Milk allergy may cause frequent ear infections, skin rash, a runny nose, abdominal pain, etc.

Q: My daughter has been diagnosed to have milk allergy. She gets terrible abdominal pain and diarrhoea when she drinks milk. What should we do?

A: Milk allergy is a generic term that usually refers to cow milk allergy. It affects 1-7 per cent of children. In addition to abdominal symptoms there may be a runny nose, frequent ear infections, excoriated buttocks or skin rash. Staying off cow milk totally cures the condition. But this is difficult as milk is present in biscuits, packaged cereals and readymade weaning foods. Goat or buffalo milk is not a viable option as these cause the same allergies. Soya milk can, however, be a substitute. Most children outgrow the allergy by the age of four years.

Walk for health

Q: How much do I need to walk a day to stay healthy?

A: Ideally, it should be 10,000 steps a day. This is a distance of approximately five kilometres. You can do it in one shot in the morning or spread it out over two-three times a day. Pedometers cost around Rs 250. They can be clipped around your waist to accurately measure the distance covered.

Itch and scratch

Q: My son’s skin is dry with white bumps on it. It is itchy and he often manages to pick the skin and draw blood.

A: Your son probably has eczema with dry, irritable skin that is prone to allergies (both to ingested food and chemicals, especially detergents). The itching and scratching propagate themselves in a vicious circle, so that the more you itch, the more you scratch and vice versa.

You can help matters by using a non-scented moisturising soap like Dove to bathe him. Apply baby oils soon after the bath to keep the skin soft and moist. Wash his clothes with non-detergent soaps. They are available at Khadi outlets as Neem-based washing bars. Check if any particular food worsens his condition. Notorious allergens are cow milk, peanuts, wheat, eggs and fish.

Consult his paediatrician about the need and dose of anti-histamines that will help reduce the itchiness. Any secondary skin infection needs to be tackled immediately.

Deworming

Q: I want to deworm my two-year-old son. Everyone I speak to gives different advice regarding medicine and schedule.

A: Deworming needs to be done because of the high incidence of parasitic worm infection in India. It is usually recommended if the child is losing weight, has poor appetite, is anaemic or has pica (a desire to eat mud, chalk or other non-food items). Also, infestation — particularly with pinworms — tends to occur in the whole family. That is why everyone needs to take the pills on the same day.

The schedule depends on the individual paediatrician. It is usually Albendazole 11mg/kg single dose, with repeat dose after three months, or Pyrental pamoate 11mg/kg for two consecutive days, or Mebendazole 20mg/kg twice a day for three days.

Washing the hand thoroughly before eating and after visits to the toilet is the most effective way to prevent worms from entering the body.

Bad habit

Q: My lower lip is itchy and dry, even in summer. As a result, I tend to bite and tear the skin, and now the lip looks sore and ugly. What should I do?

A: Picking and biting the skin of the lower lip is a bad habit, arising out of nervousness. You simply have to stop it; it is only a matter of self-control and will power which I am sure you have. Also, buy a tube of Vaseline lip care gel and carry it around with you. Apply it frequently, especially after meals and at night before you sleep.

Wispy hair

Q: My daughter is two years old. From the time she was born, she has had sparse hair and thus looks bald. We shaved her head twice, but there has been no improvement in hair growth. Please advise.

A: It may be due to a condition called “Telogen effluvium”, which is a part of the normal process in which mature hair replaces baby hair. If the rate of replacement does not keep pace with the rate of fall, the hair will look sparse and wispy. This process takes longer in some children than in others. The hair should become normal by the age of three or four years.

The other possibility is that the child is deficient in zinc, iron or calcium. Supplements can be administered. The iron requirement is 8-10 mg/day, zinc 5-8 mg/day (only 30 per cent is absorbed), and calcium around 500 mg/day (equivalent to two glasses of milk). Each interferes with the absorption of the other, so giving them all together in a single “complete tonic” will not work. They have to be administered separately at least 12 hours apart.

Do not wash her hair with harsh detergent containing shampoos; baby shampoo is best.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in