**What to do for the baby bed?**

Warnings on mattresses to avoid having babies sleep on them may have more to do with immediate danger, rather than long-term harmful effects.

By RX FOR READERS/JUDY SIEGEL-ITZKOVICH
Baby boy in sleeping on bed (photo credit: ING IMAGE/ASAP)
Baby boy in sleeping on bed
(photo credit: ING IMAGE/ASAP)
We had our first baby a year ago. We live in a very small apartment and for lack of space, put the baby to sleep first in a small baby cot and then, a few months later, in a folding camping bed. Only recently, we noticed a little tag on the bottom of the thin latex mattress that one should not put a baby to sleep it “for more than a few hours at a time.” Now we feel terrible, as we are afraid we might have caused him harm. Is it possible his back or anything else was damaged by the mattress? Should we buy a different mattress to fit the camping bed; if so, what kind? R. and A.D., Jerusalem
Prof. Francis Mimouni, chief of neonatology at Shaare Zedek Medical Center, replies: This is an interesting question. I presume the manufacturers of the bed feel somewhat uncomfortable with the thickness of their mattress, but I am not aware of any standard on how thick a baby mattress should be. I don’t think you caused any real harm to your baby’s back or anything else; when our ancestors were infants, they were probably sleeping directly on the ground! It may be the warning on the mattress was put there not because a soft one would cause damage to the spine, but because were a newborn to sink into a soft mattress, it would block up his nose when he turned over – increasing the risk of Sudden infant death syndrome. Thus, there is a recommendation that mattresses for newborns be hard. Yet there is no reason for concern about SIDS now that the baby is bigger, so you can buy a harder mattress for the camping bed.
I am in my mid-60s and my skin has become wrinkly. It was recommended I do a facial peeling; not the deep kind that is very costly and requires remaining indoors for a week, but basically just a treatment. What do dermatologists think about this? Does it help? Is it harmful? D.G.B., Tel Aviv
Veteran dermatologist and laser specialist Dr. David Friedman explains: Prior to addressing your query regarding the efficacy and side-effect profile of a light chemical peel, it is wise to review the foundations of skin care.
One must try to reduce injury to the skin and even reverse prior damage in a safe and steady manner. Prevention takes the form of topical sunscreens and the optimization of vitamin D and calcium levels. Sunscreen should cover the UVA and UVB spectrum, with an SPF of at least 30; it should be applied every three hours you are outdoors, except if it’s raining.
Today, we appreciate the significant contribution that bone integrity plays in facial shape and skin sagging. It is thus prudent to have your family physician test your vitamin D and calcium levels, and supplement accordingly.
Your dermatologist should help you in acclimating your skin to a nightly application of a prescription- strength retinoid cream such as Adaferin. The nightly use of a prescription cream will improve fine wrinkles and skin texture, and make the skin brighter and fresher.
The optimal treatment for your wrinkly skin will depend on a precise diagnosis as to the type and severity of the wrinkles, as well as your skin type and the treatment cost.
Expression wrinkles, which are caused by repeated muscle contraction, are often treated with neuromodulators such as Dysport or Botox. Wrinkles that are the result of skin sagging may be treated with hylauronic acid filler injections such as the new, long-lasting Juvederm Voluma.
Sun-induced wrinkles are best addressed by some of the new fractionated CO2 lasers that, unlike deep chemical peels, do not require an operating room and are not associated with potential serious side effects. For those who want maximum gain with minimal pain, the brand-new Pico second lasers (which have been approved by the US Food and Drug Administration and our own Health Ministry) may be the answer. Pico lasers can significantly improve fine to moderate wrinkles with almost no downtime or risk; this new generation of Pico second lasers does not interact with the skin by heating it (with potential side effects), but rather through acoustic energy.
Light chemical peels do have a mild positive effect, but I advise patients that they will achieve similar results in a more economical and safe way with a nightly prescription-strength retinoid cream regimen coupled with sunscreen and vitamin D.
For those who want a more dramatic effect, the Pico laser or fractionated CO2 usually will provide dramatic results. 
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 it to jsiegel@jpost.com, giving your initials, age and place of residence.