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Symptoms of allergy ✔Correct Answer--changes in stool, vomiting, skin rashes, respiratory
symptoms
Allergic proctocolitis ✔Correct Answer---Non-IgE-mediated
-Occurs in young infants (<6mo), frequently breastfed
-*Blood-streaked and mucousy stools*, otherwise healthy-appearing
-Majority able to tolerate milk or soy by 1-2 y/o
removal of allergen resolves symptoms in 48-72 hours
food protein-induced enterocolitis syndrome (FPIES) ✔Correct Answer--uncommon in breastfed
infants
severe vomiting 1-3 hours after ingestion
diarrhea 2-10 hours after ingestion
infant may become lethargic and hypotensive
Eosinophilic gastroenteritis ✔Correct Answer--can cause altered GI permeability and protein loss
leads to edema and growth failure
avoiding allergen will resolve the condition
eczema (atopic dermatitis) ✔Correct Answer--inflammatory skin disease
severity predicts food allergy in EBF
treating it and washing skin
ankyloglossia ✔Correct Answer--tongue-tie; a congenital midline anomaly
a defect of the tongue characterized by a short, thick frenulum
anterior attachment= tongue looks like a heart
posterior attachment= harder to observe, can interfere with breastfeeding
may decrease milk transfer and cause feeding pain OR may be able to breastfeed well with no
concerns
Techniques for releasing a tongue tie ✔Correct Answer--Frenotomy- simple release, no anesthesia,
low complications, snipped, can possibly come back
Frenectomy- resection of the tongue, with or without anesthesia, completely removed
murphy maneuver ✔Correct Answer--technique for assessing tongue tie by sweeping gloved finger
under the tongue to assess for thickness of the frenulum
Congenital anomalies ✔Correct Answer--defined as structural or functional anomalies that occur
during intrauterine life. Also called birth defects, congenital disorders, or congenital malformations,
these conditions develop prenatally and may be identified before or at birth, or later in life.
, congenital hypothyroidism ✔Correct Answer--condition present at birth that results in lack of
thyroid hormones; results in poor physical and mental development
symptoms become noticeable around 3-6 months- coarse, brittle hair, anemia, large tongue, wide
forehead, lack of skeletal growth
delayed treatment can cause severe mental retardation
deficiency of maternal iodine
T1D in infants ✔Correct Answer--frequent feeds, frequent BG checks, insulin adjusted as
complementary foods are introduced
Celiac disease in infants ✔Correct Answer--mother does not need to avoid gluten in diet when
breastfeeding
symptoms may develop after gluten is introduced in their diet
Cystic fibrosis in infants ✔Correct Answer--secretions are thick and sticky and can block the flow of
pancreatic digestive enzymes
sweat test, elevated trypsinogen
may present as meconium ileus
FTT, steatorrhea, respiratory symptoms
nutrient absorption, fat soluble vitamins is a concern
nutrition management: breastfeeding, fat soluble vitamin supplementation, pancreatic enzymes
NAS ✔Correct Answer--baby may be fussy, jittery, or sleepless
caused by maternal addiction to opioids during pregnancy
management: quiet dark room, skin to skin, breastfeeding, medications to help with withdrawal
symptoms
Galactosemia ✔Correct Answer--any intake of galactose results in multi-organ system dysfunction
feeding difficulties, vomiting, diarrhea, lethargy, poor weight gain, jaundice, cataracts, bleeding,
hepatosplenomeagly
management: abrupt weaning from breastfeeding, lactose free formula, monitor galactose 2
pphosphate levels
possibly can partially breastfeed
Phenylketonuria (PKU) ✔Correct Answer--an inherited disorder of protein metabolism in which the
absence of an enzyme leads to a toxic buildup of certain compounds, causing intellectual disability
defect in enzyme phenylalanine hydroxylase decreases conversion of phenylalanine to tyrosine
management: monitor PHE levels in the blood, breastfeeding along with phe free formulas
specific amount of formula is prescribed to keep phe levels down in the infant, complementary foods
should be phe free foods (low protein)
pyloric stenosis ✔Correct Answer--narrowing of the opening of the stomach to the duodenum,
progressively severe vomiting
management: surgery to remove an olive-like mass and feedings can resume after surgery