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Q: My daughter has had a rash around her mouth for the past month or more. She is six months old. It started when she was almost five months old right after she was in the hospital with RSV. Do you think it is just a teething rash, or could she likely be allergic to something in my diet? We have just started giving her food the past week or so, so I don’t think it is anything she is eating. She does use a pacifier and has had a runny nose off and on since her RSV. She
has a bit around her eye also. Thanks!
A: I am so sorry, but this is the one type of question that is impossible to answer in this forum. A rash can be so many things and is typically diagnosed by its appearance, which I can’t do this way. From your description it could be anything from impetigo to food allergy to eczema to baby acne.
I am sorry, but I have to recommend that you see your pediatrician to get it diagnosed and treated. Most rashes at her age are pretty easy to get rid of with the right treatment.
It’s spring, which means all the little critters of the world hatch and come out … and that makes pediatricians think of pinworms. That’s what you were thinking of, right?
Pinworms, or Enterbiasis Vermicularis, are a parasite for which humans are the only host. This means you cannot get them from the dirt, your cat or your dog. You can, however, get them from your children and your friends. Infection occurs most commonly in children ages 5-10 and does not discriminate among race or socioeconomic backgrounds.
You become infected by ingesting (eating, swallowing, breathing in) eggs or larvae. These eggs are most commonly found in the fingernails and bed linens of an infected person. At night, the female worms migrate from the small intestine, outside of the body to the anal skin folds. They do this to lay their eggs (our body temperature would kill the eggs if laid inside and, like a good mom, she is just protecting her young). The eggs become “infective” within a few hours and when they do, they become very itchy. The infected person scratches, gets the eggs under their fingernails and on their fingers, touches their mouth or eyes and — just like that — the life cycle of the pinworm has been propagated.
The eggs are able to survive for several hours on surfaces and linens (several weeks in cool, humid environments). This means that an unsuspecting family member or friend can then acquire them on their fingers and infect themselves.
Savvy little things, aren’t they?
The No. 1 symptom of infection is a very itchy bottom at nighttime. This affects sleep and can even lead to skin infections from scratching. While most pediatricians will make the diagnosis based on history alone, you can confirm the presence of pinworms by doing a “Scotch Tape test.” This is performed by taking a clear piece of tape and pressing it against the anal skin folds, thus picking up the eggs on to the tape. The tape is then placed under a microscope, where it is very easy to see them and confirm the diagnosis.
Q: My grandson will be 5 years old in August. In the afternoon he says “I need a bottle.” He drinks milk out of it. He doesn’t drink milk from any other source. What do you think about this? His grandpa and I think mom and dad should just say no more bottles.
A: I agree with Grandpa and Grandma. He is way too old for a bottle. It is recommended that parents begin taking away bottles at age one and be completely finished with bottles by age two. This is based on several health and developmental needs. Once children have the oral motor skills to chew and speak they do not need to suck down their nutrition. It is better for them to eat a variety of foods and avoid filling themselves up with large volumes of milk. As teeth come in it is important to begin phasing out bottles because the nipple places milk on the upper back side of teeth which can promote the development of “bottle rot” or decayed front teeth. And finally it is vital that children move beyond using a bottle for comfort: this is part of developing a normal independence.
Q: A recent article in the Sunday News (Feb. 3, 2013) directly below your column stated that experts recommend that children get their omega-3 fatty acids from foods and not supplements. However, my 11 year-old daughter is allergic to eggs, shellfish, peanuts and tree nuts which are the best sources for omega 3′s. I have been concerned for some time now about her not receiving the essential fatty acids that she needs, especially since she will soon be entering puberty. I have looked into supplements, but most of them contain fish oil or shellfish. Do you have any suggestions or recommendations for me?
A: Great question. In addition to the obvious risk of reactions, the other thing we worry about in the setting of food allergies is nutritional deficiencies. Children who are limited in what they can eat often find themselves eating the same “safe” foods all the time and therefore do not get the benefits of a diverse diet.
Omega threes and fatty acids are important in brain development and maintenance, have a protective effect on the heart, help ensure efficient hormone production and usage, and many more things. At any age, they are essential and many kids and adults do not get enough. How much is enough is a question that is hotly debated. Based on available evidence a goal of 500 mg of omega 3 is target for heart healthy needs. And a goal of 1000mg a day is a good target if you are looking to get effects on the brain like mood stability and focus.
Q: I am a career mom of a wild 3 year old. He goes and goes, nothing wears him out. We are going through the horrible 3s. I am looking for mommy and me classes evenings and Saturdays. Everything I am finding are weekdays during the day. It’s extremely frustrating to see no focus on career parents, maybe I am not looking in the right places. So I am asking for help. I am not a fan of the Gymboree; it’s overpriced and commercial.
It is super exhausting to mother a three year old. Because it is such a huge developmental year for him, there are the usual highs and lows that come with lots of physical and emotional changes and transitions. First, I want to recommend a fabulous book that has become the best friend of many parents. “Positive Discipline,” by Jane Nelson Ed.D. is a great read and reference for navigating these years. It is an encouraging and positive parenting book that gives great ideas for setting up your life with your chid in a way that helps you create strong bonds and enjoy your time together. T. Berry Brazelton’s “Touchpoints: 3-6 Years” is a classic that will encourage you as a mom.
Q: My 6 year old son has just recently begun to tell me that he feels his heart tingle. When I ask more about it he says it’s when he’s nervous, excited, worried or about to “attack” the girls clubhouse at recess. He says it’s not thumping and not like a sleeping foot waking up but more like tickling from the inside. I know not to mess around with heart issues but is this an issue I need to worry about or just him getting excited/nervous?
A: Chest pain, tingling, or pressure in a child is something that should always be seen by a health care provider. That said, most of the time, the cause is completely benign. Symptoms in the chest cause much anxiety among parents because they think of heart disease. However, in children chest symptoms are very rarely cardiac in origin. Let’s think about all of things that are located in our chests: the esophagus and stomach, ribs and muscles, the lungs, the breasts, and oh yeah the heart too. And we cannot forget the almighty brain who when nervous or stressed sends signals to the chest.
To pin down the source of the pain, it’s helpful to think in terms of these systems and the things that go wrong in them. In preparation for the appointment with your pediatrician think about answers to the following questions:
Is this a chronic problem that comes and goes or is this something that came on fast and is persistent? Does the pain occur during exercise? Does the child describe the sensation of
Q: Hi. My daughter is almost 7 weeks old and is exclusively breast fed. I’m currently feeding her every 3 hours during the day, and she goes anywhere between 5.5 to 7 hours at night (typically I aim to feed her with a 6 hour stretch at night, but sometimes have to wake her to do so). She’s a healthy weight (9lbs 6oz at 1 month; was 6lbs 15oz at birth) and eats and sleeps well. In fact, lately, I’ve had to wake her from a deep sleep for many of her daytime feedings. When should I start lengthening the time between her daytime feeds (what is the typical schedule of time between feedings for each month/age for breast fed babies) and how long can/should I be letting her go at night? Thanks!
A: Congratulations! I am so glad breast feeding is going well. Pediatricians recommend that the first 2 weeks of life you strictly adhere to the every 2-3 hour feeding schedule, even through the night. However, once you have cemented breast feeding and it has been proven that the newborn is going to gain weight adequately we loosen up considerably. It is much better for a child your daughter’s age to feed “on demand” as they know what they need better than we do!
You can start now letting her sleep as long as she will at night. What works for most moms is to do a feeding in the later evening (between 9-11pm) and then
Q: I have a 6 year old daughter that is a patient at Lancaster Pediatric, and she is having an issue with her scalp. She has this powdery-dry whitepatches(sometimes red) on her sides of her scalp( that is the only place I see it) that can sometimes flake if you touch it and sometimes not. I messed with it one time, and her scalp bled in the places I was trying to remove it. When I comb or brush her hair she says it hurts( that’s also when I do not touch it at all, she complains it itches). At first glance, I thought it was dandruff, but I suspect its something else. I brought her a special dandruff shampoo( it helps with other scalp issues) that helps, but it still comes back within a few days. Its a bit frustrating because sometimes its there and sometimes its not. When its there it looks bad. I use a bit of oil which makes it disappear for a bit. I do not put harsh products in her hair. I use a kiddie shampoo , conditioner, and a lite moisturizer. Sometimes, I wash her hair with baking soda and apple cigar vinegar. Recently, I been using a dandruff shampoo.
We are going to be traveling with our 4 month old soon. We have been using well water for his formula. We will have to use bottled water while traveling. Do we need to boil it first? Also, do you recommend a certain brand? We’ve read Evian is suppose to be good but can’t find a clear answer if it needs to be boiled or not.
When you are traveling to places where clean water supply is not reliable we recommend that you mix formula with bottled water. You do not need to boil it first as contaminated bottled water is very rare. Evian has been around for a long time and is widely available and would certainly be a good choice, however, you may find a local version to be a bit more affordable and probably just as safe.
We have a nearly 2 year old and a baby due in December. My husband and I want to be proactive in starting to save for college for both of our children, but don’t know where to even start. Are there any resources you would recommend that we investigate to help us start to plan? Any information you could provide would be very appreciated!
You are wise to begin early; the “rule of thumb” in college planning is “sooner is always better than later.” College cost have increased between 6-12% annually for decades; it far out paces the cost of living increases. These increases are being noticed at all levels of society and may be slowing, time will tell. Never-the-less, costs are high and wise parents begin early.
There at three roads you can explore.
Road #1 the Pennsylvania guaranteed savings plan. Pennsylvania offers two plans. First the guaranteed plan; Pennsylvania like many states offers a method to purchase tuition credits at today’s cost and used when your child attends college. Many states have this or a variation of this program. Advantage is there are guarantees. (I like that, why put at risk our children’s education?) You will probably be eligible for less financial need based aid if you use this program; thus your scholarship chances diminish.