Infant Care and Nutrition Flashcards
What is Diaper dermatitis?
-diaper rash
-fussiness, agitation, and irritability
What are the factors that contribute to skin breakdown when wearing diapers?
-Perineal region skin is thin
-occlusion, moisture, microbes, GI tract proteolytic
enzymes, urine, feces, and friction
Signs of Diaper dermatitis
-ink to red to bright red rash
-Shiny, wet-looking patches or lesions
-Sensitivity of affected area
-Dry raised bumps (papules) possible
-Rapid onset
-Severe – maceration, oozing, ulceration,
pustules
Contributing factors of Diaper dermatitis
-Diaper type
-Diet (breastfed babies with less dermatitis, due to softer poo -> better absorbed by the diaper)
-Allergic reactions (soap, clothes)
-Chemicals
How to treat Diaper rash?
A: Air the region - let the baby run naked
B: Barrier - provide barrier coverage
C: Cleansing - use smooth, non-alcoholic wipes, rinse with warm water, air dry, and limit cleansing only when stool present
D: Diaper
E: Education
When to cleanse the perianal area?
Only when stool is present, to avoid irritation
Treatment to relieve symptoms and clear the rash
-Oral analgesics
-Skin protectants: Zinc oxide, petrolatum, lanolin, glycerin, talc/cornstarch
-the greasier the better
What type of diaper is appropriate/not appropriate to use?
Best: absorptive
Avoid: diaper with dye
Patient Education
-Apply skin protectants liberally
-Reapply often – with each diaper change
-Do not remove protectant from previous application – minimize irritation
-Rash improves drastically within 24 hours of applying or making changes
When to refer
Bleeding, oozing, or pus
Hasn’t resolved in 7 days
Fever, diarrhea, vomiting
Rash or skin lesions beyond the diapering area
What is a Preakly heat?
-Heat rash caused by Blocked/clogged sweat glands
-Sweat can’t leave gland -> dilation and rupture of the pore à stinging, burning, itching
-Very fine, pinpoint, red-raised rash
-rapid onset, clears away rapidly
Treatment of Preakly heat?
depends on the symptoms
-itching -> antipruritic
-Burning/stinging? – soothers, moisturizers
Don’t use greasy, oily products, we don’t want to block the glands -> use water-based products
NO hydrocortisone for infants
How is Colic defined?
-more than 3 hours a day, for more than 3 days a week, for at least 3 weeks
-peaks at e 2-6 weeks, declines by age 3-4 months
Potential trigger for Colic
-Gas
-Lactose intolerance
-“Maternal tension”
-Oversensitivity or overstimulation (light, noise)
-Discomfort
-Boredom
-CNS dysregulation
Signs of Colic
-Uncontrollable crying
-Postural changes
Pulling legs to the abdomen
Clenches fingers
Nonpharmacologic treatment for Colic
-Change mother’s diet or formulation (but unlikely to be related to that)
-Smaller, more frequent meals (smaller amounts of air intake)
Upright positioning during/after feedings
Motion (walking, swinging, rocking, holding)
Pacifier
Swaddling
Bathing
Singing/background noise
Pharmacologic treatment for Colic
Simethicone drops (Mylicon, Little Tummys)
-helps with gas, and bloating -> give after a meal or at bedtime
-shake well
-place in the infant’s mouth, towards the cheek
-do not exceed 12 days per day
-have not shown to be effective, but no risk with using
Pharmacologic treatment #2 for Colic
Gripe water
-Contains proprietary mix of ginger, fennel, chamomile, caraway, peppermint
-no studies!
Presentation of Teethening
6+ months of age (could be sooner)
Irritability
Drooling (watery mouth)
Red gums, swollen gums
Gum rubbing, chewing/gnawing
Low-grade fever -> Tylenol (Ibuprofen from 6m)
Eruption cysts
NONPHARMACOLOGIC Treatment
-Gum massage/rubbing
-Teething rings or toys
-Wet or frozen cloth
-If old enough to chew food, something crunchy
-Mesh teether with frozen fruit
Pharmacologic Treatment
-Systemic Analgesics
Acetaminophen, Ibuprofen drops
Natural products
-Chamomile
-Lemon peel
-Clove oil
-Sugar
What are the recommendations for infant nutrients?
American Academy of Pediatrics – breast is best
Pediatricians/parents everywhere – fed is best
solid food from 5-6 mo -> just to get babies used to chewing
-main dietary for babies is milk for year 1
How does the amount of food intake change for infants?
-As they age they amount of food intake and the frequency goes down
-the overall food intake stays quite the same
When do babies need Vitamin D supplements?
-Exclusively breastfed babies
-when food intake is less than 32 oz
-4000IU of Vitamin D daily
