Irritable infant Flashcards
common causes of irritability
- infantile colic
- GORD
- cows milk protein intolerance
what is infantile colic
periodic crying affecting infants in first 3mo of life
CF of infantile colic
paroxysmal crying, often in evenings, can last several hrs
often associated with hunger, overfeeding, swallowed air
in between crying baby happy and well
when crying flushed face, distended/hard abdo, flexed legs
Mx of infantile colic
reassurance most resolve by 3mo no long term consequences avoid overfeeding, wind after food, rhythmical rocking/holding social support if stressful
what is cows milk protein intolerance and how is it treated
rare, overdiagnosed uncommon in breast fed babies CF - bloody diarrhoea - urticaria, stridor, wheeze - most sx resolve when ceasing milk for 1wk
MX
hydrolysed protein formula
usually resolves in 1-2yrs
RF for GORD
- prem, cerebral palsy, downs
weakness of gastrooesophageal sphincter
CF of GORD
vomititng - worse when lying flat or after feeds
FTT
apnoea, aspiration
MX of GORD
simple gord - nurse in upright posititon, thickened foods, wind after feeding
if severe - short course of PPI
causes of severe/sudden irritability
intussusception strangulated hernia testicular torsion infection (UTI, meningitis, AOM) NAI
red flags for irritability
poor weight gain fever vomititng lethargy poor feeding decreased social repsonse
what is intussusception, what age group, most common location
telescoping of bowel
common after viral infection most occur <3mo but 3-24mo
ileum into caecum most common
CF of intussusception
episodic screaming, pallor. well in between
red current jelly late sign
IX for intussusception
Abdp USS - target sign
AXR - bowel obstruction, air fluid level
what are the organisms of AOM
strep pneumonae, Hif, viruses
RF for AOM
prem, decreased SES, eustachian tube dysfunction, large adenoids, cleft palate, downs syndrome
