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News from Baby Medical Q&A, Issue #042
March 01, 2010

New Questions and Answers

Question: My 5 1/2 month old daughter just recently started getting what looks like baby acne on her cheeks. She has just finished a prescription of Amoxicillin a week ago for a sinus infection and has also had a bad diaper rash. On top of all of this she has also been eating rice cereal for the last week. I am not sure if this is a reaction to the cereal, or if it could have spread from diaper rash or is just acne which she already had when she was a month old.

Answer: Baby acne is usually a condition called erythema toxicum - it is common in babies and does not require specific treatment. The other condition on the cheeks is milia - click here.

Antibiotics can cause diarrhea and thrush and that is perhaps what is causing the diaper rash - click here for Thrush and click here for diaper rash. The facial rash is unlikely to have spread from this region.

I think it is unlikely that the rice cereal is the cause. You could stop the cereal for a couple of days and see if the rash clears - if it does reintroduce the cereal and see if the rash reappears - if so, then it is likely to be a reaction to the cereal. I doubt this will be the case though.

Question: My 19 month old toddler had her MMR shot about two weeks ago this past Saturday she ran a fever of 103 I called her pediatrician and I took her into his office on Sunday; he said it was viral... since Sunday she has been very irritable and NOTHING makes her happy. She is pulling at her ears and has runny nose it is clear... could this be sinus infection?

Answer: It sounds like a viral infection as you pediatrician has advised. Sinus infections are not that common and we wouldn't usually diagnose them unless there had been prolonged symptoms (10 days or so) and some specific features such as at least 3 days in a row of green nasal discharge.

Keep your daughter comfortable with Acetaminophen. If there are signs of serious illness (click here to read more) return to you doctor.

Question:My 6 month old daughter has a strawberry mark on her head that grew over the first six weeks of her life - which I think is normal - but then at 4 months another two similar red dots appeared (pin pick size which are slowly getting slightly bigger). She now has another appearing on her forehead which I am worried about how big it might grow. Is there anything I can do about these "late" strawberry marks - if that's what they are.

Answer:The most likely thing is that these are strawberry nevi. They often get bigger over the first year of life but then shrink. Some shrink earlier. No treatment is usually required unless they are in a difficult place - like blocking vision or blocking the airway. Click here for more information on strawberry nevi (birthmarks). To read about a new treatment for those requiring treatment as above, read the News and Updates section.

Question:My 3 month old baby is sometimes congested after a bottle of formula. There is a rattling sound in her chest, nose and/or back. Is this a sign of some sort of intolerance or allergy?

Answer:Milk allergy or intolerance does not cause snuffly breathing. Rattling of the chest is usually caused by narrowing of the airways which can be due to mucous. This is not a milk allergy and so there is no need to remove milk from the diet. Many babies have rattling in the chest and it is usually nothing to worry about if there is no increased work of breathing.

If your daughter has an increased work of breathing, so you see her ribs protruding with breathing, then you should see your doctor.

News and Updates

New Treatment for Severe Strawberry Nevi

For those few infants with strawberry nevi (birthmarks) that are in life-threatening sites or are occluding vision, who in the past were largely treated by steroids, there is a new treatment that has shown great promise. It is Propanolol, an anti-hypertensive medication - it has shown good results so far and further study is underway.

Reference: AU Sans V; Dumas de la Roque E; Berge J; Grenier N; Boralevi F; Mazereeuw-Hautier J; Lipsker D; Dupuis E; Ezzedine K; Vergnes P; Taieb A; Leaute-Labreze C. Propranolol for Severe Infantile Hemangiomas: Follow-Up Report. Pediatrics. 2009 Aug 10.

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