Health Problems of the Infant

Question 1

What are symptoms of anaphylaxis in infants?

Answer 1

• Anaphylactic Reaction: life threatening event
  ~ Rapid onset of airway difficulties: dyspnea, wheezing, stridor, hypoxia
  ~ Evidence of shock—hypotension, syncope.
• Food allergies are the most common cause of anaphylaxis in children.

Question 2

How do you manage anaphylaxis in infants?

Answer 2

• Epinephrine is first-line treatment.
• EpiPen or EpiPen Junior depending on weight of the child. (home, car, school)
• Observe in Emergency Department (4-6 hours) after an anaphylactic reaction for biphasic response (anaphylactic response with no exposure to allergen).
• Medic Alert bracelet.

Question 3

What is another name for Atopic Dermatitis?

Answer 3

Eczema

Question 4

How does Atopic Dermatitis (Eczema) present?

Answer 4

• Chronic inflammatory skin condition that often develops in early childhood (60% begin during the first year of life)
• Hereditary tendency
• Scaly, pruritic
• Causes secondary infections

Question 5

How do you manage Atopic Dermatitis?

Answer 5

Bathing and moisturizing is an important part of treatment:

• No bubble baths, shower gels, or hot water.
• Pat the skin dry after bathing (leaving slightly damp.)
• Hydrate the skin (e.g., Aquaphor, non-perfumed lotions)
• Relieve pruritus: Zyrtec (6 months), Benadryl (> 2 yr)
• Reduce inflammation (e.g., topical steroid -Triamcinolone)
• Prevent and control secondary infection (keep hands clean and fingernails cut)

Question 6

What is Failure to Thrive (FTT)?

Answer 6

• Lack of adequate weight gain in which the child’s weight is below the 5th percentile on standard growth charts.
• Length WNL.

Question 7

What are some “Failure to Thrive” symptoms?

Answer 7

• Weight < 5th percentile, length WNL
• Decreased or lack of subcutaneous fat
• Pale skin
• Developmental delays

Question 8

Describe the two types of “Failure to Thrive.”

Answer 8

Organic FTT

• Inadequate caloric intake/incorrect formula preparation/cleft lip
• Inadequate nutrient absorption
• Increased metabolism

Nonorganic FTT

• Abuse, neglect
• Treatment is dependent upon the cause

Question 9

Describe risk factors of Sudden Infant Death Syndrome (SIDS).

Answer 9

Maternal factors

• Substance use during pregnancy (opioids)
• Tobacco use during pregnancy

Infant factors

• Prematurity (<37 weeks gestation)
• Low-birth-weight
• Siblings of SIDS victims

Question 10

How do you reduce the risk of SIDS?

Answer 10

• Avoid smoking during pregnancy and near infant
• Breastfeeding-increases immunity
• Supine sleeping position
• Avoid blankets, pillows, stuffed animals, bumpers
• Firm mattress
• Room share without bed share
• Avoid overheating during sleep
• Pacifier-requires forward positioning of the tongue – reduce the risk of oropharyngeal obstruction.