If you notice that your child is looking pale, that is, that his skin is whiteish, it is rarely a cause for concern. It is normal for fair-skinned children to look pale, especially in winter months because of lack of sunshine, or when they are cold.

Pale skin due to anaemia (a low level of red blood cells in the blood) is rare in children.

When to see your doctor

• if you suspect that your child is anaemic;

• if your child is generally unwell and pale;

• if your child has been bruising easily, having lots of nosebleeds, or easily becomes dizzy or short of breath.

STRETCH MARKS

Stretch marks are marks on the skin caused by periods of rapid growth or weight gain, as in puberty. They are caused by a loss of elasticity in the skin. At first they appear as red streaks on areas such as the hips, breasts, buttocks and thighs, and with time fade to a silvery colour. They never disappear completely and creams tnat claim to remove them are useless and a waste of money. Stretch marks most commonly appear in adolescent girls. Encourage your child to accept stretch marks as a normal part of growth.

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Timing and lengtn of feeds

Both the timing and length of feeds will usually be determined by your baby. Allowing your baby to regulate his own feeds often works best for everyone, as he will soon settle into a regular pattern. Try to be flexible and let your baby determine how long and how often he wishes to feed. Some women prefer to feed every 3-4 hours, but there is considerable variability in this. It is really up to you to choose what works best for you and your baby. Always trust your own instincts.

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1. Write a one-page letter only. No typing, so write slowly and clearly.

2. Proofread your letter before sending it. Make sure it reads just the way you want it to.

3. Buy and use your own special stationery for this assignment. This gives the letters a special personal touch.

4. Mail the letter. Don’t just give it to your spouse, but send it to him or her.

5. Never discuss the letters. Write to each other about them.

6. Write only from the “1,” using “you” only as the object of the verb, not the subject. “I love you, I would like to take you to … I would love it if we could . . . etc.”

7. If you send a letter about a problem, remember to avoid what I call SSAADD language. Do not use sarcasm, surrendering comments, accusations, assumptions about motives, demeaning statements, or demands Tell what you like and want, not what is not happening or what fails.

8. A basic rule is that you must answer the letter you receive within two weeks after the date on that letter (so remember to date each letter). Keen a file of your letters as they are received so that dates can be remembered If you don’t get an answer within four weeks of the date on the letter you sent, you may then send another, but do not discuss the issue or question your partner about the letter. This postal assignment is a supplementary assignment. Don’t use it as evidence against or for each other or the marriage.

9. If you get very busy and feel you cannot write to your spouse for a while, tell her or him by letter. Keep this assignment going in the mail, never the bedroom.

10. Change the rules of the letter-writing only by mail.

“I never write longhand and I never write letters,” said one husband. “When I tried, though, it really helped me think things out about us. I kept my attention on us. One page was nothing. I could have written much more.”

His wife added, “At first I was sending complaint letters or trying to be cute. Now we write only every two months or so and the letters are two pages. We worked all that out by mail. Now we send love letters except for one period when we carried on a several-week fight by mail. When I proofread my fight letters, two things happened. First, I wasn’t as angry oncej wrote it out, so I had to write again. Second, I found out that I was always angry about feelings, not facts or issues.”

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Waiting, seducing, tricking, maneuvering, playing coy, being wise—all will fail. “I have waited for him to call for two weeks,” said the woman. “Why don’t you call him now, here, from my office?” I asked. “What! Are you out of your mind? Just call him like I can’t wait to talk to him? Like I am after him?”

“Aren’t you?” I asked

“Well, of course, I would kill to have him. But I just have to wait it out. I don’t want to be hurt,” she said.

“But you are already hurt. You came to me because you feel alone, just passively waiting, ineffective. So act!”

She called, and his roommate announced that he had left town for a new job. “Thanks a hell of a lot,” she said. “I told you this would happen. I feel like a complete fool.”

She was angry, hurt, disappointed, and had taken a severe blow to her self-esteem. But now she could act, she could try to find him and ask what happened, or move on to someone else and try again. She really had little choice, but sitting home for two or three more weeks would have only been a waste of time and might have built her up for an even bigger letdown.

I find that the young people I see in therapy talk much more about the relationship than self, feelings, and love. They try to analyze “it,” figure “it” out, come up with a new trick to work “it” out. Nothing works as well as going full tilt after someone you want and keeping on course with that person once you are married. We “go after someone” romantically by giving ourselves, by sharing, not pursuing.

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Some people suffer from excessive sweating in this area, causing considerable embarrassment with stained clothes. Being conscious of the excessive sweating and worrying about it only seems to make it worse.

The treatment hasn’t always been satisfactory. Anti-perspirants don’t seem to help. Drugs to counteract the nervous influence on the gland give mixed results.

Surgery has sometimes been necessary to either cut out the sweat glands or to cut the nerves which control them.

Some recent reports indicate a local application to the armpits can be of use. Aluminium chloride hexahydrate 20 per cent in absolute alcohol applied each night for a week and then reduced slowly to a maintenance dose of one application each week gave good results. There was some initial irritation of the skin which settled with a mild coritsone cream.

The long term effects are as yet uncertain but, in the short term, this treatment seems to offer some help to those plagued by excess underarm sweating.

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Losing half a kilo a week shouldn’t be too hard. That works out at nearly 26 kilos or four stone in a year and that is a lot of weight.

If you want to lose weight and you want to avoid putting it back on, change your attitudes. Don’t look on the negative side and moan about the nice things you can’t have. Think positively. Think how nice you will look when you have lost weight. Think of the nice new clothes you can buy when you are slim. And think of how good you will feel, and how healthy you will be.

Be adventurous in your eating. Experiment with new foods and new ways of cooking. Dieting can be fun. But if you do weaken and have a piece of cake, then you may as well enjoy it. Don’t wolf it down and feel guilty. Go to the cake tin and place the piece of cake on a plate. Put the cake tin away, take the plate to the table and sit down and eat it slowly.

It is a good idea to eat all your food slowly and enjoy it. If you eat slowly you may actually eat less.

Having lost weight, be careful with your eating for the next six months. The appetite and weight controlling centre in the brain acts like a thermostat. It will act to keep your weight constant. Once you have lost weight it will take some time for this regulatory centre to adjust to the new body image.

Many people are prepared to do almost anything to lose weight except what is really necessary, and that is to eat properly. It sounds simple and it is. But I must admit it is difficult to do. Good luck and think slim!

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It is due to the normal breakdown of the foetal red blood cells which occurs after birth and the inability of the immature liver to handle this workload properly. In the premature infant the liver may be more immature and unable to cope, so the level of bilirubin or bile in the blood may rise to dangerous heights. This can cause damage to the brain.

When Rh or other blood incompatibilities are present there may be a great increase in the number of red cells destroyed. The number may be greater than the liver’s capacity for handling it and so the jaundice may reach danger levels.

One new method of dealing with the jaundice in each of these situations is to treat the infant by exposing him to light. This treatment hastens the breakdown of the bilirubin and so may prevent it reaching dangerous levels.

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Predicting those who may gain or lose fat as a result of depression is not a simple task. In a study carried out by the US National Health and Nutrition Examination Survey (NHANES) it was found that younger men (less than 55 years of age) who were depressed seemed to put on more weight over time than those who were not. This was particularly so if education levels were low. In contrast, depressed young women seemed to put on less weight than their non-depressed counterparts. But again, education levels seemed to play a part with the more highly educated putting on less weight with depression than those with lesser education. In these instances, psychological counselling to deal with grief and depression should be the primary process of any intervention rather than initiatives dealing with obesity per se.

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This varies from three to seven days and may be extended by a couple of days if complications occur.

Why are antibiotics necessary?

Doctors in countries such as Australia routinely prescribe antibiotics after surgery to reduce the risk of postoperative infection.

Why am I having bowel pain after my hysterectomy?

Many women experience significant bowel pain two to four days after a hysterectomy. The sensation and the site of the pain is different from that occurring in the first day or two after surgery. The cause of the pain is temporary paralysis of the bowel which leads to constriction or swelling. As it recovers and tries to eliminate the accumulated gas and waste materials, it contracts more violently than usual.

I am still having a discharge three weeks after a hysterectomy. What is the cause of the discharge and when will it stop?

The discharge may be the result of vaginal wound healing, a wound infection, or a vaginal infection such as thrush. It usually stops one to four weeks after surgery. Occasionally it continues for a longer period of time and if this applies to you, see your doctor.

Why am I so tired since my operation?

Most people who have major surgery feel very tired in the first few weeks afterwards. This is related to the stress of the medical condition for which they had the surgery, the anxiety associated with having an operation, and the demands of surgery, anaesthesia, drugs and any postoperative complications such as anaemia or infection. If the tiredness persists for two to three months, it may be associated with a depressive reaction to the surgery. In such situations, a visit to a caring doctor is in order. Make a long appointment so that you can discuss the problem fully. If tiredness persists, it may be due to depleted oestrogen levels caused by damage to, or removal of, the ovaries at the time of the hysterectomy.

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