Colic & Atopic Dermatitis Flashcards
What age can colic start from?
4 months of age
How is Colic characterised?
child cries for at least 3 hours per day on at least 3 days per week for at least 3 weeks
baby becomes red in the face, clench fists, draws knees up
Passing wind and difficulty passing stools may also occur
How does Colic come about?
multiple factors
- spasmodic contraction of the smooth muscle causing pain and discomfort which could be caused by allergy to cows milk or lactorse intolerance
- emotional/behavioural/social problems
What are specific questions you could ask the pt?
history of crying?
Aggravating factors? - like hunger, thirst, being too hot or old and trapped wind
How does an acute infection and GORD differ from colic?
acute - no excessive crying
GORD - regurgitation happens more than 5 times a day and baby cannot gain weight and refuses to feed
When would you refer the pt?
- persistent crying by a baby who is inconsolable (may indicate a more severe underlying condition)
- baby failing to put on weight with age
What OTC prep is given for those with colic?
No substantial evidence to support any of the tx available.
Simeticone has some evidence -Infacol
Also, lactase enzymes - Colief (breaks down lactose present in milk), low-lactose milk formulas
Gripe mixtures
How is simeticone thought to work?
has Antifoaming properties reducing surface tension and allowing easier elimination of gas from the gut by passing flatus or belching
What dose of simeticone should be given and does it have any side effects or interactions?
2.5ml after each feed
does not have any side effects or interactions
What are a few counselling points you should give to the mothers?
- parents should be reassured that colic is a natural occurrence and babies should grow out of it
- for breastfed infants the mother can try excluding cows milk and other dairy products from their diet
- massaging babies has had reported benefits
What is atopic dermatitis? what age does it start?
non-infective inflammatory skin condition due to genetics characterised by an itchy red rash
Starts at 6 months
Which location on the body is most common for pts to have atopic dermatitis?
cheeks, back of the elbows, wrists, back of the knees
How would you arrive at a differential diagnosis?
- Onset before the age of 2 years
- Hx of dry skin
- Hx of eczema in the skin creases (also cheeks in children under 10 years)
- Visible flexural eczema
- Personal hx of other atopic disease
What are the clinical features of atopic dermatitis?
irritable, scratching with dermatitis at varying severity
Itching - ‘itch, scratch, itch cycle’
What are some OTC preps or advice given to pts that have atopic dermatitis?
- Avoid irritants such as perfumed soaps, detergents, hot baths (lukewarm water is preferred)
- Emollients - moisture the skin, also prevents penetration of irritants and decrease the need for steroids - avoid emollients with lanolin can cause sensitisation
- Antihistamines - to stop itching
- Corticosteroids
