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Q&A with a Pediatrician

Q&A with a Pediatrician

Conversation with Amanda Penny, MD, Children’s Medical Group Pediatrician

Q: How should a child be treated for fluid buildup in middle ear?

A: That is a great question. An accumulation of middle ear fluid can occur behind the tympanic membrane or ear drum. This build-up is related to eustachian tube dysfunction that is caused by genetics, nasal congestion, allergies, sinus infection. This condition may be treated with an antihistamine and/or a decongestant and/or a steroid nasal spray. Simply put, if you can improve or reduce the nasal symptoms, then the eustachian tube works better, and the build-up of middle ear fluid resolves. Often, with time the fluid simply goes away. However, if the fluid persists for an extended amount of time, then small tubes can be inserted in the ear drum by an ENT specialist to clear this middle ear fluid.

Q: What is the best way to treat a baby’s cradle cap if it isn’t going away on its own?

A: Cradle cap may be treated by applying an oil (mineral oil, baby oil, coconut oil) or dandruff shampoo (Selsun blue, T-gel, etc.) to the scalp. After applying the oil or shampoo, you can gently rub the scalp with the brush that was provided in the hospital. I do not recommend daily applications, rather 2-3 times per week is all that is needed until the cradle cap is gone. If your infant has cradle cap on the eyebrows, you can place a small amount of oil on a Q-tip and gently rub the eyebrows. Usually, this will remove the cradle cap there.

Q: How common is yeast infection in babies? How do you identify it and how does it differ from a regular diaper rash? What is the right treatment for it?

A: Yeast infections are some of the most common causes of diaper rashes in infants. The diaper area is moist and warm and yeast thrive in this environment. Typical yeast diaper rashes have small red bumps that occur the outside of the rash, which we call “satellite lesions”, and rash is present in the creases. A common diaper rash will have redness but no outside bumps and often spares the creases. If you are concerned that your infant has a yeast diaper rash, you can pick up an over the counter antifungal cream, such as clotrimazole. First, apply the antifungal cream to the diaper area, and then apply a diaper ointment with zinc oxide on top. The antifungal medicine treats the yeast infection and the zinc cream helps heal the rash. If you are unsure what type of rash is present in your infant, please call your pediatrician for help.

Q: What are the pros and cons of circumcision for boys? Would you recommend it and why?

A: Circumcision remains a highly debated topic. The benefits of circumcision include slight decreased risk of urinary tract infections in boys and reduced risk of some diseases in men. Benefits also include some protection against penile cancer and prevention of inflammation. Risks of circumcision include pain, bleeding and infection at the site of circumcision. During prenatal visits with parents, I talk to my patients about the risks and benefits of circumcision. Ultimately, this is a very personal decision which I defer to the parents.

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