Neonatology Flashcards
When should newborns double their birthweight?
By 4 to 6 months of age
When should newborns triple their birthweight?
By 12 months of age
What is the 50th percentile for weight at birth?
3.25 kg
What weight would be considered large for gestational age for a full-term baby?
> 3900 grams
What weight would be considered small for gestational age for a full-term baby?
<2500 grams
What is considered low birth weight?
<2500 grams
What is considered very low birth weight?
<1500 grams
What is considered extremely low birth weight?
<1000 grams
When should a child be 1.5 times their birth length?
1 year old
When should a child be twice their birth length?
4 year old
When should a child be three times their birth length?
13 year old
What is the 50th percentile for birth length?
50 cm
What is the 50th percentile for head circumference at birth?
35 cm
What is the growth rate for an infant’s head during the first year of life?
1 cm/month for the 1st 6 months
0.5cm/month for the next 6 months
What makes colostrum yellow colored?
Carotene
What are 10 contra indications to breast-feeding?
- HSV with lesions on the breast
- HIV
- Active untreated TB
- Most recreational drugs
- Chemotherapy
- Metronidazole
- Sulfa drugs (in the first month)
- Tetracycline
- Some psychotropic drugs
- Classic galactose deficiency in baby
When should you start iron supplementation in babies?
- Premature babies: 2 months
- Full-term babies: 4 to 6 months
What physical exam findings are seen in an infant with a gestational age < 35 weeks?
- Hair all over body and face
- 0-3 creases on sole, none on heel
- Ear cartilage slowly unfolds
- No breast bud
- Males: no palpable testes, few rugae
- Females: prominent clitoris
What physical exam findings are seeing in a full-term baby?
- Many creases on soles
- Breast buds
- Palpable testes
- Many rugae
- Springy ear cartilage
Which babies should be screened for retinopathy of prematurity?
- Birth weight <1500 grams
- Gestational age at birth <32 weeks
Which babies are at the greatest risk of developing retinopathy of prematurity?
- Born at <29 weeks gestation
- Birth weight <1200 grams
When does breast-feeding jaundice appear and what is the cause of it?
- “Feeding” = problem with feeding
- Occurs within the first few days
- Due to insufficient intake and dehydration
- Work on technique
When does breastmilk jaundice appear and what causes it?
- “Breastmilk” = problem with the milk
- Appears at DOL 3-7
- Steroids in mom’s milk -> decrease liver conjugation -> indirectly causes indirect hyperbili
- If TBili <20, ok to watch and consider supplementing with formula
- If TBili >20, hold BF x 1 day, give formula, then resume BF
- Can last weeks-months
What is physiologic jaundice?
- Dx of exclusion
- Healthy baby
- Jaundice DOL 2-5 without explanation
When is phototherapy contraindicated?
“Don’t directly to give phototherapy for direct hyperbili.”
- May cause “bronze baby Syndrome”
- OK to give with indirect hyperbili if DB is <20% of TB
What decreases the risk of hyperbilirubinemia?
Alcohol Heroin Phenobarbital Phenytoin Tobacco
What are the clinical features of RH disease?
- Rh- mom + second pregnancy
- Maternal IgM made during first pregnancy -> IgG, which can cross placenta in second pregnancy
- Give Rhogam at 20 weeks
- Give Rhogam after delivery if baby is Rh+
What causes hemolytic disease of the newborn?
- ABO incompatibility
- “O” mom with naturally occurring “anti-A” and “anti-B” IgG antibodies
- Can occur in first pregnancy
What is a cephalohematoma?
- Firm, localized and tense subperiosteal hematoma of the calvaria
- Does not cross suture lines
What is caput succedaneum?
- Swelling of the scalp from uterine wall or vaginal wall pressure
- Soft and boggy
- Can cross suture lines
At what level should umbilical cord catheters be placed?
- L3-L5
- T6-T10
What is a single umbilical artery associated with?
- Renal anomalies
- Get a renal ultrasound
- Look for evidence of VACTERL Syndrome
Where is NEC most commonly found?
Ileocecal (ileocolic) junction
What is hypospadias associated with?
SLOB Silver Russel Syndrome Laurence Moon Biedl Syndrome Opitz Syndrome Beckwith-Wiedemann Syndrome
