General

Question 1

What condition could a meconium plug be associated with?

Answer 1

Cystic fibrosis (CF). Although many infants with a mucous plug do not have CF.

Question 2

Other than CF, name two other risk factors for a meconium plug.

Answer 2

Maternal diabetes

Prematurity

Question 3

What pinky-orange material could be mistaken for blood in a wet nappy?

Answer 3

Urate crystals

Question 4

Is blood in the vagina normal?

Answer 4

Yes this is called vaginal withdrawal bleeding. It usually occurs on day 3, continues for a few days then stops.

Question 5

If infant vaginal bleeding seems excessive what could this indicate?

Answer 5

Vitamin K deficiency

Other coagulopathies

Question 6

What is polycythemia?

Answer 6

Increased heamatocrit (levels of red blood cells in the blood)

Question 7

Why is polycythemia common in SGA babies?

Answer 7

Red blood cell levels are increased due to the infant developing within a relatively hypoxic uterine environment.

Question 8

Why may a LGA baby suffer with hypoglycaemia?

Answer 8

When the overally ample glucose supply from the diabetic mother is stopped by cutting the cord, it takes a while for the infants pancreas to down-regulate the high insulin rate that the infant has got used to producing.

Question 9

What is acrocyanosis?

Answer 9

The constriction of small peripheral vessels turning the skin blue (ie hands, feet and maybe the face). There is reduced blood flow and oxygen moving through these narrowed vessels.

Question 10

When does acrocyanosis resolve?

Answer 10

Within 24-48 hours

Question 11

How can you tell if acrocyanosis in the face is normal?

Answer 11

1. The blue colour is around the lips and philtrum.
2. The skin is pink centrally
3. The tongue and mucous membranes in the mouth are pink.

Question 12

What signs may you detect there was meconium in utero?

Answer 12

1. Meconium stationed nails
2. Meconium stained umbilical cord
3. Meconium stained vernix

Question 13

What could green spit or vomit suggest?

Answer 13

Bile. This is NOT normal ever. The baby may require surgery.

Question 14

What can tint the colostrum greenish?

Answer 14

1. The increased lactation may cause some red blood cells to leak into the milk from the mothers circulation. Usually resolves over several days.
2. Iron tablets
3. seaweed tablets
4. Green coloured sports drinks
5. Herbal vitamins.

Question 15

Is bloody vomit normal?

Answer 15

Yes the infant swallows maternal blood during birth and is usually spat up during the first 24 hours. It can be bright red or brown and partially digested.