Question

Group A will complete the initial post. Group B will respond. You are called to the room and find Michael 2 hours old has been very irritable and spitting up large amounts of formula. He is very jittery. You do not know the maternal history before coming into the room so you advise the mother that you would like to return the baby to the nursery for an assessment and monitoring. In the medical record, you focus on prenatal history. You witness the baby having some significant tremors. What would you suspect? Michaels VS are: T (axillary) - 36.0, RR- 70, HR- 166, he is very alert, irritable, and does not console easily. Is moving constantly, and sucking very vigorous on the pacifier you provide for comfort. You place the baby under the warmer and obtain what labs?

Answer 1

Test the baby for vitamin d deficiency as it is the main reason for jittery and irritable behavior in most of them

Spitting up large volume of formula can be normal due to weak and underveloped pyloric spincters which is mostly common in infants and can be treated with small and frequrnt feeds and burping after every feed but to be sure investigate for GERD( gastroesophageal reflux disease)

Assess for cordination in sucking, swallowing and breathing as it can indicate immature neurologic system. Also check the blood for any prenatal substance abuse.