Baby speech not developing

Hello,
> We have a couple of concerns about our daughter who is 15 weeks old.
> She seems to be
> developing normally in most areas but there are a couple of things
> that we are seeing recently that
> don't seem quite right. Just as background... I had a normal
> pregnancy and delivery. She makes
> eye contact and smiles at us. She can reach for a toy but is not
> interested in rolling over at this
> point.
>
> The first issue is that she seems to be vocalizing less than she was
> a month ago. She used to
> repeat vowel sounds that we made and would say "ah-goo" when we said
> it, as well. She still
> makes noises, but they aren't the consonant sounds that we expect
> and the "ah-goos" are
> completely gone.
>
> Secondly, she has begun sucking on her fingers like there is no
> tomorrow! In fact, she sucks on
> them so much that she will lie in her very dark room looking at
> nothing (we don't have a mobile or
> any toys in her crib) for a long time (perhaps an hour?) so long as
> she is sucking on her fingers.
> For instance, last night I woke up at 2:30am because that's usually
> a time that she wakes at night
> to nurse. I just went in to turn down the heat in her room and
> realized that she was awake and
> lying there sucking on her fingers. I'm not really concerned about
> her weight gain right now; she
> eats plenty during the day. Our concern stems from the fact that we
> thought that babies her age
> were supposed to be soaking in the world around them while our
> little girl seems content to lie in
> darkness with her fingers in her mouth.
>
> We don't know if these issues warrant a trip to the pediatrician.
> She is our first child an we don't
> want to be overreacting, but at the same time we want to be the best
> advocates for her that we
> can be.
>
> Any advice that you can offer would be greatly appreciated!
>
I share your concern about your daughter's regression in speech and the possible disinterest in the world around her,
I think you should see your pediatrician and that s/he should arrange a formal hearing test.
From the way that you asked your question, it appears you are concerned about developmental retardation and/or autism. While these are possible, hearing loss is much more likely but you should raise these concerns with your pediatrician as well.
I hope I am wrong about all these things but, if they are present it is important to find out as early as possible so treatment can be put in place as soon as possible.
Please let me know what happens and don't hesitate to ask more questions.
Yours sincerely

Toddler diarrhoea

                       Nice to hear from you again, I am a bit of a heretic about 'flu immunization. The best study about the long term benefit of 'flu immunization in children was done in Britain many years ago in a boy's boarding school. Half of the boys were immunized each year and the other half received no immunization for 'flu. In the first year the non-immunized boys caught the 'flu much more frequently than those who had the immunization. However, after 3 the number of episodes of 'flu were equal over the 3 year period despite 1 group having annual shots. I think we can conclude that catching the'flu gives a better immunity than the immunization.
That said I think if I had neutropaenia, I would have them immunized -  not logical but I would feel terrible if they developed an ovewhelming secondary (to 'flu) bacterial infection which they could not fight very well.
If your 18 month old seems well and is gaining weight, I doubt that he has lactose intolerance - they are usually miserable with lactose intolerance. Your local doc can do a simple test on a fresh stool sample to exclude lactose intolerance. As regards the fruit, there is another sugar intolerance called fructose intolerance. Fructose abounds in fruit. It has the same stool pattern as lactose intolerance and as you describe it.
To exclude this condition there is a fancy test but you can know by excluding all fruit (don't forget the juice!) for 3 weeks and then put him back on fruit and keep a diary of his bowel actions throughout. If he is fructose intolerant he will improve markedly in the fruit-free period only to revert when fruit is reintroduced.
If he has neither lactose or fructose intolerance another 3 weeks off all milk products and no Soy! may be needed but we can discuss that when the time comes.
All the best.
David

>
> Dear David,
>
> Mum passed on your details to me because I was asking
> her a couple of questions. One is about the flu immunizations. Here
> in the USAit seems to be standard for all children and many adults
> to
> have a flu shot every year.Our children have had the other
> immunizations but I suppose since I never felt as though I needed a
> flu shot I wonder about them.They had it last year because we were
> moving to Colorado Springsand I just thought it might be helpful.
> Our children are now 3 and 18 months. Our 3 year old has chronic
> benign neutrapenia (I spoke to you about her previously)
) but apart from one cold and one 24 hour vomiting
> bug has been well throughout the year.
>
> I was also wondering if our 18 month old is lactose
> intolerant….although I’m not so sure now. He is healthy, putting
> on
> weight, and eats almost anything. The only thing is that he
> frequently wakes up with an overflowing pooey nappy in the morning
> and sometimes this happens during the day too. He would regularly
> have 3-4 pooey nappies per day. I have experimented with soy milk
> and sometimes it seems to make a difference and sometimes it
> doesn’t. We do eat quite a lot of fruit and vegetables and whole
> grain foods. I’ve cut back on him eating pears and mandarins but
> still think it’s important for him to have some fruit. What do you
> think?
>
> Thanks for your help

Red spotty rash in well 8 month-old

My 8 month old son having red spot rashes in face and arms and few
> in
> legs alone.
> No fever and the baby is active all the day.
> What could be this rashes as this is bothering m a lot?

As he is well, I would not be too concerned. There are a multitude of
possible causes but by far the most common are insect bites. As I don't know from where you are writing, it is hard to guess which is the most likely.
I would spray the mattress with a non-toxic (ie safe for humans) insect spray. If mosquitoes are likely then spraying the corners of the room where they meet the ceiling may help.
If the problem continues you should see your local doctor.
Please tell me what happens.

reddish, non-tender lesion on foot

                               I am not sure what this redness is due to but as it does not hurt and there is no pain, I am not too concerned. If it starts to hurt or she seems unwell generally, you best have your local doctor look at it.
By far the majority of foot problems at this age are due to ill- fitting footwear. I wonder if her foot is sliding back and forth within the shoe giving the reddish appearance but that is only a guess.
David

>
> I have twin daughters and recently in the last week I've noticed one
> of the girls (23 months old) has been presenting with a reddish,
> irregular shaped, bruiselike, non-raised lesion on the bottom of the
> inside of her heel/back of arch....is it possible she is stepping on
> toys wrong lately?I've also notice she likes to stomp her feet on
> the floor, but never seems like it is painful. I can rub the area
> without any discomfort to her, but I've noticed she's been studying
> this area of her feet as well. The other twin has nothing on the
> bottom of her feet. Their feet measure the same size and are both
> wearing the same design of sketcher size 6 1/2 shoes when we go out
> for 2-3 hours a day. Otherwise the girls run around with just socks
> or no socks inside the house.
>
> I am alittle unnerved by the red bruise, but was wondering if this
> is
> normal?
>
> concerned mom,
>

28-month-old falling a lot and walking into objects

Dear sir.
I read your answer to a grandmother who had a grand son or grand daughter at the age of 34 months that was falling a lot. I have been trying to find something about this issue online and that's how I ended up on your web page.
I am a guardian of a toddler who is 29 months and he has the same problem. He falls and stumbles over the smallest things and a lot of times he will walk into things like a table or the doorway etc. We have baby gates in the house to protect him from falling in any stairs and the house is really kid safe. He walks normal, seems to have a normal hearing and he is talking well for his age.
 
He has a sister that is 4 years old and she is very athletic and she never had any problems falling or walking into things like he does. The two kids spend one week with their mom and one week with their dad and are also in preschool five days a week when they are with dad. The toddlers preschool teacher asked me if we had noticed that he is always bonking into things and falls a lot. He also comes home from his mom with bruises so we know this happens here, at his mom's and in preschool.
 
He is also showing early "warning signs" of learning disability. He is left handed, his fine motor skills are not quite there , and he can't put a 4 piece puzzle together even if the picture of the shape is on the puzzle board. We know that he cant be diagnosed until he hits second grade, but we have been made aware of early warning signs. His dad has learning disability so we don't think it is unlikely that one or both of his kids could end up with some sort of a learning disability as well. The toddlers dad and I are doing things to try to prevent this from ever happening and we are doing it in form of fun play. The toddler loves to try to thread beads on a string, he has a box with different shaped blocks that has to go in one certain hole, we have easy wooden puzzles and building blocks to boost his imagination. And he plays the games only as long as he has fun doing it. I don't know if this can be a part of him always falling or walking into things as far as his motor skills goes.
 
we would be very happy if you have any ideas of what we could or should do if anything to help the "little guy" from hurting himself so much.
 
 
If you could please send me a mail back we would be very thankful.  
   
                  On reading of your grandson's problems, the first thing I thought of was "Has his vision been checked?" This was because he is walking into things but as you noted he may have a muscle problem predominantly affecting his legs.
An optometrist or an ophthalmologist can check his vision while his muscles can be assessed by a physiotherapist who can also show you exercises to help any problem detected. If necessary your local doctor can refer your grandson to the above specialists - ones with expertise in assessing children would be best.
Please let me know how things turn out.
David

baby with Sore on chin and chest problems

                    I would have been very alarmed if I had seen the baby when he/she had the chest problem. I would have feared that the probable Staph. infection on the chin had spread to the lungs and Staph. pneumonia is a life-threatening condition. However, the fact that the baby has recovered is against such a diagnosis.
Probably the sore on the chin is unrelated to the chest problem. Probably the chest symptoms were due to a viral infection known as bronchiolitis. This sounds as though it was a mild episode and that the body defences have overcome the virus - most commonly one known as respiratory syncitial virus which nearly all of us catch for the first time between 0 and 2 years-of-age.
No action need be taken about the chest now that he/she is recovering and I presume the local doctor has given something for the sores on the chin.

infant mouth ulcers

  I am so sorry your daughter has this painful mouth ulceration. If your doctor thinks it is cold sores. Then she has caught it from someone else - possibly an adult or older child with a cold sore on their lips. All of us caches this infection in the first few years of our lives. The first attack usually shows as mouth ulceration - mainly inside the mouth but often on the outside too where it looks like a cold sore on an older person. Once we have had this infection 60% of us have no further problem but the other 40% are unfortunate and have cold sores on the lips whenever stressed either physically or emotionally. The commonest stress that does this is the common cold hence the name cold sores.
It is very important to keep pushing the fluids although they are painful. A small proportion of children who have this initial infection become dehydrated and need hospitalisation.
The fact that the ulcers are near her uvula suggests that they may be due to a less common viral mouth infection, called Coxsackie. The result is much the same with reduced food and fluid intake because of a sore mouth. After this form of mouth ulceration heals we don't suffer the repeated sores as do 40% of the cold sore sufferers.
You are in for a few miserable days whichever virus is responsible. Keep up the fluids.

>
> Hello,
> I just brought my 8 month old daughter to her pedia for her 2nd half
> of her flu shot while the doctor wasdoing some exams we found out
> that the inside of her mouth has cold sores,right next to her
> uvula.I was so afraid and did not realize that causes her so much
> pain when she's eating or drinking her milk from her bottle. I was
> so
> anxious that's why i wanted to ask you if this kind of viral
> infection cangive herproblem in the future or will it happen
> again?What causes this break out?
> And why would appear it by her uvula which is very unusual?Her
> doctor
> gave her a prescription to ease down the pain which is good for 7
> days.I just cant help seeing her like this.
> Please i need your response,my email is mrlflorencio@gmail.com
> again,Thank you very much for reading my letter.

cows milk intolerance

Dear Peter.
                    It sounds as though your granddaughter is having a very rough time.
The fact that she responded to the Dairy-free diet but did not have lactose-intolerance, suggests that she has cow's milk protein intolerance.
Despite your strictness with the diet, the recurrence might be due to inadvertent exposure to cow's milk. It is amazing the solids that have milk protein in them. You need to check whether any product states that it has cow's milk solids or casein in it and avoid these. The only margarine that is safe is Nuttelex.
If all this has been done, and the problem, continues, she may have developed an allergy to some other food. Just about anything can provoke an allergy, but the most likely at her ages would be eggs.
Please let me know what happens and we can pursue some other approaches.
David

>
> I hope you can help us,our 1 year old granddaughter had diahorrea
> and
> vomiting which resulted in a stay in hospital the stool was like
> clear mucus with what appeared to be seeds in it.She had a barrage
> of
> tests these showed nothing conclusive.A dietician was consulted and
> she was put on a dairy free diet.The Vomiting and diahorrea had
> stopped and her appetite seemed to have recovered however she has
> gained no weight.
>  The original problem started at the begining of september but 4
> days ago the diahorrea started again and seems to be getting worse
> our daughter has been very careful to ensure she has had no dairy
> products in either her or the baby's diet and as you can imagine is
> at her wits end.Can you give us any advice?
>  Yours sincerely Peter Morgan.
> P.S.The tests eliminated Lactose intolerance and Celiac disease.

constipated 2-year-old

> Hello,
> I have a 2 year old daughter who suffers very badly from
> constipation
> and has done since she was eight months old.I am at my wits end we
> have been to gp and tried several medication with no luck. She is
> currently on lactulose and senna. It seems to work then just doesn't
> work for while. I was advised to increase dose from 2 5ml of
> lactulose twice day to up to ten a day. This just seems such a lot
> to
> give her but did it sometimes works and other times doesnt. She has
> also had suppository aswell which didn't work well. When she tries to
> go she is in so much pain screaming which can last hours and has
> even
> hurt her back trying to do it. She can go several days trying with
> no
> luck. I dont know what to do have tried obvious diet changes etc
> with
> no luck. What would you suggest? Could she have any other medical
> problems that cause this? Could being on these medications cause
> problems later in life?
>
> please get back to me my email is danagray19@hotmail.com i would
> really appreciate it.
>
> Many thanks
>
>


                   I am sorry your daughter is having so much pain on using her bowels. From your description, she has a fissure-in-ano.
This is a small crack in the anus where the bowel meets the skin. When she uses her bowels the crack is torn open and causes pain. This tends to stop her using her bowels making her more constipated.
She needs a local anaesthetic ointment applied to her anus as a thin smear at night after her bath and again in the morning on waking. You can buy the ointment over the counter at the pharmacy. You can also apply the ointment during the time she is using her bowels if it is hurting.
Lactulose and senna are fine. I recommend giving the senna at night. If she fails to use her bowels in the next 24 hours then double the dose. If this does not produce a result in the next 24 hours give her half glycerin suppository and continue with the higher dose of senna. Failure to use her bowels means redoubling the dose of senna and if this does not work another half suppository. After a week of success of using her bowels the dose of senna can be halved. So 1 day of failure means doubling the dose, a week of success means halving. She may get up to quite a high dose of senna but it will do no harm. Throughout all this you continue with the twice daily local anaesthetic ointment.
These instructions are quite complex, so don't have any hesitation in asking me a question. I will be happy to hear from you.
David

Frequent falls

> Dear David:
>
>
> It has been over a month now and my granddaughter is falling way
> less due to the fact that she is
> wearing those good shoes. I believe her ankles were not strong
> enough, etc. What is your
> professional opinion of this small turn of events?
>
> Thanking you in advance.
>
>
>I am delighted that she is falling less. Good shoes certainly do help weak ankles.
Did you ever get her assessed by a physiotherapist or a home visitor as I suggested?
David
>

My son, who is 18, caught acute mono over 5 months ago. He had a severe case and was unable to attend the last 3 months of school, and was one of the worst cases his doctor has seen. The severe part of his mono has gone away, but since then he still struggles daily. He has little or no appetite, strength, and seems to be constantly not feeling well. We've taken him in to get bloodwork and the results have come back 'normal'. My question is: Is this common? If not, what should we do?

The older the patient, the more severely they are affected by Infectious Mononucleosis.
A period of post-mono with the symptoms you describe is common. This may last as long as 6 months although 3 is more usual. This is despite the blood work becoming normal.
There is little you can do.You might try tempting him with his favourite foods.
David

Acne

My son has terrible pimples, and no creams seem to cure or prevent them. His confidence is down, as are his school grades and his self-esteem. He thinks he is ugly and that he’ll never attract girls. Can they be cured, and what can I do to help his emotional problems?

I feel sorry for your son – many of us can remember how miserable pimples made us feel. As you’ve found, creams and ointments are next to useless. He should not squeeze his pimples as this leads to more pimples forming.

Because of the psychological problems you describe, further treatment is needed. Ask your doctor to consider prescribing a daily antibiotic for your son. If that is not successful, ask for a referral to a dermatologist because there is a very effective (but expensive) medication that he/she can prescribe.

Usually, effectively treating the acne (as pimples are called) will improve his psychological health. It may help to have an adult who suffered bad acne talk to your son, especially if he has a photo showing his pimples. He will be able to assure your son that he will eventually grow out of the problem.