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News from Baby Medical Q&A, Issue #041
February 01, 2010

New Questions and Answers

Question:My 3 1/2 yr old son has for as long as I can recall had very dry and brittle toenails. They split and break very easily length-ways and have ridges (flaky) across them. They are not discoloured. His fingernails are soft but appear normal. He is otherwise healthy.

Is this normal or something that needs medical treatment. I am worried he may be deficient in something.

He has had mild eczema on his face in the past and his father has psoriasis. Thanks in advance for any advice.

Answer: It sounds as if you son has onychomycosis or fungal nail infection. Topcial treatments like creams often are not enough and children need to take oral treatment - sometimes for up to 4 weeks.

You could as your doctor for a topical preparation first - amorolfine or ticonazole are both good options. If they are not enough, then oral treatment will be necessary - your doctor should prescribe an imidazole (like ketaconazole) or itraconozole or terbinafine.

Psoriasis can affect the nails but I think your son is probably too young for that to be the case.


Question: Our 2 month old baby had his first shots today and this evening his temperature is elavated to around 100 degree's should we wait to take him in or go now

Answer:Babies can often have a temperature after shots. If your baby is not that unwell in other ways, you shouldn't be too worried. Go the the signs of sickness page and half way down there is a link to BabyCheck (at the bottom of the Sick Baby section) - go through that checklist and see how your baby scores - it can be helpful to reassure you if you think things are okay (or vice versa).


Question:We have just gotten a 10 month old. She is precious but sleeps with her bottle all night-seems to be her security

Answer: It does sound as if the bottle is a security or comfort item. It is not a good idea for babies to sleep with bottles as the milk or juice stays in the mouth and can lead to dental caries. You should try and substitute the bottle - try a pacifier and maybe a small blanket or something easy for your baby to hold on to.

Otherwise make sure there is nothing but water in the bottle.


Question: We recently returned from a trip to Florida. Before traveling, our 10 1/2 month old was ambitious in the way that she walked steadily, and was very strong. She had a fever down in Fl and now seems to be less interested in things, stumbles when she walks and is very clingy. What happened?

Answer: It's not unusual for babies to be less agile when they are well especially if they have just learned new tricks. Babies are also clingy when unwell. Being in a different environment may also be a factor.

Once your daughter is over her illness - viral illnesses last about 7-10 days in total - I would expect her to be back walking without problems. If not, see your doctor.


News and Updates

Don't overuse Acetaminophen or Paracetamol

Acetaminophen and Paracetamol are extremely useful pain relievers in children and they also reduce the temperature. However, there is some suggestion that use of Acetaminophen increases the risk of asthma. More studies need to be performed to be clear about this, but you should only use Acetaminophen or Paracetamol in infants who need it - don't just give to your infant if he or she has a fever - only give if your infant is miserable as well.

Reference: Etminan M, Sadatsafavi M, Jafari S, et al. Acetaminophen use and the risk of asthma in children and adults: a systematic review and metaanalysis. Chest. 2009 Nov;136(5):1316-23. Epub 2009 Aug 20.

Have you seen this website?

World Vision Haiti appeal - this is one of the many organisations working to help the people of Haiti after their terrible ordeal following the recent earthquake.


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