Children’s Health

Is creatine safe for my teenage son?

DEAR DOCTOR K: My son wants to play football, but he’s smaller than the other boys. Is it safe for him to take a nutritional supplement such as creatine to increase his muscle?

DEAR READER: Many teens, especially athletes, want to be bigger and stronger, and a fair number use creatine to do so. One study found that nearly 10 percent of high school boys have used it. Another study found that nearly half of college men have used it. Creatine is sold as a supplement, but it is found naturally in the body, mostly in muscle.

How much do newborns sleep?

DEAR DOCTOR K: I’m pregnant with my first child, a girl. I keep hearing about how little sleep I’ll be getting for the next year. Can you give me a realistic idea of what to expect?

DEAR READER: Two things make your question hard to answer: (1) each baby is different from others, even from his or her siblings; and (2) each baby’s sleep patterns change as time goes by. As you’ll see, there are wide ranges of what’s “typical” of a baby’s sleep — and some babies don’t fall even within that wide range.

Is there a link between autism and genetics?

DEAR DOCTOR K: I’ve heard that scientists have discovered genes that cause autism. Could this lead to a cure?

DEAR READER: Autism is a disorder of child development. Kids with autism have difficulty communicating and forming social relationships. The studies you are referring to identify genes that increase the risk of autism, and could someday lead to a cure. I think of these studies as the first steps down what is going to be a long road. Nevertheless, they are genuinely exciting.

Are older fathers more likely to have children with autism?

DEAR DOCTOR K: I am a 34-year-old woman married to a man more than 20 years my senior. Our first child, a son born four years ago, is autistic. I have heard that older fathers are more likely to have autistic children. Is this true?

DEAR READER: I am not an expert on autism. I have learned what I know from experts here at Harvard Medical School. No one knows the causes of autism, but today the apparent consensus is that they are biological — something a child is born with. As to your question, I’m told that some research has shown that a child’s risk of developing autism does rise as the age of the child’s biological father rises.

What determines a premature baby’s chance of survival?

DEAR DOCTOR K: My sister recently gave birth prematurely, at 33 weeks. Thankfully, the doctors think my new niece will do well and should not have developmental problems. I know that doctors are able to save more premature babies these days than they used to. What determines whether a “preemie” survives?

DEAR READER: I’m glad to hear that your new niece is doing well. Being born at 33 weeks means she was born seven weeks early. Most babies are delivered about 40 weeks after the mother’s last menstrual period. Labor starts with a perfectly timed cascade of hormonal signals between the developing fetus and the mother. Contractions develop, the cervix dilates, and before long, out comes a well-developed, healthy newborn. But sometimes labor comes early.

How can I help my teen stay healthy while losing weight?

DEAR DOCTOR K: My 15-year-old daughter wants to go on a diet. How can I make sure she stays healthy while losing weight?

DEAR READER: My first question is whether your daughter really needs to go on a diet. Before your teen starts any weight-loss program, talk with her pediatrician, who can help determine an ideal weight for your teen and give her guidance about dieting. Many people (teens and adults) view themselves as overweight when, by medical standards, they are not. They will not get any health benefits from losing weight — though they may think they will look better.

How can I help my child stop wetting the bed at night?

DEAR DOCTOR K: My 4-year-old daughter wets her bed at night. I know this happens to a lot of kids, but I wonder if I should be worried. How should I handle it, and what can I do to make it stop?

DEAR READER: You’re right — many young kids do wet the bed for a time. Bed-wetting is pretty normal for infants and young children, and usually doesn’t indicate a medical problem.

What is croup?

DEAR DOCTOR K: There have been a few cases of croup in my son’s day care. I’m sure it’s just a matter of time before my son gets it. What do I need to know?

DEAR READER: Croup is a fairly common illness in children in the age range of 3 months to 3 years. It is unusual in kids older than 6. It results in a hoarse voice and loud, raspy breathing. Taking in a deep breath, which should be nearly silent, instead is quite noisy. The most recognizable symptom is a harsh, brassy cough that sounds like a seal’s bark.

Should babies always sleep on their backs?

DEAR DOCTOR K: I have a newborn daughter, and I’m worried about keeping her safe while she’s sleeping. Please give me some advice.

DEAR READER: The biggest concern with newborns is sudden infant death syndrome (SIDS). To reduce the risk of SIDS, always place your baby on her back to sleep. In the past, some authorities said it also was OK for babies to sleep on their sides. Today, most authorities do not agree with this.

How much calcium do children need?

DEAR DOCTOR K: I have two daughters, ages 8 and 12. They both claim they’re “too old” to drink milk. How can I make sure they get enough calcium?

DEAR READER: You’re right to be concerned. Unfortunately, many children don’t get enough calcium, and they need it to build strong bones and teeth. As your kids grow, they are also growing the bones they will have for the rest of their lives. How strong those bones are by the time they become adults will strongly affect their risk for developing thin bones (osteoporosis) later in life, which can lead to fractures. Most of the bone growth occurs in the teenage years, but getting enough calcium is important for younger kids, too.