Topic: Pregnancy 04/07/08
Q. My husband and I had sex on the 22nd of March.  My cycle is usually 30 days.  It ccomes on the 5th of each month.  I took a laxative on the 30th of March.  My period is two days pass due but I have had a light pink bloody dsischarge for the past few days.  Other than full/heavy breasts, I do not have any other symptoms. Is it possible that I may be pregnant?

A. Yes, it is possible that you are pregnant.  Some women experience early signs of pregnancy such as breast tenderness, or fullness as you described even before a pregnancy test can be accurate.  Also spotting, fatigue and nausea are other early signs of pregnancy.  So, if you think you are pregnant, please be sure and take care of yourself.  I would also suggest you avoid laxatives until you have checked with your doctor or midwife.

Topic: Health 02/15/08
Q. My 9 year old daugther is very curious about my body.   recently she asked her grandma to show her, her breast!!! I don't know how to help her dealing with her sexual intentions. Is she normal or premature? Please help me. thank you

A. First of all, don't panic.  Your daughter sounds perfectly normal with a normal curiosity.  Young girls are entering puberty at a much younger age than ever before.  You can certainly use this as an opportunity to begin open and honest discussions about your bodies, their parts and functions.  And I suggest using the actual names for these body parts.  Of course, some of us may have to spend some time confronting our own discomfort and anxiety about sexuality in order to be comfortable with this discussion.  There is a new book available that I would recommend.  It is called "Third Base Ain't What It Used to Be", by Logan Levkoff.

Topic: Pregnancy 02/01/08
Q. Can laxatives cause a miscarriage at 23wks?

A. Yes, there are some studies that do link miscarriages to laxatives.  Most are too strong and can potentially stimulate the uterus.  However, any laxatives can possibly harm the baby by stripping the body of nutrients and also causing dehydration.  Even though over the counter and also natural laxatives are available, always check with your doctor or midwife before taking ANY medications during pregnancy.

Topic: Pregnancy 02/01/08
Q. Our son who is 9 months old has stopped taking a bottle or sippy cup.  I am still nursing/pumping but we have a sitter during the day and she can not get him to drink anything.  He used to drink from the bottle just fine for several months and then justed stopped.  We have tried straws, regular cups, several sippy cups and a variety of bottles.  Nothing.  It is going on 2 months and we have become concerned.  Is there another way to help him get past this and drink from a source other than me?

A. First, kudos to you for being continuing breastfeeding.  And, congratulations on having a smart baby who knows that " Mommy is best".  Don't worry about his/her drinking from a cup.  The sitter needs to continue to offer a cup, whether the sippy or a small regular cup, straw or whatever.  But, it should not become a "fight" between baby and care giver.  During the day he will get fluids from the foods eaten.  Do make sure fruits which are high density water foods are offered.  The baby will eventually definitely take fluids from a cup.

Topic: Pregnancy 11/15/07
Q. I was wondering how accurate an ultrasound due date is. I am 13 weeks as of yesterday November 12,2007. I have been with the same guy for 2 years in which we had sex on August 13 and 31 but i also had sex with someone new on Sept 1. What is the possiblity that is could be the persons that i slept with on the 1st could be the father.

A. I will try to answer your questions about ultrasounds.  Yes, ultrasounds can be quite accurate, especially if done early in the pregnancy .  However, their accuracy, as far as dating a pregnancy, diminishes as the pregnancy progresses.  You say that you were 13 weeks pregnant, which could indicate that you got pregnant toward the end of August, depending on your menstrual cycle, however, the ultrasound cannot truly tell you if the pregnancy began within a 1 day time frame.  I am afraid that the only way to determine paternity would be a paternity test once the child is born.

Topic: Pregnancy 11/08/07
Q. My last period was on the 8th of October, My cycle is usually every 28-30 days and my period lasts for 4 days. Today is the 5th of November, i had an urine test and it was negative. I feel dizzy some times, eat alot and feel bloated, do you think the negative is wrong?

A. Your question is such an important one because pregnancy tests can show a false negative.  Let me address a few reasons for a false negative test.  Sometimes the test is taken too early in the pregnancy.  It is possible that even  if you are pregnant, you are not producing enough of a specific hormone for the test to measure.  Sometimes, without meaning to, we just don't follow the instructions exactly, meaning we either did not dip in the urine well, or did not hold it properly in the urine stream.  Also, with some tests, if you do not read the result in the stipulated time, the results could appear negative.  You can always wait a few days and try the test again.  Or, better yet, see your care provider.  And, regardless, if you think you may be  pregnant begin following healthy pregnancy procedures, no smoking, no alcohol, vitamins, etc.  It actually is always a good idea to start following these guidelines, especially if a pregnancy is in your future.

Topic: Infants 11/04/07
Q. When should you put a newborn in crib in room alone?  I plan to breastfeed and the first two and half mths off, thought put baby by side of my bed in cradle, but then when should I put him in the crib alone in another room?

A. What a wonderful idea to keep your newborn in your room with you.  Doing this can actually help you and the baby synchronize your schedules and make it easier for you to feed and change during the night.  When to put your baby in a room alone is entirely a personal decision. However, if the baby will only be in your room while it is in the cradle, you need to consider at least 2 things.  Most cradles are small and cannot accommodate a growing baby.  Also, small cradles are really not safe once the baby is beginning to roll over, which can occur between 3 and 6 months or age.  And please remember, no matter where the baby sleeps, make sure to put baby on it's back to sleep.

Topic: Healthcare 11/04/07
Q. I happened to see your website and found some helpful sites.  thanks so much for being out there! I am new in the area of Tampa and I am expecting our second child.  I loved my doctor from GA but I am not too crazy about my doctor here.  Due to complications  on the first pregnancy, I will have to visit a high risk pregnancy doctor.  Do you have anything on your website that can help me on finding a good and caring doctor?

A. Welcome to the Tampa Bay area and congratulations on expecting your second child.  We do have some wonderful physicians in this area.  Depending on where you actually live, you can locate a physician by checking out these two websites.  Morton Plant Mease in Pinellas County - www.mpmhealth.org and St. Joseph Women's in Hillsborough County - www.sjbhealth.org, Women's Hospital.  On both sites you can click on find a physician. 

Topic: Development 10/12/07
Q. Hello, and let me say thank you so much for this wonderful service. I hope I am not going into too much detail, but we are just so concerned.

I have recently become concerned about my son's development. He's a healthy 29 month old, referred by our family doctor at 25 months because of concern about the lack of clarity in his speech. He had some history of ear infections, but nothing chronic. Had a 2/3 ear infections by 15 months, but nothing I can recall after that. Has had a few other colds that required nebulizing but that a while ago. He had been scheduled for a hearing test, but he had an accident the day of and missed it. He is being rescheduled, but we don't suspect a hearing problem.

We had a screening in our home by a Speech Pathologist and Child Psychologist at almost 27 months. BDI-2: Cognitive, Personal-Social, Motor Domains all normal. Adaptive skills below normal. Rosetti Scale: Interaction/attachment:15-18 months Pragmatic:15-21 months; Play 15-21 months. Language Comprehension: 15-21 months. Language Expression 18-24 months.He didn't qualify for special ed services at this time, but suggested a reevaluation at 3.

He had been cared for by a nice woman who had little/no structure in her home. She also watched 5 other children. Typically, we think he watched TV all day. We have switched to a preschool that is more structured. He is more stimulated, but has started suffering from separation anxiety in the morning, and has stopped eating lunch there most of the time. They say he does not seek the companionship of other children there and has difficulty with transitions. They say he does much better in the afternoon after a nap, however. The staff is working with us.

Some concerns in particular that we have are that he doesn't consistently respond to his name. He gets very focused on something and will sometimes ignore us when we call him. It's hard to tell if he is ignoring us or if he is not making the connection it's his name. If we add something like "Sam...want a banana" or something that interests him, he will usually direct his attention to us. Other times he responds normally. He maintains good eye contact during play and other times. At about 24/25 months he would put a couple of 2 word things together like "More Juice" or "All Done" or "Tickle Sam" but nothing much more complicated than that. In the past few months, he has become better, connecting more words like"Mommy go upstairs" or "this is my toy" "Take a bath". After some prompting, we can get him to say "I want some milk please" or "Give me Milk Daddy", but only does it spontaneously 10-20% or so.

He didn't use pronouns really, so we started pushing him. We have seen some progress in the past week, but it is hard for us to gauge. It doesn't seem like he's making a connection that me/I are really him.

What still concerns us the most is his inability to answer "what's your name." If I say "Who's that?" and point to myself or his mom, he will say our names. If I ask "Who's this" and point to him, he will say "Sam". But "what's your name?" elicits "What's your name" in response or "My name's daddy", or sometimes the name of a toy he likes. We play games where my wife and I shake hands with each other and say "Hi - My name is Daddy. What's your name?" He would usually do what we did and then say "Hi my name is Daddy" or Mommy. He will see himself in the mirror or pictures and say "That's Sam" and seems excited about that.

He would say "Pick you up" when he wants up because we would ask him "Want me to pick you up?" but has changed it to consistently saying "pick me up."

To encourage him to start using my/etc I started taking his toy and saying "That's my toy" He would copy me and take it and say the same. I have heard him say that around other kids that take a toy from him, or when we try to take hismilk he might say "Mine!" if he's not finished. He might put the toy in my hands to initiate our game and he will tell me "that's my toy" as he puts it in my hands - knowing that's what I say when we play it.

Just recently he has used "yours" appropriately - "your cheeks, daddy" while pointing to different body parts. But only a couple of times has this happened. We are concerned about echolalia. He repeats a lot of what we say. His speech development has been delayed, so we don't know if this is him having fun copying us, i.e. going through a normal but delayed stage of copying, or something else. If we ask him a question he will often repeat thelast 3-5 words. Not all the time, though, and if there is something he wants or doesn't want, he'll answer the question with a yes or no without hesitation.

When we turn the page in his favorite books, he usually knows all the words, and will say them as we turn the page. Great memory. He has known about 10-12 body parts for a while and can identify them if I point to mine, or his. He can count to 20. Identifies and greets people by name in person and inphotos. He can identify colors. Sings the ABC song, Twinkle Twinkle and some others. Saw six coins on the table and he said "Oh coins! 1,2,3,4,5,6" while moving each coin with his finger. I didn't even know he knew the word coin! Hesometimes surprises me with vocabulary I didn't know he knew. He can follow 2,sometimes 3 step instructions (when he wants to!) Knows many words, and has good receptive language (despite the test results- he easily understand a great deal of what say and ask of him). He can answer his age when asked somtimes. He asks "Where" questions a lot.

He does not point to much. If we are reading a book, it can be very difficult to get him to point to things. If I point and say "What's this" he knows all common items, and many unusal items (igloo) - even in a new book. But to get him to point, I have to take his finger and point the first few times if I ask "Where is the cat?" If it's a page I have worked on with him before, it is easier to get him to point to things. Sometimes he takes our fingers and points to things in books.

He does occasionally generate spontaneous statements - just the other night with a new bath toy he said "Ducky swimming in bathtub" totally unprompted/ unlike other things we say in the bath. In the week or so since we have been pushing him, we have made some progress with pronouns. Some days he seems to have more clarity than others and will actually apply "I want" statements to things we have never mentioned - suddenly say "I want applesauce please" but still not consistent or often. He will spontaneously ask for things he wants done - "Turn on the light Daddy" "Turn off the Fan mommy" "Go to the Bathroom Mommy" (i.e. you go back in the bathroom, mommy) "I/me Go outside" "Take off my shoes/shirt" "Open it". "It's dark in there" etc. His pronunciation is not great, but not totally unintelligible by strangers. Still mixes a lot of jumble sounds into his speech when playing by himself.

He is very affectionate, energetic and loving with us, grandparents, neighbors, pets. He laughs and plays with us a lot. He has a few "friends" he gets excited to see at first, but then goes and plays by himself, usually. Sometimes he will bring a train (his obsession) over to another child like a gift while playing. We make play dates and he interacts marginally with the other kids, if at all.

He does have imaginative play, pretending that he was me leaving for work with his little bag (like me), closing the door, then opening it and saying "I'm Back!" Sweeping the floor with us. Pretending to go to sleep and waking us up. Pretending to be a lion and roaring and chasing. "Eating" plastic look-alike toys. etc. He is very sweet and loving.

We have never noticed any sensory things, no flapping, rocking, tip toes, rubbing, etc. He is very flexible at home - we travel and he can adapt to most anything. Does not throw fits or tantrums if we diverge from much. We don't have a rigid routine for him, and he seems fine with it. At his new school, he has struggled with transitions, and they say he doesn't like to be part of circle time or usually seek out the companionship of other kids. (I am shy and never did well in big groups either, if that means anything) They do say he does much better in the afternoon after a nap, like I said.

Stacked over 6 blocks no problem, but seems less interested in blocks now. We have seen improvement in his speech since we became aware of the delays, and try to work with him, but we always fear he is plateau-ing and the changes have not been too dramatic. Again, thank you so much for taking the time to help me and all of these other parents out here.

I sincerely appreciate all of your efforts to help - it really helps relieve so much of the strain of uncertainty.

A. Thank you so much for taking the time to share the story of your son.  There are probably others who have the same concerns about their children.  Although you raise a number of issues, which, of course, cannot be addressed properly through email, I do sense who still have many concerns.  You indicated that you did have him tested by a speech pathologist and psychologist.  Since, as I said, you still seem to have many questions, I would suggest that you make an appointment or get a referral to one of the Developmental Pediatricians associated with St. Joseph's Children's Hospital.  They should be able to address the balance of your concerns. 

Topic: Childcare 10/12/07
Q. I'm trying to find a really good daycare for my 3 year old.  Right now I have her in a daycare, but I'm not feeling that comfortible with the daycare right now.  Do they have some kind of grading system some where on the net.  Thanks.

A.Thanks for your question about your 3 year old's daycare.  We are always happy to hear that when someone senses something "is not right" they act do to something about it.  We all have a wonderful innate warning system and should always listen to it.  Here is a link to the State of Florida site on evaluating day care. Hope this is helpful.  Be sure and check out their FAQ's also. 
http://www.doh.state.fl.us/ENVIRONMENT/community/group/cdc.htm

Topic: Health 10/12/07
Q. I have a questions about using insect repellent on my 3 year old.  Is there something out there that does not have deet in it.  She is in a pre-school that uses insect repellent all the time.  I notice that my child is now putting her fingers in her mouth and she never did that before.  I'm a little concern that it may not be good for her in the long run.  Can you help?  Thanks

A. Your question about insect repellent is so important, especially here in Florida.  Yes, there are repellents without DEET.  According to the CDC, they are not as effective, however, some protection may be better than the none.  These repellents are readily available, you just have to be a good label reader!  If you can't find them, check out your local health food store.  Of course, the other option, would be to get a good repellent intended for use on clothing - not on skin - and let your child wear long sleeved shirts, long pants, and socks.  Hope this helps.  Thanks for your question.

Topic: Pregnancy 10/12/07
Q. me and my guy friend were just recently had sex. and we didnt use a condom. howver i have been on my period since thursday. that just passed. what should i do i dont know if i could still get pregnant in this situation and im kind of scared. what should i do.

A. Well, yes, there is a possibility that you can get pregnant and still have a period.  You do sound very concerned, so I would definitely suggest you see your healthcare provider as soon as possible.  The other issue that I must speak to is the fact that, as you are probably aware, sex without a condom can  lead to pregnancy, but also to sexually transmitted diseases for either partner.  STDs do not always have symptoms, so please mention this to your healthcare provider also.

Topic: Health 10/08/07
Q. Would you recommend any good pediatric dermatologist? My son is one year old and has a very bad eczema. I am living in Pinellas County. Thank you very much.

A. Hi, I am so sorry your son is suffering with eczema.  As I am sure you are aware, it can be very disturbing and distracting, especially to such a young child.  Your pediatrician would be a good source for a recommendation.  Since eczema can be associated with allergies, you may want to ask for a referral to a pediatric allergist also. 

Topic: Pregnancy 10/08/07
Q. I had two miscarriages in the past year and I have discovered it's because of the Senna laxative, which I have been taking for 8 years now. I'm on a high fiber diet and I drink a lot of fluids including water, I'm also eating high fiber dried food, and nothing is really helping me, the problem is that I have discovered that I'm pregnant. What should I do?

A. Hi, so sorry for your previous losses, but please accept our congratulations on your pregnancy.  You are correct, there are some studies that do link laxatives with miscarriages.  It does sound like you are on the right track with your diet and drinking lots of fluids.  You didn't mention exercise.  Exercise and yoga can also play an important part in bowel regularity.  Of course, please check with your physician/midwife before beginning any exercise program.  And, of course, please keep your physician/midwife updated and she may also have some suggestions for you such as a stool softener, etc.