The Health Blog

Cause

It is not known why some children suck their thumb and others do not. Some continue it from infancy as a learned behaviour, and others take it up later, either spontaneously or after seeing it in a sibling or other child. Along with other rhythmic behaviours seen in childhood (head-banging, body-rocking) it is obviously soothing and pleasureable, and so continues for some time. Often it is a response to stress or insecurity, although this does not mean that there are major psychological problems present. Sometimes children who seem to have given up the habit begin it again in response to a stressful event in the family, such as the arrival of a new baby, parental arguments, separation or illness. If the child himself has been ill or hospitalised, his thumb or finger may go promptly back into the mouth.

Clinical features

Thumb-sucking is often associated with other habits, such as twisting the hair on the back of the head, or cuddling a favourite blanket or soft toy. Many parents recognise that when their child begins to suck his thumb, it is a sign that he is tired and a signal that it is bedtime or time for a nap. At other times it may be a sign of stress, although this may simply mean that the child has been rebuffed in a request by peers, siblings or parents. >

The thumb-sucking lasts for a few seconds to a few hours, and is terminated when the child has another activity that engages his attention. As the child grows older and matures, he usually finds other ways of coping with stress and frustration and comforting himself, so that thumb-sucking is no longer desirable. However, as previously mentioned, children may revert to it, either occasionally or for a prolonged period of time, after certain life events. Most children have grown out of the habit by the time they start school.

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If you or your doctor suspect that your child may be having difficulty in hearing, it is advisable to perform special hearing tests. These can be performed by either an audiologist or an ear, nose and throat specialist, to whom your local doctor can refer you. Remember that a child’s hearing can be tested at any age, even in infancy. No child is ever too young to have his hearing tested.

Audiometry

This hearing test is generally suitable only for children over 4 years of age. The audiometer is connected to a set of earphones which are placed over your child’s head. Each time a note is sounded your child is asked to signal that he has heard it. The notes are played at different frequencies and volume levels, and your child’s responses are recorded. This builds up a complete profile of your child’s hearing, and the pattern can show which type of hearing loss, if any, he has. This aids in accurate diagnosis and treatment of the specific condition.

Auditory brainstem evoked response (ABR)

This is a specialised procedure which is used to test hearing in infants. It measures changes in the baby’s EEG (see above) when sound stimuli are presented. It is best done when the baby is in a quiet state, preferably asleep. An earpiece is placed in the baby’s ear, and three electrodes (special wires) are placed on his head. Sounds are presented through the earpiece, and responses are measured. The baby does not feel any pain or discomfort.

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Being afraid is all right. Being hesitant is all right. Feeling vulnerable and defenceless is all right. They are all part of the ongoing development of our self. When we begin to work with it, we won’t know where we are, where we are going and what will happen to us along the way. This is all right too.

There is no exact blueprint on how to get to know our self, no external guide or map we can look at. The blueprint is our self. How to read the map means reading our self. The guide is our self and it will show us how to work through the various stages. From the first step to the last, it will be an individual journey. But what a journey!

As we let the process continue we begin to trust our self and we begin to trust the process. We begin to see familiar landmarks and we begin to see the bridges we need to cross. We get to know the rest stops on the way and we know with growing certainty that we are headed in the right direction.

It does mean changes, but all the resources necessary will be found in our self and we will find them waiting for us at each step. Not only will we find them waiting, we will find they have been there all along. There will be times of uncertainty when we turn back or stop along the way. When we are ready to begin again, we will find the resources are still there.

What does fear hold us back from? Being free. Self-expression. What do we want for ourselves in five years time? Who do we want to be? That person is not going to magically appear one morning. We must work towards being that person. It is a journey in ourselves to ourselves.

All the energy which has been used to suppress our self, can be freed for us to use in whatever way we wish. It is a gift of life which is waiting for all of us. The time will come again for change, far less dramatically, but come again it will and there will be new challenges to meet. This call for growth is part of the evolutionary development in all of us. It is a question of how honest we are being with ourselves, but this honesty is the way of self determination. Of individuation.

It is our choice.

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The other type of situation where it is not always possible for you to be in control is the emergency one. Say a person suddenly develops severe abdominal pain, bloating, and vomiting and can’t pass anything through the back passage. Clinical examination and X-rays show that the bowel is completely blocked and that it has burst, leaking air and bowel contents into the abdominal cavity. The underlying problem could be cancer, but it would be dangerous to spend time trying to make a definite diagnosis before operating. This is one situation where there is no real alternative to letting the surgeon combine the diagnosis and initial treatment in one procedure. It is only once the person is opened up and the cause of the problem discovered, that decisions can be made on how best to deal with it. This isn’t so bad when you realise that emergency surgery is rarely more than the first step in the treatment of any cancer. Once the emergency situation has been dealt with, there should be plenty of time to get all the information you need to make a considered decision on the best follow-up treatment for the cancer itself.

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Regurgitation may occur in the absence of a demonstrable hernia and conversely, no regurgitation may occur, even when a large hernia is present.

Indigestion is the classic symptom. Regurgitation of bitter fluids into the mouth may occur, especially with belching or when bending.

Indigestion when the person lies down at night is due to the weight of the abdominal contents pushing up against the diaphragm and causing regurgitation.

An hiatus hernia may be diagnosed on the symptoms, but can be confirmed by a barium meal X-ray. For those who have had this X-ray, the reason they are strapped to the table and tilted head down is to demonstrate reflux.

Medical control is usually possible. Avoiding foods which upset, eating small meals frequently rather than large meals infrequently and antacids are usually effective. Avoiding bending, losing weight and avoiding tight clothes around the waist are useful adjuncts to treatment.

Considerable relief may be obtained by raising the head of the bed. Using several pillows is not good as the person is then bent at the waist. Raising the head of the bed and using only one low pillow offers better results. It may be necessary to raise it 10 to 20 cms.

Operative repair of the hernia is reserved for severe cases with failure of medical treatment.

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Eventually, as these foreign red cells die, they are replaced by the child’s own Rh positive cells.

Exchange transfusions have even been done while the child is still in the womb — but is now possible to prevent this iso-immunisation by the use of anti-D gamma globulin.

This should be given to any Rh negative woman who has an Rh positive child and who has not developed antibodies. It should be given within 72 hours of the birth and will prevent formation of antibodies and so the child of the next pregnancy is protected.

An injection of anti-D gamma globulin should also be given to any Rh negative woman who aborts after the eighth week, unless it is certain that the father of the child is also Rh negative.

Anti-D gamma globulin is made by the Commonwealth Serum Laboratories from blood collected by the Red Cross Blood Banks in each State. It is made available free of charge.

When a pregnant woman first visits her doctor, her blood should be examined to determine her blood group. If she is Rhesus negative, her antibodies should also be checked. At this initial screening, it is also possible to look for other uncommon and rare antibodies.

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Like hair, nails are derived from the epidermis and consist of dead tissue—the protein, keratin. The nail is formed by special cells found in the lunula, or white half-moon crescent. This extends underneath the skin at the base of the nail. Nails grow continuously throughout life, fingernails at the rate of about 1 centimetre in three months, and toenails at approximately one-third of this rate. Consequently, damaged or diseased toenails may take up to 18 months to grow out.

The function of nails appears to be the protection of the ends of the fingers and toes, and the enhancement of the appreciation of fine touch, enabling one to pick up small objects. If the nails are very short, the sensitive skin of the finger tips may become damaged and calloused, and consequently less sensitive to light touch. Nail biters are daily reminded of the inconvenience arising from the loss of this ability. The protein keratin, of which nails are composed, contains mainly sulphur in the form of cysteine, which constitutes over 9 per cent, by weight, of the nail. Calcium, on the other hand, is present in only negligible quantities, representing approximately 0-26 per cent of the nail’s weight.

The care of nails is surrounded by almost as many myths as is hair care. Careful observation of a person’s nails may reveal much about that individual—such things as general health, disease of the skin, temperament, occupation and so forth. Doctors soon learn to recognize the bitten or picked nails of the neurotic and the smooth well-buffed nails of the scratch addict. A doctor’s suspicion of anaemia, certain internal diseases and occasionally even lung cancer may be aroused by careful observation of a person’s nails.

General cleanliness is an important part of nail care, to avoid contracting and transmitting infections. Similarly, carefully cut or filed nails will avoid complications such as hang-nail, ingrown nails and paronychia. As a general rule, fingernails should be slightly rounded at their ends, and toenails should be cut straight across.

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It isn’t just a matter of choosing the food with the lowest G.I. factor. It Is best to include a wide variety of foods in your diet to optimise your nutrient intake. Compare the nutritional properties of these carbohydrate foods and see why variety is important.

Potatoes. Australian potatoes have been tested recently and all were found to have high G.I. values.Tiny, canned new potatoes have the lowest G.I. factor with a value of 65. Despite their high G.C. factor, potatoes are a healthy food providing a fat-free source of carbohydrate along with significant amounts of vitamin C and potassium. Their glycaemic impact is lessened by eating moderate quantities and eating other low G.I. carbohydrates at the same meal.

Rice. White rice is bland in flavour, making it an ideal accompaniment to spicy Chinese. Thai and Indian food. Milling of rice removes the bran and germ, resulting in a considerable loss of nutrients. Because of this, brown rice is a much better source of B vitamins, minerals and fibre. Vary your diet to include both brown and white rice. Basmati rice is available as brown or white rice.

Sweet potato. Orange sweet potato is a fantastic source of B-carotene (the plant precursor of vitamin A) and is also quite rich in vitamin C and makes a colourful addition to any dinner. It is a good source of fibre. G.I. factor 54.

Sweet corn. Corn on the cob, or loose kernel corn, is generally a popular vegetable with children and is high in fibre. It is also a source of B vitamins. G.I. factor 55.

Legumes. Chickpeas, lentils and beans are all high in protein and so are a nutritious alternative to meat. Their content of niacin, potassium, phosphorus, iron and zinc is also high while their fibre content is higher than for the other carbohydrate foods listed here.

Pasta. Pasta is higher in protein than rice or potato and Is often eaten as a meal without including meat It Is very satisfying and quick to prepare with the addition of vegetables, or a vegetable sauce and a sprinkling of Parmesan. G.I. factor varies from 37 to 55.

Cracked wheat. Bulgur (burghul) is parboiled whole or cracked grams of wheat. Because the whole grain is virtually intact, bulgur provides lots of fibre, thiamin, niacin, vitamin E and minerals. G.I. factor 48.

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