What does it mean for a child to “fail to thrive”? No, it’s not a performance evaluation. Learn when and how to evaluate an infant for faltering growth in this episode!

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Lidia Park and Tammy Yau as well as pediatrics resident Megan Branson, with content support from Kelly Haas, pediatric gastroenterologist. Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.



Key Points:

• To diagnose with Faltering Growth (aka Failure to thrive): the infant must fall below weight-for-age or weight-for-length percentile or have rate of weight gain decline across 2 major percentiles.
• There are three categories to think about when evaluating the etiology of faltering growth:
• insufficient calories in
• malabsorption or increased calories out
• increased metabolic requirement

Sources:

• AAP. (2022, May 31). https://www.aap.org/en/patient-care/newborn-and-infant- nutrition/growth-faltering-in-newborns-and-infants/?srsltid=AfmBOopMEVV0n6cZIAM4QHQ02RDREPeELIC107ONgdtSRS8bnrfZs4tP
• Pediatrics in Review 2017, https://doi.org/10.1542/9781610021159-86
• AAP Books: Caring for the Hospitalized Child 2018, https://doi.org/10.1542/9781610021159-86
• Pediatrics in Review 2016, https://doi.org/10.1542/pir.2014-0122

Ever wonder why babies receive erythromycin eye ointment at birth and if it’s really necessary? We’re going to answer that and many other EYE-opening questions in today’s episode!

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Lidia Park and Tammy Yau with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Erythromycin eye ointment is given to newborn babies to prevent against gonococcal infection, it does not cover chlamydia infections. 10% of babies who are exposed to gonococcus can still get eye infections even when given erythromycin
• Gonococcal eye infections (ophthalmia neonatorum) can cause ulcers, rupture, and blindness. Disseminated infections can cause arthritis, bacteremia, and meningitis

Sources:

• Red book “Gonococcal infections”, “Chlamydia”, “Neonatal ophthalmia prevention” chapters
• Kapoor VS, Evans JR, Vedula SS. Interventions for preventing ophthalmia neonatorum. Cochrane Database Syst Rev. 2020 Sep 21;9(9):CD001862. doi: 10.1002/14651858.CD001862.pub4. PMID: 32959365; PMCID: PMC8524318.
• Neoreviews (2022) 23 (9): e603–e612. https://doi.org/10.1542/neo.23-9-e603
• Commentary From the AAP Section on Ophthalmology: Century of Changes | Pediatrics | American Academy of Pediatrics

What do petting zoos, river swimming, and hamburgers have in common? All have been linked with the spread of Shiga-toxin producing E. coli or STEC O157:H7, which is a strain linked with hemolytic uremic syndrome (HUS).

This episode was written by pediatricians Lidia Park and Tammy Yau with content support from Stephanie Nguyen (UC Davis pediatric nephrology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Hemolytic uremic syndrome is a microangiopathic hemolytic anemia caused by Shiga toxin producing E. coli.
• Symptoms include anemia, thrombocytopenia, and uremia
• Treat HUS with hydration (but not too much as that can lead to fluid overload), blood transfusion if needed for severe anemia, and close monitoring as some patients progress to needing dialysis

Sources:

• Peds in Review, 2020. Pediatr Rev (2020) 41 (4): 213–215. https://doi.org/10.1542/pir.2018-0346
• AAP Grand Rounds (2023) 49 (5): 55. https://doi.org/10.1542/gr.49-5-55
• AAP Grand Rounds (2024) 52 (1): 6.https://doi.org/10.1542/gr.52-1-06
• Ho, Erin. “Factors associated with Actionable Gastrointestinal Panel Results in Hospitalized Children”. Hospital Pediatrics Nov 2023