Infant and small child

Question 1

contraindications for breastfeeding

Answer 1

1. mother infected with HIV, HTLV-1, HTLV-2
2. mother with active, untreated TB
3. mother with active herpetic breast lesions
4. mother dependent upon illicit drugs
5. mother taking chemo drugs or undergoing radiation

Question 2

expected feeding for first 2 months

Answer 2

2-3 oz every 2-3 hours; equivalent: BF 10-20 min each breast

Question 3

guideline for honey

Answer 3

none if less than 1 year age

Question 4

5 major causes of cyanotic heart disease

Answer 4

5 T’s:

1. Truncus arteriosus (1 = 1 vessel)
2. Transposition of the great vessels (2 = 2 vessels transposed)
3. Tricuspid atresia
4. Tetralogy of Fallot
5. Total anomalous pulmonary venous return (5 words)

Question 5

acyanotic heart disease

Answer 5

1. VSD
2. ASD
3. PDA
4. Pulmonary stenosis
5. Aortic stenosis
6. Coarctation of the aorta

Question 6

calories required per day for the first year of life

Answer 6

120 kcal/kg per day

If FTT, need 50-100% more to ensure catch-up growth

Question 7

excessive shortening of the hand and foot tubular bones resulting in a boxlike appearance

Answer 7

brachydactyly

seen in Down syndrome

Question 8

incurving of one of the digits (typically 5th digit)

Answer 8

clinodactyly

caused by midphalanx dysplasia

Question 9

result on triple screen suspicious for Down syndrome

Answer 9

low AFP

Question 10

life-threatening defects of Down syndrome

Answer 10

1. cardiac defects: most common is endocardial cushion defect, followed by VSD and tetralogy of Fallot
2. Duodenal atresia (in 12%) -> history of polyhydramnios, double bubble on plain film

Question 11

characteristic of all Down syndrome infants

Answer 11

Hypotonia -> see slower feeding

Question 12

newborn conditions associated with Down syndrome

Answer 12

1. hypotonia
2. hearing loss
3. strabismus
4. cataracts
5. nystagmus
6. congenital hypothyroidism

Question 13

longer-term conditions associated with Down syndrome

Answer 13

1. higher risk for leukemia
2. obesity
3. atlantoaxial instability (cervical spine)
4. premature aging with Alzheimer disease

Question 14

microcephaly, sloping forehead, cutis aplasia (missing part of skin and hair, polydactyly, microphthalmia, omphalocele, flexed and overlapping fingers

Answer 14

Trisomy 13 (Patau)

Question 15

weak cry, single umbilical artery, micrognathia with small mouth and high arched palate, overlapped index finger over 3rd digit, rocker-bottom feet, short sternum

Answer 15

Trisomy 18 (Edwards)

Question 16

can occur in infant of BF vegan mom

Answer 16

methylmalonic acidemia

trace mineral deficiency (due to decreased transit time)

Question 17

BF complications

Answer 17

1. HIV transmission
2. jaundice exacerbation (increased unconjugated bilirubin)
3. hemorrhagic disease of the newborn (low vit K)