Questions for Dr. Altmann

[Jessica at Parenting.com]

For the month of October, we're thrilled to have a pediatrician, Dr. Tanya Altmann, in the Community!

Reply to this message to ask her any child-related health questions you may have!
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Biography

Dr. Tanya Remer Altmann is a board-certified pediatrician in private practice; clinical instructor at Mattel Children's Hospital at the University of California, Los Angeles; and mother of 2 young children.

She is editor in chief of The Wonder Years (Bantam and AAP) and serves on the editorial boards of the top-selling parenting book, Caring for Your Baby and Young Child: Birth to Age 5 (AAP), and Healthy Children magazine (AAP).

Most recently, she released Mommy Calls (AAP), the new must-have resource for parents of children up to age three! Beginning in her residency and continuing throughout her years in practice, Dr. Altmann has kept track of the various questions asked by new and experienced parents. Mommy Calls represents what she considers to be the top 101 most common questions parents ask their pediatrician.

Click here to buy Mommy Calls!

[CLS]

Dr. Altmann - Welcome and thanks for taking the time to answer our questions! I have a 3 year old son. Allergies and asthma run pretty strong on both sides of the family, so it was no surprise when he started getting a constant runny nose at about 6 months. We took him to an allergist who did a scratch test, and discovered that my son was allergic to several foods and also has hayfever. They warned us that since he was so young he could still develop new allergies, but he could also outgrow any or all of his current allergies. Luckily he has outgrown most of the food allergies, but he still suffers from hayfever. We give him the generic allergy medicine Dehistine pretty much every day, even during the winter. If we don't give it to him, he gets stuffy/runny almost instantly after the missed dose. Even on the medicine he still has some drainage, and sometimes the drainage is so bad that it causes ear infections and/or sinus infections. (He actually got ear tubes at 15 months, which have since fallen out.) Obviously, the benefits of the medicine outweigh any short-term risks, but could we be doing long-term harm by giving him this medicine EVERY day? Are there any other things you would try to ease the allergies? My friend suggested trying acupuncture, but I'm a little scared of subjecting my son to it. We do run a humidifier during the winter, and we are careful to keep him inside on high pollen days. We also rarely open the windows in our house and never the ones in his bedroom. Thanks in advance for any advice you can offer.

Crystal

[oftheatlantic]

Dear Dr. Altman,
When my son was about 4 months old, the doc gave me the okay to feed him baby food. So I started out with bananas and worked our way to carrots and other fruits and veggies. He loved it! He ate it for the longest time. Well, he got really constipated, and I didn't know if it was the baby food, or the medicine that his doctor perscribed for his acid reflux. So I stopped feeding him baby food. He is now 7 months old. When I try to feed him baby food again, he throws it up. He throws up table food too. Should this be a concern? I was going to take him to the doctor, but she is on maternity leave until January, and the other doctor in that office is a weirdo. I need help!

Thanks!

[boopersbail]

Dear Dr. Altman,
Thank u so much for being being able to answer questions! I have a beautiful 17 month old daughter named Bailey Nicole. I myself am 22 yrs old and sometimes feel like im doing everything wrong being a young mother and a first time parent.. My problem with my daughter is this... She is very energetic and never sleeps. No naps, and wakes up at least 4 times during the night. Her normal wake up time is 9 am, and i try to get her to sleep by 8 p.m. When she does wake up at night, shes up for 1/2 hr or more. During the day, she runs and plays, and is very active, but at the same time, she whins and cries and gets bored very easily...A schedual never worked out, and after the hair pulling and me crying, i truely am at my whits end. Her pediatrician says that if she is tired she will sleep, but thats not a good enough answer for me. I read books and magazines and really have tried everything. Her father is always working and i get no help from him. When i sent her to my mothers house for a few days she was on a consistant schedual and my mother said she had no problem with her, and that i was lying on my own daughter...lol
Can u please help me? I dont know what else to do....Thank u so much

[sbruorton]

Dear Dr. Altmann,
My daughter is 11 months and has a lump in her breast behind her nipple. Her doctor indicated it is 2 cm, it's not causing her any discomfort, and there has been no change in it since we discovered it in July. He has been monitoring it every month and indicated that it is most likely either a cyst or estrogen build up from breast feeding. I stopped breast feeding when she reached 6 months (in May) so I don't believe it is estrogen build up. We've scheduled an ultrasound but I'm still concerned. Have you ever come across this in your practice and do you have any comments or suggestions I could bring up during the ultrasound?

[cajuncat743]

Dear Dr. Altmann,
My daughter just turned 4 months old. 2 weeks ago, she developed thrush inside her mouth, and also a yeast infection on her vagina and a tiny bit on her neck. The doctor said her mouth was very mild, and gave her an oral antibiotic, and told us to get over the counter antifungal medicine for her yeast infection and for my nipples. Well, two weeks later she still has it inside her mouth and vagina and we have to go back to the doctor. Was this the proper medication she and I should have been given? And how long will it take to clear this up?

[Dr. Altmann]

Dr. Altmann - Welcome and thanks for taking the time to answer our questions! I have a 3 year old son. Allergies and asthma run pretty strong on both sides of the family, so it was no surprise when he started getting a constant runny nose at about 6 months. We took him to an allergist who did a scratch test, and discovered that my son was allergic to several foods and also has hayfever. They warned us that since he was so young he could still develop new allergies, but he could also outgrow any or all of his current allergies. Luckily he has outgrown most of the food allergies, but he still suffers from hayfever. We give him the generic allergy medicine Dehistine pretty much every day, even during the winter. If we don't give it to him, he gets stuffy/runny almost instantly after the missed dose. Even on the medicine he still has some drainage, and sometimes the drainage is so bad that it causes ear infections and/or sinus infections. (He actually got ear tubes at 15 months, which have since fallen out.) Obviously, the benefits of the medicine outweigh any short-term risks, but could we be doing long-term harm by giving him this medicine EVERY day? Are there any other things you would try to ease the allergies? My friend suggested trying acupuncture, but I'm a little scared of subjecting my son to it. We do run a humidifier during the winter, and we are careful to keep him inside on high pollen days. We also rarely open the windows in our house and never the ones in his bedroom. Thanks in advance for any advice you can offer.

Crystal

Hi, Crystal.

It sounds like your son is a very allergic child. I would recommend you see a pediatric allergist to reevaluate what may be triggering his symptoms. With proper environmental control of what he is specifically allergic to, it is possible that his current medication can be decreased from "daily" to "as needed." You may also want to ask your pediatrician or allergist about trying a nasal corticosteroid spray daily to help prevent his symptoms as this is what is recommended first line for nasal allergies in a child his age. I hope this helps. Good luck!

Dr. Tanya

PS - I have to travel over the weekend, but I'll post more replies on Monday!

[helovesmemore1]

Dear Dr. Altmann,
I have and 18 month old son, that for the most part has been really good about going to bed and sleeping mostly through the night. Lately, however, my son has been giving me a heck of a time going to bed, sometimes I cant get him to fall asleep til midnight. By then I am more ready to fall asleep then he is. Also when I finally get him to sleep he still will wake up once or twice in the night, is this normal? I thought he would have grown out of it by now. He has always been in his own bed, bassinet or crib, and has done fine until now. Is this just a faze that he will pass through? Is there anything I can do to get this bedtime thing back to normal.

Thank you!
Vanessa

[Dr. Altmann]

Dear Dr. Altman,
Thank u so much for being being able to answer questions! I have a beautiful 17 month old daughter named Bailey Nicole. I myself am 22 yrs old and sometimes feel like im doing everything wrong being a young mother and a first time parent.. My problem with my daughter is this... She is very energetic and never sleeps. No naps, and wakes up at least 4 times during the night. Her normal wake up time is 9 am, and i try to get her to sleep by 8 p.m. When she does wake up at night, shes up for 1/2 hr or more. During the day, she runs and plays, and is very active, but at the same time, she whins and cries and gets bored very easily...A schedual never worked out, and after the hair pulling and me crying, i truely am at my whits end. Her pediatrician says that if she is tired she will sleep, but thats not a good enough answer for me. I read books and magazines and really have tried everything. Her father is always working and i get no help from him. When i sent her to my mothers house for a few days she was on a consistant schedual and my mother said she had no problem with her, and that i was lying on my own daughter...lol
Can u please help me? I dont know what else to do....Thank u so much

Hi,

Almost every parent at some point or another feels that they doing something wrong. Often children like to test limits more with their parents than with other caregivers because they trust you, which may be why grandma has an easier time. Luckily, your daughter has proven that she can live on a schedule and sleep well at your mom’s house, which means you are doing something right.

Why not take Grandma’s schedule and use it at home as well? Children need repetition, routing and daily patterns, so they know what is coming next. I’m not saying it’s going to be easy, but I think it is definitely doable.

Make a consistent bedtime routine that signals to her that this is nighttime. Something like bath, pj’s, story and lights out. Be consistent and let her learn how to put herself to sleep at bedtime and when she wakes up in the middle of the night. Most 17 month olds also still need a nap time, so find out what time she naps at grandmas and do the same, or start about an hour before she seems really cranky in the afternoon.

The first few days and nights may be tough, but stick with it and within a few days, everyone should be sleeping well. With a daily routine, consistency and some tough love she’ll get back on track really soon.

Good luck!
Dr. Tanya

[Dr. Altmann]

Dear Dr. Altman,
When my son was about 4 months old, the doc gave me the okay to feed him baby food. So I started out with bananas and worked our way to carrots and other fruits and veggies. He loved it! He ate it for the longest time. Well, he got really constipated, and I didn't know if it was the baby food, or the medicine that his doctor perscribed for his acid reflux. So I stopped feeding him baby food. He is now 7 months old. When I try to feed him baby food again, he throws it up. He throws up table food too. Should this be a concern? I was going to take him to the doctor, but she is on maternity leave until January, and the other doctor in that office is a weirdo. I need help!

Thanks!

Hi, Jess.

I understand that you don’t feel comfortable with the covering pediatrician, but you do need to find a pediatrician that you do like. January is a long time away and your son needs be evaluated. By 7 months old, almost all infants need some form of solid nutrition, so start slowly with rice cereal or Stage 1 baby food (or a very pureed consistency if you’re making it at home). Advance him as he tolerates, adding in a new food item every 4 days.

If he continues to throw it up, he needs to be seen by either a pediatrician or a pediatric gastroenterologist. He should also be weighed and checked regularly, especially since you have had some concerns with his feeding. If he gets constipated, it’s okay. You don’t need to stop the solids, simply give him some prune juice, or Stage 1 prunes (even everyday is fine). Please see a pediatrician as soon as possible. Proper nutrition at this age is very important for growth and development.

Dr. Tanya