DEAR DR. DONOHUE: My grandson is 2 months old. At 1 month, he started throwing up after each feeding and began to lose weight. His pediatrician detected stenosis, and the baby had an operation that is supposed to cure him. We would like some facts on this. Does the stenosis ever come back? – M.R.

ANSWER: I am positive that your grandson had pyloric stenosis. The pylorus is the tubular end of the stomach through which food passes into the small intestine. It is a thick band of muscle that stays closed until the stomach has ground up and partially digested food, and then relaxes to allow food to enter the intestine for absorption.

In pyloric stenosis, the muscle is overgrown and stays closed. That’s why the infant regurgitates food. Often the vomiting is described as projectile; it gushes out as if squirted from a fountain. It need not be so, however. Furthermore, vomiting might not occur with every feeding.

Doctors can often feel the enlarged muscle when they gently press the baby’s abdomen with their hands. Ultrasound pictures of the stomach provide definitive proof of the condition.

Surgery solves the problem. The surgeon incises the enlarged pylorus muscle, and that almost always cures the trouble. No surgery is successful 100 percent of the time, but this operation comes close to being so.

Your grandson will have no problems later in life from his infant pyloric stenosis episode.

DEAR DR. DONOHUE: We have a child with scabies. I am mortified. I am compulsive about keeping the house and my children clean. How could he have gotten this? Do we need to keep other children or all visitors away from our house? If we need to do so, how long do we have to continue the quarantine? – B.D.

ANSWER:
Scabies and lice launch mothers into orbit. Both can happen in the cleanest of homes and to the cleanest of children. There should be no shame attached to either. Did you know that 300 million people worldwide catch scabies every year?

Scabies is a mite, a creature so small you need magnification to see it well. It usually spreads from contact by an uninfected person with an infected one. It is less often picked up from clothes or inanimate surfaces. The mite lives for only 24 hours when it is not on a human.

Almost immediately upon landing on the skin, the female mite burrows a tunnel in it to lay her eggs. In two weeks the eggs mature, and the new adult scabies mites surface on the skin, where they mate. Once mated, the recently matured female digs another tunnel into the skin, and the cycle keeps repeating.

Itching is the primary symptom. It intensifies at night or after taking a hot bath or shower.

Treatment with scabies skin creams renders an infected person noncontagious in one day. You do not have to bar visitors from that point on.

Itching can persist for some time after successful treatment. It’s a manifestation of an allergy to mite products that remains after the mites have died. Antihistamines can generally control it.

DEAR DR. DONOHUE: My daughter is in the eighth grade and has just begun to wear glasses. Her father insists she take them off when she is home. He says that constant wear weakens her eyes and that she will become totally dependent on glasses. Is this correct? – V.H.

ANSWER:
Your daughter probably is nearsighted. She can see things up close but not in the distance. Things written on the blackboard are blurs to her. Nearsightedness also goes by the name of myopia.

Wearing glasses will not weaken her eyes. Taking them off will not strengthen her eyes. Myopia results from eyes that have become too elongated in the eye socket. Incoming light focuses in front of the retina instead of on it. The focused light must land directly on the retina for clear vision. The lenses in her glasses take on the job of focusing light squarely on her retina so she no longer sees the world in a haze.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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