SIDS/Failure to Thrive Lecture Powerpoint Flashcards
Failure to thrive definiton
Children whose weight falls across 2 or more percentiles on the growth chart in 6 months time, failure to gain weight without a superficially evident cause, disproportionate failure to gain weight in comparison to height due to caloric insufficiency without obvious etiologyinitially manifests as weight loss then head and length circumference in later stage
Short stature is NOT the same as…
…failure to thrive
How to read a growth chart for short stature vs failure to thrive
If their height and weight falls along the same curve as the normal range but is just small then that is normal, a failure to thrive patient will see weight drop off abruptly resulting in an almost horizontal leveling off, but height remains consistent
Signs/symptoms of failure to thrive (4)
- Deceleration of weight gain on growth chart
- child seems withdrawn, difficult, etc
- poor hygiene
- unstable or depressed family psychosocial situation
Causes of failure to thrive (5)
- organic (GI or neurologic based, see height and weight change together***)
- environmental deprivation/nonorganic cause (majority, often due to incorrect feeding)
- normal (es smol)
- genetic syndromes
- prenatal complications
Labs to rule out organic causes for failure to thrive (6)
- CBC
- sed rate
- urinalysis and culture
- chem profile
- thyroid hormone
- pituitary hormones
Failure to thrive treatment (4)
- admission to inpatient setting if severe
- high caloric diet
- providing affection, stimulation, etc
- CPA contact potentially
Failure to thrive prognosis
-only 1/3rd ultimately resolve without long term consequence, many remain small and demonstrate developmental, educational, and personality deficiencies
Sudden infant death syndrome (SIDS) definition
Death of infant <1 years old unexplained even after thorough case investigation including complete autopsy, examination of death scene, and review of clinical history, no genetic connection, rare in first month of life with most peaking between 2-4 months and 90% by 6 months
Back to sleep/safe to sleep campaign
Initiative backed by US child health and human development department to improve investigation and reporting of SIDS, has successfully cut deaths in half
Apparent life threatening event (ALTE)
Near crib deaths that are observed in the weeks or days prior to a SIDS event, includes apnea, color change, change in muscle tone, choking or gagging
SIDS etiology
unknown, numerous have been suspected ranging from recent URI or GI infection to bronchopulmonary dysplasia or prolonged QT interval, perhaps a combination of factors
Risk factors for SIDS (5)
- race (native American and african american)
- fall and winter months
- midnight to 6am
- low birth weight
- poverty
SIDS prevention (4)
- have infants sleep on back
- maternal avoidance of cigarrete or drug use during pregnancy or 2nd hand after birth
- breast feeding
- no soft mattresses or too much bundling, do not cover face
AAP recommendations on preventing SIDS (13)*****
- sleep on back for every sleep
- using firm sleep surface
- infants should sleep in parents room, near bed, but on separate surface
- keep soft objects and loose bedding out of crib
- do not smoke during pregnancy
- consider a pacifier at naptime and bedtime
- avoid overheating at bed
- pregnant women should have routine prenatal care
- proper immunization
- avoid marketed devices to reduce SIDS
- do not use home monitors
- encourage time on stomach
- inform other caretakers about this
