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urbanMamas snowed-in health hotline

Monroe_poxy My sister Hannah just called with a concern; her baby, Angelica, has had a diaper rash for several days, and a fever for the past few. Today she developed a rash on her stomach and Angelica, 15 months old, has been very fussy. She needed advice; she's been calling the pediatrician's office but the line has been busy.

I advised her to see if she's been overbundling Angelica (her power was off yesterday) and switch to breastfeeding only; maybe Angelica's having an allergic reaction and at least that will reduce her exposure to new foods. It couldn't be chicken pox, we decided, as it didn't look like the pox; Angelica's had her regular vaccinations; her only exposure (to my children) couldn't have caused it as they've all either had the pox or been vaccinated long ago. Twitter friends offered the possibilities of thrush, roseola, or hand and mouth disease.

Then it occurred to me that, if Hannah's struggling with a not-necessarily-emergency problem, many other are too, and as doctors' offices aren't answering their phones with great regularity, we'll have to work together to figure it out. So here's an open thread to ask each other for advice (and give yours to Hannah if something occurs to you). I'll start it off: Monroe broke his front tooth in half this weekend (well, in 1/3 and 2/3 vertical chunks) after launching himself face-first into a stack of cookie sheets.One of the chunks is wobbling back and forth and our local dentist office is closed; he hasn't been crying (though he's worked himself a mark near my nipple -- ouch!) and I figure we may as well wait out the storm before getting it looked at. Any problems I should look out for?

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My 13 month old was fussy and feverish last week. Luckily it peaked on Friday when the roads were at their best and we were able to see the doctor. She was more aggressive in running tests just because they knew it was going to be challenging to get care later. Nothing was found and he was much better by Sat. While it is never good to have a sick baby I'm sure glad it happened last week instead of this week. Good luck.

Ouch for those teethies. Keep an eye on the gums above the teeth. A pimple looking thing or swollen areas will indicate an abscess, which would need to be looked at promptly. Otherwise, if he's not in any pain I think it should be ok to wait. Thank goodness he seems ok. :(

I personally do all my self-diagnosing at www.askdrsears.com. It hasn't failed me yet. There is a great diaper rash picture of yeast that is always an aha for me when I'm questioning "is it really yeast, again?" It has great descriptions of all the standard rashes like Roseola and has saved me many trips to the ED.

One other option for getting healthcare questions answered is to see if your insurance carrier has a free nurse line. We have UHC and the 24 hour nurse line, where you talk to an actual nurse, has been great with 3am questions about Mastitis and if fever/cold symptoms were bad enough to warrant a trip to the ER. You can call the 800 number on your card and they can give you the nurse line number. I know it's not an option for everyone in these crazy economic times but it's part of what you/your employer pay for if you have coverage, so it's good to use it.

Hi - please help with suggestions - 1 yr old very anemic. On iron drops ferinsol. very constipated and miserable. She is mostly still nursing - will not eat from spoon(like cereals or anything pureed/soft/mashed) will eat pear and avacado chunks only. will not drink anything.

I am sorry I can't help with the specific medical questions. One thing I want to make all Kaiser patients aware of is your right to go to any hospital in an emergency and you will only pay your normal Kaiser copays. Kaiser has really cut back on their urgent care hours and the only hospital is out at Sunnyside. (On a side note - I still can't believe they sold Bess Kaiser and do not have a hospital within the city of Portland.) Medical emergency is pretty much defined by you - things listed so far would qualify. Use your best judgement or if you are in doubt and worried about charges call the ask a nurse. I know that living two blocks from Emanuel there is no way I would travel out to Sunnyside for an emergency in good weather let alone this.

I think the advice nurses at OHSU are working, so might want to call them. Good luck! I've been dealing with bitten nipples myself. OUCH!

Debbie- I would think the pediatricians office should be open Friday. Cause of the anemia? Most kiddos are eating finger foods and skipping the spoon feedies at 1 year. Certainly fruits will help ie little bits of prune or prune juice (watered down). stay away from banana which are constipating. Have you tried water in a sippy cup or regular adult cup. As for foods that will help increase iron once constipation taken care of . . .meat (overcooked and mushy or stringy), leafy greens (obviously cooked and mushed up), turkey, beans, etc. Just thoughts.

Debbie - If your babe is constipated enough that it's slowing down her eating, try giving her a glycerin suppository. They are over the counter and come in pediatric size. Once she's pooped and is more comfortable, you can get in a routine of giving her stewed prunes every day while to prevent constipation while she's taking the iron drops. Good luck!

Thanks both of you.. I desperately need some advice. The ped's office is not much help. I have emailed the urbanmamas@gmail hoping they would post my situation..no response from them :-(
The ferinsol (ferrous sulphate) is making her very very constipated. Yes, I did the glycerin suppository yesterday and it worked. Her poop was black, tar-like, sticky, and formed into hard dry sausages (sorry). We had been giving her pureed (stewed) prunes through syringes - kicking and screaming. This didn't really help :-( So for now I stopped the ferinsol. I tried Floradix and I need to give her 30ml through syringes (because she doesnt drink any juices/water in quantity - like an ounce - only takes sips) This has been a terrifying thing for her - kicking, screaming and a whole lots of tears :-( I hate to see my baby like this. So today I stopped that too. I need some ideas moms. Should I just do the ferinsol and use Miralax stool softener. But I find some disconcerting information about this stuff on the internet. My questions are
1) what is the best form of iron supplement. Will the ferrous sulphate be enough?
2) Maybe just once a day? 15mg instead of the 45mg prescribed?
3) Is there an iron that does not cause constipation in babies and in sufficiently concentrated form that I can give in a dropper
4) Baby just started eating 3 or 4 mouths of sticky brown rice, is there iron that I can add to this rice somehow? is there a product like that?
4) Any moms who have dealt with this problem successfully...and fixed anemia without constipation.

Please please tell me what to do.. As you can tell, I am very very depressed about this and going nuts :-(
I was anemic during my last trimester and my baby has been born with low iron stores.. and I didnt give her any fortified cereals from 6 months on..just exclusively bfed.. which was the problem I realize so late.

debbie

hi debbie,
sweet mama! you sound so very distressed. so first: i think it sounds like you are doing all the things you can think of to help your baby - including asking here.... so how about a deep breath and know you're not doing anything to intentionally hurt the child, eh?!

if you're still nursing, that's great because you can take the floridex and eat iron rich foods yourself. i dont know how long you've been feeding food but the transition to solids can be a difficult one (both my little ones had some constipation from it). there is no timeline on drinking from glasses, eating with spoons, etc - just follow your intuition. which, again, i think sounds right on target. if you'd like to chat more, i'm happy to trade ideas about the rest of your questions. best wishes to you,
ognie@yahoo.com

Does your one-year-old drink milk at all? I know ovaltine and other supplement drinks are far less than perfect, but it can add some iron (15% per serving), though absorption is complicated by milk. It, at least, does not constipate, but too much can cause problems in the reverse.

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