Neonates

Question 1

When is crying usually worst in newborns?

Answer 1

Usually peaks at 6-8 weeks (3hrs a day/ worse in evenings)
Subsides by 4 months
Cannot differentiate hunger and thirst cries

Question 2

What are some approaches to suggest to parents with crying babies?

Answer 2

Baby centred approach
Take parents concerns seriously
Help parents recognise when their baby is tired and hungry and apply a conisitent approach
Involve the health visitor
Vocal, vestibular (rocking) and tactile (hugs) stimulation may help
If not coping then admit but don’t over medicalise

Question 3

What is infantile colic?

Answer 3

This is intermittent crying with pulling of the legs for >3hr on >3days/wk

Question 4

What is the management of infantile colic?

Answer 4

Movement
Let the baby finish the first breast first (hindmilk is easier to digest)
Probiotics can help if breastfeeding
Reassure strongly and reduce stress, encourage grandparent involvement

Question 5

What are the pathophysiology and signs behind cows milk protein allergy?

Answer 5

This is a seperate entity to colic and is either IgE or non-IgE mediated
Causes colic symptoms, GORD, Blood/mucus in stools and may result in faltering growth

Question 6

What are the components of the apgar score and what is it out of?

Answer 6

Appearance
Pulse
Grimmace (response to situation)
Activity (muscle tone)
Respiration
Score is 0 to 10

Question 7

What are the benefits of delayed umbilical cord clamping?

Answer 7

It allows more blood to transfer to the baby and increases circulating volume
This reduces the risk of intraventricular haemorrhage and necrotising enterocolitis

Question 8

When should vit K be given to babies?

Answer 8

Vit K should routinely be given to all babies after birth with an IM injection into thigh
This is because they are born with a deficiency and stimulating a cry helps open the lungs

Question 9

When shoud breast feeding be initiated after birth?

Answer 9

As soon as the baby is alert enough

Question 10

When should the newborn assessment be done after a baby is born?

Answer 10

In the first 72 hours

Question 11

When is the blood spot screening for newborns done?

Answer 11

Done on day 5 and screens for 9 congenital conditions including sickle cell, cystic fibrosis, congenital hypothyroidism