- Trauma
- Fever
- Vomiting
- Breathlessness
- AMS
- Feeding
- Crying/consolability
- Medication
- Immunizations
- Mothercraft (young mother, improper feeding/burping technique, sarong)
EXAMINATION
- Vitals
- Irritability, abnormal cry (post DPT, meningitis, neonatal abstinence syndrome, infantile spasms)
- General appearance - toxic, lethargic
- Head - bulging fontanelles (raised ICP), facial brusing (NAI), cephahaematoma (HI)
- Ears - Otitis media
- Eyes - Fundus - retinal haemorrhage, FB, corneal abrasion (fluorescein stain)
- Abdo - distension, masses, tenderness e.g. (intussusception, IO, pyloric stenosis), anal fissure (GE), KIV PR if bloody stool
- GU - ENSURE EXPOSURE COMPLETE. Genitalia for torsion of testes, incarcerated hernia, haematuria, open diaper pin
- Extremities - stranged digit (hair tourniquet), bruising (NAI)
- Skin - bruises, stigmata of NAI
INVESTIGATE
KIV
- UFEME
- FBC
- AXR (intussusception, volvulus)
- CXR (SVT, ischaemia)
- ECG
What is infantile colic?
- Occurs in 2nd to 3rd wk of life
- Most resolve by 3/12
- Lasts several hours each time, commonly late afternoon, evening, with flatus
- May be due to immature GIT, poor feeding technique, CNS, ?cows milk injury, not enough burping, suckling, parental anxiety, baby's temperament
Treatment of infantile colic:
- Reassurance
- Rocking, car rides
- Infacol 8 drops pre feed
Indication for admission
- History/Ex suggestive of physical illness, esp poor feeding, vomiting, fever
- Abnormal UFEME, FBC, CXR, AXR
- First episode of acute onset in a previously healthy baby especially if they are outside the infantile colic age range
- 2nd presentation at ED
- Inconsolable after 1 hour in ED
- Parents anxious/cannot cope
Discharge information
- Reassure no obvious abnormality
- Bring baby back to ED /GP if crying worsens or if fever/vomiting/poor feeding
- Simple mothercraft
- No changing of milk formula necessary. May give infacol
