BIOLOGY 2D03 Lecture Notes - Lecture 4: Health Visitor, Tachypnea, Fetal Distress
19 Jun 2018
School
Department
Course
Professor
Failure to Thrive
FTT: hild’s weight drops aross two etiles/ is likely if weight below 2nd centile
History
10 month old female Amy
PC:
o FTT – initially on the 25th centile – now below 2nd centile , when she was
weighed by the health visitor two days ago
o Feeding:
Initially breast fed for first two weeks (encouraged by midwifery
team)
Formula fed from then on (cow and gate) – started usig ow’s ilk
three months ago as formula was too expensive
Started weaning a month ago – not successful, only takes very small
amounts – mostly mushed up version of whatever mum was eating
Meal time: often chaotic, not regular – frustrated whe A wo’t
eat and spits things out so stops trying
Nil GI symptoms
o Amy appears uninterested and apathetic
PMH:
o Two episodes of bronchiolitis over the winter
OHx:
o No antenatal issues (nil IUGR)
o Emergency c-section at 38 weeks for failure to progress in the second stage
of labour and fetal distress
o Post-natally – 1 day stay on NICU due to transient tachypnoea of the
newborn
DHx:
o UTD with all immunisations
FHx: Nil
SHx:
o Young, single mother – 20 years old
o Lives in council house
o Has to care for mother who suffers from mental health issues
o Struggling financially
o Social class V
o Amy has little interaction with other children
Differential Diagnosis
Non organic/ environmental (95%):
Inadequate availability of food:
o Insufficient breast milk/ poor technique
JWH, JM, AJS
83
Document Summary
Ftt: (cid:272)hild"s weight drops a(cid:272)ross two (cid:272)e(cid:374)tiles/ is likely if weight below 2nd centile. Pc: ftt initially on the 25th centile now below 2nd centile , when she was weighed by the health visitor two days ago, feeding: Initially breast fed for first two weeks (encouraged by midwifery team) Formula fed from then on (cow and gate) started usi(cid:374)g (cid:272)ow"s (cid:373)ilk three months ago as formula was too expensive. Started weaning a month ago not successful, only takes very small amounts mostly mushed up version of whatever mum was eating. Meal time: often chaotic, not regular frustrated whe(cid:374) a(cid:373)(cid:455) wo(cid:374)"t eat and spits things out so stops trying. Nil gi symptoms: amy appears uninterested and apathetic. Pmh: two episodes of bronchiolitis over the winter. Shx: young, single mother 20 years old, lives in council house, has to care for mother who suffers from mental health issues, struggling financially, social class v, amy has little interaction with other children.
