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News from Baby Medical Q&A, Issue #021
June 01, 2008
New Questions and Answers
Question: My toddler had a large bowel motion today and as I was cleaning her from front to back I noticed that her vaginal opening is grown together. There is just a tiny opening that her urine has been passing through. Since this is new to me, I flipped out. Our doctors office isn't open today and I am very concerned.
Don't freak out. This is a common problem in little girls and will get better by itself. Sometimes we prescribe a bit of estrogen cream to be applied twice daily for 2 weeks to help the vagina open up again.
It is caused by the body getting confused and trying to heal what it thinks is a cut - little girls don't have estrogen so are more dry in the genital region. It will improve by itself with time.
Question: My 8 months old baby girl has a hair on her genital area, since 3 or 4 months but not from birth.
Is that a problem ?
Are there any investigations she should have?
Did any delay of medical investigations cause any problems?
Answer: Sometimes babies can have fine pubic hair - we call it premature adrenarche. As long as there are no other signs of puberty, so the breasts are not enlarging, then I wouldn't be worried.
If that is all the problem is no further tests are needed at this time and there is no problem with any delay.
See your doctor if there are other changes or the hair keeps increasing or the breasts start increasing in size.
Question: I have a 7 weeks old baby. She has an umbilical granuloma. I tried using alcohol for 3 weeks but a crust developed several times and when it fell, the granuloma remained there. I read that in the UK it is treated with salt. Here, in the US the doctor uses silver nitrite, which I read can burn the skin and is also toxic. I would like to get more guidance on the salt treatment.
Can you provide guidance on the salt treatment? Is there any other treatment that you know of? What happens if it is left with no treatment? Will it disappear with time? Currently it oozes a liquid but no blood. Thanks.
Answer: The guidelines for salt are to apply a pinch of table salt to the granuloma. Then hold a piece of gauze over the salt for 10 - 30 minutes, then wipe with a clean gauze soaked in warm water. Then dry. Do this twice a day for at least the next 3 consecutive days.
Silver nitrate can cause nasty burns and I would try the salt first. Also, try folding the diaper back so the granuloma is exposed to the air and can dry out.
Most granulomas will resolve without any treatment but it can take time.
Question: My 5 year old will be sitting on the couch watching cartoons and her heart will race so fast that she will tell me to feel it. She also has to take breaks when she's playing because she doesn't feel well. Could this be a problem with her heart?
Answer: If your daughter's heart rate is too fast to count, it may be that she has a rhythm disturbance like SVT (supraventricular tachycardia) - this is when the heart beats at an abnormally fast rate because the electricity through the heart is taking a short-cut. It is usually not a serious condition but can cause discomfort.
One way to check if there is SVT is to have a EKG during an attack. Alternatively, when your daughter next has an attack, ask her to close her mouth and blow hard (like you do when unblocking your ears) - if her heart returns suddenly to normal, SVT is likely.
Regardless, if your daughter's heart beats faster than you can count, so above 210 beats per minute or so, see your doctor. If you can count your daughters' heart rate (so if it is less than 200 beats per minute and particularly if it is less than 160 beats per minute), SVT is less likely.
Most cases of SVT do not require treatment unless they are frequent. Treatment consists of medications or surgery.
News and Updates
Pain free blood tests.
A new study has shown that a needle-free powder lidocaine delivery system reduces the discomfort of blood testing and intravenous cannulation in children.
Reference: Zempsky WT, et al. Needle-free powder lidocaine delivery system provides rapid effective analgesia for venipuncture or cannulation pain in children: randomized, double-blind Comparison of Venipuncture and Venous Cannulation Pain After Fast-Onset Needle-Free Powder Lidocaine or Placebo Treatment trial. Pediatrics. 2008 May;121(5):979-87.
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