Umblicus Content of cord: two umblical arteries one umblical vein wharton jelly Sheath derived from amnoin

Umblical Sepsis Umblical cord is cut & tied at birth- leaves a raw area. The stump separates by gangrene dry wet Stump can be sterile or infected. Infection also called omphalitis

Umblical sepsis contd Necrotic tissue of cord – excellent medium for bacterial growth. Organism isolated-Staphylococcus aureus, Gp A hemolytic streptococcus Omphalitis may remain localized or spread to abdominal wall, peritoneum,umblical or portal vessals.

Complications Abdominal wall cellulitis Abcess formation Necrotising fasciitis Bacteremia Portal vein phlebitis- Extra hepatic portal hypertension

Infant Colic Also called evening colic Occurs in young well infants Usual age: 1-2 weeks of age, persist upto 3-4 months Characterized by intermittent episodes of abdominal pain, severe crying usually in afternoon, evening

Infant colic Diagnose- infant cries for > 3 hrs/day for more than 3 days for more than 3 weeks. Cause- not known Clinical features- begins with sudden loud cry, face becomes red & legs are drawn up on the abdomen, abdomen is tense. The attack terminates after the infant is exhausted or passes flatus/feces.

Low Birth Weight Baby Defined as baby weighing < 2500gms at birth Type Preterm(< 37 wks) SGA/IUGR

Characteristics of preterm baby Small size Large head Small face Thin pinkish shiny skin Abundant hair Poor activity

Handicaps of LBW baby CNS: poor sucking, swallowing, lethargic Respiratory system: irregular breathing, immature lungs(HMD) GIT: functional immaturity Thermo stasis: loses heat, less fat insulation Renal : immaturity, decreased GFR,decreased concentrating ability CVS: delayed PDA closure, poor peripheral circulation

Handicaps cntd Metabolic disturbances Liability to nutrient deficiency Increased susceptibility to infections

Handicaps of SGA baby Can be malnourished infants,hypoplastic, or mixed group. Birth Asphyxia Polycythemia & hyperviscosity of blood Insufficient temperature regulation Metabolic disturbances

Clinical features of Neonatal Sepsis General : Lethargy Refusal to suck Poor cry Poor weight gain Excessive wt loss

Respiratory system Cyanosis Tachypnea Chest retractions Grunt Apnea/gasping

CNS Lethargy Seizures High pitched cry Excessive irritability Neck retractions Bulging fontanelle Poor reflexes

Other clinical features Temperature instability Poor perfusion, shock GIT: distension abdomen, diarrhoea, vomiting Sclerema,excessive jaundice, bleeding,