. During a brief illness a baby can learn to depend on parental intervention to get him back to sleep. After that, the sleep disturbance may persist well beyond the original cause. At 10 months, many babies are experiencing separation anxiety, and so if they awaken even briefly, they may cry out. If your son has separation anxiety, he will probably cry during the day if you walk away form him, especially if you're out of his sight.
Did your child learn good sleep habits, or did you just get lucky in that he slept through the night once he was in the crib? If your baby was always asleep when you put him in his crib, he actually never learned to fall asleep on his own and you've just been lucky that his sleep has been undisturbed all this time.
There is nothing any parent can do to prevent a child from waking. If you can't find anything disturbing your son's sleep, the best you can do is to not try solutions to the sleep disturbance which will encourage the baby to continue demanding your intervention. Avoid feeding the baby or bringing him into your bed. If he cries out, you need not go to him immediately since he may fall back asleep. But if he is crying and not stopping, it is best to go to him and try the minimum intervention necessary. If you can calm him without taking him out of the crib that would be best. If you take him out, make it as brief as possible and keep trying to decrease your degree of intervention.
Dear Jennifer:
Sincerely,
Dr. Warren
-JLM
Dear JLM: The sleep habits of adolescents are related to social and psychological changes of growing up rather than biological. As children they always knew that night time was for adults. As they enter their teens and are allowed to stay up later they become aware of more adult entertainment on TV late at night and dance clubs and other social activities which don't begin until late and end late. At the same time, they discover that night time is their time since their working parents are often ready to go to sleep before they are. In addition, they tend to stay in bed when they have nothing to do, nothing to do being defined as their friends are not available. With few exceptions, things the family is doing or chores that you want done do NOT constitute something to do.
As their own life begins again to mirror the real world with family and job responsibilities, many will find more normal hours, but it is at this time when sleep habits become independent of parental regulation that some teens discover they are night people rather than morning people.
Sincerely,
Dr. Warren
These illnesses are mostly colds with coughs. We change the filter on our furnace frequently.
My three year old has recently begun complaining of stomach pain. She doesnt wince with gentle pressure on her abdomen. She is not in severe pain but this has gone on for a week, in conjuction with a cold. Hope you may have an answer for me. I searched your archives and didn't see anything similar. Hope I didn't overlook an answer.
Thank you for your valuable time.
-Concerned Mommy
Dear Concerned Mommy: I do remember some time ago hearing about people getting sick from the formaldehyde in foam insulation being piped into their walls, but I never heard of a "sick house syndrome". There are a number of reasons an environmental change may cause illness.
The first question I'm tempted to ask is why did you move? If you moved from a house to a trailer as temporary quarters because of construction or a fire, stress could play a role in the increased frequency of illness. Since the illnesses you are dealing with are mostly colds, you may be spreading more illness to each other because of the closeness of the quarters. If your trailer is more airtight than your prior living quarters, poor ventilation may play a role. If the heating method is different, dry air may contribute to respiratory problems. Even if your furnace has a clean filter, you must be sure that there are no fumes from it in your quarters.
Essentially, you want to evaluate your new environment for allergens and irritants like molds, gas leaks, or fumes, and any changes in your life style that may contribute to increased susceptibility to infections or spreading infections around.
Sincerely,
Dr. Warren
-SB
Dear SB: Most children who have inguinal (groin) hernias are born with them, but they may not become evident until later on. Hydrocoeles that develop after infancy are generally associated with hernias unless they are caused by infection or injury which is rare. The treatment for these hydrocoeles is surgical to repair the hydrocoele and the associated hernia.
Sincerely,
Dr. Warren
Thank you
-Concerned Parent
Dear Concerned Parent: The skull is made of multiple bones which fuse to form a solid piece. When a baby is first born, these bones are not fused allowing for the head to be somewhat compressed in order to fit through the birth canal. The anterior fontanel, also known as the soft spot, which is on the top of the head, is a diamond shaped opening where 4 bones come together. This fontanel closes between 10 and 16 months. There is a triangular posterior fontanel in the back of the head where 3 bones come together which is usually small and closes within the first few months. Most people are aware of the soft spot, but few parents are aware of the posterior fontanel, which is where I believe your son has a dent. Usually when the bones fuse the result is smooth, but I have seen indentations at the fontanels and bulges at the suture lines (immovable joints where skull bones come together). As long as the head grows normally, these are of no significance and do not cause problems down the road.
Sincerely,
Dr. Warren
Also, my son drinks nothing but water and juice...On special occasions I would like to give him soda. I drink diet coke. Will it hurt him to drink it. I know he is not on a "diet", but I really don't want him to have any extra sugar. Or, would a clear soda be better like Sprite or 7Up?
-TG
Dear TG: Meat is an excellent source of protein, but its protein is equaled by the protein in milk, yogurt, and eggs. Meat is way overrated in the American diet. A child can live very well without meat as long as he has other sources of protein. Read my article, Nutrition Without Tears for a full discussion. Soda is not harmful to children, but it has no nutritional value so you wouldn't want your son to drink a lot of soda and end up eating and drinking less nutritious foods because his belly is full of soda and gas. Diet soda with Nutrasweet is okay for an occasional treat. It doesn't matter if the soda is clear or a cola, but keep in mind that many colas and even some clear sodas have caffeine. Look for caffeine free soft drinks for your child.
Sincerely,
Dr. Warren
Now to my question. The doctor recommended switching formulas to a soy-based one and increasing juices (she hasn't had any yet) which could include orange juice. Any juice except apple juice was his recommendation. Now in my readings I haven't come across anything about soy-based formula used for constipation. Also, he prescribed a cream: nystatin-triamcinolone acetonide to put on her bottom to help heal it. I got the prescription and read all the stuff that came with it and am very hesitant to use it. He said it would also be good for a yeast infection. Now, why would this cream be prescribed for an infant with a sore/bleeding bottom due to passing hard stools? Can you give me some advice and let me know if my doctor is with it or not? Thanks.
-JW
Dear JW: It sounds like your daughter has an anal fissure from passing a constipated stool. There is no good reason to switch to a soy formula to manage this problem. The two most constipating foods are rice and bananas, so these should be avoided.
Fruit juice may help to soften the stool. Prune juice given regularly is an excellent stool softener. If the stool should become too soft, cut down the amount of prune juice slowly rather than eliminating it which could result in a return of the constipation. Pear juice is a reasonable alternative if your baby won't drink prune juice. Apple juice could also help and I have no idea why your doctor objects to it. My major objection to giving children any fruit juice in excess is that it cuts down on their formula intake and can cause diarrhea with nutrient malabsorption. If you give fruit juice to help with constipation, give the minimum amount that does the job.
Since I didn't see your baby's anus, I'm reluctant to suggest that your doctor is wrong about using an antifungal cream, but if your daughter had a hard painful stool with resultant bleeding from a fissure, it is unlikely that a yeast infection plays a role here. The triamcinolone is a steroid which is used to reduce inflammation. Anti-inflammatory steroids are sometimes used in anal preparations to aid healing of hemorrhoids and fissures, but generally, the management of an infant's fissure caused by constipation is to treat the constipation.
By the way, just in case you didn't know, your doctor's D.O. degree does not make him any less qualified than someone with an M.D. degree. My son's first pediatrician was a D.O. and was also the assistant director of the pediatric ICU where I went to medical school.
Sincerely,
Dr. Warren
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