Common presentations in infancy

Question 1

Benefits of breastfeeding for baby

Answer 1

ideal nutrition
life-saving in developing countries
decreased infection risk
promotes attachment
decreased risk autoimmune disease

Question 2

Benefits of breastfeeding for mother

Answer 2

promotes attachment
(mild) contraceptive effect
decrease risk breast/ovarian cancer + T2DM
cheap + convenient

Question 3

Normal formula feeding requirements

Answer 3

150 ml/kg/day
6-8 feeds/day

Question 4

How much weight loss is normal for a newborn?

Answer 4

up tp 10%
peaks at day 3
expected to return to birth weight by day 14

Question 5

Management if a newborn loses more than 10% of birth weight

Answer 5

direct observation of feeding + expert support
consider further investigations (blood glucose, bilirubin, electrolytes, septic screen)
rarely supplementation with formula may be required

Question 6

What condition can occur if a newborn isn’t feeding well?

Answer 6

hypernatraemic dehydration

Question 7

What is kernicterus?

Answer 7

serious brain condition that can occur in newborn babies
It’s caused by high levels of bilirubin in the blood damaging the brain and spinal cord

Question 8

What is important to consider when thinking of causes of neonatal jaundice?

Answer 8

age at onset

Question 9

Jaundice osnet <24h causes

Answer 9

haemolysis - Rh haemolytic disease, ABO incompatibility

sepsis
congenital infection

Question 10

Jaundice onset 2-14 days causes

Answer 10

physiological
breast milk jaundice
dehydration
infection
bruising eg. instrumental delivery
rare causes (eg. crigler-najjar)

Question 11

Management of neonatal jaundice

Answer 11

treat cause
adequate hydration
phototherapy
exchange transfusion

Question 12

Causes of prolonged jaundice in neonate (>2 weeks)

Answer 12

must rule out biliary atresia (causes conjugated hyperbilirubinaemia)

unconjugated:
- breast milk
- infection, especially UTI
- hypothyroidism

Question 13

What is biliary atresia?

Answer 13

blockage in the tubes (ducts) that carry bile from the liver to the gallbladder
bile ducts inside or outside the liver do not develop normally
bile flow from the liver to the gallbladder is blocked This can lead to liver damage and cirrhosis of the liver

Question 14

Baby crying differentials

Answer 14

hunger
colic
reflux
sepsis
constipation
Cow’s milk allergy
non-accidental injury
strangulated hernia
torsion
hair wrapped around toes
meningitis
corneal abrasion
pneumonia

Question 15

When does baby crying peak?

Answer 15

6 weeks