Clin Med - Developmental Peds Flashcards
For age 1wk to 1 month: amount/feeding & times/day
- 2 to 4 oz
- 7 to 8 (more for breastfed babies)
For age 1- 3 month: amount/feeding & times/day
- 5 to 6 oz
- 5 to 7 times/day
For age 3 - 6months: amount/feeding & times/day
- 6 to 8 oz
- 4 to 6 times/day
For age 6 - 12months: amount/feeding & times/day
- 7 to 8 oz + incr amts of solid foods
- 4 bottles/day & 2 to 3 meals of solid foods
Preventative Measure Taken @ birth
- Erythromycin ointment
- Vitamin K
- Hep B Vax
- newborn genetic screen
- Congenital Heart Dz screen
- Hearing screen
Contraindications to early newborn discharge (5)
- Jaundice </= 24hrs
- High risk for infx
- Known or suspected narcotic addiction or withdrawal
- Physical defects requiring eval
- Oral defects
Relative contraindications to early newborn discharge
- Premature or early term infant
- Birth weight <2700 g (6lb)
- Infant difficult to arouse for feeding; not demanding regularly in nursey
- Medical or neuro problems that interfere w/ feeding
- Twins or higher multiples
- ABO blood group incompatibility or severe jaundice in prev. kids
- Mother who prev. breast-fed infant w/ poor weight gain
- Mother w/ breast surg involving periareolar areas
What is considered hypoglycemia in newborns?
- BG <50mg/dL @ birth - 4hrs
OR - BG <45mg/dL 4-25hrs
RFs for hypoglycemia
- LGA
- SGA
- IUGR
- Preterm or post-term birth
- Perinatal stress
Tx for hypoglycemia
- start feedings w/n 1hr (at risk or sx neonates
- start IV glucose (10% dextrose & H2O)
What are the 5 types of neonatal jaundice?
- Physiologic
- Pathologic
- Bilirubin toxicity
- Acute bilirubin encephalopathy
- Chronic bilirubin encephalopathy
What are the main reasons for unconjugated hyperbilirubinemia? (3)
- Incr bilirubin production
- Decr rate of conjugation
- Unknown/Multiple Factors
What are the 3 main causes of incr bilirubin production?
- antibody mediated
- non-antibody mediated
- non-hemolytic
List the two antibody mediated causes of pathologic jaundice.
- ABO incompatibility
- RH isoimmunization
List the 2 non-antibody mediated causes of pathologic jaundice.
- Hereditary Spherocytosis
- G6PD deficiency
List the 2 causes for decr rate on conjugation.
- Crigler Najjar Syndrome
- Gilbert Syndrome
List the 3 reasons for unknown/multiple factors that cause pathologic jaundice.
- race (east Asian)
- prematurity
- breast feeding
Causes of physiologic jaundice
- low UDPGT activity
- relatively high red cell mass
- absence of intestinal flora
- slow intestinal motility
- incr enterohepatic circulation of bilirubin in the 1st days of life