Dr Bernadette Carr is here to answer your questions

I wonder if my four-year-old son has asthma. He had a respiratory infection with a wheeze, his GP prescribed an inhaler and he recovered. 

I notice him wheezing occasionally, and there is a history of asthma in my husband’s family.

Asthma is commonest in children and is often associated, at onset, with a recent history of a viral upper respiratory tract infection.

It is a condition of the small tubes, or bronchi, that carry air in and out of the lungs. The lining of the tubes becomes inflamed when they are irritated by a trigger, such as:

* Change in weather

* Upper respiratory tract viral infections, such as a cold or flu

* Dust mites

* Tobacco

The trigger causes the muscle around the tube to tighten and increases the production of phlegm, making it difficult to breathe. This is what causes the symptoms that we identify with asthma:

* Wheeze

* Cough

* Breathlessness

* Tightness in chest

* May present with vomiting and reduced appetite.

Asthma is more common in young boys but, after puberty, it is more common in girls. It is also a life-long condition, although the asthmatic may not have the symptoms all the time.

Your son’s wheeze may be caused by asthma, but there are other conditions of childhood that can cause this or similar symptoms. Given the symptoms that you have noticed and the family history, I would advise you to make an appointment for your son to see his GP, who will be able to examine him and listen to his chest.

It would be useful if you had a record of the frequency of the symptoms and if you have noticed any potential trigger(s). I am sure the GP will be able to reassure both of you and offer advice.

My seven-month-old son has a flaky scalp. Could this be cradle cap?

Infantile, seborrhoeic dermatitis, or cradle cap, is an inflammation of the skin and mainly affects the scalp in young babies. It can also affect other parts of the body, such as on the nappy area, face, chest, back and limbs.

The exact cause is unknown, but it is thought that babies who have cradle cap produce more oil, or sebum, from the sebaceous glands in their skin.

The scalp will develop greasy, yellow patches, as the oil causes old skin cells to stick to the scalp, instead of falling off. They gradually become flaky; the surrounding skin may be red.

It is not usually itchy and most babies do not experience any discomfort.

It is common for babies to have a mild form during the first six weeks of life, but it usually goes away on its own within two to three months.

As the condition resolves by itself, treatment is not usually needed, but gently washing the baby’s hair and scalp every day, with a baby shampoo may help to improve the appearance. It is important not to pull at the flakes of skin.

The scaling may be removed by massaging arachis oil, baby oil, or olive oil once a day into the scalp.

I would advise you to make an appointment for your son with your GP, who can examine your son’s scalp and advise on the most appropriate treatment.

Be alert to any changes in health or behaviour in your son. If you notice that he is scratching his head, or there is swelling, call your GP.

If he is feeding poorly, has a raised temperature, is crying or is distressed, seek urgent medical attention for him.


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