Tuesday 25 July 2017

Dear Dr Nina: Should my daughter's brittle hair be a cause for concern?

Genetics play a large role in determining the kind of hair we end up with.
Genetics play a large role in determining the kind of hair we end up with.

Nina Byrnes

Advice from our GP on how to a child's weak and brittle hair.

Q. My little girl has soft, wavy hair that was reddish when she was born, turned bright yellow around the age of one and a half and is now a darker flaxen colour. However, despite having never had more than a trim, her hair has not grown even as far as her shoulders. The remaining yellow hair - what we call her "angel hair" - also comes out in tufts. She would love more than anything to have long hair. Is there a reason that it doesn't grow, and is there anything I can do to encourage its growth and strength?

My gran had similar hair but had been severely malnourished as a child. My daughter was treated with Zantac for reflux from aged five months to age two. I wonder if this had any effect on her hair growth?

A. Genetics play a large role in determining the kind of hair we end up with. If you are concerned about your daughter's hair think back to the kind of hair you had as a child or that of her father's, aunts, uncles and grandparents as this may point you in the right direction.

The rate at which our hair grows may also be determined by genetics along with other factors. Some children are born with thick heads of hair, others remain bald well into their first year. All of this may be normal and doesn't mean there is something wrong. The fine baby hair present at birth often falls out and may be replaced by hair that differs greatly in colour, texture and shape.

In order to understand hair health it is worth spending a minute understanding how hair grows. Each hair follicle passes through a growth phase that lasts four to six years, then a rest phase that last several months before it falls out - being replaced by a new hair in the growth phase. In a normal cycle, about 90pc of hair is in the growth phase with 10pc in the rest or fall out phase at any one time. Hair change becomes noticeable when the amount of hair in the rest or falling- out phase increases and the growth phase is reduced. So it is normal that hair changes and sheds especially in the early years.

Nutrition plays a big role in hair health and growth. It is important to eat a broad varied diet. B vitamins, healthy fats and micro nutrients such as selenium are particularly important.

It is also important to ensure you have adequate iron and protein in your diet, as deficiencies in these can reduce hair health.

A medical check up is always worthwhile as thyroid disease or other autoimmune conditions may play a role. Blood tests may reveal a lot about nutrition and hair health. Stress, illness, dieting and certain medications may also negatively impact on hair growth and strength.

A simple cause of hair damage is pulling hair too tight in a hairstyle. Rethinking the way you style your child's hair may help. Overheating hair with hair-dryers or straighteners can also damage hair. Use nourishing shampoo and conditioner always.

There are a number of rare genetic and metabolic conditions that are associated with brittle breaking hair. Brittle nails may be associated with some of these. Others are associated with developmental delay. If your daughter is developing normally in every other way, these conditions are very unlikely. Scalp health is also very important - dandruff or flaky scalp may be caused by a fungal infection, which can impact on hair growth and texture. Antacids such as ranitidine (Zantac) may result in reduced absorption of vitamins and minerals, which ultimately may impact on hair health.

In order to improve your daughter's hair health, start with a GP check-up. If no medical cause is found I would then focus on ensuring a very healthy diet with plenty of lean protein, healthy fats, adequate fluids and ensuring silica, iron and zinc in the diet. Finally it is important to be realistic in your expectation long flowing locks may not be in the stars for everyone.

Q. My toddler eats nothing but pasta. Does he need a vitamin supplement?

A. Kids are smart and given a choice between treats and health food, few will choose the latter. A broad varied diet is essential to good health. If your child is just eating pasta it is likely their diet is deficient in a whole host of important nutrients.

Meals however, don’t need to be a battleground. The key is to offer healthy choices. The whole family should eat the same meal. Don’t offer snacks in the hours preceding a formal meal. Don’t cave in and offer treats to a child who refuses other food — they will just do the same again. Don’t allow fizzy or sugary drinks. These will just fill them with empty calories. Involving children in meal choices and preparation can help improve their diet.

Treats should be exactly that and not part of every meal. It’s also important to ensure adequate fluids, they may often mistake thirst for hunger and a drink can suffice where a snack is requested. A parent’s example is important. If they aren’t eating a healthy diet the child can’t be expected to.

Children are naturally fussy and their palates develop, as they get older. Five portions of fruit and vegetables are recommended but they don’t all have to be different. If they like carrots and apples then let them have carrots and apples every day. When introducing new food, the taste rule can work. Taste it. If it’s not nice but it’s okay, it must be tried. Keep introducing these foods. It can take more than 10 tries to acquire taste for something new. If a meal isn’t eaten during normal table time, remove the plate but do not offer other foods later. In the short term while your child is getting used to the change in house rules it may be worth giving a multivitamin but this should never be a substitute for healthy eating.

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