Q I am 43 year old man and my wife 41 year we have 4 year and 6 month daughter. We are very confused whether to go for second child as my only daughter feels very lonely. Can you advice?

First, determine whether you and your wife are physically, mentally and financially ready to have a second child. It is definitely possible to conceive at this age; however there are many factors that you should take into account before arriving at a decision. A womans fertility decreases drastically in her forties so there is a major possibility that your wife may have to use donor eggs to achieve pregnancy. The risk of complications during pregnancy such as diabetes and high blood pressure increases. Moreover, there are higher chances of premature and still births. You may need to use assisted reproductive techniques thus escalating costs. I am not trying to discourage you, but giving you the facts. On the other hand, some women do get pregnant well into their 40s, and many of them have complication-free pregnancies and healthy babies. Both of you should make an informed decision after knowing all the pros and cons. For any further clarification, visit a gynaecologist who will brief you about all available options. Do consider the possibility of adoption too.

Q My 10 year old daughter continues to wet the bed. Not every night, but i thought it would stop as she grows but still hasnt. I wonder if there is something medically wrong.

If you daughter has nocturnal enuresis sometimes, it may need further evaluation, as this is not so common in teenagers. There are some factors that may affect urine control in teens. These include excessive intake of caffeine drinks like tea or coffee, deep sleep pattern which can be a normal for growing teen, excessive emotional stress or fear of something, inconsistent sleep timings etc. These things can be corrected in order to fix the problem. Other things to give consideration are certain medications, diabetes of other medical diseases, family history of parents having the same problem, urinary tract infection, etc. If she is having this problem since her childhood, then this can be considered as primary nocturnal enuresis and she can be out of 2% of girls who continues with this till they reach their teen. This thing can be improved with proper counselling to her. Making her to use bathroom before going to bed. Limiting her fluid intake before going to bed. She can be effectively treated with moisture alarms while asleep. It will be less likely that she will need medications for this. Proper counselling and educating her may motivate her to take initiation to cure herself. You may take her to physician to rule out underlying disease if any.

Q Why does your babies tongue keep thrusting out?

Its because of tongue-thrust reflex. It is also called as reverse swallow or immature swallow. This tongue-thrust reflex can make early feedings a bit of a challenge. Try to get your baby to relax during feedings and dont push him to eat more than hes inclined to. If hes bottle-fed, make sure the hole in the nipple is the right size making it easy for him to suck milk.

Q Need help related to phimosis

Treatment of phimosis are of two types surgical and non-surgical. The choice of treatment will depend upon the acuteness and severity of the problem. Consult an urologist to decide what is best for you.

Q I get angry very often. How can I control my anger?

Getting angry is normal. One needs to concentrate not on "not feeling angry" or "controlling anger" but on how to manage that anger correctly. First of all try to identify the things, people, or situations that trigger anger. You can even keep a dairy. Note the ways in which you react to these situations. Then look for alternative ways of responding to the same situations. Practice this alternative adaptive response till it becomes a part of your nature. Recognizing anger and triggers, practicing alternatives and doing this persistently with positive attitude is the key.

Q Is there any relation between obesity and headache?

There are studies which suggests that obese people are at increased risk of developing migraine. Hence it is advisable that you maintain a healthy weight.

Q Whats causing my palpitations and how can I get rid of them?

The causes for palpitations are - strong emotions such as anxiety, fear, or stress; palpitations often occur during panic attacks; caffeine, nicotine, alcohol, or illegal street drugs such as cocaine; some medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration; hormone changes associated with menstruation, pregnancy or menopause etc. In most cases, palpitations are found to be harmless and often go away on their own. Treatment depends on the cause of your palpitations. Some lifestyle changes like exercise and yoga and quitting smoking and alcohol help a lot.

Q Can eating plain cornstarch be harmful?

Cornstarch is a commonly used cooking ingredient. It is safe to eat plain cornstarch. This is unlikely to cause significant health concerns.

Q Do men suffer from menopause like women?

The phase of life similar to menopause is called as andropause in men. It is marked by lethargy, sadness, weariness, lack of drive, irritability, poor concentration and sometimes loss of sexual desire in middle-aged men. This leads to boredom, lack of fitness, heavy drinking and lack of self-esteem.n Though, male menopause is controversial, as there isn~t any calculable fall in the levels of male hormones in middle age like females have fall in sex hormones drastically, yet it is advised that men experiencing the symptoms should exercise regularly and eat healthy, nurture a hobby, and have a peaceful mind and renew interest in life.

Q My 22 months old boy still has anterior fontanelle open. Is it a concern

In most cases anterior fontanelle closes between the age of 7-19 months. Delay in closure can be due to causes like premature birth, intrauterine growth retardation, downs syndrome, etc. I would suggest that you get your child examined by a pediatrician to rule any abnormality.