HEALTH Q & A

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1. On two recent occasions, my five-year old son came into my room and slept with me. However when I asked him the next morning why he had slept in my room, he said that he didn’t know what happened. Could he have sleep-walked?

Sleep-walking is an unusual but normal subconscious behaviour. The child is in a transitional state between being awake and sleeping, somewhat similar to hypnosis. Rarely does a child hurt himself while sleep-walking. However if you do find your son sleep-walking, do not suddenly arouse him, otherwise you will frighten him. Just gently guide him back to his room. Chances are he will not even remember his sleep-walking.

2. After taking some prawns, my son developed a rash on his arms and legs. How can I find out what he is allergic to?

The detection of food allergies in older children can be rather difficult. Since older children are already consuming a wide variety of foods, the addition of a new food item often goes unnoticed. Furthermore, your child may suddenly react to a food which has not given any problems in the past. Also, the “culprit” substance causing the allergy may well be hidden. For example, your child who is allergic to squid may have symptoms after eating some fishballs which unknown to the parents may also contain squid. If a child only has a mild one-time allergic reaction, it is often difficult to find the cause of the allergy. For temporary relief, medication such as antihistamines, is available on prescription. When hives are present, calamine lotion may provide some relief for itchiness. However, when allergic reactions are severe or when they recur frequently, medical advice should be sought. A doctor may probe into your child’s diet and also his exposure to environmental substances that are likely to cause allergy. Some foods have been found to cause allergies more frequently than others. These include nuts, oranges, wheat, chocolate and shell-fish (such as crabs and prawns). If the allergy-causing foods cannot be detected, a doctor may ask that such foods be eliminated from your child’s diet for a period of time. You will then be asked to observe the symptoms and whether they disappear with the avoidance of such food. Your cooperation-operation and participation are extremely important in the treatment of your child’s allergy. Unlike diseases which can be treated with medication, an allergy does not have a cure. A child may grow out of an allergy. Thus a six-month-old who cannot tolerate a food may be able to do so one year later. Meanwhile, however the allergy-causing food must be eliminated from his diet. Do not try to reintroduce a food which has been found to cause a severe reaction in your child, unless the doctor suggests it. Adult onset food allergy is rare. It may be that people do not know they have a sensitivity to certain food until they reach adult life because they never tried them before.

3. My baby was hospitalised and treated for jaundice when she was seven days old. I was told not to breast feed her for a few days. Can I continue breast feeding my baby after she is discharged from hospital?

Jaundice is a common condition which can occur in the first few days of life. It may not be present at birth but starts around the second or third day and builds up to a maximum towards the end of the first week. Newborns are born with a slight excess of red blood cells and when this surplus is destroyed, the red pigment in converted into a yellow one. Breastfeeding can some times exacerbate and prolong the condition. If it is a mild case, you can continue breastfeeding but in other cases it is better to wait until the level of jaundice falls before continuing with breastfeeding.

4. My second child is easily distressed and fretful most of the time. What am I doing wrong?

First of all, stop blaming yourself. Just as there are happy people and there are worriers or tense people, babies too come in different packages. It is still unknown what makes babies the way they are but it is believed that factors such as genetics and culture play an important part in forming a baby's temperament. If your baby is apt to burst into tears or shrieks at the drop of a hat, there is little you can do except handle him with greater care and patience. But check first for a few possibilities: Is baby wet, hot, hungry, bored, tired or sleepy? Trust your instincts for the right answer. Try giving him a comfort object or a bottle of water or milk to suck. Throw in a few hugs and cuddles as extras and see if that dries up the tears. Try some familiar household sounds like the whirr of the drier or the hum of the vacuum cleaner. Babies are often soothed by these sounds. If yours is disturbed by it, try the sound of silence. Is baby teething? Offer him a chilled teether. Does he have a cold? A blocked nose may also be a pain in the ear. Get to know your baby. Do what he enjoys -- may be a tickle, a favourite song or rhyme, a bounce on the knee? Keep smiling and may be you will get your baby smiling too. Are you feeling blue as well? Maybe baby is just picking up the vibes you are giving out. Babies are remarkably sensitive to mummy’s moods. Does baby seem "not quite right"? Even if you are not sure what is bothering baby, call your doctor for advice and/or assurance. 

5. What causes crooked and bucked teeth and what can prevent them from happening? Is it true that thumb sucking and biting of nails can cause crooked teeth?

Irregular teeth can be inherited. The child may have mum’s small jaw and dad’s huge teeth. This competition of limited space causes teeth to be misplaced. If this is the case, the orthodontist will have to remove one or more good teeth to accommodate the others. Besides the role of chewing and grinding food, milk teeth or primary teeth act as space retainers for their permanent successors. Should a primary tooth be lost prematurely, the two adjacent teeth will tend to crowd into the available space rightfully reserved for the permanent tooth. This leads to overcrowding and eventually an irregular placement of teeth, hence the “crooked” teeth. To prevent this, the dentist can help by fixing “space maintainers”, which are wires placed on the adjacent teeth to halt their movements. Alternatively, braces - an acrylic plate with wires to maintain space, can be worn. “Bucked” teeth, otherwise affectionately known as “Bugs Bunny” teeth are usually the result of bad childhood habits. Thumb-sucking or the prolonged use of a pacifier (the rounded ones), nail biting, lip biting, tongue biting, tongue thrusting and pencil biting have the effect of gradually pushing the teeth out of their normal position. Sometimes, such habits stem from deep-rooted feelings of insecurity and repeated admonishing would fail to make the child break the habit. Parents should not only be firm but understanding when helping their child overcome the problem. If you suspect your child’s teeth may not be properly aligned, you should bring him to an orthodontist, who will be able to advise you accordingly.

6. My four year old child will soon gave grommets put in her ears as she has glue ear. How do the grommets work and will she need a second operation to remove it?

Glue ear is caused by the build-up of sticky mucus in the middle ear, which is between the eardrum and the middle ear, hence causing impeded hearing. One of the man causes of glue ear is poor ventilation in the middle ear. Each ear contains a small channel called the Eustachian tube running from the middle of the ear to the back of the throat. Air passes through these tubes into the middle ear compartments, helping to keep them clean. What grommet basically do is to prevent the build-up of mucus which can give rise to poor hearing. They are very small tubes which are fitted into the eardrum, allowing air to circulate freely in the middle ear and fluid to drain down the Eustachian tubes. This is a common and simple operation which is usually performed by an ENT (ear, nose and throat) surgeon who will make a tiny incision in the eardrum before sucking out the fluid and fitting the grommets. Your child should not need another operation as the grommets will fall out on their own when the hole in the eardrum naturally closes up, usually six to eighteen months after the grommets have been inserted.

7. What is cradle cap and will it harm my baby?

Cradle cap may look unpleasant but it is not harmful and your baby feels no discomfort. It is not dry skin, as many think, but dried oil from the numerous tiny glands on the scalp. Cradle cap, seen as a yellowish-brown crust on the baby`s scalp usually occurs within the first three months of life. It is not contagious and it is not an indication of poor hygiene and can occur in the cleanest babies.

8. My newborn doesn’t seem to react to noises like the vacuum leaner or the kettle. Can her hearing be poor?

If you have any doubts about your infants hearing just try snapping your fingers or clapping behind her head. You could also shake a rattle to one side of her head and see if you can elicit a response. According to paediatricians, most newborns will react to a sound by startling. The reason why newborns sometimes appear not to notice loud sounds is that they have a wonderful ability to block out their environment as and when they want. Also, the sounds that you feel she is not responding to may be ones she is used to hearing while in the womb. It is also possible that she is responding but you can’t make out as yet as her reaction is so subtle. Sing to your baby, talk to her, put on some good music and see if you can catch a little response. If you continue to have doubts check with the doctor.

9. I have a 19-month-old son and he is grossly underweight. Although I have given him vitamins, cod liver oil and gripe water, there has not been much improvement. I am worried about his growth.

You should weigh and measure your son accurately and repeatedly every three to six months, and plot the measurements on the growth chart which can be found in his health book. If he is below the bottom line and shows a downward trend, he may need further investigation. You should consult a doctor if he is not growing well. Giving him vitamins may help his nutrition but gripe water is intended more for infant colic and does not have much effect on the appetite and growth.