Smallest in class
Q My son is the smallest in his class and it is beginning to get to him. His father and I are both of average height and were not particularly small as children. He eats well and is very active and fit but I'm beginning to get anxious on his behalf. Is there anything we can do?
A Unless your son has an underlying condition limiting his growth, which is rare, he is likely to end up being average height. You need to know whether he is growing at a normal rate ("growth velocity"). Ask your GP to weigh and measure him accurately and plot the results on up-to-date growth charts. If your son is excessively short (in the smallest 0.4% for his age) or appears not to be thriving, your GP will refer you to a growth specialist. If repeat measurements in six months' time show normal growth velocity, you can all be reassured. You can explain to your son that he is likely to be at least as tall as his father. Listen to his concerns and act promptly if there is any bullying - young boys are very size-sensitive. Useful information: Child Growth Foundation (www.cgf.org.uk).
Alzheimer's worries
Q I'm 65 and my memory is awful. I'm terrified that I'm getting Alzheimer's as my mother did in her 80s. Every time I can't find a word I get in a terrible tizz. How do I know if it is dementia? It's making me very low.
A Dementia is fairly rare in people of 65 but affects one in five people over 80. It's hardly ever inherited so there is no particular reason for you to develop it. Most people worried that their memory is going are actually a bit depressed. Because Alzheimer's causes gradual disorientation, the sufferer is usually the last to be aware of his or her symptoms. Your GP will be able to ask you a series of questions to test your memory, carry out some simple urine and blood tests and refer you to a specialist if dementia is suspected. If you are depressed, you can discuss treatment options. Remember, your chances of having Alzheimer's are extremely slim.
Emergency pill
Q I've had to use emergency contraception twice in the past six months when condoms have split. I'm 42 and worried it is bad for me.
A Virtually any woman can take emergency contraceptive pills as long as she is not pregnant. If you need to take them again as a one-off, that should be fine. But why not have a coil fitted or consider a long-lasting progestogen implant or three-monthly progestogen injections? Your GP or family planning clinic will advise.
Not talking at two
Q My two-year-old isn't talking much and his 18-month-old cousin says much more. My health visitor said that boys often speak later than girls. Is this the case?
A Two-year olds can usually ask for a drink, the toilet, snacks and mimic your speech. They can join two or three words together and often babble incessantly. Some kids speak later and less than others. First, make sure your son can hear and arrange hearing tests with your GP if you are concerned. If he plays imaginatively, interacts with you and other adults and children, can walk, run and kick a ball and understands what you say to him, he is unlikely to have any developmental delay or autism. But a formal assessment by a community paediatrician may be reassuring. Many children just speak later than others and do just as well in later life as early talkers. He will benefit from every moment you spend reading and talking to him.
Is HRT safe for me?
Q I have been taking hormone replacement therapy for five years ( I am 62) and have recently been advised by my GP that I should give it up due to increased risk of breast cancer if I take it for more than five years. There is no history of breast cancer in my family and I was taking it to reduce the progression of heart disease - I get angina - and prevent osteoporosis. Is this new advice? I thought HRT was for life?
A HRT is a question of balancing pros and cons for you as an individual. There is no one right or wrong answer. Current evidence suggests that after five years of continuous use, there is a small increase in risk of breast cancer, more marked after 10 years. It sounds as though you are at low risk. If you have a strong reason for wanting to take HRT, you may be prepared to put up with a possible slight increase in risk of breast cancer.
These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.
