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

Dear HOUSE Calls,

My two-and-a-half year old daughter recently slept for 14 hours in a row. Is that normal?

Wow, that actually sounds wonderful, as a parent!

Before saying this is normal or not, 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.  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 at the same time every day and waking up at the same time every day.

We also 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 two-and-a-half year olds take a nap in the afternoon of 1-2 hours duration and sleep for 11-12 hours overnight.

There are some medical conditions that could be related to this problem if these long nights seem to be happening frequently.  We particularly think of problems with anemia, thyroid conditions, and sleep apnea.  You should bring her in to see her doctor if this continues.  Good luck.

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 sun burns, but in general we simply counsel women to use the same good, common sense, that is, 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. Cristy Page, Dr. Adam Zolotor, and Dr. Adam Goldstein on behalf of YOUR HEALTH and the UNC Department of Family Medicine.

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