Infant Care

Question 1

What is the signs of normal umbilical cord care?

Answer 1

• clean and dry
• slightly moist with slight mucoid discharge and odour
• falls off 5-15 days after birth
• small amount of blood on separation
• small amount of mucoid material on separation (for a few days)

Question 2

What are the signs of infection on the umbilical cord (omphalitis)?

Answer 2

• erythema, edema, and tenderness extending beyond 5 mm- required medical attention
• if accompanied by: fever, lethargy and/or poor feeding - requires urgent care

Question 3

What things should be done to ensure that the umbilical cord is kept clean?

Answer 3

• wash hands with soap and water before and after contact with umbilical area
• clean around base of the cord with water on cotton tipped applicator or with a soft washcloth after bathing and at diaper changes
• fold diaper below cord stump
• exposure to air or cover with loose clothing
• avoid buttons, bandages, etc over the naval

Question 4

What should be done to care for a circumcised penis?

Answer 4

• ensure effective pain relief (topical anesthesia during the procedure, consider acetaminophen for 24-48 hours post procedure)
• remove and replace gauze with every diaper change for 24 hours (apply petrolatum underneath to prevent sticking)
• gently wash with warm water for 1-2 days
• continue to apply petrolatum for 3-5 days
• normal progression: small amount of blood, redness and swelling, yellow discharge/scab develops and then decreases with healing.
• complete healing takes 7-10 days

Question 5

What are the red flags that the patient should watch out for when caring for a circumcised penis?

Answer 5

• bleeding over a quarter size on the diaper, worsening redness/swelling (not starting to decrease within 48 hours), fever, lethargy/poor feeding, no urination within 12 h of the procedure

Question 6

What should be done for the care of an uncircumcised penis?

Answer 6

• foreskin gradually separates
• not fully retractable until age 3-5
• foreskin should not be forced back
• penis should not be washed regularly during bathing, milk soap may be used
• as the foreskin naturally retracts, cleaning and drying underneath the foreskin can be performed
• as the foreskin retracts skin cells are shed which may appear as white, cheesy lumps (smegma)

Question 7

Breastfeeding is always the preferred method of nutrition for the first ______ and beyond

Answer 7

6 months

Question 8

What supplementation is recommended in breastfeeding?

Answer 8

• vitamin D

Question 9

What is the standard recommended formula product?

Answer 9

• cow milk based formula

Question 10

What are the sx of a standard milk allergy?

Answer 10

• develops in 2-4% of infants, generally occurs within the first few months of life
• vomiting, wheezing, hives, rash, bloody diarrhea, skin rashes
• NOT a lactose intolerance

Question 11

Lactose free cow milk based formula is NOT recommended or appropriate for what conditions?

Answer 11

• acute gastroenteritis

- galactosemia, or congenital lactase deficiency

Question 12

Lactose free cows milk products are ineffective for treating ____

Answer 12

colic

Question 13

What is lactose important for?

Answer 13

• mineral absorption and maintenance of normal gut flora