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15 June 2010

Ask the paediatrician

One of 40 medical experts, the Paediatrician is standing by to answer questions about symptoms, treatment, vaccinations and development stages for babies and children.

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One of the original professionals to join Health24's online expert service, the Paediatrician has answered a large share of more than 250 000 questions sent in by our readers to date.  If these frequently-asked questions don't cover what you need to know, send your question in to the Paediatrician.

Q: dummy or thumb

My baby is 3 months old. He self-soothes by sucking his thumb. What would you advise - thumb or dummy?

A: Everyone has an opinion on this. Dentists seem to prefer babies to suck dummies to soothe themselves, but there is no strong evidence that dummies are better than thumbs. In fact, a thumb is always available and cannot fall on the floor and does not need sterilising. Children appear to give up dummies and thumb-sucking at about the same age, so the question of habit-forming is not a problem.

Q:  eczema

My 2yr old has been diagnosed with Atopic Eczema by the Dermatologist. He has asked me to used Protopic for light rash, Elocon for more severe times and to bathe him with Vita-Sure-Repair. Thus far I did not have to use the Elocon. The Dermatologist has asked me not to change his diet in any way. The Protopic &  VIta-Sure does seem to have helped. My problem is that he scratches himself a lot at night - can I do something about this? Should I make changes to his diet - he loves milkshakes and cheese! One more thing he is a terrible eater - can you suggest a multi-vitamin?

A: Dermatologists do not believe that allergy affects children with eczema, but many foods certainly can aggravate eczema. In fact the word 'atopic' means allergic.  It would be worthwhile asking your paediatrician to test your son for food allergies, especially milk, egg and peanut and other allergies such as grass, cat and housedust. It is always worthwhile avoiding the acid fruits in children with eczema such as citrus, pineapple and tomatoes. Ask the paediatrician to prescibe a medicine to reduce night itching, such as Aterax syrup.
Try  Scotts emulsion as an immune booster and also a good source of A and D vitamins and Omega 3.  Also give your son a probiotic every day such as Probiflora

Q: baby runny nose

My  little girl is 16-months-old. It seems that every time she cuts a tooth she gets a runny/blocked nose. I do use Salex, but obvouisly she can't blow her nose. How do I get the mucus out of her nose, and what, if any, medication can I use? It sounds like a postnasal drip, blocked but also running. Also, I have been wondering about where the mucus goes - into the tummy or to the lungs?

A: This mucous will run down the back of your daughter's nose and most well land up in her tummy. Continue to use Salex or Sterimar childrens' nose spray to clear her nose. It may help to use a nasal aspirator to clear her nose of excess mucous, but she may not allow you to use this device.

Q:  my son fell off the bed

Please help. My 18-month-old son was sitting on my bed (which is very high), and as I turned my head I heard a bang. He was lying on the floor, flat on his back against the drawers under my bed. It sounded like he first hit my wrought-iron table then the floor.  He screamed for about 10 mins. I picked him up and checked that there were no marks on him. He just kept touching his head. He is at home with my Mother-in-law. She said that he is acting fine. I am so stupid..... Should I take my son to the hospital for a check up?  Please can you tell me what to look out for?

A: I am sure that you had a big fright when your baby fell off your bed. Fortunately in most cases babies are not badly hurt when they fall off a bed onto the floor. Of concern here is that your baby also appears to have hit head on an iron table. He does not appear to have any obvious injuries, and from what you say here, he is behaving normally. The danger signs are:  vomiting, food refusal, excessive drowsiness and sleeping for longer than usual. If you are in the slightest bit worried about your baby, please take him to be seen by your doctor or the nearest emergency paediatric clinic.

Q: clingy baby

My son of 28 months has become extremely clingy over the last two weeks. There was a huge storm one evening while I was out, and my husband had to calm him down. Since then he follows me around, tells me he wants to come with me where ever I go - even if it's to the kitchen to cook. Even bedtime is a problem, I used to be able to put him down and walk out - now I have to sit with him until he falls asleep. How can I help him get over this issue as it's exhausting for me, and I feel so sad that he's lost his confidence.

A: Your son has had a big fright recently due to the storm and as you correctly say he has now lost his confidence. It is very common for children of this age to have separation anxiety.Your son needs lots of love, patience and reassurance and gradually he will get back his confidence.Read to him at bedtime and he will fall asleep more easily.

Q:  potty training

My son 26 months is going to the toilet at school, but refuses to go at home. I have tried leaving him for a while, but when I ask him to go to the toilet he refuses.  He gets so upset when I take him in - he even bit me once! How do I approach this situation, because he can't move into the next class at school if he is not potty trained.  I'm not trying to force him, but would love if he went in the potty.

A: From what you say here it appears that your little boy does use the toilet at school, but he will not use the toilet at home. Give him a few days off when you do not even mention the potty and then try again. Tell him that he will get a reward if he tries to use the toilet. It may be better if he rather uses a potty instead of trying to get him to sit on the toilet. You will have to work out the method that seems to work best for your son. Read more on our Parenting Forum on Health24 and on Google.

Q:  baby to sleep in her own room?

My wife is expecting and our baby is due soon. Because we had issues getting our first child to sleep in his own room, I don't want to make the same mistake again. Having said that, I know the new baby will be breastfed and probably need to be close to her mother.  What is a good age to move the cot to the baby's own room?

A: This is very variable and always depends on circumstances. You could move your baby from as young as 4 months.  Many babies are moved at between 10 and 12 months, but again this is very variable.

Q: baby not sitting at six months

My friend and her husband are concerned that their second baby boy of six months is not sitting yet. He was born after a 12-year wait when she was in her 40''s. She had a healthy normal pregnancy, a booked C-section in a private hospital, and she was under a gynae and has a paed for her son.

He is a beautiful baby, gurgles, laughs and talks all the time. I think he is perfectly normal and will sit in his own time. (They are both professionals and I think want babies to follow milestones on cue!)
I would be grateful for your opinion.

A: There does not appear to be any need for concern as your friend's baby seems quite healthy and happy.Not all babies sit at 6 months and many only learn to do so by 7 months.

Read more:

Developmental stages: toddlers to teens

Visit the child safety centre

(Images: iStock)

(Joanne Hart, Health24, May 2010)

 

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