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News from Baby Medical Q&A, Issue #065
February 01, 2012

New Questions and Answers

Question: I would like to see more info on what a white patch (irregular circle of approx 2cm X 2xm) could mean? My 5 month old baby has a white patch that has appeared on the back of her leg in the last five days. No rash, no irritation, it just looks like it's lost pigmentation. I can't find information anywhere and I have a 4 month wait to see my Paed.

Answer:The white patch may be a few things depending on what else is going on.

1. If your baby has eczema, it's not uncommon for the skin to become hypopigmented (so look white). This returns to the normal colour within months usually.
2. A very white patch is vitiligo and this is permanent.
3. There are some other rashes that usually improve with age.

See the skin rash diagnosis page for more information.

Question: My year old nephew doesn't react to pain. For example his older sister who is 4 was playing with him on the trampoline and he fell awkwardly and bit down hard on his tongue and made it bleed. He must have bitten it very hard as you could still see the marks several hours later. All he did was sit there. No cry or squeal or anything. Same as when he was bitten on the arm by his sister and got a nasty scratch from a kitten. Why could this be?? It is scary because it is hard to tell if he has hurt himself and if so how badly. Please help my sister in law and I know what to do about this.

Answer:Some children do have very high pain thresholds - sometimes it is a tendency that runs in families.

Pain is a protective mechanism that prevents us from further tissue damage when it occurs. What you and your sister-in-law can do is make sure you check your nephew after incidences that could cause damage, like falls from high up. You will also get other clues to damage other than crying - for example, your nephew would be limping if there was a fracture.

Some children seem to have high pain thresholds when young and then then later on have normal pain thresholds.

Question: My son is 3 yrs old and started preschool about 3 months ago. As expected he has been getting sick a lot. He has always been a picky eater but his appetite has taken a turn for the worse.The change is that even though he used to dislike to eat he used to get so hungry that he would eat. Lately he has gone from 3 full meals and 2 snacks to breakfast per day. He seems uncomfortable and when I try hard with him , he throws up. I am very concerned because I know throwing up everyday cannot be normal.PLEASE HELP . What should I be concerned about? Does he have worms?

Answer: It does sounds as if your son has lost his appetite. Is he having milk or food at the preschool that fills him up?

If you have seen worms, then treat him for that but it doesn't sound like worms to me.

It is common for children to get lots of coughs and colds when they start preschool, and this includes gastroenteritis which can cause vomiting.

Low iron stores can cause poor appetite and so iron supplements may help.

If your son doesn't improve his eating soon or if he loses weight or you are just still worried about him, see your doctor.

Question:My 5 month old baby's doctor has told us that his head is growing faster than it should be...What does that even mean? We have had an ultrasound done and they said it was fine but then checked it again and she said it was still growing to fast. What exactlly does that mean?

Answer: It is good to hear that the ultrasound is normal. When babies are growing their heads grow too and follow a growth pattern on a growth chart - see the growth chart page and click on the link to view the head circumference chart at the bottom of the page.

I assume your doctor is concerned because the head circumference is showing growth crossing the centile lines - sometimes this happens if the head is "squashed" at birth and then the baby finds it's natural growth curve, which may be at the top end of the range, particularly if one of both of his parents have large heads. If this is the case, there is no need to be concerned. You might need to check with your doctor what she is actually concerned about.

Sometimes the head grows too quickly because there is a blockage in one of the ventricles that contain fluid in the brain - this causes the fluid to build up and the head grows to accommodate the fluid. If this is the case, the ultrasound usually shows the excess fluid. Also, you may see some slowing of development. This is a serious condition called hydrocephalus and is usually treated with surgery to insert a shunt that clears the blockage. As I said, the fact that the ultrasound was normal is very reassuring that hydrocephalus is not the case in your baby.

News and Updates

Delaying introduction of solids does not reduce allergy or atopic diseases - In the past, it had been thought that you could prevent allergy and atopic (allergy related) diseases like eczema and asthma by delaying the introduction of foods like dairy and egg etc. This study from the Netherlands has found that this assuumption that delaying introduction of foods prevents these diseases is not correct. As stated on the food allergy pages, delaying introduction of foods is not recommended.

Reference:Tromp II; Kiefte-de Jong JC; Lebon A; Renders CM; Jaddoe VW; Hofman A; de Jongste JC; Moll HA. The introduction of allergenic foods and the development of reported wheezing and eczema in childhood: the Generation R study. Arch Pediatr Adolesc Med. 2011; 165(10):933-8 (ISSN: 1538-3628)

Have you seen this website?

Purple Crying is a very informative website about dealing with crying babies. Have a good look around the site as there is so much useful information on here.

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