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News from Baby Medical Q&A, Issue #038
November 01, 2009

New Questions and Answers

Question: At age one my grandson was babbling & saying single simple words. At age 2 now, he does not talk at all. He understands & reacts appropriately when spoken to.His hearing is excellent (he can hear a pin drop in the next room). But, he has not spoken a word in months even with coaxing. He grunts & points at what he wants.Today while babysitting him, he distinctly said "my bottle" outloud once & then would not repeat it but reverted back to grunting & pointing. I cannot find anyone who has ever heard of this behavior/condition. Is this a sign of Autism? Thank you for your time.

Answer: It sounds as if your grandson has good hearing and good understanding. He clearly can make words because you heard him. For some reason, he prefers to use grunts etc now. It sounds as if a lot of energy is put into getting him to speak, so he gets a lot of attention by not speaking.

I wouldn't worry and I'd just ignore his grunting in that I wouldn't make a big deal trying to get him to speak. When he does speak I wouldn't make a huge fuss but I'd acknowledge it - so day something like"it's so much easier to understand you when you use your words".

Autistic children do have communication problems but from what you've said I didn't get that impression. If your grandson points to objects of interest and in interested in what others around him do, it is unlikely to be autism. There is a questionnaire you can look at called CHAT - click here.

Question: My 18 month old son chews on his fleece blanket & actually pulls threads from it and eats it... should I be worried...? Does he digest the thread? If not, where does it go?

Answer:Eating unusual things, like fleece, is called pica. This is not an unusual condition in children.

First, the fleece thread is not digested. It will pass through the gut to eventually pass in the bowel motions. If your son eats a lot of thread there is the danger that the thread will collect in a ball in the stomach - this can cause a blockage. If your son has vomiting that doesn't improve, a blockage may be likely - see your doctor as the treatment will be surgery.

Pica is often seen in children who are slightly low in iron. I would advise a 3 month course of iron supplements, which you can get from your doctor, to see if this improves the situation.

The other thing that can cause pica is high lead levels in the blood. If you live in an area where there is lead - usually old houses with peeling paint, then it would be wise for your son to have a blood lead level check. If there are any concerns about his development, then a blood lead level would be wise as well.

If your son is having blood taken, checking iron levels as well as lead levels is wise.

Question:My four month old son has vitiligo on his right eyebrow and eyelid. Can it be cured?

Answer: The most important thing for you baby now is to protect the skin so use a sunscreen, (with at least SPF 30)

In the future when your son is older, other treatments may be available, including cover-up treatment (so covering the white area with products that make the skin look darker), or maybe topical treatments such as steroids or psoralens (both of these would need medical supervision).

For now, keep your baby's skin protected from the sun with a sunscreen.

Question:A three yr old put a floride pill up her nose - will it do any harm to her?

Answer:As long as the flouride pill has not become blocked in the nostril, there should be no concerns. If the pill is still in the nostril and you can't get it out by asking her to blow, you may need to see your doctor. Don't push it up any further.

News and Updates

Children at Risk of Low Vit D levels

A recent US study looking at Vit D levels found that there was widespread low Vitamin D levels in children, particularly Hispanic and non-Hispanic black children.

Vitamin D is necessary for strong bone growth.

To ensure adequate Vitamin D levels, children should have adequate sun exposure (without sunscreen so it's best to give sun exposure in early morning and late afternoon not in the midday sun). Children need exposure of the arms and legs or of the arms, hands and face three times a week - white children need 10-15 minutes on each occasion, and darker skinned children need 15-20 minutes on each of the 3 occasions per week.

Reference: Jonathan M. Mansbach, Adit A. Ginde and Carlos A. Camargo, Jr. Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D? PEDIATRICS Vol. 124 No. 5 November 2009, pp. 1404-1410 (doi:10.1542/peds.2008-2041)

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