Wednesday, January 7, 2009
So what is cradle cap? Who gets it and how do I get rid of it? Is it contagious? These are the typical questions I get during a 15 minute appointment. Good news! No it's not contagious. BUT...bad news...it can be a pain in the butt to get rid of completely.
Cradle cap, also known as seborrheic dermatitis, is common in babies and typically develops in the first 3 months of life and resolves by 6-12 months of age. It's secondary to overproduction of the sebaceous glands from maternal hormones. Once you see it you'll never forget it! It consists of dry scaly, flaky skin that can, if severe enough, cause an inflamed scalp. It can even show up in the eyebrows.
My daughter first developed cradle cap at about 4 weeks...she's now 3-months-old and still is the poster child. People are like, "ain't you like a pediatrician or something?"..."don't you know what this is?" YES...but I can't seem to get rid of it!
So how do you treat cradle cap? I first tried baby oil and gently brushing out the flakes. This does work (and it did)...but you have to be persistent about it, otherwise it will keep coming back! You can also try olive oil (I decided to use baby oil instead...I had a hard time coating my baby's head with cooking oil). If that fails...you can then try a shampoo with selenium sulfide (selsun blue). I decided to go out and try this technique myself today...so I'll keep you posted.
Tuesday, January 6, 2009
Monday, January 5, 2009
I love rashes…well…as a physician, not as a parent. I’d say that a good 5% of all my visits are for some form of a rash; from diaper rash to acne. Rashes are often benign, but very rarely can be life threatening. I’ve decided today begin covering some commonly seen rashes from the newborn period to twelve months of life. For each diagnosis (not everyone) I’ve provided a link to dermatlas.net. Please consult your physician for any questions regarding your child’s rash (this is for informational purposes only).
My favorite newborn rash is erythema toxicum. This is seen from as early as a few hours after birth, and it typically goes away within 1-2 weeks. This is a very common rash and is harmless. It can often look very fearsome and cover the entire torso…but again it’s very harmless. Typically it consists of yellowish papules with a red base and often is displayed in areas that are in constant contact with clothing or a diaper. This rash does not affect the palms or soles.
Acrocyanosis is also commonly seen in the newborn period; however, it isn’t really a rash. This is when the hands and feet have a bluish discoloration and the remainder of the body is healthy pink. Again, this is benign but only in the newborn period. This is from vasospasm of the small vessels in the hands and feet and will correct on its own, usually before leaving home from the hospital.
Acne neonatorum (neonatal acne) often is distressing to parents and it always seems to pop-up right before family pictures. Don’t worry…it will go away and it won’t cause scaring. Typically it presents at 2-4 weeks of age and usually resolves by 4-6 months of age. Be careful with lotions and creams, as these can often make them worse. If you do apply a lotion, try and use a very gentle lotion (without dyes or fragrances) such as eucerin or cetaphil.
Eczema comes in various shapes and sizes and it can really be a time consuming rash. It’s a form of dermatitis and it requires constant lubrication with lotions, and at times will need steroid creams for severe flairs. It is often referred to as the “itch that rashes,” …in other words…it is dry skin that itches and after one scratches, it forms a rash. Again, it comes it many shapes and forms, but typically it is a rough, raised and erythematous (red) patch. Its location is dependent on age. In newborn and infants, it is often seen on the cheeks and torso.
I see plenty of diaper rashes, and it too comes in various forms; from contact to fungal. Most commonly it forms secondary to the moist environment that has developed in your loved ones diaper, and a simple barrier cream will do the job. But occasionally a fungal infection can develop. If fungus is among us then the rash consists of red “satellite” lesions (little red bumps) that surround a red inflamed rash in the diaper region.
Well…that’s all for now. I’ll continue my fun with rashes later.
Wednesday, December 31, 2008
Okay...I feel better now!
Sunday, December 28, 2008
Given the complexity of the various stages of development, I thought I would quickly outline some of the important milestones for the various ages up to 1 year.
1) Birth - 1 month: Responds to sound, blinks, fixates on face, moves all extremities, has a startle response.
2) 2 months: Attentive to voice and noise, coos, lifts head and neck when on belly, smiles responsively.
3) 4 months: Babbles, laughs, raises body on hands, rolls from front to back, good head control, reaches for objects, grasp without release.
4) 6 months: Babbles, rolls 2 ways, sits with support, single consonants, transfers objects (from one hand to the next), rakes.
5) 9 months: Responds to own name, understands "no" and "bye-bye", sits independently, self finger feeds, stranger anxiety, crawls, creeps, scoots, inferior pincer grasp.
6) 12 months: Pulls to stand, walks independently (average range 9-15 months), plays peek-a-Boo, precise pincer grasp, bangs blocks together, 1-3 words spoken but also says mama and Dada (not yet specific), wave bye-bye, drinks from a cup.
The last 3 months have been the most challenging and rewarding to date (the first 4 weeks being the toughest). My daughter quickly became the poster child for colic. I remember some days lasting forever with nothing but the wretched sound of my daughter screaming for no apparent reason. I tried everything from swaddling and shushing to long rides in the car seat, all to no avail. But the good news is this did eventually pass. Now my daughter can be awake, happy, and sometimes even entertain herself for periods of time.
Then came the smile! This is such an important milestone and the most rewarding experience yet. Seeing my daughter smile has helped to alleviate some of the pain from the prior 2-3 months. Her smiles can quickly put me in a better mood (if she only knew how easy it is to please new parents). If I'm lucky, I can occasionally get her to bust out a huge toothless grin in the middle of screaming episode.
Her next homework assignment...rolling over!
Tuesday, September 30, 2008
Thirty-six and 3 days now! Whoever said pregnancy was 9 months surely was mistaken! We've made it 9 months and...well...NO BABY. I'm glad of course! The last thing I need is my own child to spend any amount of time in the NICU! Speaking of NICU...this has probably been the longest month of training to date. If I have to interpret one more gas or look at any more residuals I think I'll pull my hair out! Only 20 more days in the unit...not that I'm counting.