Skin Reactions and Nutrition in Infants: A Pediatric Guide

Rubbing of both feet

Hello Dr.
Lin: I would like to ask you a few questions...
1.
My daughter is currently seven months old.
Recently, she has been bitten multiple times by mosquitoes on the soles of her feet and around her ankles, and the skin around her feet is very red and somewhat swollen.
She also likes to rub her feet, and the redness and swelling do not subside.
Is it safe to apply some adult ointments on her, such as Betamethasone cream? 2.
In the past few weeks, she has been very reluctant to drink milk, with a total daily intake of about 350cc.
When we visited the hospital for vaccinations at six months, her growth and development were all normal.
Is this amount of milk sufficient to meet her daily nutritional needs? (During the day, she eats some complementary foods, such as rice porridge or apple puree.) How can I improve her milk intake? Please help me with these questions, thank you...

Qiao Ma Mi, 30~39 year old female. Ask Date: 2005/05/31

Dr. Lin Huizhen reply Pediatrics

Dear Dr.
Lin Huizhen, Director of Pediatrics at Tainan Hospital, Department of Health, Executive Yuan:
1.
This type of ointment can be applied, but it is advisable to prevent some children from licking their feet.
You may consider putting on socks after applying the medication.
2.
It is normal for children at this stage to show a disinterest in milk.
As long as their activity level is normal, they are in good spirits, and their appetite continues, there is no need for concern.
The phase of milk aversion may last for several weeks.
You can try offering milk while they are sleeping at night.
The variety of solid foods you are providing during the day is already quite rich, so keep up the good work.
Remember not to force-feed the child, as this phase of milk aversion will eventually pass.
Wishing you and your baby good health and all the best from the Department of Pediatrics at Tainan Hospital!

Reply Date: 2005/05/31

More Info

Hello! Thank you for your questions regarding your daughter's skin reactions and nutritional needs. Let's address each of your concerns in detail.

1. Skin Reactions to Mosquito Bites: It's common for infants to have reactions to mosquito bites, which can manifest as redness, swelling, and itching. The skin around the bites may become inflamed, and your daughter’s tendency to rub her feet can exacerbate the irritation. While it may be tempting to use adult topical medications like hydrocortisone cream (such as "Mometasone" or "Betamethasone"), it's generally not recommended to apply adult medications to infants without consulting a pediatrician first. Infants have sensitive skin, and adult formulations may contain ingredients that are not safe for them. Instead, consider using a gentle, pediatric-approved hydrocortisone cream or an over-the-counter antihistamine cream specifically designed for children. Additionally, keeping her nails trimmed can help prevent her from scratching and causing further irritation.

2. Nutritional Needs and Milk Intake: At seven months, your daughter’s total milk intake of approximately 350cc per day may be on the lower side, especially if she is primarily breastfed or formula-fed. The American Academy of Pediatrics recommends that infants between 6 to 12 months should consume about 24 to 32 ounces (approximately 700 to 950cc) of breast milk or formula daily, alongside solid foods. Since she is also eating some solid foods like rice porridge and apple puree, it's essential to ensure that she is getting enough calories and nutrients from both her milk and her solids.
To encourage her to drink more milk, you might try the following strategies:
- Routine: Establish a consistent feeding schedule that includes milk before solids. This can help ensure she is hungry for her milk.

- Variety: If she is bottle-fed, consider trying different nipples or bottles to see if she prefers one over the others. If she is breastfed, you might try different positions or environments to make feeding more comfortable for her.

- Offer Milk in Different Forms: If she is open to it, you can try offering milk in a sippy cup, which some infants find more appealing than a bottle.

- Limit Distractions: Ensure that feeding times are calm and free from distractions, which can help her focus on drinking.

3. Monitoring Growth and Development: Since you mentioned that her growth and development were normal during her last check-up, it’s important to continue monitoring her weight and growth patterns. If you notice any significant changes or if her milk intake continues to decrease, it would be wise to consult your pediatrician for further evaluation.

4. Skin Care: After mosquito bites, applying a gentle moisturizer can help soothe the skin and prevent dryness, which can lead to further irritation. Look for fragrance-free, hypoallergenic moisturizers designed for infants.

In summary, while it’s essential to address her skin reactions with appropriate care, ensuring she receives adequate nutrition through both milk and solids is equally important. If you have ongoing concerns about her skin or nutritional intake, don’t hesitate to reach out to your pediatrician for personalized advice and support. They can provide tailored recommendations based on her specific health needs. Thank you for your questions, and I hope this information helps you care for your daughter!

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