8 November 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
My husband and parents tell me that is his security blanket and just let him do it - he will grow out of it. I have lots of friends with children his age and they occasionally pull the hair while being held but nothing near the extreme that he goes to.
Do you have any suggestions?
-AP
Dear AP: The wonder of children is that each is a human being with special likes and dislikes. Books can give you general ideas about child behaviors and age appropriate norms, but nobody but your son knows what makes your hair so special to him, and his knowledge on the subject is primitive and non-verbal. It is likely he will outgrow his attachment to your hair before he is ever able to think about it or discuss it rationally.
What you must realize, is that your son has focused on your hair as a special part of you. When he nuzzles in your hair he smells the special "Mommy's hair smell" and feels a closeness to you. If you cut of your hair and gave him a bunch of it, it would not meet his needs. With this understanding, you must decide what type of playing with your hair and how much is acceptable to you, keeping in mind that as he gets older you will try to decrease this behavior.
I do understand why you find your child's attachment to your hair annoying, but be careful not to deal with the problem in such a way as to make your child feel rejected or pushed away. In all likelihood, the day will come when you will miss his nuzzling in your hair and recognize the affection that is part of this annoying behavior which is unique to your child.
Sincerely,
Dr. Warren
-PH
Dear PH: I have mixed feelings about putting effort into changing your nephew's eating habits at this time. On the one hand, we cannot depend on growing up and maturity to make children develop appropriate social skills, and the lack of these skills may be an additional handicap for your nephew at a future date. On the other hand, a child with ADHD/ODD has more than enough behavioral issues to deal with each day, and I'm not sure breaking this habit is an important issue at this time. As parents, we must always choose our battles wisely, or be always battling.
Assuming that eating with his hands is a habit, and that daily attention to this habit will cause considerable mealtime stress, the boy's mother could make a few formal family dinners a month - everybody gets dressed up, your nephew participates in the preparations, your nephew gets to choose a special dish or dessert, an attempt is made to make these formal dinners a treat rather than a chore, and in honor of these occasions your nephew makes a concerted effort to use his utensils properly. The use of utensils should NOT be a discussion topic during these meals. All success should be rewarded with praise, even if the proper use of utensils is punctuated with lapses into finger picking. If this approach meets with success, it can be expanded to be more frequent or to include guests for dinner, or some other special kinds of dinner arrangements, not necessarily formal.
Sincerely,
Dr. Warren
-JRR
Dear JRR: The lack of protection should not have caused your girlfriend's labia to become swollen, but there are a few possible explanations.
It is generally advisable to use birth control pills for one full cycle before having unprotected sex.
Sincerely,
Dr. Warren
-Y
Dear Y: Congenital absence of a muscle is usually limited to one muscle, most commonly the sternal head of the pectoralis. As an isolated defect it has no special significance. The contour of the body is defined by the musculature over the bones. Absence of the pectoralis can significantly affect the appearance of the chest. Puberty has no bearing on the condition; however, with pubertal changes, both the musculature and the breast tissue may become more prominent, accentuating the asymmetry of the chest.
Sincerely,
Dr. Warren
Although a very happy girl, Brianna has had every kind of congestive nasal, URI, ear infection, etc. imaginable. My sister is understandably overly concerned, because she fears there may be something congenetive that she is unaware of. The pediatricians seem to just keep giving her more antibiotics and drugs. Is there anything else she could be doing? She has been sick throughout the winter; when I visited last month, she was so stuffed up, and when she sleeps, she breaths very heavily.
My sister lives in the Boston area. Perhaps you may have some suggestions as to where she could go to have other tests done which will put her mind to rest. I would really appreciate hearing from you, and I apologize if you have addressed this issue in any of your available articles. I guess we all consider our situations unique and of great importance. Thank you so much.
-CD
Dear CD: A death that remains a mystery has a way of haunting people, but because it is a mystery, there is no indication that it was related to any genetic condition which could have been passed down to your niece. Her problems are common childhood problems related to upper respiratory infections. They do not have anything to do with a condition that can cause an unexplained death with an enlarged heart.
If your niece remains chronically congested, a consultation with an ENT surgeon to evaluate her adenoids, tonsils, and middle ears may be warranted. An allergy evaluation may also be useful. You might find it useful to review my articles, Upper Respiratory Infections (URIs) and Another Ear Infection!?!.
I do not know any pediatricians in the Boston area, but Boston and Cambridge have many fine teaching hospitals including Boston Children's Hospital, so I'm sure your sister should be able to find well qualified specialists to evaluate her daughter.
Sincerely,
Dr. Warren
-Babu
Dear Babu: Many newborns have large amounts of body hair including on the forehead and ears. This will all come off. It is perfectly normal and nothing to worry about. I'm sure if it were anything unusual, the pediatrician who cared for her at birth would have told the parents. Since this hair will come off on its own, it is best not to try removing it since that might risk injury.
Sincerely,
Dr. Warren
I have a one year old with lung problems. She was affected with the RSV virus at 6 weeks old. She was hospitalized for 3 days. Ever since then she has constantly had a cough and breathing problems. My doctor has put her on a nebulizer and told me to hope she grows out of it. When she wakes in the morning her lungs are so junky but she seems ok through the day. Sometimes she gets this sound in her throat that sounds like she needs to clear her throat. My sister has commented on how horrible she sounds and says she sounds like she has CF. I surfed the net and was disappointed on the diagnosis aspect. Now I'm getting really worried that she may have it.
Thanks for a response.
-D
Dear D: The diagnosis of CF [cystic fibrosis] must be considered in a young infant who has persistent wheezing or recurrent pneumonia. RSV does not result in a permanent lung condition. On the other hand, your daughter could have asthma. This becomes even more likely if there is a family history of asthma. If your daughter's wheezing is not under good control with her current treatment regimen, you might want to consult a pediatric pulmonologist. If things are not that bad, at least you could ask your doctor to arrange for your daughter to have a sweat test to rule out CF. It's a fairly simple and painless procedure, and will put your mind at ease.
Sincerely,
Dr. Warren
Thank you for any advice you may be able to give me.
-Marg
Dear Marg: There is absolutely no harm to keeping a baby on formula past one year, but it is expensive and not nutritionally necessary. If your baby is on a milk based formula like Enfamil, Similac, or Carnation, she should have no difficulty tolerating milk. If she has been on a soy or hypoallergenic formula, she could be lactose intolerant or sensitive to milk protein. If she is lactose intolerant, you may be able to switch her to Lactaid milk (a low lactose milk). If she can't tolerate milk protein, she will have to stay off milk, in which case a non-milk formula is a perfectly reasonable alternative.
Sincerely,
Dr. Warren
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