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News from Baby Medical Q&A, Issue #033
June 01, 2009

New Questions and Answers

Question:Do you give a one year old castor oil everyday?

Answer: It is difficult to answer this question because it depends why you are giving the castor oil.

Castor oil has laxative properties and works quite rapidly when given in doses of about 5 mls - see the constipation treatment page. I would not use the castor oil regularly in a 1 year old with constipation - I would favor other laxatives but castor oil does work.

I understand that castor oil is often recommended to prevent constipation in babies. It is given as a small amount of castor oil (6 drops per day) sweetened with milk in the first year of life. If you are giving it daily just to keep your child healthy like this, I would suggest a small dose like 6 drops per day. You can then adjust the dose up or down depending on the response, but I wouldn't give more than 5 ml a day.

Castor oil can also be used as a massage oil - in colic, massage warmed oil on the belly in a clockwise direction.

I hope that this information has answered your question.

Question: My 5 year olds penis foreskin is very tight, even more so since he forced it back tearing the skin on both sides. This has healed leaving scars and has made the opening of his penis even tighter than before, which causes soreness and infections often. I have also noticed that when he is urinating the urine balloons up under the skin before forcing its way out. I took him to our GP who referred him to Hospital for a second opinion. The specialist said that he would need a circumcision as the scar tissue has healed causes the skin to become even tighter. This decision was given within minutes of examining him.

We are very anxious about the operation in its self but also have the added worry of our child being put under general anaesthetic. Is there another procedure that is not as intrusive as we are worried about the after effects of the operation and the added worry of general anaesthetic being given? Is there any chance of the skin loosening on its own later on, or something that we can do ourselves to help it along?

From very worried and anxious parents.

Answer:I can understand your worry. It does sound as if the foreskin is tight and your doctor is right - when the skin is forced back it can tear and when the tear heals it contracts the skin making the foreskin tighter. The ballooning with peeing is because of the tight foreskin.

This is called phimosis and is a reason for circumcision.

If your son isn't getting infections underneath the tight foreskin (called balanitis) and it isn't worrying him too much at the moment, you could wait and see if the skin relaxes a bit over time before having surgery.

If you are going to wait and see, gently pull the foreskin back as far as it will go comfortably in the bath - don't force it. Over time, this may just relax the skin enough so a circumcision wouldn't be necessary. It's worth at try anyway if you don't want to rush into surgery. Just beware that you don't force the foreskin back and cause a tear as that will only make matters worse.

A small amount of steroid ointment applied to the foreskin can help relax the tissue so that with time the foreskin can retract fully. You can discuss this option with your doctor. It might be worth trying before surgery.

As for the general anaesthetic, there is always a small risk and I wouldn't advise unnecessary operations but this may become a necessary one. The operation is relatively short and so the risk is small, but you are right to be concerned.

Question: Hi - is it ok for me to give my 14 month old daughter a few daily drops of my Omega 3,6,9 oil?

Answer:Omega 3 and other such oils are important in the diet. You can get these if the diet contains fish such as tuna, salmon, rainbow trout, sardines, Atlantic mackerel, and herring. A serving of an oily fish once a week is often enough.

Fish oil supplements have been given to children as young as 20 months and there has been suggested benefit in some aspects of learning and behaviour. There has also been a study that has shown a reduction in viral respiratory infections in children given fish oil - see News and Updates.

If you use a supplement it is important that you use one that has been shown to be safe in children and to use it in the correct child's dose. You should choose a supplement that is made from the pure fish oil as opposed to one made from fish livers as fish livers may contain other toxins or very high levels of Vitamin A and neither of these is desirable in a toddler.

Having said that, there are no reports of adverse effects from the Omega 3 oils in itself.

Click here for further information on Omega 3 in children.

Question: My daughter is four years old and has been complaining that her bum is sore. She does have a mild red rash around her anus. This has only been a problem for a day. Could you give me some ideas on what could be causing this or should we see our family doctor? Thank you.

Answer:If the area around the anus is very red, your daughter could have a streptococcal infection - your doctor would need to do a swab and prescribe antibiotics.

If the skin is slightly red and your daughter is scratching, she could have worms. The best way to test this is with the "cellotape test" - first thing in the morning, put a strip of cellotape over the anus and then pull off. If there are worms, you should see them on the cellotape. Antiworming medication will be necessary.

News and Updates

Fish Oil Reduces Viral Illness

A study in Thai school children who were given fish oil containing 200 mg eicosapentaenoic acid plus 1 g docosahexaenoic acid, given 5 days a week for 6 months, has found that they had fewer and shorter episodes of viral respiratory illnesses than a similar group of children given a placebo.

Reference: Alice Thienprasert, Suched Samuhaseneetoo, Kathryn Popplestone, Annette L. West, Elizabeth A. Miles and Philip C. Calder. Fish Oil N-3 Polyunsaturated Fatty Acids Selectively Affect Plasma Cytokines and Decrease Illness in Thai Schoolchildren: A Randomized, Double-Blind, Placebo-Controlled Intervention Trial. doi:10.1016/j.jpeds.2008.09.014

Have you seen this website?

Food Intolerance Network - information on food additives and how they may affect childrens' behaviour. It includes information on the FAILSAFE (free of additives, low in salicylates, amines and flavour enhancers) diet.

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