mouth ulcers

Dear Maha Khan,
These sound like aphthous ulcers whose cause is unknown. I am surprised that he does not have a little bit of pain. Usually these become less of a problem with time and there is no treatment other than pain relief. Do NOT use aspirin or Bonjela, which also contains an aspirin-like  substance. I presume that your son is otherwise well when he has these ulcers. If he is indeed unwell then he should see a doctor for diagnosis and management, as I can think of 10 or so causes for mouth ulcers. One possibility is an allergic cause. If so they would usually occur at a particular time of the year or exposure to certain substances.
However, aphthous ulcers are by far the most likely cause and they do no harm and disappear with increasing age.
David Robinson

On 10/8/2012 5:37 PM, maha khan wrote:

Hi there, my 6 years old son has mouth ulcer he has 4 time this , almost every year he has . we do not know why it happen ?  first time he had very severe mouth ulcer but now he has painless ulcer please help me why its happen with him every year , being a mother its painful for me to see my son like this please please help me please .

Facial rash

My granddaughter has many white lumps on her face and now on her eyelids


Is she just a few weeks to a few months old, these are so common as to be considered normal. If she is older do they itch which would make one consider allergy. If not I would not be concerned except I would check for tinea between her toes and treat it if present.
Dr D. Robinson

child sleeping excessively

Dear Tiffany,
Children sleep more with any infection - infectious mononucleosis included. Does he have any other features to suggest he is ill?
Is he getting enough sleep at night or is it possible that he stays awake using his computer or mobile phone. This is a very common event these days.
A scary possibility is of some drug he has taken is the cause.
Can you wake him? If not take him to an Emergency Department.
I think a medical check tomorrow would be needed in any case.
David Robinson

On 10/6/2011 9:44 AM, Tiffany wrote:
> Tiffany has left a
> new comment on your post "Infectious Mononucleosis
> ":
>
>
> I have a question my son who just turned 7 years old has been falling
> asleep at school i picked him up today from school and he was sleeping
> in the Principles offer for an hour an a half took him home which was
> 330 and its now 730 and hes still sleeping could he have Mono. hmm im
> not to sure how to come back on here so can u please email me
>
> thanks so much!!!
>
>

Labial Fusion in a 6 Year-old

My 6-year-old daughter has fusion of the labia discovered when she had a urinary infection. Her doctor has separated them with a probe which hurts and they fuse together again despite applying Vaseline as the doctor suggested.
She is now terrified of anyone looking except me (her mother) and says there is no problem. What should I do?

You could apply an oestrogen cream to the labia twice a day as this will encourage the fused area to break down without any trauma. This will happen anyway with the surge of oestrogen at puberty and if it is not causing any problems you might wait until then. If she suffers repeated urine infections then it should be dealt with now.

Toddler Chronic diarrhoea

My 21 month old was experiencing a severe 'smokers' cough for about 9 months and then developed chronic diarrhoea which was frequently very milky. Suspecting lactose intolerance I changed from cows milk to soya milk (not a good idea in infants by the way), his poo changed colour but otherwise was the same. I went straight to Jan de Vries (Auchenkyle, Troon, UK) he prescribed echinacea and a herbal bowel preparation and within 2 weeks his cough was gone and he was back to his normal poo pattern. He also recommended that I switch to Nanny's goat milk formula as cows milk is extremely high in protein and can be very difficult for some infants to digest. Don't know if this is in any way the same as very few tests were done but it might be worth getting the opinion of a qualified naturopath. DO NOT give herbal remedies without consulting a practitioner!!!!

Thank you for this account of your child's problems and their resolution. I am glad he is well again. Goat's milk is very low in folic acid but these days most commercially available goat's milk feeds have it added.I am not sure what role the echinacea played but in adults with certain conditions it should not be used - no problem for children though. Infants who are allergic to cow's milk protein are also often allergic to Soy.
I am very pleased that the diarrhoea has stopped.

Email Working Again!

David Robinson apologises that email questions addressed to Paediatric Questions and Answers have not been reaching him. Questions on any paediatric topic from babyhood to adolescence are welcome,and so are re-sent email questions.

diarrhoea in a 2 and a half year-old

 
A bit of a background on my son. I had polyhydrominos (excess fluid level of 29) diagnosed at 30 weeks pregnant. My son now two and one month developed breathing problems at 2 months.  (sounded like a 60 yr old smoker with emphysema) This breathing difficulty including stopping breathing intermittently went on undiagnosed for 7 months despite doctors visits and hospital visits two to three times per week. Finally he was diagnosed with a trachea which is half the size it should be therefore restricting breathing when he gets cold etc. He also was diagnosed with pnemo virus?? Which is the reason he was actually admitted to hospital ( this virus only lasts two weeks though) During his hospital stay they discover he also had Hydrocephalus which has since been changed to "benign enlargement of the subarachnoid spaces" and he is seeing a neurosurgoen regarding this who is doing MRI's at 3 month intervals to watch the fluid levels.
 
My question is he has diarrhea nappies approx 6 times per day every day. I have told numerous doctors this and all but the last one a paediatrition ignored this and said it must be his 'normal'  The last one said he is maybe lactose or fructose intolerant and to put him on latcose free milk to see if that helps. We have done this now for 3 weeks and there has been no change if anything his poos are worse. They are a milky white slop and frequent overflow his nappy. He is off his food two out of three meals and even then we have to 'prime' him like a lawnmower and force the first bit into his mouth to get him to even start  to eat. As a baby he was a hungry little bub and ate 2 hourly. I am at a loss to understand what to do for him. I end up cooking and offering a few different meals at each sitting hoping he will eat one with gusto. He if he had his chance would drink milk all day. I have decided to limit his milk to half a bottle to try to force him into eating solid food. I am open to all ideas and suggestions.

                       You and your son have had quite a time of it and I feel sorry for you.
As regards the diarrhoea and poor appetite, I think he should have a microurine and colony count done to look for a urinary tract infection. If that is excluded then I would try withdrawing fructose. This is done by stopping all fruit, including fruit juice for 3 weeks.
You might ask what is he going to drink and I would allow him a little milk and plenty of water. Hopefully this will improve is appetite for other solids.
How is he growing by the way? Please let me know what happens. If he has no urine infection and does not respond to the fruit withdrawal, there are other things that can be tested.
When did the diarrhoea start and did it have any relationship to dietary changes such as introducing cow's milk formula or adding solids to his diet?
David