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• Kangaroo care is a technique practiced on newborn, usually preterm, infants wherein the infant is held, skin to-skin, with an adult. • The kangaroo position provides ready access to nourishment. • The parent’s stable body temperature helps to regulate the neonate’s temperature more smoothly than an incubator, and allows for readily accessible breastfeeding. • Babies who are eligible for kangaroo care include pre term infants, weighing less than 1,500 grams, and breathing independently. • Cardiopulmonary monitoring, oximetry, supplemental oxygen or nasal (continuous positive airway pressure) ventilation, intravenous infusion, and monitor leads do not prevent kangaroo care. • Babies who are in kangaroo care tend to be less prone to apnea and bradycardia and have stabilization of oxygen needs
Since the neonate developed Jaundice on day 3 of life it indicates physiological jaundice. It appears when total serum bilirubin exceeds 5 mg% and progresses in cephalocaudal direction. Dermal pressure may reveal the anatomic progression of 1. Face = 5 mg/dL 2. Mid-abdomen = 15 mg/dL 3. Soles = 20 mg/dL The yellow color usually results from the accumulation of unconjugated, nonpolar, lipid-soluble bilirubin pigment in the skin. • This unconjugated bilirubin is an end product of hemeprotein catabolism from a series of enzymatic reactions by heme-oxygenase and biliverdin reductase and nonenzymatic reducing agents in the reticuloendothelial cells
• Breathing difficulty in children when lying down is a condition in which a child has trouble catching his or her breath or breathing normally when lying down. Breathing difficulty in children when lying down (pediatric orthopnea) includes: Airway obstruction e.g., foreign object Chronic obstructive pulmonary disease Cystic fibrosis Corpulmonale Heart failure Baby feels better when held against shoulders.
Early manifestations of congenital infection vary and involve multiple organ systems. • About 60% of infants born with congenital syphilis are asymptomatic at birth. • Symptoms develop within the first 2 months of life. In symptomatic infants, the most common physical finding, seen in 100% of cases, is hepatomegaly. • The other common findings are skeletal abnormalities, rash, and generalized lymphadenopathy. • Radiographic abnormalities, periostitis or osteitis, involve multiple bones. Sometimes, the lesion is painful and an infant will favor an extremity (pseudopalsy). • The rash is maculopapular and may involve palms and soles. In contrast to acquired syphilis, a vesicular rash and bullae may develop. These lesions are also highly contagious. • Mucosal involvement may present as rhinitis (“snuffles”). Nasal secretions are highly contagious. • Hematological abnormalities include anemia and thrombocytopenia. Late-onset congenital syphilis (diagnosed >2 y) Manifestations include neurosyphilis and involvement of the teeth, bones, eyes, and the eighth cranial nerve, as follows: 1. Bone involvement - Saber shins, saddle nose 2. Teeth involvement - Notched, peg-shaped incisors (Hutchinson teeth) 3. Pigmentary involvement - Linear scars (rhagades) at the corners of the mouth 4. Interstitial keratitis - Presents in the first or second decade of life 5. Sensory-neural hearing loss (eighth cranial nerve deafness) 6. Classic Hutchinson triad - (1) defective incisors, (2) interstitial keratitis, (3) eighth cranial nerve deafness