Minor Disorders of Newborn and its Management

MINOR DISORDERS OF NEWBORN AND MANAGEMENT

Molding

•         The head may appear asymmetric in the newborn of a vertex birth.

•         Caused by the overriding of the cranial bones during labor and birth.

•         Dimnishes within few days after birth.

•         Head moulding

Cephalhematoma

•         Collection of blood between the cranial bone and the periosteal membrane

•         Unilateral or bilateral and do not cross suture lines

•         Disappear with in 2 to 3 weeks

Caput succedaneum

•         Collection of fluid between the periosteum and the scalp

•         Overrides suture line

•         Present at birth

•         Caput

Forceps and Vacuum marks

•         Reddened areas over the cheeks and jaws. Disappear with in 1 or 2 days.

•         Vacuum extractor suction marks on the scalp.

•         No treatment is necessary

Telangiectati nevi

•         Pale pink or red spots frequently found on the eyelids, nose, lower occipital bone and nape of the neck.

•         More noticeable during the periods of crying.

•         Fade by the second birthday.

•         Telangiectati –stork bite

Stuffy nose

·         It may lead to mouth breathing and

·         excessive air swallowing which may lead to

·         abdominal distention and vomiting.

Management :

•         The nostrils may be cleansed with cotton

•         wool soaked with normal saline.

Sticky eyes

•         It may be due to a chemical irritant or bacterial conjunctivitis due to Staphylococcus.

•         Erythromycin (0.5%) ointment every 6 hrs for 7-10 days.

Subconjunctival hemorrhage

•         Found on the sclera

•         Caused by the changes in vascular tension or ocular pressure during birth

•         Remain for a few weeks

•         Reassure the parents

Oral Thrush

•         1% gentian violet solution or nystatin suspension, applied to each side of the mouth with a cotton swab 3-4 times a day.

•         Oral thrush/ Epsteins pearls

Milia

•         Exposed sebaceous glands, appear as raised white spots on the face, especially across the nose.

•         No treatment is necessary, because they clear up spontaneously with in the first month

Erythema toxicum

•         Perifollicular eruption of lesions that are firm, vary in size from 1 to 3mm and consist of white  or pale yellow papule or pustule with an erythematous base. It is often called newborn rash or flea bite dermatitis.

•         No treatment is necessary. Disappear in a few hours or days.

Napkin rash

•         More common in artificially fed babies.

•         It can be prevented by frequent care and attention to the napkin area along with immediate changes of the napkins after each soiling.

Perianal dermatitis

•         It is situated around the anal opening. It is due to the alkalinity of the stool and also

•         seen in artificially fed babies.

•         Management: Use of lactose, instead of glucose.

Congenital phymosis

•         Pinpoint prepuce which makes the baby cry during the act of micturition.

•         Management: dilatation by mosquito forceps.

Pseudomenstruation

•         Thick, whitish mucus vaginal discharge which is tinged with blood.

•         Caused by the withdrawal of maternal hormones

Smegma

•         White cheese like substance is often present between the labia

Physiological jaundice

•         This is observed in 60% of term and 80% of preterm neonates.

•         Occurs after the first 24 hours of life.

•         Resolves with hydration and frequent feedings

Constipation

•         It is commonly met in artificially fed babies.

•         Management :

•         Correction of the diet and extra water is usually effective.  If it fails, milk of magnesia 4ml by mouth is effective.

Mangolian spot

•         Macular areas of bluish black or gray- blue pigmentation on the dorsal area and the buttocks.

•         Fade during the first or second year of life.

Nevus flammeus

•         Port wine stain

•         Red to purple area of dense capillaries

•         Commonly appears on the face

•         Cosmetic cream

Nevus vasculosus

•         Strawberry mark

•         Raised, clearly declined, dark red, rough surfaced birth mark usually found in the head region

•         It resolves spontaneously