(photo credit: Courtesy Shaare Zedek Medical Center))
I am a new mother of a three-month-old baby boy. He likes to be in my arms a lot when he’s awake, and it’s tiring. I put him on his back, as well as on his stomach when he is awake. How much time at once can he sit half-upright in a plastic “salkal” [baby car seat] and observe what is going on around him? Can sitting there for an hour or two cause any damage? K.B., Beersheba
Gila Rabinowitch, head of the pediatric section of occupational therapy at Tel Aviv University’s Sackler School of Medicine, replies:
It’s very important to put infants in different positions – on the back, on the stomach when the baby is awake and supervised by a parent, and on the two sides.
One can also put the baby in the “sal-kal” seat or car seat or baby carrier, but never leave him at this age for too long. He will usually show when he becomes uncomfortable.
When he reaches the age of five or six months, he is usually at a level of normal development and can turn over. Thus he will be able to go by himself from one position to another. But even then, he should not be “locked up” in one position for too long. It’s important that he be able to move his limbs freely. When he sitting in a sal-kal, it’s best to give him a safe toy – of course not something too small [that could be dangerous if put in his mouth] – that he will investigate and examine.
Babies need to be challenged in their motor activities so they can learn about their environments and not only to sit and passively observe the surroundings.
My 89-year-old mother is suffering from a fungus in the folds under her breasts caused by sweating, as she cannot stand to wear a bra. She has tried everything from calamine lotion to anti-fungal ointments, aloe-vera gel and baby powder, and even eau de cologne. She takes a shower every night and wears strips to separate the folds of flesh, but still cannot get rid of this problem, from which she has suffered for a couple of years.
Does she need to go to a dermatologist? Which ointments or soaps could help her? Are there certain foods she should avoid, like sweets and cakes? Would showering with povidone iodine (used to wash with before surgery) help at all? E.N., Givat Shmuel
Veteran pharmaceutical consultant Howard Rice responds:
Fungal infections are prevalent in moist places, and under the breasts is notorious for being such a place. It is therefore recommended that the folds under the breasts be kept dry. She should carefully clean the affected place with water (no soap or cologne, since they are irritants, or aloe-vera gel). The place should be carefully dried, and an anti-fungal preparation should be rubbed into the skin until it’s absorbed. The fungus flourishes within the dermis and epidermis (the top two layers of the skin) since it thrives on keratin found there. After the ointment has been absorbed, put some talc or potato or corn starch there, and also on the part of the bra in contact with the skin. She should of course wear a bra only after she has no further irritation. Between the folds, she can put some gauze with talc on it.
The over-the-counter medications she should use at first are any of the many sold in pharmacies. These include Agisten and Lamisil. If these do not help, ask the physician to prescribe Whitefield’s ointment, applied once daily. It gently removes the upper layers of the skin to expose the fungus and eliminate it. I would not advise oral therapy unless she has a systemic infection – certainly not at her age, when drug interactions can be more severe. She should stay away from sweet foods until the problem is solved. Povidone iodine would not help much in this case. Although iodine is anti-fungal, it is less effective than the standard anti-fungus preparations – and it is also messy. ■
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