Common Symptoms in Babies/Children Flashcards
How much does a baby normally cry
Crying peaks at around 6-8 weeks old with about 3 hours per day worst in the evening, usually this subsides by 4 months. All crying is the same whether it’s for pain, sleep, hungry or thirsty.
How can crying impact a mother’s health?
Crying can worsen baby blues and may tip a mother over the edge if her reserves are low so complaints must be taken seriously. Offer help by directing to website such as purple crying or cry-sis.
How should you help parents deal with crying?
Encourage turn taking between parents and the involvement of grandparents. Help parents to ‘read their baby’, may involve a health visitor. Singing, rocking, driving or tactile stimulation such as hugs may help distract baby.
How does a baby communicate that they have colic and what simple methods can be used to help?
Often shown by crying and simultaneously grabbing and pulling up the legs for >3h on >3days a week. Moving the baby often helps, letting baby finish the first breast as the hindmilk is more digestible. Low allergen diet may help.
Describe the 4 types of nappy rash
- Common ammonia dermatitis – red desquamating rash, sparing the skin folds. Usually due to moisture retention. Responds to frequent nappy changing, nappy free periods, careful drying and emollient creams such as sudocream.
- Candida – isolatable in half of all nappy rashes. Widespread vivid red sharply bordered erythema with satellite spots beyond the rash. Treat as above but add in clotrimazole. Avoid oral antifungals. May add 1% hydrocortisone if needed.
- Seborrheic dermatitis – diffuse red, shiny rash extends to the skin folds and often occurs in other seborrheic areas such as occiput – cradle cap.
- Isolated psoriasis
What is threadworm and how should it be managed?
Most often presents with perianal itching or Vulval itching. Extremely common in the UK. Children ingest the eggs from the environment. Small cotton white worms can be seen moving across the anal area.
Whole household should be treated with a single dose of Mebendazole and all advised on hygiene improvement.
What vomiting is normal in a baby and what isn’t?
Posseting – effortless regurgitation of milk during feeds is completely normal, as is vomiting between feeds. Usually this is onto parents as if during or directly after a feed. Good to ask about damage to carpets as normal posseting will be unlikely to damage carpets whilst pathological vomiting might.
What can cause excess vomiting?
GORD and gastritis
Over feeding – 150ml/kg/day is normal
Pyloric stenosis (projectile vomitting at 8 weeks old) – should observe as ‘projectile’ is a term used loosely by many people.
Infections such as UTIs or gastroenteritis
Adverse food reaction
Rarer causes Pharyngeal pouch Poisoning Raised intracranial pressure Metabolic conditions such as DKA, acute intermittent porphyria Bilious green vomiting – get urgent help
When are growing pains common and what is the medical term used for them?
A common presentation in General Practice is a child complaining of pain in the legs with no obvious cause. Such presentations, in the absence of any worrying features, are often attributed to ‘growing pains’. This is a misnomer as the pains are often not related to growth - the current term used in rheumatology is ‘benign idiopathic nocturnal limb pains of childhood’
Growing pains are equally common in boys and girls and occur in the age range of 3-12 years.
Describe the common features of growing pains
Never present at the start of the day after the child has woken
No limp
No limitation of physical activity
Systemically well
Normal physical examination
Motor milestones normal
Symptoms are often intermittent and worse after a day of vigorous activity
What are head lice and how are they managed?
(Pediculus humanus capitis)
Common in young children, infestation mostly just in the head. Spread by direct contact and diagnosed by finding nits or live lice. Treat with wet combing and a special fine-toothed comb.
