Parents need not worry about the amount the child is eating if the weight gain is steady

Q: My six-year-old daughter does not eat. She hates food and runs away at the very sight of it. I have heard that cyproheptadine increases appetite and might help her to gain weight. Please advise.

A: Cyproheptadine hydrochloride is actually a strong anti-histamine that works very well for allergy, especially to cold temperatures. As a side effect, it increases the appetite. It is used for this purpose in cancer and AIDS patients, but very rarely. It should not be used as an appetiser in children.

If your daughter does not eat well, try to figure out the reason behind it. Is she ill? Does she have an unrecognised low-grade infection in the urinary tract or elsewhere? Does she have worms? Or are you unrealistic in your expectation of the amount she should eat? Are you giving her too much milk? Around 400 ml a day is all that is required. Have you tried giving her food she likes?

Record your child’s weight. Her paediatrician will have the records as he/she has probably been weighing her regularly. If the weight gain has been steady and satisfactory, you may be unnecessarily worried.

Neck rash

Q: My daughter, aged 1½ years, has red rash in the skin folds of her neck. We have tried prickly heat powder but it did not help. What should we do?

A: Most babies have skin folds in the neck. After bathing, the area needs to be dried carefully using a soft towel. Rash often occurs if water and soap are left behind. After drying, apply a cream containing miconozole (Canestan/Candid). Do not use steroid creams. The rash will disappear immediately if steroids are used only to reappear later.

Club Foot

Q: My husband’s foot is twisted inwards. He limps when he walks. My one-year-old son’s foot, too, appears to be twisted. What should we do?

A: You are probably referring to the condition talipes equino varus or “club foot”. It is inherited and often present on both sides, and is commoner in male children. It can be associated with other skeletal abnormalities. It is possible to diagnose the condition early by examining the child and taking X-rays. Treatment needs to be started as early as possible. This involves plaster casts and sometimes corrective surgery.

Dwarf Partner

Q: My husband is a dwarf — similar to those we see in a circus. I want to know if our children, too, will be dwarfs.

A: The “circus dwarf” actually has a condition called achondroplasia. It can arise as a result of dominant inheritance. The eventual adult height may be around four feet. There are other associated problems in such children, like a large head (hydrocephalus) and recurrent ear infections. If they do not have any major problems, they survive and have a normal life span.

Insulin Injections

Q: My 17-year-old son has been diagnosed with diabetes. He has to take three injections of insulin everyday. Can we change this to tablets?

A: If the doctor has started your son on insulin injections, it probably means his pancreas is not producing enough insulin. Insulin cannot be taken as tablets. It is a protein that gets digested in the stomach.

Your son will probably do very well with one of the new preloaded “pen-type” devices. These can be carried in the pocket. If the temperature is very high, it can be put in a miniature insulated bag. The step of withdrawing the medication from a vial is avoided — just set the pen and poke. The needles are very fine and the procedure is practically painless.

Many famous people like Jonty Rhodes and Wasim Akram, to name a few, have achieved great things despite being dependent on insulin.

Breast Examination

Q: How often should I get a mammogram done?

A: The Americans and British have different recommendations. One says every two years and the other every three. If your mammograms have been consistently normal and there is no family history of breast cancer, every three years is probably enough.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in