Doctor fields questions about autism, bowleggedness and allergies
Tuesday, June 29, 2004 7:51 AM PDT
By Dr. Sue Abell
Printable version
E-mail this articleDear Dr. Sue,
I've heard that a baby whose head is growing rapidly may be developing autism. Is this true?
Dear Parent,
There have been several studies that looked at abnormal brain growth in infancy as a marker for autism. The most recent was published in the Journal of the American Medical Society in 2003. This study included 48 autistic patients. It was found that a large proportion of these patients had heads that were smaller than average at birth (about the 25th percentile), but that grew more rapidly than usual so that by somewhere between six and 14th months of age their heads were well above the norm (84th percentile on average). Those children with the most severe forms of autism showed the greatest increase in head size.
This is a very intriguing finding that definitely deserves further investigation in larger study groups. Meanwhile, keep in mind that by definition, 25 percent of totally normal babies have head sizes at the 25th percentile! And many normal babies have a similar period of very rapid brain growth. (At least 6 percent of children, according to some sources.)
If your baby has very rapid brain growth, your pediatrician will be investigating him for any other problems that can cause large heads. If those are ruled out, then careful observation of his development would certainly be worthwhile.
Dear Dr. Sue,
My three-month-old loves to stand on my lap, or anywhere else, while I hold him. My mother says that I shouldn't let him put weight on his legs or they'll end up being bowed. Is she right?
Dear Parent,
This is one of those myths that never seems to die. It probably originated during a time when more babies had abnormal bones due to a greater incidence of rickets. Bones that are abnormally soft will be deformed by weight-bearing.
Normal bones, however, actually straighten in response to use.
The definition of bowlegs is legs that are further apart at the knees than at the hips. The curve occurs in the thigh bone, not the bones below the knees.
Don't be frightened if your baby looks like she is bowlegged during her toddler years; this is common and is due to the folded position the legs were in before birth. It also doesn't help that in toddlers the calf muscles tend to lie along the outside of the leg, adding to their bowlegged appearance. As your child gets older she may well go through a knock-kneed stage and then usually her legs will straighten out all by themselves. Treatment is only needed when the curve gets worse and worse with age, a condition known as Blount's disease.
Dear Dr. Sue,
My daughter, who is four, is really suffering from allergies this year. She's been plugged up and sneezing since the middle of the winter. She's miserable.
I've been giving her Benadryl but she gets a little hyper when I do, so I use it very sparingly and only when she's at her worst. Should I use something else? I hate to medicate her for something that's not serious, but I feel really bad for her.
Dear Parent,
Allergy symptoms are sometimes undertreated due to a belief that they are just a minor nuisance and that sufferers can just live with them. When symptoms are mild, that's just fine. When symptoms are severe, however, they can affect a child's mood, ability to sleep, ability to concentrate, and even appetite (since they sometimes can't taste their food). Allergies sometimes lead to recurrent sinus infections, chronic fluid behind the eardrums which can be great enough to cause hearing loss, flares in asthma, and even in changes in the shape of the palate resulting in dental problems.
It's important to try to pin down what your child may be reacting to and to limit exposure to those things when possible. If it's not clear what the culprit is, try eliminating as many suspects as possible. Keep pets outdoors, or at least always out of her bedroom.
Dust and dust mite allergies are very common. Cover her mattress and pillow with airtight cases that totally enclose them. Wash her bedding weekly, and allow her to sleep only with stuffed animals that can be laundered weekly also. Consider treating carpets with a spray that kills dust mites. Invest in a dehumidifier if her bedroom seems humid (especially if it's a basement room).
Bathe her and wash her hair at night when she comes in from playing, to remove pollen..
Remember to clean your furnace filters regularly.
When it comes to medications, I feel strongly that the sedating antihistamines like Benadryl are inappropriate. Even children who don't seem drowsy may suffer from subtle effects on learning or concentration following these medications. Those that are hyperactive after a dose may be fighting drowsiness or may feel agitated without drowsiness. The other problem with these medications is that they generally have to be given every four to six hours to control symptoms. I would suggest generic loratidine (the active ingredient in Claritin) for children over age two who have bothersome symptoms. If symptoms aren't controlled with loratidine, see your pediatrician for other options. These might include ruling out a sinus infection, other prescription antihistamines, nasal steroid sprays, or an evaluation by a pediatric allergist.
Dr. Sue Abell is the mother of four children and a pediatrician at the Child and Adolescent Clinic in Longview. She welcomes any questions about children's health or related family matters. Dr. Abell can be reached by writing to her at the clinic, or in care of The Daily News, P.O. Box 189, Longview, WA 98632.
Past Month's Most Commented Stories