Q: My 18-month-old son has developed a small swelling/lump at the base of his neck just where the neck starts to curve up. He is perfectly normal otherwise and is active and lively. However, since the discovery of the lump, I have been a bit concerned. He also suffers from atopic dermatitis and the condition is under control through his diet, yet he gets bouts of itching at night. Lately, he has been having difficulty in passing stools and cries while doing so. The stool appears to be soft, but he has a tendency for constipation. Maybe the dietary restrictions on him limit the amount of fibrous food. He was given a jab for meningitis C, two weeks ago with no side effects emerging. What should be done further with regard to the swelling/lump at the neck?

A:The swelling that you mention appears to be a small lymph gland at the back of the head. It is most likely due to a little infection in the scalp area. You need not worry. No active treatment is required just yet. Just keep the swelling under observation. If the swelling increases or there is pain, you need to consult your doctor. Pain during passage of stool is likely to be due to a fissure or crack in the anal skin due to the passage of a hard bolus of stool. To relieve pain, apply a lignocaine (local anaesthetic) cream in the anal region regularly for a week. Also, take all measures to avoid constipation.