Food allergies are most common in infants and young children.  This is especially true in the first year of life before the gut and immune system have become fully developed.  Fortunately, many of these early allergies are outgrown as the child gets older.  Food allergies beginning at an older age are more likely to last a lifetime.

About 90% of all food allergies in children are due to five foods:  eggs, cow’s milk, peanuts, fish and soybeans.  Most of these allergies are relatively mild, but sometimes life-threatening reactions occur.  Serious reactions are most common with shellfish and peanuts.

The main symptoms of food allergies include swelling of the lips, tongue and throat, itching of the throat, abdominal pain, vomiting and diarrhea.  Most allergists do not believe headaches are a typical symptom of food allergies, however.

For the serious reactions, the food needs to be avoided indefinitely.  For minor reactions, especially in young children, the foods can be tried again every 3-6 months to see if the reaction has faded.  If there is no reaction, the food does not need to be avoided.  Discuss this with your doctor before attempting a trial of the food.

Routine allergy treatments, such as shots and antihistamines, are seldom helpful in the care of most food allergies.  Identifying and avoiding the allergenic food is the key.

However, keeping the ears free of infection and fluid is very important at this age when so much of a child’s learning and social development depends on good hearing.

Fortunately, there are many things a parent can do to help protect a young child’s ears from infections.

First and foremost is a clean environment.  Pollution is a big factor in causing the congestion that will eventually lead to plugged ears, fluid accumulation, and infection.

Cigarette smoking is a major cause of irritation to the airways.  Children will get a runny nose, congestion of the nasal passages, and a cough from cigarette smoke.  These conditions predispose to infections and also prevent the child from resolving infections as quickly and easily.

Heating with wood or kerosene is another source of pollution which contributes to congestion and infection.  Heating with oil, gas, or electricity is far cleaner.

For young children, being put to bed with a bottle is a problem.  The milk or juice will pool around the Eustachian tube and promote infections.  Breast-feeding, on the other hand, has been shown to reduce the risk of ear infections.

The other big cause of ear infections is through exposure to viruses from other children, especially in day care centers.  The larger the group of children, the greater the number of viruses that are spread around.  Try to keep the day care groups small.

For some children, however, the virus can be very serious.  These are usually children who are between the ages of two and five months.  They are old enough that they have lost the immunity they received from their mothers and too young to tolerate such a harsh virus.  Children who have lung, heart or immune problems are also at greater risk of complications from RSV.  One of the other problems with this virus is that it may take two or three infections before a child develops good immunity to it.

The virus is spread by coughing and close contact, such as touching hands.  The virus is so common that most children have had the infection by three years of age.  After this age, RSV infections are seldom a problem.

The virus causes a great deal of irritation to the lining of the airways and lungs.  Increased mucus and sloughed cells cause the tiny airways to plug up.  This plugging slows the air that is leaving the lungs, so the lungs become over-expanded in a way similar to emphysema.  In the more severe cases, the airways become completely plugged up and the airways collapse.

Treatment is usually aimed at reducing the symptoms and making sure a child is getting adequate oxygen.  Infants often need to be hospitalized for RSV infections.  A steroid syrup or shot is commonly used and can decrease the symptoms.  In severe cases, an antiviral antibiotic can be used, but its usefulness is still being studied.

This can occur every one to two hours during the night for some infants.  So how do you train a baby to go to sleep?

One of the major lessons a small infant has to learn is how to comfort himself and fall asleep.  Yes, it is a learned process.

Your child needs to be given time to learn this skill.  Parents should let their infant cry for a period of time before checking on him and comforting him.  The child must eventually learn to make himself comfortable to prepare for sleep.  Of course, if it is time for a feeding or he needs a diaper change, there is no reason to delay.

One of the important reasons for learning this skill well is that the sleep cycle of an infant is only an hour long, so he will arouse every 60 minutes.  If he is unable to comfort himself and go back to sleep, he will cry until a parent comes to rock him back to sleep.

Parents should not feel guilty over rocking their baby to sleep, but by returning too soon, they do not allow an infant the time needed to learn to comfort himself for sleep.  Returning too soon can train the infant to cry until he gets the parents’ attention.

But a parent should also not feel guilty about giving an infant time to fall asleep on his own.  After 20-30 minutes of crying, however, it is wise to check on your baby, change diapers if necessary, try feeding the baby, and if everything is well, settle him down and put him back in the crib to go to sleep.

Estrogens help with the hot flashes and other symptoms, but the WHI (Women’s Health Initiative) study showed that there is an increased risk of blood clots traveling to the lungs, heart attacks, and possibly breast cancer.

Estrogens can still be used, but the risks must be carefully discussed with your doctor and appropriate tests done prior to starting them and then regularly while using estrogens.

There are a few choices besides estrogen.  One of the first steps is using soy protein.  Soy contains a type of plant estrogen.  Studies have not clearly shown that this type of estrogen is a safe alternative, and it is not as effective in controlling symptoms as estrogen but many women are using it without known problems.  The recommended dose is about 2 glasses of soy milk per day.

Other medicines that have been used include low doses of certain antidepressants and a blood pressure medicine called clonidine.

Regular aerobic exercise is extremely important.  It will help with hot flashes, it lowers the cholesterol, strengthens the bones, and helps lose weight.  In short it has nothing but good effects during menopause.

A calcium supplement is very helpful in keeping the bones from thinning.  At least 1000 mg. per day is the recommended dose.  This can come from the diet, in the form of calcium tablets, or as calcium-containing antacids.

Alcohol is one of the most common chemicals we use and, tragically, recent reports cite it as the most common cause of preventable birth defects, especially mental retardation.

Women who use alcohol regularly during their pregnancy greatly increase their risk of having a baby with birth defects.  In addition to mental retardation, these defects include facial malformations, growth retardation, limb defects, and heart abnormalities.

The baby’s brain develops throughout the pregnancy and is very sensitive to excessive alcohol levels.  If the mother drinks two ounces of alcohol daily, there is up to a 20% chance that the baby will have some abnormality.

Does occasional drinking cause any harm?  Doctors do not know for sure if small amounts increase the risk, but binge drinking is known to have an adverse effect.  In fact, a single episode of binge drinking during the critical period of heart development at about 5-6 weeks, may result in heart defects in the baby.

Other commonly used substances such as nicotine and caffeine may also add to the harmful effects of alcohol.  A woman should avoid alcohol as well as other chemicals during pregnancy.  If in doubt about the safety of a medicine or a chemical, ask your doctor.

With this high incidence of premature labor, it is very important for every expectant mother to watch closely for any warning signs of premature labor and to call her doctor if they occur.  Even though the medical care for premature babies has improved immensely, there are still many hazards for the baby who is born too early.

The warning signs of premature labor are often mild and not clear cut.  A woman should talk to her doctor and have an exam any time she has a concern.

The most common sign of premature labor is contractions of the uterus.  Although there normally are weak uterine contractions throughout the second half of the pregnancy, an increase or change in their pattern or strength may be significant.  This is especially true if there are other warning signs such as a dull pain in the low back or pressure in the pelvis.  Abdominal cramping with diarrhea is another symptom that needs a check-up.

Passing the “mucus plug” or having a change in one’s discharge may indicate that the cervix is opening.  Bleeding may also be a sign of pre-term labor and is a warning sign of more serious problems.

Premature labor is treated with medicines that stop or slow the contractions.  If there are any predisposing factors, such as infections of the cervix or bladder, they must be treated too.  As soon as the baby is mature enough for a safe birth, the medicines are stopped.

There is one vitamin, however, that has been proven to be important during pregnancy.  It is called folic acid, and it is needed to ensure the normal development of the baby.

Studies have confirmed that a diet low in folic acid was associated with a seroius abnormality in the baby called a “neural tube defect.”  This is an incomplete development of the spinal cord, usually in the lower back.  It leads to paralysis of the legs and lack of bladder and bowel control.

Studies have shown that when women take a supplement of folic acid during the first three months of pregnancy, the chances of their babies having a neural tube defect are decreased by 72%.  This significant finding indicates that perhaps three out of four of these serious defects are preventable.

A woman’s daily requirement of folic acid is increased if she smokes cigarettes or if she uses certain medicines, particularly ones for treating seizures.  These women should certainly receive folic acid supplements.

Since babies develop very rapidly and these defects are determined in the first few months of pregnancy, it is important to see your doctor very early to start the prenatal vitamins.  It is even wise to have a pre-conception visit to start folic acid before becoming pregnant.  Your doctor can also review your medicines and help you quit smoking, if necessary.

Most burns are caused by direct heat (flames or hot objects) although some are caused by electricity or chemicals.  Even sunburns can be a cause of first and second degree burns.

The first step in caring for a burn is to cool it off.  Quickly apply cool wash cloths or place the burn in cool water.  This helps stop the reaction and decreases the pain and burning.  Remove rings and jewelry which may obstruct circulation if swelling occurs.

You should have all burns checked by your doctor.  Burns that seem mild at first may develop secondary infections or scarring.  The face and hands are particularly important to treat appropriately to prevent any unnecessary cosmetic problems or limited function of the fingers or hands.  A tetanus shot may be needed.

Many burns have associated injuries that may go unnoticed because of the pain of the burn.  This may include trauma and lacerations from falls or explosions, or lung damage from smoke inhalation.

Dress the wound in clean, dry sheets.  You do not need to apply any ointment because this will need to be cleaned off by your doctor, adding to the discomfort.  Antibiotic creams can be applied after the wounds are clean.

If the burn is caused by a chemical, first aid includes prolonged irrigation with water to dilute and wash away the chemical.  Electrical or lightning burns are particularly troublesome because of internal injuries that are much worse than what appears on the surface.  These need immediate attention and prolonged follow-up.

Cataracts are so common they can almost be considered a normal sign of aging.  Virtually anyone who lives long enough will develop them.  But just what causes cataracts or brings them on at an earlier age, is not known for sure.  Presently, ophthalmologists believe that lifelong exposure to ultraviolet light outdoors is the most significant factor.  The ultraviolet light can also come from man-made sources.

There are numerous other factors which may play a role for certain people.  Injuries to the eye are a cause in some people and often result in cataracts at an early age.

Cortisones and cancer drugs may contribute to formation of cataracts.  Use of these and a few other uncommon medicines may necessitate regular exams by your ophthalmologist.

Cataracts are also more common in people who have diabetes or a family history of cataracts.  Infants can be born with cataracts caused by rubella and other viral infections which had occurred before birth.

Whatever the cause, the result is basically the same.  The crystal clear cells of the lens become cloudy and opaque and vision is lost.  The visual impairment may vary from minor difficulty with needlework and reading to complete loss of useful vision.

Cataracts are treated by outpatient surgery which takes less than an hour.  Only the eye is anesthetized and unless there are other eye problems, the vision is restored in 98-99% of people