Mouth sores might affect your children

Mouth sores might affect your children

Dear Dr. Donya,

I received your e-mail address from The Jakarta Post and it
said feel free to write, so I am.

My question concerns my 10-year-old daughter who suffers
regularly from what is called sariawan, a kind of mouth sore. The
problem is, she is the only one in the family who gets it and I
actually do not even know what it is exactly, or what causes it,
much less how to treat it. I've had no luck with doctors here in
Jakarta who just dismiss it and say take some vitamins and it
will get better soon. Sometimes she gets two or three at the same
time and can hardly eat. I'm really concerned and have no idea
what to do about it, or even if there's anything that can be
done. Is there anything you can tell me about this condition? Any
advice will be greatly appreciated.

-- Marshall Lesesne

Dear Marshall,

I am sorry that I don't know what "sariawan" is. In cases of
mouth sores, "aphthous ulcer" is very common and can occur quite
often especially when there is stress or infection. The
medication that can relieve the pain will be "sore mouth gel",
"kamillosan" or "trinolone oral paste". If you apply it early, in
some cases, it can be over in a few days. You can also rinse the
mouth with salty water (by mixing salt with water) and then rinse
the mouth three to four times daily after meals and before bed
time. Many viruses are activated by stress. I would suggest you
look at your daughter's schedule and social situation to see if
she is overbooked, or experiencing uncomfortable change. Please
keep me informed on her progress.

-- Dr. Donya

Dear Dr. Donya,

I have a six-month-old baby girl -- 70 cm long and 8,2 kg in
weight. I do not have any problem feeding her. On the contrary, I
am worried about her big appetite. For your information, her
daily meals consist of:

Early morning bottle-feed (about 200 cc.); Breakfast with
four small spoons of baby-rice, followed by a second bottle of
milk. Sometimes, instead of water, I give fresh orange juice with
the breakfast (about 100 cc.); Lunch of blended potatoes or
pumpkins, mixed with carrots or broccoli (three to four big
spoons), followed by the third bottle of milk; Tea-time meal of
grated fruits (apple, pear, papaya, banana); Evening meal, with a
bottle of milk.

Am I giving her right proportions and quality of foods? Are
there other local vegetables or fruits that can I give her? Is
there going to be any problem with her teeth development (she
already has two teeth) with the above meals?

My baby now has started to sleep on her front, while
previously she always slept on her back or on her side. She can
also sleep from 10 hours to 12 hours continuously at night.

Is there any problem with the sleeping position? If there is,
how to make her sleep in another, more convenient position?

Since my husband is a foreigner, we speak at home, and with
her, three different languages. Will this negatively affect her
speaking development?

She prefers sitting (alone) and standing (supported)
positions, than laying down. Will it become a problem,
considering her age, for the development of her body?

-- Yeyen

Dear Yeyen,

Your baby girl is in good shape. You can increase the amount
of meals to as much as your baby can take and cut down milk if
you are worried about her weight. Your menu sounds good to me;
you can also give her green or yellow vegetables; bak choy,
cabbage, beans, tofu. Nothing is wrong with her teeth
development.

Her sleeping position is fine. If she can control her rolling
or move her head, she should not have any problem.

About language, your baby will have no speaking problems. When
she starts speaking, its good for the parents to use one language
in one sentence. In the end she will learn what is what. There is
no need for you to worry that she may not be able to verbally
express herself as quickly as a child who is learning a single
language. Do not worry. Your daughter's development is normal and
you already have a wonderful baby.

-- Dr. Donya

Dear Dr. Donya,

My child is 16 weeks old. She has only got a shot for the
hepatitis B. My friend said the hepatitis B vaccination should be
given three times: at one month, two months and six months.
Should she get the full course of the vaccination all over again?
We will go to Sumbawa next month, meaning if I try to get her
vaccinated, the second vaccination will be 21 days apart from the
first one. Is that all right, or should I wait until we get back?

She also has not had her 4th DPT vaccine. Should she complete
the course? My friend recently told me about the MMR vaccine,
which is not common at all here. Here in Indonesia kids get the
measles vaccine. How important is this vaccine, and if my baby
has already got the measles vaccine should she also get the MMR
vaccine? Does it need a booster?

-- Asih

Dear Asih,

For your 16-week-old baby, she can get the second shot either
when she goes to Sumbawa or when she is back home. It is better
to give it a month after the first shot. If you cannot give it to
her on time, a delay in the schedule is OK. She does not have to
start all over again.

About the second question, I would guess you have another
child who is more than 18 months old and needs the 4th dose of
DPT. She can also get the shot without restarting the course. MMR
should be given to 13-month to 15-month-old babies because those
younger than 12 months old do not have good responses to measles
vaccines. So in your case, if your baby has already been given
the measles vaccine, I would recommend getting the MMR vaccine
now. When she is at school, there is the likelihood she may be
exposed to rubella or mumps.

A booster should be given at 11 years or 12 years old because
rubella is a concern in child-bearing women, who may get infected
during pregnancy and it will affect the fetus.

-- Dr. Donya