Rx for Readers

Is it or is it not okay to playfully throw a baby in the air?

By JUDY SIEGEL-ITZKOVICH
baby 88 (photo credit: )
baby 88
(photo credit: )
Is it or is it not okay to playfully throw a baby in the air, or to lift the baby high and then drop the arms down quickly (so the baby does not leave the arms)? I keep feeling that it can't be good for the baby. - M.S., Jerusalem Dr. Linda Cahill, medical director of the Butler Child Advocacy Center at the Children's Hospital at Montefiore Medical Center in the Bronx, New York, replies: I advise against throwing a baby playfully in the air because there is a significant risk of dropping the baby or catching it in a way that could cause injury similar to whiplash to the spine and neck or even rib and other fractures as pressure is exerted as it is caught. Throwing a baby and catching it can cause brain or spine injury. Babies, especially infants, can't hold their heads up well before they are three or four months old or sit without support until four months later. The head and spine of infants need the support of a mattress, car seat or steady, firm and stationary adult arms and hands. I advise avoiding any rapid movement of a small baby - including dropping him down rapidly while still holding him because it might compromise the solid support needed by the infant head, spine, trunk and extremities. There are ways to play that are fun and much safer, such as singing, talking and reading to the baby. I am a retired male and have had psoriasis since I was 18. I have been going to the Dead Sea once a year for two or three weeks with beneficial results, but the psoriasis returns after a few months. For the last two years I have been using Waldman UV 100L narrow band, building up slowly to three minutes and 25 seconds, both front and back, two or three times a week. Is it dangerous to use this machine indefinitely? My psoriasis will return without this therapy, which is the most successful I have had. - W.M., Ra'anana Prof. David Enk, a senior physician at the dermatology department at Hadassah University Medical Center in Jerusalem's Ein Kerem, comments: Phototherapy - light treatment - has proven extremely effective in controlling a number of inflammatory skin diseases, first and foremost psoriasis. Phototherapy comes in two forms: as natural sunlight or as energy from artificial light sources. Natural sunlight is especially effective around the Dead Sea, probably because it contains a high concentration of long-waved ultraviolet A rays, whereas the shorter UVB waves are filtered out before reaching the deep water basin and because of the unique climatic conditions in the area. Phototherapy from artificial light sources is either given as UVA (in combination with psoralen, a drug that increases the UVA sensitivity of the skin; this combination is called PUVA) or as UVB. Over the years, various UVB lamps have been developed that selectively deliver only the energy required to treat psoriasis but filtering out the wavelengths that cause sunburn. On such lamp is the "narrow-band "UVB lamp that you are using at home. Over the years, concerns have been raised regarding the potential of the various phototherapy regimens to cause skin cancer. PUVA has been associated with development of skin cancer (even the most dangerous form, melanoma), but only after continued use over many years. In contrast, narrow-band UVB is not associated with melanoma development, whereas prolonged use might cause a more benign form of skin cancer, called BCC (basal-cell carcinoma). Overall, however, UVB phototherapy is probably one of the single most safe treatment modalities for psoriasis, also because BCC can be easily treated should it occur. Treatment options are many, ranging from applying creams and phototherapy to systemic treatments including pills. Lately, a new group of injectible drugs called biologics has been added to the fight against psoriasis. They are very expensive, and the long-term side effects are still unknown. Which treatment to use is complicated: and depends on disease severity and side effects. Dermatologists tend to limit each treatment to about a year before shifting to a new one to limit the risk of serious side effects. You should continue UVB phototherapy as long as you have active psoriasis lesions (usually three weekly sessions). When lesions have cleared, stop UVB totally instead of reducing the number of treatments. There is no evidence that so called "maintenance treatment" is effective. Try to treat new lesions with Daivobet ointment - and only if that isn't effective, renew the UVB sessions. Consult a dermatologist once yearly to be checked for skin cancer. 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 residence.