Issues in newborn care

Current beliefs and management strategies for treating infant colic

INTRODUCTION

The purpose of this study was to describe the current beliefs about the etiology of colic as well as current management approaches used by pediatric health care providers.

METHOD

An open-ended, short- answer survey concerning beliefs about the etiology and treatment of colic was conducted at major National Association of Pediatric Nurse Associates and Practitioners and American Academy of Pediatric meetings. The two groups of providers surveyed, pediatric nurse practitioners (PNPs) (n = 216) and pediatricians (n = 215), were similar in age and years of practice.

RESULTS

PNPs were more likely to define colic as "excessive crying." No differences were found in the beliefs regarding etiology of colic. Pediatricians reported seeing more colicky infants per month. A strong relationship existed between etiology and primary treatment approach. Statistically significant differences were found between PNPs and pediatricians in approaches to management of colic.

DISCUSSION

Colic remains a prevalent and mysterious malady, with a critical need for more evidence-based treatment protocols. Differences in approaches used by providers were found, with PNPs more likely to use behavioral and environmental approaches to treatment.

Immunizations, neonatal jaundice, and animal-induced injuries

This article reviews recent advances and recommendation changes in the areas of immunization, neonatal hyperbilirubinemia, and animal-induced injury. Physician education of families and care of patients in these three topic areas are important public health measures. First, pediatricians are always actively promoting public health through immunization, so the 2003 vaccination recommendations are critiqued along with perceived barriers to proper immunization. New information about smallpox vaccine is included in this year's review because of increased concerns about the use of smallpox as a weapon of bioterrorism since the world events in recent years. Next, the continued study of the management of hyperbilirubinemia in preventing kernicterus is examined. Finally, the management and prevention of animal-induced injuries is reviewed. In each of these areas, the pediatrician plays a prominent role in promoting the health and well being of children.

Nutrition and food allergies: the dietitian's role

BACKGROUND

A varied nutrient intake provides the opportunity for an adequate nutrient intake balance while reducing malnutrition risks. When a food allergy diagnosis has been made, medical nutrition therapy with scheduled follow-up visits can provide a way to monitor the overall health effects of food elimination. Identifying individuals at risk may protect and possibly improve the patient's nutritional and overall health status. Medical nutrition therapy with appropriate food allergen substitution(s) provides the tools necessary giving the food-allergic patient the specific focus needed for improved nutrition self-care and food allergen avoidance.

OBJECTIVE

To reduce the food allergic patient's risk of developing malnutrition by providing exceptional nutrition intervention.

DATA SOURCES

Review of the literature with clinical perspectives.

CONCLUSIONS

The food-allergic patient is less likely to develop nutrient deficiencies or malnutrition when provided with appropriate food alternatives and careful monitoring while eliminating the food allergen(s), short- or long-term, from the diet. The dietitian is the most qualified professional to address the food-allergic patient's medical nutrition therapy needs.