A There's probably no need: Most kids have pancake-bottom feet until they're about 3 years old; after that, an arch should begin to develop. Once your child is that age, you can check his arch by watching him walk on concrete with wet feet; the concrete should be dry in the area of the arch. If it isn't, he may need an evaluation. How to tell: Have him stand barefoot on a hard surface. Stand behind him and place a ruler along his Achilles tendon, which runs from the back of the calf and ankle to the heel. If the line of the ruler is perpendicular to the floor
the flat feet seldom need treatment and generally don't bother the child. But if the line angles inward, with the heel turning outward (called pronation), it can be a cause for concern and you may want to see your pediatrician.Some orthopedists take a more conservative "leave it alone, he'll outgrow it" stance. But in my practice I've seen many children and teens who've developed sore knees and ankles because their flat feet have thrown off weight distribution and, consequently, put too much pressure on the joints. (This can be particularly troublesome for obese kids, since the extra weight adds even more pressure.)
Treatment is simple and can begin as early as age 3: A soft orthotic (an arch support available from a podiatrist or at some children's shoe stores) slips comfortably into a child's shoes. He should wear them every time he has shoes on, for a minimum of four to six hours a day.
Sunburn remedies
Q What's the best way to relieve my daughter's sunburn?
A If the skin is reddened but not blistered, it's a first-degree burn that needs only hydration, moisturizing, and time. To soothe it, try a home remedy I often prescribe: Add a cup of oatmeal to your child's bath, and let her soak for as long as she wants. (A lukewarm bath is best for the skin, but if the sunburn is sore, cooler water may be more comfortable.) As soon as she gets out of the tub, gently blot (don't rub!) her skin with a towel--but don't dry it completely. Leave the burned area damp, and then liberally apply a moisturizer with aloe to it (steer clear of topical antihistamine and anesthetic creams, which can cause inflammation). Beyond soothing your child, the moisturizer will trap the water in the top layers of the skin and may cut down on itching and dryness. Repeat this regimen for several days afterward.
If the skin is blistered, your child has a second-degree burn that needs more intensive care: It's at greater risk of infection. The doctor may recommend a prescription cream to apply several times a day. Don't break the blisters--they're nature's own protective dressing--and tell your child not to pick at them. Once they open on their own, keep the area covered--usually with cream and nonadherent gauze.
Prevention is the best form of protection. Blistering sunburns are a risk factor for the development of skin cancer--so be sure your child wears sunscreen with an SPF factor of at least 30 (that contains avobenzone or zinc oxide) whenever she's exposed to the sun.
Constipation cures
Q My baby has had a little blood in her stool lately. Is this serious?
A No. This is common and harmless--and almost always due to a tiny tear in the rectum (called a rectal fissure), typically caused by constipation.
Nonetheless, you'll want to take some steps to help soften her stools, since rectal fissures can cause some discomfort and a very fussy baby.
Constipation--and rectal tearing--almost always occur in formula-fed babies and those who are starting to eat solid foods. So if your baby's on formula, consult her pediatrician about changing to another type that may be more intestine-friendly or ask if, in addition to the formula, you can give her a couple of ounces of plain water. For babies over 6 months, add high-fiber fruits that contain a lot of water--like prunes and plums--to her diet. (Four ounces of prune juice diluted with four ounces of water is a good option as well.) Talk with your baby's doctor about cutting back a bit on cereal--this may ease her constipation too.
Meanwhile, to help her pass her stools painlessly, try smearing a bit of petroleum jelly on the outside of the anus once or twice a day. Within five to ten days, the tear should be healed.
If, however, your baby sometimes goes through phases where she has infrequent bowel movements, it's not always a sign of constipation. Stool patterns can change regularly without it signaling a problem. Babies can go a few days without having a poopy diaper--and those who are breastfed may go less frequently than formula-fed infants, since mother's milk is digested more fully and therefore produces little waste.
When to see your pediatrician: if the pattern persists for many months or if your baby's stools are really hard (a sign that she's not getting enough water). He may prescribe a suppository or suggest additional testing.
BY WILLIAM SEARS, M.D. Pediatrician, author of 32 books on childcare, and dad of eight
[BOX:]
Check out Dr. Sears's message board at
(see page 12 for access info). The site lets you search answers to past questions or ask your own.William Sears, M.D.
League of Legends Trading -> User Submitted Ne…
