Intro week-normal child Flashcards
Average birth weight
Approximately 7 pounds/3.3kg ○ Double at 5 months ○ Triple at 1 year ○ Gains 30g/d from day 10 - 3 months 1-10 years expected weight in kg =2x(age+4)
Average head circumference of newborn
35-36cm
When do children get their fist teeth
6 months
Average birth height
50cm
Average height at 1 year
75 cm
Average height at 4 years
1 m
Symptoms of pylori stenosis in children
- Loss of weight
* Projectile vomit (MILKY-not bilious)
Classic sign of pyloric stenosis in children
olive shaped mass right hypochondrium with visible peristalsis
how many calories should an infant get (0-1 years) ?
110 kcal/kg/d
how many calories should a child (1+ years) get ?
1+ years 1000 +(100xage) kcal/d
• 150mls/kg/day after first week until weening • Approximately 30ml per Oz • E.g. 5kg, =750ml/day, which is 25Oz Wean from 6 months: iron containing foods at 6 months; avoid egg and wheat until 6 months; puree to 7 months; doorstep milk and normal food at 12 months; full fat milk to 5 years
How big should feeds be?
Feeds : 150mls/kg/d after first week until weaning
how many calories in one 150ml feed?
110kcal
How many ml in one Oz
30ml=1 Oz
How much milk should a 5kg infant get?
The baby should get 110 kcal/kg/d which is the same as 150ml/kg/d…..150mlx5=750ml/day (25 Oz)
At what age can you ween a baby from
6 months
What maintenance fluids should adults receive?
1L bag every 8hr
What maintenance fluids should children receive? For example a 28kg child?
- 1st 10 kg 100ml/kg/day
- 2nd 10kg 50 ml/kg/day
- 3rd and subsequent kg=20mls/kg/day
E.g. 28 kg child will require
(10x100) (10x50) + (8x20)/24=69mls/hr
OVERWEIGHT BMI for adults vs children
adults is BMI of 25-29.9
Children is >91st centile
OBESE T BMI for adults vs children
adults is BMI of 30-34.9
Children is >98th centile
What age do children raise head 45 degrees (partial control)
6-8 weeks
what age do children sit unsupported and state red flag age
6-8 months. RED FLAG is 9 months without sitting unsupported
what age do children start to crawl
8-9 months
what age do children cruise
10 months
what age do children start to walk unsteadily
12 months
what age do children start to walk steadily
15 months
what age should children be able to run
18 months
red flag age for not being able to walk unsupported
18 months-unless bumshuffler then 2 years
what age should children be able to jump/ hop
2 years should be able to jump
3 years should be able to hop
what age should children be able to go on climbing frame and skip?
4 years: climbing frames
5 years: skips
Differentials for not walking at 18 months
- Cerebral palsy
- Duchenne’s muscular dystrophy (Gowers sign)
- Hip dysplasia (although should have been picked up)
- Proximal muscle weakness (Get them to lie down and stand up-if they role over they have PMW-should do creatinine kinase
when should babies loose their primitive reflexes
Persisting primitive reflexes -shouldn’t continue after 6 months (patients with dyspraxia may have persisting)
reasons for uneven moro reflex
brachial plexus injury/ cerebral palsy
what is tested for in the 1 week old Gutherie heel prick test?
PKU hypothyroidism CF haemoglobinopathies (sickle cell ) acylcarnitine • 8 weeks: general examination • 4-5years: orthoptist • School entry: height and weight; hearing Primary and secondary school: none
what is involved in the birth neonatal exam?
examination of eyes, heart, hips; automated hearing screen
when do babies have another general examination
around 8 weeks
• 4-5years: orthoptist
• School entry: height and weight; hearing
Primary and secondary school: none
When should children visit orthoptist for screening
age 4-5
at what age is soiling abnormal
4 years
At what age should children be dry in the day
2-3 years
At what age should children be dry in the night
3-4 years
why do you ask about urine stream in new born boys
posterior urethral valves obstruction
when should babies produce me
95% meconium in first 48 hours (should never lose more than 10% of weight however losing 5% is normal)
differentials for no meconium
Cystic fibrosis
Stenosis/atresia (E.g. duodenal, anal, Hershprungs-always from distal to proximal)
what is normal birth time/premature/post mature?
Normal 40 weeks
Premature<37 weeks
Post mature >42 weeks
when are night terrors and nightmares common
Night terrors (4-7 years) Nightmares (8-10 years) Sleep walking (5-10 years)
When should children be able to sleep through night?
90% will sleep through the night by 6 months
how much sleep should children get
• Birth 16 hours/d; • 6 months 14 hours/d; • 2 years 13 hours/d; • 4 years 12 hours/d; 18 years 8 hours
what age is pincer grip?
9 months
what age is palm grab
6 months
