Resources

Illnesses - Ta-Zz

THUMB-SUCKING AND PACIFIERS

General Information:

Babies and young children love to suck on thumbs, fingers, and pacifiers. A security object often becomes part of the ritual.  The baby's desire to suck on the breast or bottle is important for nutrition and a full 80% or more infants suck on hands or pacifiers when they are not hungry. Sucking seems to help young children comfort themselves.

If your baby loves to suck, it is a good idea to give her an orthodontic pacifier (Nuk) by about 1 month of age so that she will not begin sucking her thumb. The pacifier does not cause the severe overbite that can result with prolonged thumb-sucking and is easier to wean your child from since it is not part of her body. Do not use home-made pacifiers such as nipples taped to bottle tops since they can come apart and choke your child.  Do not put your child's pacifier on a string around his neck that can result in choking. Rather use a pacifier that clips on part of his clothing. Do not coat the pacifier with sweets or honey since these can cause cavities or infant botulism in babies. Do not use a pacifier that has fluid in the middle of it since this can become contaminated with bacteria.  Also rinse off his pacifier each time he is finished with it or it falls on the floor. The sucking drive decreases as children age with only about 15% sucking their thumb or fingers by 4 years of age.

Treatment:

1. Thumb-sucking before 4 years of age does not usually cause any problems.  However, a sucked thumb acts as a kind of orthodontic device, creating an undesirable overbite. If your baby rejects the pacifier and is clearly going to be a thumb sucker, try to encourage the baby to hold the thumb in all the way to reduce the overbite effect.
   
2. Occasional thumb-sucking during the day when your child is tired does not cause problems; if constant during the day encourage your child by reminding him that big boys do not suck their thumb and by showing him the callous on his finger that may hurt at times.
   
3. Thumb-sucking at bedtime is usually not voluntary and probably unimportant if it stops after your child falls asleep; if it is constant during the night consult your dentist to see if it is affecting her teeth.
   
4. If by 5- or 6-years old your child continues to suck his thumb frequently and your dentist is concerned that it is affecting the alignment of his teeth, then a bitter-tasting medicine (Stop-zit) can be applied at bedtime or a dental appliance may be placed in your child's mouth to prevent his sucking.
   
5. Encourage her to stop the pacifier if she is 3 or 4 years by giving her stars or marks on her hand and lots of affection when she is able to go for a short period without the pacifier. Never punish or humiliate her to give up the pacifier.

VAGINITIS
[BACK TO LIST]

Vaginitis is very common in a girl before puberty because her vagina is very sensitive to irritants at this age.  But she is less likely to have a yeast or bacterial infection than when she is a teenager or a young adult. She likely will complain of urinary pain because of the inflammation of her vagina.  Usually her urine will need to be examined to be assured that she does not have a bladder infection.

The most common causes of vaginitis are bubble baths, soaking in soapy water, scratching accidentally, soap residue on her underwear, self-exploration, poor hygiene, and wiping in the wrong direction after a bowel movement. Tight clothes and nylon underwear may cause irritation.

Treatment:

1. Stop all bubble baths and do not give your daughter soap until 5 minutes before she gets out of her bath.  Do not wash her vagina directly since soaking in her bath for 15-20 minutes is sufficient for good hygiene.
   
2. Teach your daughter proper hygiene and wiping from front to back after bowel movements to avoid bringing stool to the vaginal opening.
   
3. Use mild soaps or double rinse all underwear.
   
4. Have your daughter wear cotton underwear and looser clothing.
   
5. A cream to apply 3 times a day may be prescribed by your doctor.  Vaseline may help if your daughter has accidentally scratched herself.

Call Your Doctor If:

1.  She has large amounts of discharge of any sort.
2.  She has a vaginal discharge that contains blood or is very foul smelling.
3.  You have any suspicion that an older child or adult has had sexual contact with her.

VOMITING
[BACK TO LIST]

General Information:

Most children who are vomiting have a viral infection causing a mild stomach upset. Antibiotics do not help vomiting and diarrhea caused by a viral infection. If your child is more than 6-months-old, vomiting and diarrhea can usually be effectively treated at your home.  However, call your doctor if any of the following signs appear:

• Blood in the stool
  High fever
  No urination in 8 hours
  Excessive sleepiness
  Very dry mouth
• Crying without stopping

Vomiting and diarrhea are ways your child eliminates harmful organisms when he has a viral or bacterial infection or tainted food (in the case of food poisoning).  The main danger of prolonged vomiting and diarrhea is the danger of dehydration, not the vomiting or diarrhea itself. This usually resolves on its own after a couple of days.

Treatment:

1. Give him no fluids for 30 minutes since the last episode of vomiting.
   
2. Give him 1-2 teaspoons of Gatorade or other sports drink every 30 minutes if he is older than 12 months (or Pedialyte for babies less than 12 months). These drinks replace his salt, water, and other minerals lost through vomiting.  Do not give him fruit juices which may cause more vomiting. An old home remedy is Coke frozen into an ice cube tray, then chopped up for the child to take a little at a time.
   
3. If he keeps fluids down, you may double the amount given him every 1-2 hours.
   
4. If he vomits again, restrict his fluids for 30 minutes and then resume the above procedure. Call your doctor if he does not seem to be improving.
   
5. Continue giving him clear liquids for 8 to 24 hours. Chicken broth with a little rice or noodles and plain soda crackers are usually well tolerated during recovery. If vomiting stops, restart a mild diet if older than 12 months (BRAT: bananas, rice, applesauce, toast) or breast feeding or lactose-free formula for infants.  In a day or so, slowly return to a regular diet in 2-3 days.
   
6. His symptoms will take a minimum of several days to go away.
   
7. When offering her fluids, avoid using red or orange liquids since they could make her stool look bloody.
   
8. Medications for vomiting or diarrhea do not help much in children, and at times can cause serious side effects, especially in young children. For this reason, most doctors are careful in the use of medications and stress the cautious approach as described above.

WARTS
[BACK TO LIST]

General Information:

Warts are caused by the human papilloma virus which causes the characteristic raised, round, rough-feeling growths that are most commonly found on the hands. These are not usually painful unless they are located on the soles of the feet or if your child is constantly picking at her wart.

Most warts will disappear after two or three years, but with treatment will go away in 1 to 3 months, although with some difficulty. Most warts are only mildy contagious to others and so your child can attend school and other social functions. However, you should encourage your child to not pick at his warts as they are likely to spread on his hands or other body parts. A related illness caused by a different virus is called moluscum contagiosum which are smaller, wart-like growths that usually occur in clusters of several to dozens. These are much more likely to spread on your child than regular warts.

Treatment:

1. Try nonprescription medicines recommended by your pharmacist. These various brands are composed of acid which slowly dissolves the wart over several weeks. Use this treatment every day according to the instructions
   
2. At least once a week use a pumice stone to buff away the surface of the wart so as to speed up the dissolving process. This buffing process will work better if you first soak the wart for about 15-20 minutes in warm water to soften it.
   
3. Stop the buffing process if your child says that it is hurting or if you see any blood coming from the wart. It might be easier for your child to do the buffing while you supervise.
   
4. Freezing preparations can be used in the pediatrician's or dermatologist's office. It is normal to have to use this process more than once, sometimes multiple times.
   
5. Plantar warts on the bottom of your child's foot are usually more difficult to eliminate because they are pressed up into the foot by your child's body weight while walking.
   
6. Similar processes can be used on the mollusum contagiosum although it is a little more difficult to apply the acids since these are much smaller than the common wart.
   
7. Make an appointment to see your doctor if your child complains of increasing pain or he develops excessive redness around the wart while you are treating it at home.

WEANING
[BACK TO LIST]

General Information:

Weaning from breast feeding is usually accomplished before 18 months of age although some women will nurse their children longer. In developing countries it is normal and safer (due to scarcity of drinkable water) for mothers to nurse their children until 2-3 years of age.

Issues with the bottle are different. It is recommended that an infant be off the bottle and to the cup by 12 months of age, 15 months at the latest. The infants should not be given fluid in the middle of the night in a bottle because it can cause choking, ear infections, and cavities from prolonged exposure to sugar in the formula. During the day children older than one year will tend to carry their bottle around with them much like a security object. They will also sip on the contents repeatedly throughout the day. These children will often develop bottle cavities where they have multiple teeth affected and many teeth needing to be capped, pulled, or drilled.

Treatment:

1. With breast-feeding, eliminate the least favorite feeding (usually in the middle of the day) and replace it with a formula in a cup if older than 6 months and less than one year of age.
   
2. Continue to eliminate more nursing times every few days. This allows your breasts to reduce the amount of milk they are producing.
   
3. Finally, eliminate the bedtime feeding which is typically the most preferred by your baby.
   
4. If you develop engorgement of your breasts while trying to wean, take a warm shower and try to express the excess milk until you feel more comfortable.  If this does not help you may need to add one nursing time back and wean more slowly.
   
5. For bottle-feeding, you can replace the bottle with a cup every few days in much the same way that you wean from nursing. However, you can wean faster if your child tolerates it because you do not have to worry about breast engorgement.
   
6. For both breast- and bottle-feeding, once the weaning is complete, if your child asks to nurse or for a bottle, hold her for a while and explain that breast- and bottle-feeding are for little babies and she is a big girl.
   
7. Some infants are excessively attached to the bottle and will throw a tantrum if not given the bottle. Regardless of how upset he is, for health reasons do not give in when he is on the cup. His tantrums will subside in a few days.

YEAST INFECTIONS IN BABIES
[BACK TO LIST]

General Information:

Yeast infections of your baby's diaper area and mouth are very common. These infections usually cause only minor symptoms even when the infection covers a large part of your baby's bottom or mouth.  Often the yeast is acquired when your baby passes through the birth canal since the yeast normally lives in the vagina. Yeast infections are more likely to occur when your baby is on an antibiotic since antibiotics kill germs that compete with the yeast, while not harming the yeast.

Babies have frequent yeast diaper rashes because the yeast inhabits the rectum. With each bowel movement, his skin is exposed to the yeast. Since it is harder for your baby to fight an infection than an older child, medicines are usually needed to eliminate the yeast. However, even in severe cases he is likely to be only a little fussy.  The infection does not progress into something more serious.

Yeast in her diaper area appears as a bright red, slightly raised rash. At the edges there may be little isolated red spots just beyond the main rash. Your baby may have some itching with her yeast infections, but seldom will she have any pain.

Yeast in his mouth is also called thrush. It appears as milky white patches on the tongue and the sides and back of his mouth. Thrush may make your baby's mouth a little tender if extensive, but it seldom causes him to reduce feeding. Your infant may have yeast in his mouth and diaper area at the same time.

Treatment:

1. Do not be overly concerned about yeast infections in your baby. These are mild infections that do not cause her severe problems unless she has a poor immune systems (such as in leukemia, other cancers, and AIDS).
   
2. For the diaper rash the main treatment is a cream with a yeast-killing medicine in it such as Lotrimin which can now be bought without a prescription. Usually it takes about 2-3 days before much improvement is seen in him and it may take 10 days before completely resolving.
   
3. Changing her more frequently may help.
   
4. For the thrush in the mouth some doctor's offices will apply gentian violet to his mouth with a cotton swab. This temporarily stains his mouth purple, but is an effective way to eliminate mild cases.
   
5. Oral medicines such as Nystatin take longer to kill the thrush in his mouth, but also work best if the medicine is applied directly to the yeast by using a cotton swab and applying throughout the mouth including the sides and inside the lips.
   
6. Do not give her food or drink for 30 minutes after using the medicine.

Call Your Doctor If:

1. He has recurrent yeast infections.
2. She has difficulty eliminating yeast infections.
3. The diaper rash is spreading outside the diaper area or seems to be quite tender.