Common Pediatric Problems Flashcards
1
Q
What is infantile colic?
A
- Excessive crying with no clear aetiology
- Paroxysms of crying
- No clear trigger
- Louder, higher pitched cry
- Increased body tone
- Difficult to console
- Completely mirrors the normal crying pattern of infants (peaks at 6 weeks of age, gone by 4 months)
2
Q
How is infantile colic diagnosed?
A
- Rule of Three/Wessel criteria
- Crying for >3 hours/day, >3 days/week, for >3 weeks
- Onset >3 months of age
- Usually parents seek help at the peak, when resolution naturally follows (around ~ 3-4 months)
3
Q
What is the etiology of infantile colic?
A
- GI disturbance
- Early form of migraine
- Overstimulation
- Tense/stressful environment
- Neurodevelopmental issue
4
Q
What is defined as normal crying?
A
Less than 2 hours a day in the first 3 months of life
5
Q
How is infantile colic managed?
A
- Family support and education
- Changes in feeding technique
- Soothing strategies
- Nutrition via hypoallergenic maternal diet or extensively hydrolyzed formula
- Probiotics
- Simethicone, lactase, sucrose
- All strategies have no/conflicting/insufficient evidence
6
Q
How common is GER?
A
- Very common
- 50-60% of infants in first 4 months of life
- Occurs frequently between feeds
- Typically improves and resolves by the end of the first year
7
Q
How is GERD differentiated from GER?
A
- Reflux disease is defined as episodes associated with complications
- Deviates from normal reflux
- Complications might include esophagitis, poor weight gain, respiratory complications
- Complications vary with age
- In GER, there will be good weight gain and no impacts on health
8
Q
What are other considerations when diagnosing GERD in infants?
A
- Feeding adequacy
- SDOH
- Formula preparations
- Maternal mental health concerns
- Sleep patterns
- Pyloric stenosis
9
Q
How is GERD managed?
A
- Tobacco smoke avoidance
- Positioning therapy
- Avoiding overfeeding
- If suspected allergy to dietary proteins, trial of hypoallergenic formula
- Trial of thickened feeds
- If all above fail with associated complications: 2 week trial of PPI medication
10
Q
Diagnosed of GERD is based on…
A
Clinical history with assessment of total caloric intake and nutrition first
11
Q
What are temper tantrums?
A
- Begin 12-18 months
- Worsen at 2-3 years and improve thereafter
- Can persist for longer in language delay
12
Q
How should temper tantrums be prevented?
A
- Provide choice when possible
- Positive reinforcement of good behaviour
- Regular meals, snacks, and naps
13
Q
How should temper tantrums be managed?
A
- Remaining calm
- Ignore tantrum and distract with another activity
- Provide food/sleep if needed
14
Q
What are breath holding spells?
A
- Occur in 6 months to 6 years
- Can be cyanotic (more common) or pallid
- Typically apnea occurs during expiration following pain/trauma leading to crying
- May be accompanied with LOC, decreased/increased tone
15
Q
What is the aetiology of breath holding spells?
A
- Autonomic dysfunction
- Genetic component
- Iron deficiency +/- anemia
