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