Doc, why are my breasts different sizes?

Doc,

Why don't my breasts match?

Dear reader,

For many people, the breast sizes are not exactly the same, with some having a difference of a whole cup size. This may be more evident during the developing years when one breast grows faster than the other one, though in most instances, the sizes eventually become the same or close to the same. In case the difference is obvious, you can get an insert to use on the side with the smaller breast so that they look like they are the same size. The only way to permanently change the sizes is through plastic surgery.

However, if your breasts have been of same size and one has suddenly grown bigger, then you need to be examined by a doctor and also do breast scans, and any other necessary tests to check for abnormal growths and any other disorders.

My child has been having small rashes all over his body for six months since I started giving him milk constantly. I have tried giving him drugs like piriton, amoxicillin and even hydrocortisone, but there is no change. He is now 18 months old.

Dear parent,

It is likely that your child is allergic to milk proteins. This means that when he takes cow milk, the body initiates an immune reaction against proteins in the milk. This can cause a rash, itching, runny nose, tearing, swelling of the lips, eyes or face, abdominal pain, diarrhoea or vomiting. If there is a severe reaction, there may be wheezing and difficulty in breathing or swelling of the mouth and throat, which is a medical emergency.

Allergy to cow’s milk (and other sources of milk other than breast milk) is common and is more likely to happen if the child also has other allergies or if close family members also have a history of allergy. For most children, the allergy reduces with age and may disappear by the age of five years.

The best way to avoid this reaction is by avoiding cow’s milk and any other products made with milk. If you are still breastfeeding, this is a good source of nutrients. It is advisable for you to see a paediatrician for a proper diagnosis and for a way forward regarding the child’s nutritional needs.

Dear Doc, I am 30. Please help me before I get depressed. When I am sleeping, I'm told that I talk loudly. In fact, not talking but crying! Even when I take a nap during the day. The funny thing is that I have never recalled any episode of talking or crying while asleep. A few months ago I overheard neighbours discuss that I moan and cry while masturbating! I felt embarrassed but there is nothing I can do because I don't remember what I say or do while sleeping!

Cyrus 

Dear Cyrus,

Sleep talking, also called somniloquy, and sleep-related sexual abnormal behaviour are both types of parasomnia, which are abnormal behaviours when falling asleep, while asleep or when waking up.

Sleep talking is quite common, with two thirds of people experiencing it at least once in their life. The words may be clear or it may just be gibberish or mumbling; and you may talk normally or in a voice or language different from the one you usually use. The sleep talking incident takes between a few seconds and a few minutes, and the person talking usually does not remember. Sleep related abnormal sexual behaviour include masturbation, initiating sex and making sex noises while asleep.

On its own, sleep talking is not harmful, other than being embarrassing when others hear you or when it disturbs the quality of sleep of people who are nearby. There is no known cause of sleep talking though it may be more common in people who have close relatives who also sleep talk. You are more likely to sleep talk if you have been experiencing sleep deprivation; if you are unwell or you have a fever; after taking alcohol or other substances; and in the presence of a mental illness. You are also more likely to sleep talk if you have another parasomnia such as sleep walking and night terrors. If the sleep talking is so severe that it interferes with the quality of your sleep, or if it is associated with other sleep disorders, then it would be advisable to be reviewed by a doctor. You may be referred for sleep study if necessary. Sleep talking has no cure but can be reduced by getting better sleep.

To be able to sleep well, get a daily activity schedule and stick to it, plan and eat healthy balanced meals; take enough water during the day, and not in the evening, to avoid going to the washroom a lot at night; exercise (preferably in the morning) and practise good sleep hygiene.

Sleep hygiene refers to those practices that improve quality of night time sleep and contribute to alertness during the day. These include: i) Make your bedroom a relaxing place with a good bed and find a way to block out noise and light such as using heavy curtains.

ii) Sleep at the same time and wake up at the same time every day, whether it is a work day, weekend, leave day or holiday

iii) Try to sleep when you are tired or sleepy to avoid spending too much time awake looking for sleep
If you are unable to fall asleep after 20 or more minutes, wake up and do something boring or calming, with the lights dimmed, until you feel sleepy again.

iv) Avoid bright light and gadgets (like TV, computer, phone) or anything very interesting.

v) A well-timed bath (one to two hours before bedtime) may help you sleep better.

vi) Develop and follow a sleep time ritual. For instance, every day I shower at 9pm and read a book for 30 minutes. I then pray for 10 minutes in the dark in my bedroom before I enter bed.
Keep your day time routine the same, whether you had enough sleep or not. Hopefully by evening you will be tired enough to have a good night’s sleep.

vii) Expose yourself to natural light during the day and keep the bedroom dark at night. The light and darkness will help your internal clock with the sleep-awake cycle.

viii) Avoid using the bed or bedroom for work or watching TV, using the laptop or the phone.

ix) Avoid caffeine or tea before sleep as they can be stimulating.

x) Do not take a heavy meal just before bed time. Milk has tryptophan, which is a natural sleep inducer, so taking a cup of milk may be helpful. Also, avoid alcohol about four-six hours before sleep as it interferes with the quality of sleep.

xi) Avoid sleeping during the day. If you have to, take one 20 to 30 min day time nap before 3pm.

xii) Do not watch the clock when you are unable to sleep. It adds to your stress and makes it more difficult to sleep. If this is a problem, hide the clock.

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