Wed, 27 Aug 2003

Dental care, children and candy

Dear Dr. Donya,

I know that openness is one of the keys to building a quality relationship with our children. But sometimes, my daughter asks for things that may not be good for her health.

Candies, for example. You see, I have a niece, who is two-and- a-half and likes candies very much. I don't know why my brother lets her have candies every day. And since both my wife and I work, I have to drop my daughter (and her nanny) off at my brother's house every Monday, Wednesday and Friday, so that the nanny can be "supervised" by my sister-in-law.

Lately, when my wife and I pick up my daughter in the afternoon from my brother's house, she persistently asks for candies. Apparently, she's seen her cousin eat candies.

Luckily, my sister-in-law has been successful in teaching my daughter to ask for my permission before she can have candies.

At first, I just answered, "It's not good. It will hurt your teeth," and she understood for a while. But now, she's even more persistent and will cry if she doesn't get any candy. So one day, as a "shortcut" to make her stop crying, I said to her that if she ate candies, a clown (she's frightened of clowns) would come to the house and scold her.

I regret having said that, but it works. She does not ask for candies anymore.

Was this wrong?

-- Mukti

Dear Mukti,

I think your reason for not allowing her to have candies is good, but I do think total abstinence from candy or sweets is quite hard.

Have you ever taken your daughter to the dentist?

A good candy rule is that she must brush her teeth immediately after eating them. Take her to the dentist for a checkup every six to 12 months -- through this, she will learn how important it is to take care of her teeth.

-- Dr. Donya

Routine vaccines for toddlers

Dear Dr. Donya,

I have two sons, one is 11 months old, the other is four years old.

I would like to ask you two questions:

1. Should the two boys be vaccinated against Hepatitis A and B?

2. Apart from the usual vaccination program (DKTP, BMR, TB), are there any other vaccinations they should have?

Thank you and best regards,

-- Jamy

Dear Jamy,

1. Hepatitis B is generally part of your child's routine vaccination, and can be given either at birth or at two or four months, depending on the country in which you reside. The vaccination is given in three doses each separated by a two-month interval.

I recommend getting your sons vaccinated if they have never gotten the Hepatitis B vaccination, because Hepatitis B can turn into a chronic liver disease or increase the risk of liver cancer. Hepatitis A is not a routine vaccination, so this depends on your financial situation.

The symptoms of Hepatitis A in children are quite mild. If you can afford the vaccine, prevention is always better than treatment. The efficacy rate is around 80 percent, and the vaccine lasts around eight to 10 years.

2. Japanese B encephalitis vaccination would be useful when traveling out of the country, especially in Asia. I would recommend being vaccinated against chicken pox or Varicella when your sons reach the age of 10 and have not been infected by then.

A note about the influenza vaccine: If your sons are healthy and do not have allergies nor suffer from asthma or a chronic lung or heart problem, they may not need the influenza vaccine, which requires a yearly injection.

Best regards,

-- Dr. Donya