Neonatal and Infants

What should be ordered for neonates who are jittery and were born to diabetic mothers?

Serum glucose for confirmation if bedside glucose is low, serum calcium to rule out hypocalcemia, another cause of jitteriness, serum magnesium as infants of diabetic mothers are at risk for hypomagnesemia, newborn sepsis workup if there are signs of infection (e.g., temperature instability, poor feeding, lethargy).

What are signs of neonatal HSV?

Signs of neonatal herpes simplex virus (HSV) infection include skin lesions, seizure, mucosal ulcerations, temporal lobe encephalitis, and systemic symptoms such as fever and lethargy. Early recognition and treatment are crucial to improve outcomes.

Even if an infant has acrocyanosis, if they are actively moving and crying, what is done immediately after delivery?

Place the infant on the mother’s chest

What does NRDS surfactant deficiency result in?

increased surface tension

What are signs and symptoms of bronchiolitis?

Signs include wheezing, coughing, and difficulty breathing; imaging shows hyperinflation

What causes bronchiolitis?

Most commonly respiratory syncytial virus (RSV), leading to inflammation and obstruction of the small airways in infants.

What should be suspected if there’s an absence of a red reflex?

Cataracts or retinoblastoma

Is it concerning if an infant cries and strains prior to passing stool?

In most cases, it is not concerning. This is commonly due to infant dyschezia, a benign and self-limiting condition.

What is seen in allergic proctocolitis?

Blood-streaked stools, mucus in stools, and signs of discomfort in infants.

What are concerning signs for necrotizing enterocolitis?

Abdominal distension, bloody stools, feeding intolerance, and lethargy, with air in the bowel on X-ray

If an infant is born to a mother with active Hepatitis B, what should be given?

Hepatitis B immunoglobulin and vaccine

What are signs of neonatal sepsis?

Temperature instability, respiratory distress, lethargy, poor feeding, and irritability.

What is used to treat neonatal sepsis?

Ampicillin and gentamicin

What sleeping positions contribute to SIDS?

Sleeping on the stomach or side.

What are signs of lactation failure jaundice?

Signs include poor feeding, lack of weight gain, inadequate output, and high bilirubin levels.

When would it be safe to introduce highly-allergenic foods?

Around 4 to 6 months of age, especially for infants at high risk of allergies.

What is the condition of cyanosis with feeding that is relieved by crying?

This is choanal atresia, a congenital condition where the nasal passage is blocked, leading to difficulty breathing during feeding.

What are signs of infantile colic?

Signs include excessive crying, fussiness, and difficulty in soothing, typically occurring in the evening.

What is done to treat infantile colic?

Treatment may include soothing techniques, changes in feeding practices, and sometimes medication to relieve discomfort.

What antibiotic is used to treat infantile UTI?

Cefexime or any 3rd-gen cephalosporin

What is miliaria and how does it distribute?

Heat rash, caused by blocked sweat ducts that leads to small, red bumps or blisters. It typically appears in areas prone to sweating, such as the neck, back, and folds of the skin.

What does erythema toxicum look like?

Appears as red spots or bumps on a newborn's skin, often with a yellow or white center. It usually resolves on its own within a few days.

How can you think about the gross motor milestones in infants?

"Head to Toes, Roll, Sit, Stand, and Go!" and “4,6,9,12 Rule”; the progression of motor skills from controlling head movement to walking.

How can you think about language milestones in infants?

"Coo, Babble, Words, Sentences!" and “2,4,6,12,24,36"

How can you think about fine motor milestones in infants?

"Grasp, Reach, Transfer, Pincer!"; the ages for this are 0,4,6,12

How can you think about social milestones in infants?

"Smile, Laugh, Wave, Play!"; ages for this are 2,4,9,12

How can you think about growth milestones for infants?

"Double, Triple, Grow!"; should see these patterns at 4, 12, and 24 months

When should hydrocephalus be suspected?

In an infant or young child with a rapidly enlarging head circumference crossing multiple growth percentiles

What is physiologic anemia?

An asymptomatic condition characterized by a normal decrease in hemoglobin with a nadir at age 2-3 months because of transient down-regulation of erythropoietin due to increased tissue oxygenation after birth.

When should hypospadias warrant further investigation?

When the urethral meatus is located at the perineum or scrotum, there’s an underdeveloped penis/glans, and severe penile curvature. 

If an infant has hypospadias and the parents want circumcision, what should be done?

Get pediatric urology to advise

When an infant is found to have neurological abnormalities and microcephaly, what should be done?

Brain MRI

If a 10 week old infant develops fever and seizures, what should be done?

Consider a lumbar puncture and obtain imaging to rule out infections.

What kind of imaging do infants with bilious vomiting get?

Upper GI series

If an infant who was recently introduced to solid foods ends up developing constipation, what intervention should be done?

Increase dietary fiber intake and ensure adequate hydration.