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House Calls, May 3, 2012

Posted on May 3, 2012May 3, 2012 by Staff

Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu

This week we respond to questions about toddler sleep and sun exposure with estrogen.

Dear HOUSE Calls, My 2-and-a-half-year-old daughter recently slept for 14 hours in a row. Is that normal?

Wow, as a parent, that actually sounds wonderful! We would want to know more about how she was acting before and after and what else is happening with her health, development, environment and family life, and also more about her regular sleep patterns. Perhaps if she missed her nap the previous day and went to sleep late, she might be catching up. Also, if she was sick with a fever, we would probably relate the excessive sleep to being sick. We usually find that toddlers do best in terms of sleep with predictable schedules – going to bed and waking up the same time every day. We find that most aberrations in infant and toddler sleep are related to stress, and different children respond to this stress in different ways. This could be as simple as mastering a new developmental milestone (potty training, for example) or as severe as parent separation. Most 2-and-a-half-year-olds take a nap in the afternoon of one to two hours in duration and sleep for 11 to 12 hours overnight. There are some medical conditions that could be related to this issue if it seems to be an ongoing problem. We particularly think of problems with anemia, thyroid conditions and sleep apnea. You should bring her in to see her doctor if this continues.

Dear HOUSE Calls, I take estrogen hormone therapy, and the package directions say to avoid natural and artificial sunlight. Is this a really big concern?

This is interesting because you will find similar instructions on birth control pills, which contain estrogen. We have never found this to be a problem, so we spoke with a dermatologist who agreed that this is not an important issue. Women on estrogens may be slightly more prone to sunburns, but in general we simply counsel women to use the same good, common-sense sun protection that we recommend to everyone. Cover up, use sunscreen and avoid midday sun. There are some medicines that can really predispose you to burns, such as tetracycline and doxycycline, so if you take these, exercise extra caution with the sun.

House Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page and Dr. Adam Zolotor on behalf of Your Health and the UNC Department of Family Medicine.

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