initial PKU screening - ✔✔- ALL infants during first few days of life
- 2nd screening is done if 1st screening was done before 24hr of age and should be completed
by second week of life
- outcomes are best when phenylalanine is restricted within 1st month of life
tx for PKU - ✔✔restricting phenylalanine starting in first month of life; reduce levels to less
than 360 via dietary restriction; must continue lifelong
screening for congenital hypothyroidism - ✔✔- done shortly after birth
- test either T4 or TSH level
- any abnormal levels should be confirmed with venous T4 and TSH immediately
- untreated could lead to severe neurocognitive development
treatment for congenital hypothyroidism - ✔✔- levothyroxine 10-15mcg ASAP
- monitor levels with total T4 or FT4 concentrations to ensure adequacy of therapy
screening for sickle cell - ✔✔- done with 24-48hrs of life
,- sickle cell anemia is Hgb S, F, A2
- sickle cell trait is Hgb FAS
- confirmatory testing is hemoglobin electrophoresis, which is required to identify the type of
sickle cell disease the child has
infants with sickle cell should receive: - ✔✔- prophylactic PCN by 2mo (through age 5?)
- pneumococcal vaccinations at recommended intervals
how long should kids ride in the backseat? - ✔✔untill 13yr
how long should infants/toddlers be rear-facing? - ✔✔- rear facing only: 22-35lb
- rear-facing convertible: 40-50lb, 5pt harness equipped
toddler/ preschooler car safety - ✔✔- forward facing with harness: 40-65lb
- forward facing without harness: 100-120lb
- ride in harness until at least 4 yr
school-aged car safety - ✔✔- booster seat
- use seat belt positioning booster until the vehicle blt fits properly, typically when theyre 4'9"
and are 8-12yr
- all children younger than 13 ride in backseat
- belt should be across upper thighs and across middle of chest
distance between crib bars - ✔✔2 and 3/8 inches apart
how big should toys be for babies? - ✔✔at least 1 and 3/4 inches diameter and 2 inches long
, how hot should water be? - ✔✔around 100F, set water heater to less than 120F
weight of the baby after birth - ✔✔baby will lose weight after birth and should regain by 7-
10 days; should double weight by 6mo and triple weight by 1yr
how often should a baby breastfeed? - ✔✔8-12x/day, with 6-8 wet diapers a day and 3-4
stools per day
normal stool for breastfeeding baby - ✔✔yellow/ green/ seedy/ pasty, 3-4 per day
vitamin D with breastfeeding - ✔✔breastfed babies must be given vitamin D supplement to
prevent ricketts (400IU daily); if mom is vegan, child also needs b12 supplement
how much does a bottlefed baby consume? - ✔✔- birth- 1mo: 2-4oz every 2-4hr (16-
24oz/day)
- offer 2-3oz every 2-3hr, if still hungry, give more
- never prop bottle
diapers with bottlefed baby - ✔✔- 6-8 wet diapers/day
- 3-4 stools/day
- stool will be yellow/brown pudding texture
- no vit. D supplements required
stump cleaning - ✔✔use water and allow to air dry; often falls off after about 2 weeks; watch
for signs of infection and report immediately
circ. care - ✔✔- petroleum gauze should remain on penis for 24hr
- keep clean and dry
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