QUESTION 1

Dear Doctor,

My son, Jalen, is 3 years old. Since the beginning of last year, his hair has been dropping and the texture is getting very rough. I have brought him to the doctor and also changed his shampoo but there has not been any improvement. What is the possible cause of his hair problems and is there a need for me to bring him for further consultation or treatment?

Tay Poh Leng
 

ANSWER:

Dear Poh Leng,
There are many possible reasons why a toddler may experience hair loss. These include fungal infections over the scalp, hair-pulling behaviour, deficiencies in iron or zinc or thyroid problems. It can also be normal in toddlers. If the problem persists, you might like to bring Jalen to a paediatric dermatologist for some tests to ensure that he does not have any of the above conditions. Diet may play a part if he is deficient in iron or zinc. Giving him regular doses of multivitamins will help supplement his diet with these minerals.

– Dr Lim Kwang Hsien

QUESTION 2

Dear Doctor,

My son, Zharfan, was born with multiple congenital problems including an imperforated anus and a tethered spinal cord. Thankfully, all the operations have gone smoothly so far. However, now he is experiencing a problem with his bladder called “Neurogenic Bladder”. He can only empty 50% of his bladder while the rest has to be emptied using a catheter. He has been given daily antibiotics and Oxybutin to relax his bladder. The problem is that after taking the medication, he has not been able to pass motion. I have tried a cream tube and feeding him bananas but they don’t help. Are there any other alternatives to help improve his bowel movement?

Ernie Haslina Zainal
 

ANSWER:

Dear Ernie,
Unfortunately, both an imperforated anus and a tethered spinal cord will lead to long term problems of constipation. Oral laxatives such as lactulose or liquid paraffin will help improve the consistency of his stools (i.e. from hard stools to soft stools). However, due to his tethered cord and his reconstructed anus, Zharfan may sometimes have difficulty passing out even soft stools. You can help by doing regular massaging over his tummy to stimulate his bowel movement. On occasions where he does not pass motion for a few days, you should use the cream tube your paediatrician has given you to ease his discomfort. I believe that, with time, his bowel habits will improve as he grows.

– Dr Lim Kwang Hsien