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Clinical Manifestations of Classic Phenylketonuria • The affected infant is normal at birth. • Mental retardation may develop gradually and may not be evident for the 1st few months. • Vomiting, sometimes severe enough to be misdiagnosed as pyloric stenosis, may be an early symptom. • Older untreated children become hyperactive, with purposeless movements, rhythmic rocking, and Athetosis. • Infants are lighter in their complexion than unaffected siblings with blonde hair. • These children have an unpleasant odor of Phenyl-acetic acid, which has been described as musty or mousey. • Most infants are hypertonic with hyperactive deep tendon reflexes. • Microcephaly, prominent maxilla with widely spaced teeth, enamel hypoplasia, and growth retardation are other common findings in untreated children.
• A problem that may beset a bottlefed baby in which it forgets how to nurse on mother’ nipple • Breastfeeding requires far more vigorous mouth and tongue motions and greater muscle coordination than bottlefeeding. • On bottle nipples or even pacifiers, a newborn can forget how to nurse properly. • This confusion can lead to diminished or discontinued nursing. Nipple confusion is usually not a concern after the early weeks, once the baby is nursing well
• Lets evaluate data step wise to arrive at answer. 1. Baby can sit in tripod position by 5th month. 2. Bi dextrous approach by 5th month. 3. Monosyllables by 6th month. 4. Stranger anxiety by 7th month.