A neonatologist with high experience levels is important
                     Common Baby & Child 
Specialist Medical conditions
Dr Kamal Gupta
KAMAL 
MULTISPECIALITY HOSPITAL
Introduction
 Common Baby and Children Conditions
 Hyperbilirubinemia in newborns (Physiologic Jaundice)
 Colic
 Flu and common cold
 Infected Ears
 Fever
 Irritation and Vomiting 
 Baby spitting up
 Diarrhea
 Oral thrush or diaper dermatitis
 Breathing Issues, Mouth Issues
 Feeding Issues
 Eradicating Issues
 Camel hat
Neonatal Hyperbilirubinemia 
 Neonatal Hyperbilirubinemia (total serum bilirubin level above 5 mg per dL 
(86 μmol per L) is one of the most common problems encountered in 
newborns.
 Newborns produce bilirubin at a rate of approximately 6 to 8 mg per kg per 
day.
 Newborns produce twice the rate of adults due to increased red blood cell 
turnover in neonates. 
 Bilirubin production typically declines to the adult level within 10 to 14 
days after birth.
 The average full-term newborn will have a peak bilirubin level of 6mg/dl on 
the third or fourth day of life. 
 Levels usually go down to about 2-3mg/dl by the end of the first week, 
gradually reaching the adult value of 1mg/dl by the end of the second week.
 Phototherapy should be initiated when the total serum bilirubin level is at or 
above 15 mg per dL (257 mol per L) in infants 25 to 48 hours old, 18 mg 
per dL (308 mol per L) in infants 49 to 72 hours old, and 20 mg per dL (342 
mol per L) in infants older than 72 hours. 
 Jaundice typically results from the deposition of unconjugated bilirubin 
pigment in the skin and mucus membranes. 
Pathophysiology
Babies in womb need higher Hb (RBCs) to get oxygen from mother’s blood
After birth, fetal hemoglobin (Hb) broken down
Bilirubin is the final product of degradation of heme of these extra red blood 
cells (RBCs)
Excess bilirubin is removed from the bloodstream by the liver and excreted in 
the stool
The newborn’s immature liver may not excrete the bilirubin fast enough in the 
first days after birth
Hyperbilirubinemia (Physiological Jaundice) (especially common in 
premature and low birth weight infants and Babies who don’t feed and stool 
often enough during the early days ) 
 
Treatment
 Feed the baby early and often. 
 colostrum acts as a laxative, and frequent stooling lowers bilirubin levels. 
 Keep track of urine and stool output 
 Avoid water supplements. Only 2%of the bilirubin is excreted in the urine, 
and 98% in the stools. Colostrum and milk contain fat, which stimulates 
bowel movements, and water can just fill the baby up so that he is less 
interested in nursing. 
 Encourage the baby to stay awake and to feed at least every two hours. 
Jaundice makes the baby sleepy.
 Supplement with the expressed milk. If the baby is sleepy at the breast, and 
is having fewer than three large bowel movements in 24 hours, consider 
expressing the milk after feedings and give it to him (preferably not with a 
bottle at this stage – he may become confused by rubber nipples if he is only 
a few days old). Use a dropper, syringe, cup, or tube-feeding device if 
possible. 
 Expose the baby to indirect sunlight. Undress him down to his diaper and 
put him in a room that gets a lot of light. His skin is very sensitive, so never 
put him in direct sunlight. 
 Avoid medications such as aspirin and sulfa drugs. 
Colic
 Colic is defined as a crying lasts for more than 3 hours 
a day, 3 days per week for more than 3 weeks.
 Colicky babies usually get fussy toward the end of the 
day, but colic can happen at any time.
 Colic affects as many as 25 percent of babies. Colic 
usually starts a few weeks after birth and often improves 
by age 3 months. By ages 4 to 5 months, the majority of 
babies with colic have improved. 
Possible Mechanisms of 
Development
Infants swallow air                 Mothers’ diet                     Infants have
During feeding                       containing gas                     immature 
and crying                            producing foods                    digestive
                                           cabbage, broccoli,                 system and
                                           cauliflower, volatile            lack of probiotics
                                       chemicals, allergens, etc.
Increase gas and                  Trace elements                     Indigestion
Bloating                               passed to the baby
                                          through the breast milk
                                              Gas & Bloating
                                                     COLIC
Colic
Symptoms
 Predictable crying episodes. A baby who has colic often 
cries about the same time every day, usually in the late 
afternoon or evening. The crying usually begins suddenly 
and for no clear reason. The baby may have a bowel 
movement or pass gas near the end of the colic episode. 
 Intense or inconsolable crying. Colic crying is intense and 
often high pitched. The baby's face may flush, and he or 
she is extremely difficult to comfort. 
 Posture changes. Curled up legs, clenched fists and tensed 
abdominal muscles are common during colic episodes.
Colic
Causes
 The cause of colic is unknown. Researchers have explored a number 
of possibilities, including allergies, lactose intolerance, an immature 
digestive system, maternal anxiety, and differences in the way a baby 
is fed or comforted. Yet it's still unclear why some babies have colic 
and others don't. 
Risk factors
 Infants of mothers who smoke during pregnancy or after delivery 
have a greater risk of developing colic. 
 Colic doesn't occur more often among firstborns or formula-fed 
babies. 
Complications
 Colic doesn't cause any lasting medical consequences. Babies who 
have colic grow and develop normally. 
Colic Treatment
Drugs
 Colic improves on its own, often by age 3 months. 
 Some physicians prescribe medications, like… 
 Simethicone is probably the only harmless medication, but it has not 
been shown to provide significant benefit compared with placebo.
 Dicyclomine hydrochloride (Bentyl) was previously widely used but 
was later found to be associated with apnea, coma, and death. 
 Hyoscyamine sulfate (Levsin) may cause anticholinergic toxicity.
 Diphenhydramine (Benadryl) causes sedation but may cause 
paradoxical agitation and should not be used in children younger than 1 
year old.
 Other drugs that are no longer recommended for colic include 
phenobarbital and paregoric, mainly because of the dangerous side 
effect of oversedation.
 Some research suggests that treatment with probiotics  (substances that help 
maintain the natural balance of "good" bacteria in the digestive tract) can 
soothe colic. More research is needed to determine the effects of probiotics 
on colic. 
Contact Us
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alandhar/