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News from Baby Medical Q&A, Issue #037
October 01, 2009

New Questions and Answers

Question: My grandson is 1 year old now. He is starting to scream if he is not being held. Prior to this, Mom has been able to put him in his walker, or have him crawl around and investigate everything and he has been perfectly content to do this. She is a great mother and pays a lot of attention to him - reads to him, sings and plays games - she is being a great mom. Why the screaming? If she tries to put him down for a nap - he screams. If he is on the floor and she is trying to do something that makes it impossible to hold him, he screams and pulls on her clothes. The screaming lasts for an hour, it doesn't stop until she finally picks him up. He was sleeping through the night, now he wakes up every two hours screaming.

She is getting weary of the screaming and doesn't quite know what to do. Any suggestions?

Answer: If your grandson settles immediately he is picked up, then there is unlikely to be anything wrong with him. The most likely thing is that he screams to be picked up and to get his mother's attention.

It is clear your daughter has given your grandson a lot of attention and that is good. However, she also needs to be able to do what she needs to do as well, and your grandson will need to learn this. Currently, he knows his mother will pick him up if he cries, even if it takes an hour.

Your grandson is not being naughty or anything like that, he just wants to get what he wants which is time with his mother. He doesn't know yet that she is unable to give him constant attention. It's something that he needs to learn now, and your daughter needs to teach him this.

It's really important that once a decision is made to change the behaviour (the screaming) that nobody gives in. Giving in because the baby makes it too difficult, only reinforces to him that he just has to perservere (in his case, scream more) and he will get what he wants.

During the day, when he is put down, he shouldn't be picked up while screaming. This is as long as your daughter knows that he is basically well. If he's unwell, then she needs to attend to him. Your daughter should tell your grandson that she won't pick him up while he's making that noise. If it goes on and on, there will be a moment when the screaming settles down - at that time, your daughter can pick up your grandson (so he associates quiet with being picked up).

For the nap, I would use a similar technique - see the Controlled Crying Technique.

For the night time, it's important that your grandson has learned to go to sleep alone. This is the first thing to ensure. Then the Controlled Crying technique could be tried.

Question: I have a 16 month old little girl. I just noticed the past 2 days that the white part of her eyes are grey.

Answer:It is normal for baby's eye whites to look white. Having said that there aren't that many conditons that make the whites of the eyes look grey.

I am a bit concerned that they are a blue/grey and if that was the case, I would worry about oxygen levels in the blood being low. Having said that, if the oxygen levels were low, I would expect blue coloration around the mouth and finger and toe nails as well.

The most likely thing is that your baby is well. See a doctor if your baby is not well in herself, has blue or dusky lips or nails, is breathless or you are still worried.

Question:When I was a teenager I begin to get these blotches of skin discoloration on my neck, chest and back they come and go but I always have some (occasionally a lot). They look like cafe au lait spots, there's no itching, scaling, etc. The are smooth, reddish brown some are small, some larger, they are light but distinguishable (I am very fair-skinned). I showed my doctor and she didn't know but she was going to try a fungal treatment even though she didn't really think it looked like that. Have you any idea?

Answer:Have a look at my page on skin diagnosis .

It sounds like pityriasis versicolor to me. there are pictures of this rash on DermNet NZ. Treatment is with antifungals or agents with selenium. Some of the anti-dandruff shampoos have selsenium (eg. Selsun) - apply the shampoo with showering for a couple of weeks.

Question: My 15 month old swallowed a small paper sticker - is this dangerous?

Answer:You don't need to worry. The sticker should pass out through the bowels in due course.

Small objects will pass into the stomach usually without blocking the airway or oesophagus. If there was a blockage in the airway, your baby would have choked. If the object blocked the oesophagus, your baby would be vomiting or not able to drink or eat.

Most objects will also usually pass through the bottom end of the stomach and then eventually out through the bowels. As long as that happens, there are no concerns.

Objects to worry about include: -small toys etc that may block the airway and cause choking, -sharp objects that might cause damage to the lining of the oesophagus, -objects that are too large to pass through the bottom end of the stomach. These will not come out in the bowel motions and may cause vomiting -small lithium batteries - these are dangerous as they can erode the lining of the stomach. If your child swallows one, it is important to seek medical attention - it the battery doesn't pass through the stomach, surgery would be needed.

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News and Updates

Bulging Fontanelle in a Baby

Many mothers have heard that a bulging fontanelle is a sign of serious illness in babies and means meningitis. As you see on my Meningitis page, this is not usually the case and if your baby is well, then a bulging fontanelle is not a serious sign. A recent study of children with bulging fontanelles has confirmed this. Very few of the babies with a bulging fontanelle had meningitis or other serious illness.

Reference: S Shacham, E Kozer, H Bahat, Y Mordish, M Goldman. Bulging fontanelle in febrile infants: is lumbar puncture mandatory? Archives of Disease in Childhood 2009;94:690-692

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