Medical Advice About Toddlers

Sam Norman: It’s that time again when our resident doctor Su Laurent joins the Baby Channel to answer the questions that you have sent in by text message. Hi Su, we’ve got some very interesting questions there. The first is what are the signs that a baby is teething? Su Laurent: Well, teething is a very interesting one, isn’t it? Sam Norman: Yeah. Su Laurent: And we will be through with our children and a lots and lots of things are put down to teething and I found lots of people say, oh I think he is teething months and months before the teeth appear. Sam Norman: Everytime through my teeth, it’s a tooth, isn’t it? Su Laurent: Exactly but I think the real signs are both in a redness of the cheeks, really an intense redness. And you can sometimes look in the gums and feel that they feel rather sort of swollen and red and they’re looking like teeth are about to come through. A lot of drooling very often and lot of putting the hand in the mouth and then sometimes, a little bit of diarrhea as well. Sam Norman: Why the diarrhea? Su Laurent: Oh, it is quite interesting, I don’t know, I think it isn’t quite clear why but there have been a bit of research to look at is this true? And the answer was, yes it is true, it does happen, presumably something to do with the gut, bulks that live in the gut or also slightly by the teeth coming through. Sam Norman: With your hand in the mouth or whatever -- Su Laurent: Who knows, who knows. Sam Norman: Yeah. How long the onset of teething does it take for the first two, three years? Su Laurent: Well, this is an another really interesting one, because it depends on whether you are right with what you’re calling teething. Sam Norman: Yeah. Su Laurent: And some people say, oh my child is being teething for four months until the first tooth appeared and I would say that wasn’t teething four months ago. I would say true teething, the teeth are going to start appearing within a matter of weeks, not months. Babies can be born with teeth. The average time for the first tooth is about six months, but normal childrens, sometimes that won’t happen until at least a year. Sam Norman: And is it always stressful for the child or can you just teething --? Su Laurent: No. I think some of them just, you just notice it, I often I found in the first year, the teething bit was a bit stressful but it was fine. The second year, I suddenly noticed, there are more teeth out there and I hadn’t realized it’ll come through. So I think it sort of gets better. Sam Norman: Next question, please could you give me some information and advice on weaning. My son is five months old and I am concerned about over or under feeding him, now that’s a tricky one, isn’t it? And at which point to cut out bottle feeding? Su Laurent: Okay. Well, weaning -- the current advice that we’re giving all parents is don’t wean them on to solid food until they are six months old. Sam Norman: Right. Su Laurent: Now that’s because your baby doesn’t need anything other than milk until they are six months. But you can be sure that many, many parents are still giving solids earlier now, I certainly did. Sam Norman: I did, third month I think. Su Laurent: About four months. I think what happens is, the baby start to tell us, his mums and dads so they are beginning to be a little bit hungrier and you’ll notice that, maybe they’d been sleeping through the night then not anymore and they’re looking around and they’re sort of reaching out and trying to pick up food. So sometimes, starting it a bit earlier, I don’t think it’s a problem, I shouldn’t be officially saying this. And then starting on a little bit of one type of food, something breast milk and to some extent for them, the milk is quite sweet, so they’re going to take -- more likely to take the things that are quite sweet, like a bit of mushed up banana. Then they are to the kind of gluey baby rice stuff that we all buy as the first weaning food. Sam Norman: Right. Su Laurent: I mean my children certainly spat out baby rice to begin with. Sam Norman: What about allergies if you feed too early? Su Laurent: That’s a very good question. Don’t give anything containing wheat before the age of six months. That is sort of a categorical note. Sam Norman: Very good advice. Su Laurent: And only really try to begin with fruits, vegetables, and baby rice, just keep to a minimum, keep to one at a time. If they are fine with that, then try something new. Try just one time a day giving them a spoon full of something to begin with and then get to twice and then three times and take it at your baby’s pace. Sam Norman: Right. Su Laurent: Your baby will tell you if that’s what they want. Sam Norman: Because it’s just tempting, isn’t it? Trying to get them to sleep through the night or feed them to them. Su Laurent: It’s tough. Sam Norman: Yeah, exactly. Su Laurent: Exactly, yes. Sam Norman: But avoid that temptation. Su Laurent: And one more thing I think it’s important to say is your Health Visitor is the person to talk to about this. Sam Norman: Okay. Now here is another one, it’s interesting. My nine month old son was born with a condition called hypospadias, did I pronounce that correctly? Su Laurent: Yeah, yeah. Sam Norman: He is going to get a corrective operation very soon. We’ve told that his penis will work fine afterwards and it will look normal, is this true? First of all, what it is hypospadias? Su Laurent: Well, I suppose the audience know and it’s where the -- what happens is that the urine comes out of the tip of penis through something called urethra and usually as we know, it usually works its way all the way through the tip but some little boys are born with the urethra opening below the tip and may be --. Sam Norman: Poor little might. Su Laurent: And may be just below the tip, or it may be somewhere down the shaft, underneath the shaft of the penis or maybe right actually coming out of body; right at the very base of the penis. What happens is, these very clever surgeons called urologists create a tube that goes all the way to the end. Boys are very luck because they are born with a full skin, which is a natural little bit of extra skin that they don’t really need, that can be used to create this tube. Sam Norman: Oh I see. Su Laurent: So the big message to all parents whose babies are born with hypospadias is, do not have them circumcised because that little bit of full skin is going to be what’s used to create the tube. Sam Norman: That’s correct. And what does the operation involve, I mean I think, it have to be circumcised as they do this? Su Laurent: Well, it depends on the extent of hypospadias is to with this one operation or several operations. Sam Norman: Right. Su Laurent: Because it may have to be done in several stages. But the end result I must say is excellent and I should be -- should tell these parents, they should be encouraged because the end result of the little boys that I’ve seen is excellent. Sam Norman: You know, lots of functional -- Su Laurent: No, it seems to work very well. Sam Norman: How do you know if your baby has got it? Su Laurent: You will be told at birth because part of the general examination of a newborn baby is to look at their little willies and check that it comes out of the right place. Sam Norman: Right. Su Laurent: And also you’ll notice as a parent because when your baby pees, the baby boys we know they shoot up in the air, shooting out off the wrong place, you’ll spot it pretty quickly. Sam Norman: Right, okay. Now and here is the next one. My daughter Jessica is nearly 15 months old and I am very concerned that she isn’t showing any inclination to pull herself up, let alone walk, should I be worried and what can I do to encourage her? Su Laurent: Well the normal age, age for starting to walk is around about 13 months but it’s perfectly normal not to walk until 18 months, so she is well within the normal range. Sam Norman: So no need to panic? Su Laurent: No panic, provided everything else about Jessica is normal in terms of her development. Sam Norman: Yeah. Su Laurent: So no panic. Just encourage her to do her own thing. Sometimes the position in the family makes a difference, you will tend to spend a lot more time with our first children, wandering around with them, encouraging to do things. Sam Norman: Yeah. Su Laurent: Second ones and third ones just get along with it. So don’t worry. If you are worried, obviously ask your Health Visitor, but mostly you will be reassured about the baby at 15 months. Sam Norman: Just they say, get on with the children. Su Laurent: Yeah, exactly. Sam Norman: Now this is an interesting one. My baby is 16 months old but he can’t crawl or stand up by himself, he has no interest in play and can’t grip or pick up toys. I am really worried as he does not show the normal signs of a baby his age. Is that a worrying one? Su Laurent: Well, I would say this one probably is a little bit more worrying, yes because what we’re hearing is not just a question of growth motive problems probably. Sam Norman: Yeah. Su Laurent: It may be more fine motive problem as well. And it may be that this baby is not socializing very much, not playing very much. And it’s difficult to know there are a lot of different reasons this could happen and one end of the spectrum is that actually this is a normal baby. Sam Norman: Just a late developer. Su Laurent: Just a late developer. But I think this baby really should go along to see to the GP or the Health Visitor for a general checkup and hopefully for some reassurance but it may be that the baby needs to have few tests. Sam Norman: Because we are obsessed only with children fitting into sort of boxes and they have to be at a certain stage -- to a certain age and it’s not often helpful, I mean something --? Su Laurent: No. I think one of the big problems that we all go through as parents is, we compare our baby to other babies. Sam Norman: Yeah. Su Laurent: And if baby isn’t doing what our friends’ babies' are doing, we get very worried, often unnecessarily. Sam Norman:Yeah Su Laurent: And often what will happen is the baby will just develop in their own speed. We don’t know, for example, if this baby is showing any signs of talking yet, and may be this baby is quite chatting and quite interactive but just isn’t a sort of baby who is very mobile. Sam Norman: But he should see a GP? Su Laurent: I think so, to be reassured hopefully. Sam Norman: Okay. My baby is five months old and he -- because I had this one, about in the cot so much that he ends up upside down and with his head under the covers. I am terrified and got deaf and dump what to do? Su Laurent: Well the answer for this baby is, a baby – a sleeping bag, these babies grow at sleeping bag, did you ever one of those? Sam Norman: Eventually. Su Laurent: Yes. Sam Norman: I feel they sort of came onto the market just towards the end of baby’s initial days. Su Laurent: Well, I did for my second too, not for my first. Sam Norman: Yeah. Su Laurent: And it’s wonderful, you just zip them in, the hands come out of the top, they are zipped in completely and they keep warm all night, doesn’t matter how much they wriggle around, nothing can come over their heads because there is nothing to put over their heads. So that is definitely the answer for this one. But the one bit of reassurance for these parents is that, that most babies can wriggle around an awful lot in their cot, usually they can wriggle their way out of danger. Sam Norman: Yeah. And then my elder son loved to have something on his face when he was sleeping, he used to put muslin air bed or something. Su Laurent: I think yeah, something light like a muslin and also never you just do those for young babies. Sam Norman: No. Su Laurent: And so if this baby is wriggling around under sort of a light sheet or a light blanket, that’s one thing, but I wouldn’t mind this baby to wriggling around under a big duvet Sam Norman: Okay. How come –- this is the great chestnut, isn’t it? How can I get my child to sleep through the night? He is six months old. I never could. Su Laurent: This is a great chestnut and this is six months, if you are lucky, your baby will just do it naturally, if you are lucky. But I must say that I wasn’t one of those lucky parents. Sam Norman: No, I was never –- Su Laurent: It sounds like you aren’t either. And I decided that, that I just couldn’t cope with sleepless nights anymore and I had to just go through a sleep program. There are two or three good books out in the market, one of them, that is naturally by the Great Womens Sleep Team. Then how to get your baby to sleep through the night? And my strong advise is, do what they say. Sam Norman: Okay. Su Laurent: The general message is that to get your baby to sleep through the night, you have to get them into a good sleep routine so that you have to put them into bed, you have to get them used to go into bed and must be awake and then leave them while they are awake so that they know that is okay to wake up the night and find their mummy and daddy there. Sam Norman: And they controls crying. Su Laurent: They control crying. Sam Norman: Just a nightmare. Su Laurent: And many parents say to me, I won’t may be sleep through the night but not to hear them crying. And I often say, well, that’s fine but it may be two years until you get to that point. Sam Norman: I remember my Health Visitors is --, she said, no baby ever died of crying. Su Laurent: Absolutely, nor do they get deep psychological problems either, that’s important thing. Sam Norman: I am 18, this viewer says and I had a baby girl 9 months ago and she is wonderful. I’ve got postnatal depression or puffing and I am too ashamed to get help, do you have any tips to get me over this? Su Laurent: Well the first thing I suppose is to acknowledge it and that’s a big step to acknowledge this because postnatal depression is something that a lot of people just brush under the carpet indeed. Sam Norman: Yeah. Su Laurent: But please, please do get help, don’t be ashamed about it, it is very, very common, I say to this young mum. Having a baby turns your life upside down, not to say your body, your friendships, your hormones, it is a wonderful thing but you do need help because actually for you baby, you’ll need help if you got postnatal depression. Sam Norman: Yeah. Su Laurent: And your GP will taught you in complete confidence and will help you. I mean tips, just they are getting on weight, think about your diet if you got postnatal depression, make sure you’re eating healthy food, getting plenty of sleep, socializing with other people who’ve got young babies and that’s very important, you can get very cut off. Sam Norman: Yes. Well, it can be very reassuring to contact and to meet other people. Su Laurent: Yes. Sam Norman: Yeah. Su Laurent: But do go and chat in confidence to your GP. If you are not sure about your GP, find one that you do like, that you feel like you can really talk to or your Health Visitor, they are often very helpful as for the postnatal depression. Sam Norman: Yeah, I mean my Health Visitor spotted mine, I was having my second child but it’s very difficult sometimes to decide whether you’re just sleep deprived -- Su Laurent: Yes. Sam Norman: And exhausted or depressed. Su Laurent: And if you don’t know, why don’t you go along and have a chat about it, I think it’s helping. Sam Norman: Yeah, exactly. Su Laurent: Yes. Sam Norman: Very good advice. Would you advise controlled crying to get my nine month old baby boy into routine? Su Laurent: Well, as we have just said, I mean, we are talking about routine, I was assuming we’re talking about sleep again. And yes, I mean I must say I am a controlled crying person, I’ve done it through all three of mine. I have many friends who have done it for all of theirs. What it really means is, one or may be two or three bad nights and you are soaping those three bad nights for more or less forever after good nights. Isn’t it worth it? That’s all I can say. Sam Norman: My advice is also. Thank you very much Su, that was wonderful. Thank you. Su Laurent: Thank you. Sam Norman: Hope you all are very reassured by that.