By Jeannette; Matheny, Samuel C.; Lewis, Evelyn L. South-Paul
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Extra resources for Current Diagnosis & Treatment In Family Medicine
Past medical history must include a complete perinatal history. Children with lower birth weights and those with specific prenatal exposures are at higher risk for growth problems. Forty percent of children with FTT have birth weights below 2500 g; only 7% of all births are below 2500 g. Low birth weights may be caused by infection, drug exposure, or other maternal and placental factors. The child with symmetric growth retardation is of particular concern. Infants exposed in utero to rubella, cytomegalovirus (CMV), syphilis, toxoplasmosis, or malaria are at high risk for low birth weight, length, and head circumference.
AfricanAmerican infants tend to have slightly lower peaks in serum bilirubin. In Asian infants, serum bilirubin levels rise more quickly than in white infants and tend to reach higher peaks on average (8â€“12 mg/dL; 135â€“205 mol/L). This leads to a longer period of physiological jaundice among Asian and Native American newborns. Preterm infants (<37 weeks gestation) of all races may take 4â€“5 days to reach peak serum bilirubin levels, and these peaks may be twice that observed among full-term infants.
Chronic undernutrition: short height, normal weight for height, normal head circumference. Acute or chronic undernutrition: short height, proportionately low weight for height, normal head circumference. Congenital infection or genetic disorder impairing growth: short height, normal to low weight for height, small head circumference. The general examination provides a wealth of information. Vital signs should be documented: bradycardia and hypotension are worrisome findings in the malnourished child.
Current Diagnosis & Treatment In Family Medicine by Jeannette; Matheny, Samuel C.; Lewis, Evelyn L. South-Paul