Childalert's Dr Tim Evans answers questions

Common health questions from Mums

Dear Dr Tim,

Are there any dangers to a new born baby to travel by plane considering air pressure changes etc. in the plane? Are there any recent research results on this subject?

There was a paper published last year suggesting that babies flying in pressurized aircraft at very young ages were at a greater chance of cot death than those that hadn't been subjected to these conditions. The cause was thought to be due to the fact that in pressurized aircraft one is exposed to an atmosphere equivalent to 8000ft. There was also the suggestion that all passengers experience a certain degree of mild hypoxia which would exacerbate the dangers to young babies. The debate is ongoing and my personal advice to parents is that babies should not fly until they are 6 weeks old, later if there is any neurological, cardiovascular or respiratory problems present and then only on the advice of their Hospital Specialist or GP.


Dear Dr Tim,

My daughter is ten months and had a recent check up when attending a hearing test; they are concerned because she isn’t putting weight down on her feet. We have been told to encourage her to do this but are unsure how, we have tried standing her up but she sometimes cries, she was delivered by section because she was breech with toes to ears could this have something to do with it. Also when we do stand her up she always stands on tiptoes, could you tell me if this is right.

Thank you for your enquiry. I am sure that the fact that she was breech and delivered by Caesarean section has not adversely affected her development. Some children are far keener to weight bear on their feet than others. Many children when beginning to do this do so on tip toes and this is not a problem. However if you believe that she is in pain when attempting to stand you should take her to see your GP for a checkup and full examination. I hope this answers your question.


Dear Dr Tim,

My 8yr old son has developed a facial twitch in the last few weeks. It seems to affect his mouth and nose mostly but sometimes his eyes twitch as well. He seems to be happy and does not have any problems at school as far as I am aware. He is quite sensitive and does get worried about things. I did say something to him about it when he started but he got upset and said he could not help it. I have not mentioned it since, hoping that he would get out of the habit. I don't want to take him to the Dr's as I feel this will make him more aware of it. Do you have any advice?

Thanks for your e-mail. The facial twitches you describe are known as tics. They are the commonest involuntary movements in childhood. They are usually seen in children of school age. They are habit spasms which are brief, repetitive, and involuntary and usually involve movements of the eyes, face, and limbs, such as repetitive blinking or shaking of the head. They tend to be stereotyped, increased by anxiety and often have a genetic basis. Is there any family history of this? They are best ignored as far as possible. They can be caused by tensions in the household or at school especially if there are difficulties there or he is struggling with schoolwork.

The best advice is to do nothing, supported by reassurance that they will disappear with time. Do not draw attention to them. However if he is being teased at school generally or specifically related to these tics his teachers should be alerted. Treatment is in the form of relaxation techniques and occasionally medication. Hopefully this will not be required.


Dear Dr Tim,

My two year old daughter suffers from a constant stream of ear infections. Apart from the fact that they are so painful for her, I am worried that she is permanently on antibiotics. Will her immunity be lowered in later life as a result and, anyway, isn`t there more that could be done for her than constant prescriptions? One of my friends has a child who had `grommets` put in her ears - what are they and would they work on my little girl?

Thank you for your enquiry about your two year old daughter who suffers from recurrent ear infections. In many cases antibiotics are indicated in order to combat the infection and therefore the pain. In some cases however, the pain is due to the presence of thick mucus behind the ear drum creating a pressure, which triggers the sensation of pain. This mucus blocks the Eustachian tube that connects the middle ear to the back of the nose such that is unable to drain away. As more mucus accumulates, so the pressure increases and the likelihood of pain increases. This particularly happens when the child is lying flat and as you might have discovered, the pain is often worse in the middle of the night. While this Eustachian tube is blocked and the drainage of mucus obstructed, a perfect environment for bacterial infection exists. The approach to this problem is therefore twofold. The first is two improve drainage and this can be done by having a humidifier present in your daughter’s bedroom at night and indeed even during the day in the room in which she plays. This has the effect of reducing the stickiness of the mucus and making it more likely to pass through the semi obstructed tube. The second approach is to treat any complicated bacterial infection with antibiotics. The use of repeated antibiotics when truly indicated is not a problem and certainly does not affect the immunity of your daughter. However, if a course of antibiotics is not completed, there is a possibility that the bacteria present will develop a resistance to that antibiotic which will result in problems in the future. Grommets are sometimes used when simple measures fail to produce an alleviation of symptoms and the child is continually troubled by repeated infections in the presence of excess mucus. Small ventilation tubes are therefore placed in the ear drum, this procedure being performed under a general anesthetic in hospital. If this can be avoided, all the better, since as the child grows, so the symptoms tend to improve anyway. Therefore, most ENT specialists take as conservative approach as possible. Finally there are other treatments that can be taken to improve the symptoms of a child with recurrent ear infections and this is in the form of homeopathy, cranial osteopathy, and acupuncture.


Dear Dr Tim,

Since he was about four my little boy has complained of bad headaches on the front of his forehead. I wouldn`t call them regular exactly, but they seem to coincide with periods of stress (like when our cat died) and tiredness. He is always a bit hot and feverish with the headaches and has sometimes vomited a little. He seems to need to `sleep it off` as is right as rain the following morning. I have been worried sick about whether it could be a brain tumor although our GP and optician have both checked him over and said he looks OK. I have been told that while the headache associated with fever it is `nothing to worry about`. He is now 7 and the attacks seem to be getting slightly less frequent. Is he growing out of it? Could it be some form of migraine? It runs in my family and my mother, uncle and I have suffered quite badly as adults, though never as children.

Thank you for your enquiry about your little boy’s headaches. Headaches are quite common in children and certainly can be associated with periods of stress and are certainly more common in children of school age. They certainly can be migraine like, especially in the presence of a strong family history. If this is the case, tiredness or certain types of food, and even excessive exposure to computer games can certainly precipitate them. The severe headache that is associated with a high temperature should be taken more seriously. The temperature should be controlled by taking such medicines a Calpol or Neurofen. However, if the headache is associated with fever, drowsiness, vomiting, stiff neck and a rash that does not Blanche on pressure, the possibility of Meningitis is significant and the child should be taken directly to the casualty department as a matter of urgency. As your GP said, the likelihood of this being a brain tumor is very small indeed especially with the reassurance of a full and normal ophthalmic investigation. If your little boy’s symptoms continue, you should certainly take him back to see the GP who might, in view of its chronic nature refer him to a neurological specialist for further investigations.


Dear Dr Tim,

My baby is ten months old now and while I love her very much, I find feel very depressed a lot of the time. I manage to do what I have to and she is well taken care of, but I have to admit to feeling listless a lot of the time and keep bursting into tears. This can`t be the `baby blues` I`ve read so much about, can it? I thought that only happened in the first couple of months or so. But if it is, are there any natural remedies I could take? I am still breastfeeding and don`t want to take any conventional anti-depressants

Thank you for your enquiry about your depressed mood. You tell me that your baby is ten months old and you felt that it was unlikely that in view of this that you had postnatal depression. This is not altogether true as postnatal depression can occur many months, even years after the delivery of a baby. As you will know looking after a small baby, it is incredibly tiring and, depending on your babies feeding and sleeping habits, it can be very draining on your energies. Therefore to feel low and tired at times is perfectly normal. It is only when the symptoms become severe that you should look to seeking further help. Symptoms such as general fatigue, fluctuating moods and tearfulness, deteriorating sleep patterns, especially early morning waking, (i.e. even before your child awakes), a dread and panic of the day ahead and whether you are able to cope with it, a sense of low self-esteem and self worth, a poor appetite and a total lack of interest in sex certainly suggests that you are truly clinically depressed. If you do suffer from these severe symptoms medication would be indicated especially if there was any suggestion of suicidal tendencies. However, if the symptoms were less severe than this, one could try certain homeopathic and natural remedies that might make the difference, e.g. St. Johns Wort and Evening Primrose Oil. Other measures might include taking on some extra help enabling you some time of your own such that you can get out and leave the house and perhaps take some exercise or go shopping. Some mothers believe that to feel that they are being suffocated by the pressures and restrictions imposed on them by parenthood is wrong. We all need to take time out of our busy working lives and careers. Yours as a mother is the most difficult and challenging of all. It is also enormously rewarding. I hope that this has gone some way to answering your question.


Dear Dr Tim,

I`m a busy management consultant but was forced to take 3 weeks off work recently with shingles. People keep telling me I went down with it because I am so stressed all the time - however personally I think it`s because our 3 kids all had chickenpox quite recently and I understand shingles is a related condition. Who`s right?

Thank you for your enquiry about shingles. Shingles is the complication of a previous chicken pox infection. The virus becomes lodged and remains dormant in a dorsal root ganglion of the spinal cord. It may remain dormant for your entire life without being reactivated. However, at certain times including stress, you can suffer an outbreak of shingles. You cannot catch shingles from someone else`s chicken pox. However, it is possible for a vulnerable person to catch chicken pox from your shingles. Another interesting point is that shingles will only affect one side of the body and therefore if your rash affects both the right and left side of your body, it cannot be shingles, an alternative diagnosis should be sought. Not many people know that!


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