Ask an expert: Dr Rob Hicks

Ask an expert: Dr Rob Hicks

Our resident sexual health expert, Dr Rob Hicks, helps answer any medical questions you might have and gives advice on personal matters


I had my six-week post-natal check, but was surprised that my abdomen was not examined at all, especially as I had a C-section. Should I have had a more thorough check or does it vary from woman to woman?

Generally speaking the post-natal check is an opportunity to review what happened during the birth of your child and how your are recovering, how you are finding looking after a new baby, to discuss contraception, and for you to raise any questions or concerns that you have.

With regards tests and examinations, this does vary among doctors, but the NHS suggests that usually at the post-natal check a woman will be weighed, have her blood pressure measured and urine tested. The patient may, but not always, be offered an examination to assess the healing of any stitches she has had. In addition, a woman’s rubella immunity and whether she’s due a cervical smear test will be reviewed.

My husband and I used to enjoy lengthy, passionate lovemaking, even late in my pregnancy, and now baby is three months old, my hubby wants to kick-start our sex life to what it was before. I’m just not in the mood and am usually too tired. How can I be honest and tell him I don’t feel sexy and energetic enough?

Many women feel exactly the same as you do, so please try not to worry and remember that things usually work out. Talk to your partner about how you’re feeling – and why – as this will help reassure him about any concerns he may have.

Looking after a baby is tiring, so sex may be the last thing on a woman’s mind. Tiredness and a lack of libido may be down to anaemia, an underactive thyroid gland, or postnatal depression, so have a chat with your doctor and ask for advice. You might find yourself more in the mood if you have the opportunity to be intimate together without fear of interruption, so if family offer to have baby overnight there’s your chance to focus on just the two of you.

I’m quite shocked to discover that my four-year-old son is playing with his willy. I’ve told him to stop but I know he’s still doing it. I’m concerned that he’s far too young to be so obsessed.

This is normal and healthy behaviour so there’s no need for you to be embarrassed. Children explore their bodies and your son is doing just that. Any additional pleasure he’s getting from it is just a nice sensation. Do not punish your son for doing this, and there’s no need to tell him to stop. In fact, telling him to stop is likely to make him want to do it more. The last thing you want to do is make him feel guilty for doing something that most children do. Let him know that it’s ok but, like going to the toilet, it is best done in private. If he does it in public then try to distract – not bribe – him with a game or story, or other fun activity.

My two-year-old daughter can be constipated one day and have diarrhoea the next so I’m not sure which condition I should be aiming
to treat. Could you advise, please?

The likelihood is that she has constipation, as sometimes when a child is significantly constipated they can actually have loose 
and soft bowel motions. She will need a check-up with her GP, though, to confirm this. Constipation in children is common and usually arises when a child is not
 getting enough fibre and liquid in their

Diluted prune or apple juice provides necessary liquid and also stimulates the bowel. Puréed fruit and vegetables also 
help, along with wholemeal bread and rice. Lactulose liquid (available from your pharmacist) helps keep liquid in the motions, making them easier to pass. 
Massaging a child’s tummy in a clockwise direction can help get things moving, too. Keep things relaxed and allow your child time when they’re trying to go to the toilet.

I’m planning to breastfeed my baby who’s due in October, but I’m worried about how this will affect my sex life post-birth? How can I explain to my husband that my breasts are going to be out of bounds for the foreseeable?

Medically speaking, it’s safe for breasts to be involved in breastfeeding and sex. However, many women feel their breasts are ‘out of bounds’ while they’re breastfeeding because 
emotionally they find it difficult to separate the involvement of breasts in feeding and their involvement in intimacy and sex. For others it’s because their breasts become very tender when breastfeeding, so the last thing they want is them being handled during sex.

Some women worry about how their breasts look at this time and don’t want attention drawn to them, others fear that breast 
milk will leak during sex and dislike that. Whatever your reason for your feelings, 
be honest with your husband about this. There are plenty of ways to enjoy intimacy 
with each other that don’t involve your breasts – and remember to use contraception if you’re not planning 
on becoming pregnant again soon.

My baby often seems to have a red, dry rash at the back of his neck and on his ankles and wrists. Could this
be caused by my washing powder?

Yes, but there are other reasons too, so 
your baby needs a check-up with your GP. It may be caused by clothing rubbing against the skin. Synthetic materials are more likely to irritate the skin than natural fibres, as is wool, so try and stick to cotton. Skin creases are where eczema usually appears too, so that may be the cause.

Keep your son’s skin well moisturised, paying particular attention to the areas affected. It’s not easy, but do your best to prevent him from scratching – keeping 
fingernails short and using cotton mitts helps. You could try changing to a non-
biological washing powder.

I know breastfeeding is best for my baby and I do it at home but whenever I do it in public I feel very self-conscious. Is it just me that feels this way?

You’re certainly not alone in feeling this 
way. Many breastfeeding mums feel 
the same, often because of the critical looks and comments they get for doing something that is perfectly natural, and that they 
are encouraged to do.

In fact, the recently
published Lansinoh Breastfeeding Survey found that more than one in four mums didn’t like the idea of breastfeeding in 
public – and ten per cent of those surveyed found it embarrassing. Some breastfeeding mums find it easier if they are out with a friend who is also breastfeeding, as it gives an extra boost 
of confidence and support.

going to places where there’s a good 
chance other mums will be breastfeeding in public too, or to places that aren’t 
too busy with people so you get used 
to breastfeeding in public. Another option would be to use a breastfeeding apron 
that can shield your baby and your breast from prying or critical eyes.

I had an episiotomy during the birth 
of my second daughter eight months ago. Since then my sex life hasn’t been the same as I suffer from pain during intercourse – it feels as if the scar will tear. I did see my GP about it but I was so embarrassed that I can’t actually remember what he advised, and I feel foolish about having to ask again. What do you recommend?

Your GP won’t mind you asking again so please don’t feel awkward. You don’t have 
to have a face-to-face consultation, either 
– you can ask over the phone if you prefer. Being tense and anxious means sex is more likely to feel uncomfortable because 
it prevents you being relaxed, and this in turn makes adequate lubrication less likely. Using a lubricating gel (such as those 
from the Durex range) during sex can help.

Many women find that actually avoiding penetration for a while and just enjoying foreplay with their partner helps to increase confidence about sex not hurting. Using a vibrator can also help when fear of pain from penetration exists. If a skin condition, such as eczema or thrush, may be contributing to the problem, these can be easily treated. Sometimes the underlying cause is an emotional problem relating to a difficult 
or traumatic birth experience, or a fear of further pregnancy. If you think this could be the case, then counselling and ensuring effective birth control can help overcome 
the problem.

My son has been diagnosed with croup, which my GP is treating, but the sound of his coughing is really making me panic. I have never heard a cough that sounds so unnatural. Could there be something more wrong with him – and if not what home remedies might help?

It can be scary hearing the cough of croup, which sounds like barking, but be reassured that, generally speaking, it gets better on its own without specific treatment, often within a few days. Give your son plenty of TLC. When he’s distressed, sitting him upright on your lap will help a lot. Age-appropriate paracetamol or ibuprofen can be given to relieve fever and discomfort, provided your GP has said that this is ok. Many children with croup also benefit from steam inhalation.

This is often best and most easily done by running a hot 
bath or shower and then sitting with your child in the bathroom (but not actually in the bath or shower), with the doors and windows closed, while they breathe in 
the steam. If his symptoms do not begin to improve, or get worse, or if you are at all concerned, then don’t hesitate to seek further medical advice from your doctor.

Sometimes my 11-month-old baby holds her hand over one eye when she’s looking at me, or turns her head to one side. I thought she was just playing ‘peek-a-boo’, but could there be anything wrong with her sight?

You should have your baby’s eyes checked, initially by your GP, who will probably refer you to the paediatric eye department at the hospital where an optometrist will examine her and do some visual tests. These will help to ascertain how well she sees things, how well her eye muscles work, and whether she has any problems tracking objects.

Sometimes behaviour such as this is just 
a child learning through experimentation and play about what happens if she covers her eyes or tilts her head a certain way. However, if there is an underlying problem then it’s important to identify it as early 
as possible, so any necessary remedial 
steps can quickly be taken to encourage good visual development.

My two-year-old son is not speaking yet, and a friend has suggested that 
I ask my doctor about the possibility of him being autistic. I’m really angry with her for saying this and don’t want to pursue it, but now it’s been said I can’t stop worrying about it. 
Is there really a link between lack 
of speech and autism?

The simple answer is that yes, a delay in beginning to talk may be associated with autism. But speech delay may be caused 
by many other things too – for example, 
a problem co-ordinating the movements 
of the lips, tongue and jaw that makes it difficult for a child to form words properly, or even a hearing problem that means he 
is not able to imitate the sounds you are making to him. What is most important is that you 
ask for your son to be assessed as soon 
as possible.

Your GP is most likely to recommend he is initially seen by a speech and language therapist, who’ll be able to help pinpoint any specific hurdles to speech that your son is experiencing, and how these can be overcome. In the meantime, keep communicating with him as much as possible through talking, reading and singing.

I had my six-week post-natal check, but was surprised that my abdomen was not examined at all, especially as I had a C-section. Should I have had a more thorough check or does it vary from woman to woman?

Generally speaking the post-natal check is
 an opportunity to review what happened during the birth of your child and how 
you are recovering, how you are finding looking after a new baby, to discuss contraception, and for you to raise any questions or concerns that you have. With regards tests and examinations, 
this does vary among doctors, but the 
NHS suggests that usually at the post-natal check a woman will be weighed, have her blood pressure measured and urine tested. The patient may, but not always, be offered an examination to assess the healing of any stitches she has had. In addition, a woman’s rubella immunity and whether she’s due a cervical smear test will be reviewed.

My husband and I have always enjoyed exotic holidays and are thinking about taking our nine-month-old son to Egypt this spring. I feel it’s pretty safe for 
him to travel, but am I exposing him 
to unnecessary risk?

Many children travel to overseas countries and are fine. However, it’s important to take precautions and use common sense. Make sure he’s up to date with his usual childhood vaccinations.

Also, make sure you have the recommended travel vaccinations, and speak with your doctor or travel clinic about whether it’s appropriate for your son to have travel vaccinations – this will depend upon considerations such as his age and the areas to be visited.

Obviously, follow the advice regarding eating and drinking safely, for example drinking bottled water but not tap water. Remember to pack all the essentials and things you might need such as age-appropriate paracetamol and ibuprofen. It would also be a good idea to have travel
insurance that includes medical care.

My nine-month-old has always had cold hands and feet, and it doesn’t seem to be getting better with age. I’ve tried mitts at night, but they just get taken off during her sleep. It doesn’t seem to upset her, but some mornings her little hands are starting to get a blue tint. Is there anything else I should be doing or is it best to visit my GP to seek advice?

This is a common situation in children,
and in adults too, and can often be perfectly normal and harmless. If your daughter is growing and developing well, and achieving all her milestones – and, importantly, isn’t getting any worse – then it’s probably nothing to worry about.

Regarding the blue tint in her hands,
she should have a check-up with your
GP to be on the safe side. If your doctor
is concerned at all, then he or she will probably recommend a further assessment with a paediatrician.

I’m pregnant for the first time and am worried about the size of my bump – at four and a half months, it’s quite small. How do I know my baby is growing as he should be?

The size of your bump will be unique to
you and depends on a number of different
criteria, including the position of the baby, and your size and posture. A first-time mum’s bump often appears smaller because the stomach muscles are usually still tight
– in later pregnancies stomach muscles are
 often more lax. A bump can also appear small when there’s less fluid surrounding a baby. Ask your midwife or GP to check your bump. If she has any concerns then you’ll probably be referred for an ultrasound scan to confirm how well your 
baby is growing.

My daughter is nine months old 
and suffers from colic early in the evenings. I find that Infacol really helps but is it okay to use every day?

It’s unusual for colic to still be occurring at nine months of age, so I think it would be wise for your daughter to have a check-up with your GP to confirm that she has colic and not another problem that requires a different treatment. Regarding Infacol, the active ingredient in it – simethicone – isn’t absorbed into a baby’s body so it is believed to be safe to use as needed.

Do consider other ways of soothing your baby, such as gentle rocking and placing her safely near comforting sounds such as the hum of a washing machine. Remember that colic can be exhausting for parents, so make sure you have time for yourself.

I had my first baby last year at the age of 38 and am keen to try for a second. Are there specific tests available that would evaluate any risk factors for me and the baby?

Only a year has gone by, so your risk factors will be pretty much the same as last time round. You will probably be offered screening to assess your risk of having a baby with Down’s syndrome, as I expect you were in your last pregnancy. Other than that, the antenatal process will probably be the same for you if nothing has changed regarding your health and circumstances. Remember to take a daily folic acid supplement whilst trying to become pregnant and for the first 12 weeks of pregnancy, and a daily vitamin D supplement once you’re pregnant. Ideally, cut out alcohol and maintain a healthy lifestyle to give yourself the best chance
 of everything going to plan.

There’s a woman in my NCT group who suffers from bad heartburn, as do I, but she won’t take anything to relieve it. Is she being overly cautious or am I being shameful for taking a daily dose of Gaviscon?

Everyone does what they feel is right for themselves and their baby, so you should not feel guilty. Heartburn is common in pregnancy, so keeping it at bay will help a person feel better and help them enjoy being pregnant. Do check with your pharmacist or GP that the remedy you’re using is suitable and consider other ways to keep heartburn at bay, such as eating smaller meals 
more frequently, avoiding 
foods and drinks that trigger 
symptoms, wearing loose 
clothing, and sitting in a
 more upright position.


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