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Moms Get Real With Dr. Bill

 
01:01:32 June 5, 2015
Parents of young children face a wide variety of challenges on the road to raising happy, healthy kids, and it’s not always clear how best to handle every situation. In our first Pediatric Chat “Roundtable Discussion” Dr. Bill McNett sits with four mothers of young children and engages in a frank, and humorous chat, fielding a variety of questions about childrearing and offering key insights.



Featured Guest:
William McNett, M.D.
Nemours/ Alfred I. duPont Hospital for Children

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Responses From Our Team      Click a question to view the response

Premie Weight'

We typically expect preterm infants to be delayed in growth based on their actual gestational age. So we correct for the amount of prematurity. After a year or so this correction is no longer necessary. 

Wax buildup after shower'

This is most likely fine. You baby has extra ear wax that is clearing itself naturally. If there appears to be no pain the ear is likely normal.  Use a clean wash cloth moistened with water to gently wipe it away. We do not suggest using Q tips in the ear. 

 

Hearing should be checked in the newborn and thereafter at your doctor visits.  This is very important. 


Coughing in children'

Asthalin (Salbutamol) and Levolin (Levosalbutamol) are both bronchodilators used to treat asthma. For children they are best used when you child is diagnosed with asthma (wheezing) and is under the care of a doctor. Asthma is a dry cough and if your child has a persistent dry cough a doctor should listen to their lungs. 

 

Coughs are common in children and we have learned over the past decade that medications are not helpful unless a doctor finds an infection (likely associated with a fever and difficulties with breathing) or asthma. Most coughs are related to viruses and have to run their 3 to 7 day course. Remedies like honey and vaporizers, when used properly, can be helpful.


Baby isn't crying'

Crying is very variable in infants. Some cry very often and some babies barely cry at all. So your baby may be, and likely is, very normal. That said it would be a good idea to have her examined by her provider. Some neurological problems can start out with decrease in activity and crying. Its unlikely that there is a problem but something that should be evaluated. Mom’s intuition should never be ignored!


White spots on genitalia'

It is hard to know what these spots are without a good history. In this case we would need to know the person's age and social situation. We would also want to know if the spots hurt or itch, if they were changing in any way, and what size they are.  If it was growing or if there were more than one. The most concerning diagnosis would be an infection. If that is not the case small white spots could be something normal like skin glands.  The penile skin is very thin and glands can be easy to see.


How do I know if there is something stuck in my baby's rectum?'

Thanks for the question. We are not sure why you are asking about this, but in general its is very difficult to have a Q tip or ‘foreign body’ stay in the rectal area. It is most often returned in the stool. That said if there are symptoms you are concerned about you should ask your primary care provider.


Why is there blood in my newborn's stool?'

Stool in the diaper of a 5 year old should be brought to the attention of your pediatric provider. Most of the time this is a normal finding and could be due to just a rash or a small fissure (cut) in the rectum. But it can also be a sign of another problem so it should be checked out.


My child is having febrile seizures'

Remember that the rapid rate of rise of the fever can lead to a seizure, so you want to make sure that you have medications to treat fever on hand.  Also, you can stagger Tylenol and ibuprofen and treat with both.  Tylenol is given every 4 hours and ibuprofen is given every 6 hours.  Make sure that you are treating with the maximal doses based on the child’s weight. A great resource is www.kidshealth.org, which will answer many of your questions.


What is this lump on the side of my child's head?'

It's hard to tell what the lump is that your daughter has without doing a physical examination. It would be important to know, for instance,  if it hurts to touch has any skin changes around it. It sounds like it can wait until you can see a pediatric provider this week. Which is probably a better option than urgent care since it should probably be followed. 


Temper tantrums in children'

It’s hard to be sure from your description of your son is not exhibiting normal behavior for a 5 year old. Particularly when he has just started school. Sometimes adaptation to school can be a challenge and he may be acting in a normal fashion given that new stress. But teachers are skilled at identifying issues and we suggest you follow up with your provider as your teaching  has suggested. If there are behavioral issues its always better to capture them early, since early treatment leads to better outcomes. If your provider agrees that the behaviors could be abnormal they may suggest further testing.

What does my baby's keyrotyping report tell about my baby's health?'

First.  Congratulations on your baby. He seems to be growing nicely. The chromosome pattern appears to be consistent with trisomy 21.  Your doctor should talk to you about this.  They will look for other things with your son and discuss the findings with you.

Is a high fever a side effect of vaccines?'

Vaccines can cause fevers. But in general the fever is not this high. It is more likely that he has a cold. At 4 months he is old enough to work with your provider to see if he needs to be seen.  In general if he is generally acting ok, is drinking well, breathing comfortably, and does not have other significant symptoms a regime of Acetaminophen and lots of fluids may be all he needs.  A common cold May last 3 to 5 days. 


What are these scaly, red lesions on my child's skin?'

The two conditions that come to mind would be eczema and psoriasis.  Eczema is typically located in place like the creases of the elbows and knees, is itchy, and can occur in children with a family history of asthma, seasonal allergies, and food allergies.  Psoriasis on the other hand can occur in place like the scalp, back of the neck, around the belly button, and knees and shins.  The rash looks scaly and may not be itchy.  A primary care doctor or dermatologist can help make the diagnosis and treatment plan.

How do I know if my toddler is healthy based on his blood work results?'

We don't have the complete story on your son. We are curious why he is getting so much blood work. We wish you the best as you stay connected to your provider.

Is my sick son contagious?'

It sounds like your son may have a viral illness.  It is probably best for him to avoid your mother until he feels better. If he does need to be near your mom good hand washing and avoiding sneeze spray if the best protection from colds.



Does my child have GER?'

 

 

If the baby is spitting up your doctor can prescribe an ant acid such as Zantac to help after ensuring there are no other causes of the symptoms.

 

We would need more information before we can help answer your question.  If, for instance, your little one is an infant we would say that GER is very common and some feeding techniques can help but likely not eliminate these events.  If your little one is older we would need to see how common and how much reflux was occurring along with other symptoms. Sometimes medications, for instance, are helpful for older children. GER is rarely a big problem, however, and if your child is gaining weight, happy, and thriving most often it resolves on its own.



Can my sick three-month old be exposed to a Vicks humidifier?'

Humidification can provide some symptomatic relief for congestion. It works simply by loosening up (or thinning) secretions particularly in the nose and throat. It’s likely more beneficial in the colder months, when natural humidity is low. There is no evidence that humidity helps the body fight the infection or shorten its course, so like acetaminophen, its role is relieve symptoms. Though additives have been tried over the decades, none have been found to be effective, though the ones available over-the-counter do not appear to be harmful. When using humidifiers it is of course necessary to use safety precautions as will be written in the instructions of the device (i.e. clean thoroughly daily, be sure to keep it out of the reach of the child, etc.).



Can you explain my newborn's excretions and yellowing of eyes?'

Thanks for your question. This may still be normal but this infant boy needs to be followed by a provider who is comfortable with newborns. There may be many reasons for this flattening of results including poor feeding.  It is important figure out the type of bilirubin, the feeding and weight history, and other health indicators. The level is not dangerous at this point but close follow up is needed.


Is my infant's posture normal?'

From your description this seems like normal infant posture. It is reassuring that he opens his hands and moves well. Your pediatric provider will check for tone and reflexes to be certain. At 3 months he should have had his first sets of immunizations and will be due again around 4 months.  That's a good time to check in. 

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