Rx for readers: Putting her oar in

A grandmother seeks advice on thumb sucking vs pacifiers, while a granddaughter seeks prevention and treatment of glaucoma.

Thumb cartoon 520 (photo credit: Don Coker/Columbus Ledger-Enquirer/MCT)
Thumb cartoon 520
(photo credit: Don Coker/Columbus Ledger-Enquirer/MCT)
Although not a strictly medical question, I – as a grandmother – would like to know if babies and toddlers should be allowed to put their fingers in their mouths. Friends discourage this with their babies, as they claim it leads to thumb sucking. Instead, they give a pacifier and try to keep the thumb away.

I always thought that babies use their mouths as a means of discovering new textures and objects and believe the use of pacifiers can inhibit good speech and also be bad for teeth if used for a long period. Please advise what to do and when to get rid of all of them.

– S.A.S., Kfar Saba
Prof. Yossi Shapira, head of pediatric dentistry at the Hebrew University-Hadassah School of Dental Medicine in Jerusalem’s Ein Kerem, replies: You indeed cannot force an infant to stop sucking a thumb, and I wouldn’t do it even if I could. It is a natural reflex to put a thumb or other finger on one’s mouth. In addition, you can’t force an infant to give up a pacifier.
There is a period of the first teeth coming out, and there is irritation and stimulation, so the thumb or other finger or pacifier serves a purpose. There are also those who recommend pacifiers for young children to reduce the risk of sudden infant death syndrome.
In any case, make sure that the fingers and nails are clean and do not cause harm. While you can’t force avoidance of fingers at this age, a pacifier is better because unlike a pacifier, the finger is always there. A pacifier can be abandoned. At age three and a half, for example, the child has the cognitive ability to understand why thumb sucking or pacifier use is not advisable.
It can begin to cause overbite then. Explain things, advise and give positive and negative incentives to get the child to manage without pacifiers and fingers. If it doesn’t work, one can use bitter-tasting nail lacquer to kick the habit. But make sure you do it calmly and not as a punishment.
My grandmother, now deceased, suffered from glaucoma, and just thinking about it makes me – aged 45 – nervous.

What should one know about preventing and treating glaucoma; how much of a genetic connection is there and what early testing does one undergo?

– B.V., Rehovot
Dr. Anat Robinson, a senior ophthalmologist at the Rabin Medical Center-Beilinson and Hasharon campuses in Petah Tikva, responds: Glaucoma is an eye disease that attacks the optic nerve with no previous clinical symptoms. When one has already recognized its existence, irreversible damage has been done. Proper early diagnosis, treatment and followup can prevent irreversible harm to vision that will help you live with glaucoma.
Pressure in the eye causes damage to vision. Only an ophthalmologist can measure it, and it can be done easily with a device that takes only seconds. It does not hurt and does not cause fuzziness of vision. It is very important for people already diagnosed with glaucoma to be tested regularly to see if there is any decline in their situation. Among the examinations is a field vision test. Also bring the ophthalmological medications you take. The pupils have to be expanded to see better, and this causes temporary fuzzy vision.
Put your eye medications into your daily schedule. If you forget, leave a note or even a recorded message so as not to forget. Use a mirror for inserting drops into the eye and make sure they have reached the right place. If the drops must be refrigerated, do so.
In treating children with eyedrops, have them lie on their backs and gently open the eyelids. Aim the drops to the angle of the eye closest to the nose and hold the bottle steadily.
Field of vision tests are important to follow up glaucoma. It requires alertness. Bring your reading and distance glances to the examination. During the test, one can breathe deeply and open and close their lids. Keep a copy of the field of vision test results for yourselves.

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.