My two grandsons, aged three-and-a-half and two years, are healthy and well-developed physically and cognitively for their ages. They are, however, picky eaters – and I am convinced that is due to the numerous bottles of Similac formula (three to six per day) that my son and daughter-in-law still give them to calm them down and stop their crying.

Besides the psychological damage of prolonging their infancy and running the risk that they become – if they are not already – addicted to it, I am concerned about possible nutritional damage, as I worry that most of their calories are obtained from the fortified milk formula, placing a possible burden on their kidneys. Maybe there are other health-related issues as well. Is there any scientific evidence backing up my concerns? If so, what should be done?

C.B., Jerusalem


Prof. Francis Mimouni, chief of neonatology at Jerusalem’s Shaare Zedek Medical Center, replies:
There is probably no perceivable or measurable nutritional damage from “eating” mostly formula at these ages. In fact, by consuming a diet mostly based upon formula, these children are not going to miss any essential nutrient, and they will probably have no excess of anything.

The real issue is that from a developmental standpoint, these children should receive a much greater percentage of their nutrients from solids that will provide them with other nutrients such as dietary fibers and the like. In addition, continuous bottle feeding mostly at night may also contribute to the development of significant dental caries (cavities) and destroy their baby teeth. Good dietary habits based upon the famous food pyramid start early in life, and these kids would probably be better off if such habits were learned at their age.

As for whether consuming only formula causes any psychological harm, this is not measurable and has not been tested.

I read that over a third of Israelis suffer from toenails and fingernails infected by fungus (onychomycosis). I am a 45-year-old man, and I am one of them. I have several nails affected by such infections, and a lab test found they were infected by Candida albicans. I have tried a variety of liquid and cream treatments, but not pills. Nothing worked. There are many advertisements for laser treatment that is claimed to be “miraculous” and that comes with a “money back” guarantee. Of course, this is all paid for privately and is not in the basket of health services. Have laser treatments for onychomycosis been proven effective?

B.F., Rishon Lezion


Prof. David Enk, acting chairman of the dermatology department at the Hadassah University Medical Center in Jerusalem’s Ein Kerem, answers:
In spite of the many promises and high expectations related to laser treatment of nail fungus infections, the unfortunate truth is that there is no scientific proof of the efficacy of laser treatment of onychomycosis and the clinical experience has also been rather disappointing.

I therefore advise my patients not to waste their money on this treatment. If local treatments (liquids or creams) do not help, the next step should be pills (fluconazole), probably for four to six months. A blood test is needed first to make sure that liver function is normal, because the medications could interfere with it. If you follow your dermatologist’s instructions regarding regular blood tests, the pills are safe and quite effective.

Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail them to jsiegel@jpost.com, giving your initials, age and place of residence.

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