1. General
    2. 1. Introduction to Pediatrics
    2. Growth
    3. Development
    4. Developmental and Behavioural Disorders
    5. Adolescent Health and Development
    6. Fluid and Electrolyte disturbances
    7. Nutrition
    8. Micronutrients in Health and Disease
    9. Newborn care
    10. Immunization
    11. Infections and Infestations
    12. Genetic Disorders
    13. Inbor Errors of Metabolism
    14. Inborn Errors of Immunity
  2. Systemic
    3. 15. Diseases of Gastrointestinal System and Liver
    16. Hematological Disorders
    17. Otorhinolaryngology
    18. Disorders of Respiratory System
    19. Disorders of Cardiovascular System
    20. Disorders of Kidney and Urinary tract
    21. Endocrine and Metabolic Disorders
    22. Diseases of Central Nervous System
    23. Neuromuscular Disorders
    24. Childhood Malignancies
    25. Rheumatological Disorders
    26. Ophthalmic Disorders
    27. Skin Disorders
  3. Other
    4. 28. Poisonings, Injuries and Accidents
    29. Pediatric Critical Care
    30. Important Medical Procedures
    31. Rights of Children
    32. Integrated Management of Neonatal and Childhood Illness
    33. Rational Drug Therapy
General
9. Newborn care
NORMAL NEWBORN
▢ Definitions:
❖ Newborn period (First 4 weeks):
  1. 1st week -> Early newborn period
  2. Next 3 week -> Late newborn period
❖ Birth weight:
  1. Low birth weight (LBW): < 2.5 kg
  2. Very Low Birth Weight (VLBW): < 1.5 kg
  3. Extremely Low Birth Weight (ELBW) : < 1 kg
  4. Big baby/ Macrosomia: > 4 kg
▢ Intrauterine Growth Chart:
❖ SGA:
◉ Constitutional:
◉ Pathological/ IUGR:
◈ Identificaiton points:
  1. Loose skin folds (Atleast 3)
  2. Placenta and Umbilical cord - Thin
  3. Head circumference - Chest circumference > 3 cm
❖ Types:
Maternal cause (Uteroplaceto insufficiency)
Fetal cause
More common
Gestationa hypertension
  1. Genetic
  2. anomalies
Onset
Late (2nd/ 3rd trimester)
Early trimester
Effect
Brain sparing effect
Asymmetric IUGR
  1. Head size - Normal
  2. Rest of body - Small
  1. No brain sparing effect
    1. Every body part is small (Symmetric IUGR)
◉ Ponderal index (PI):
◈ Formula: PI = Wt(g) / Length (cm)^3 x 100
◈ Symmetric IUGR: PI > 2
◈ Asymmetric IUGR: PI < 2
❖ LGA (Large for Gestational Age):
> 90th percentile
◉ Causes:
  1. Constitutional
  2. Infant of Diabetic mother (Gestational)
  3. SOTOS syndrome (Cerebral gigantism)
    1. Intellectual disability
    2. Premature tooth eruption
    3. Developmental delay
  4. BECKWITH WIEDEMANN syndrome
    1. Macroglossia
    2. Anterior abdominal defects
      1. Omphalocele
      2. Umbilical hernia
    3. Hemihypertrophy
    4. Increased risk of Wilm's tumor
❖ Assessment of Maturity:
◉ Antenatal assessment:
  1. Mother's last menstrual period (LMP)
  2. 1st trimester ultrasound scan
◉ Post natal assessment:
◈ Expanded New Ballard System (ENBS):
  1. Based on Neuromuscular maturity
  2. Based on Physical maturity
❖ Post term Baby:
  1. Meconium staining
  2. Overgrown finger nails
  3. Skin wrinkles
NEWBORN CARE
▢ Routing Newborn care:
❖ At birth (5 cleans):
  1. Clean hands
  2. Clean surface
  3. Clean scissors/ blade
  4. Clean cord clamp
❖ Delayed Cord clamping:
◉ Timing: 30-60 sec
◉ Advantages:
  1. Reduces risk of Anaemia
  2. Preterm - Reduced risk of bleeding
❖ Prevention of Hypothermia:
  1. Delivery room temp - 25 degree C
  2. No free draft of air
  3. Skin-to-skin contact
❖ Breastfeeding:
❖ Rooming in: Keeping the mother and baby together
❖ Prophylaxis:
  1. Vit K -> i.m; anterolateral thigh; 1 mg (if < 1kg- 0.5 mg)
  2. Indicated for Haemorrhagic disease of Newborn
▢ Normal observation:
❖ Vital signs:
❖ Temp: 36.5 to 37.5 degree C
❖ HR: 110-160/min
❖ RR: 40-60/min
❖ BP: 60-40 mmHg
❖ CFT (Capillary Filling Time):
  1. Measure of How well is the circulation
  2. < 3 S