ITEMS IN AFP WITH MESH TERM:
ABSTRACT: Physicians should use a checklist to facilitate discussions with new parents before discharging their healthy newborn from the hospital. The checklist should include information on breastfeeding, warning signs of illness, and ways to keep the child healthy and safe. Physicians can encourage breastfeeding by giving parents written information on hunger and feeding indicators, stool and urine patterns, and proper breastfeeding techniques. Physicians also should emphasize that infants should never be given honey or bottles of water before they are one year of age. Parents should be advised of treatments for common infant complaints such as constipation, be aware of signs and symptoms of more serious illnesses such as jaundice and lethargy, and know how to properly care for the umbilical cord and genital areas. Physicians should provide guidance on how to keep the baby safe in the crib (e.g., placing the baby on his or her back) and in the car (e.g., using a car seat that faces the rear of the car). It is also important to schedule a follow-up appointment for the infant.
ABSTRACT: The number one cause of death for children younger than 14 years is vehicular injury. Child safety seats and automobile safety belts protect children in a crash if they are used correctly, but if a child does not fit in the restraint correctly, it can lead to injury. A child safety seat should be used until the child correctly fits into an adult seat belt. It is important for physicians caring for children to know what child safety seats are available and which types of seats are safest. Three memory keys will help guide appropriate child safety seat choice: (1) Backwards is Best; (2) 20-40-80; and (3) Boost Until Big Enough. "Backwards is Best" cues the physician that infants are safest in a head-on crash when they are facing backward. "20-40-80" reminds the physician that children may need to transition to a different seat when they reach 20, 40, or 80 lb. "Boost Until Big Enough" emphasizes that children need to use booster seats until they are big enough to fit properly into an adult safety belt.
ABSTRACT: Down syndrome is caused by triplicate material of chromosome 21. The syndrome has a variable physical expression, but congenital cardiac defects, transient myelodysplasia of the newborn and duodenal atresia are highly specific for this chromosomal disorder. Routine health maintenance is important because infants and children with Down syndrome are more likely to have otitis media, thyroid disease, congenital cataracts, leukemoid reactions, dental problems and feeding difficulties. Since infants with this syndrome are prone to respiratory infections, immunization recommendations should be followed closely. Motor, language, social and adaptive skills should be assessed at each office visit. The psychosocial aspects of care should be discussed with the parents of an infant with Down syndrome. If necessary, the parents should be referred to family support and specialty resources. Institutionalization of infants with Down syndrome is now unlikely. With newer surgical techniques, early therapy to minimize developmental delay and proper health supervision, the functional prognosis for infants with Down syndrome is considerably improved.
ABSTRACT: Although the cause or causes of sudden infant death syndrome (SIDS) remain unknown, the incidence of SIDS is on the decline in the United States and other countries. This decline has been accomplished largely through public education campaigns informing parents about several important factors associated with an increased risk of SIDS. These factors are prone and side infant sleeping positions, exposure of infants to cigarette smoke and potentially hazardous sleeping environments. Risk-reduction measures such as placing healthy infants to sleep in the supine position, avoiding passive smoke exposure both before and after birth and optimizing crib safety are beginning to lower the SIDS rate in this country. Through patient education, family physicians can further reduce the incidence of the number one cause of death in infants one week to one year old.
ABSTRACT: Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down syndrome must be voluntary. A nondirective approach should be used when presenting patients with options for prenatal screening and diagnostic testing. Patients who will be 35 years or older on their due date should be offered chorionic villus sampling or second-trimester amniocentesis. Women younger than 35 years should be offered maternal serum screening at 16 to 18 weeks of gestation. The maternal serum markers used to screen for trisomy 21 are alpha-fetoprotein, unconjugated estriol and human chorionic gonadotropin. The use of ultrasound to estimate gestational age improves the sensitivity and specificity of maternal serum screening.
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